Blocking humanitarian medical aid in Gaza is a death sentence

Bilal Irfan, Abdullah Ghali, Sarah Siddiqui, Abeerah Muhammad & Shraddha Shah

Mondoweiss  /  December 1, 2024

As healthcare workers who have recently participated in medical missions to Gaza, the West Bank, and Lebanon, we are greatly alarmed by Israel’s decision to bar at least eight medical organizations to Gaza. The medical community must speak out.

As international healthcare workers who have recently participated in medical missions to Gaza, the West Bank, and Lebanon, in collaboration with Palestinian medical professionals and advocates in this sector, we write with great alarm over the recent decision by Israel to deny entry to at least eight medical organizations as of October 15, 2024. Some of the affected organizations include FAJR Scientific, Palestine American Medical Association (PAMA), Palestinian American Bridge (PAB), Glia, Baaitulmaal, PalMed, PANZMA, and HEAL Palestine. This list may not be exhaustive and other organizations may very well also be affected, with some of the denials now being rescinded. This decision comes on the heels of evacuation orders in northern Gaza affecting upwards of 400,000 people, and with several humanitarian teams still on the ground in Gaza amidst ongoing bombardment.1 Volunteer physicians have reported on the medical and surgical care needed by the many victims of the Israeli airstrikes on the Al-Aqsa Martyrs Hospital complex in Deir al-Balah, which resulted in tents catching fire and patients burning alive, on October 14, 2024.2

This new policy is an escalatory step as part of a punitive pattern of imposing arbitrary restrictions on the entry of healthcare workers into Gaza. This includes, but is not limited to, previous entry denials to international healthcare workers of Palestinian descent following the Rafah invasion, other healthcare workers denied entry without explanation, or put on a ‘pending’ status for weeks on end.3 The number of medical personnel and supplies allowed to enter has also progressively decreased over the months among medical organizations. It is worth noting that the consequences of this new denial extend beyond the surgical and clinical care domain, even impacting the didactic aspect of these missions: training on-ground healthcare personnel and medical students, of which there is a critical shortage due to mass arrests, torture, and killings.4 At the time of writing, Israeli forces have destroyed the only two medical schools in the Strip, the Islamic University of Gaza and Al-Azhar university, and killed nearly 600 Palestinian healthcare workers, unlawfully detained 300, with many more having been injured, displaced, or are missing.5

As was communicated to us regarding the WHO, there is expected to be at least a 29% reduction in healthcare services for trauma cases without the aid of these medical non-governmental organizations (NGOs).678 Our organizations have collectively cared for tens of thousands of patients in Gaza, providing medical and surgical services, including supplies, along with humanitarian aid like food, shelter, and other basic necessities.9 It is difficult to accurately assess the full impact given the scale and acuity of our operations, in the setting of deteriorating conditions under which our teams have been operating within. During this time, the destruction of healthcare infrastructure has expanded to unprecedented proportions.10

On October 10th, the UN Independent International Commission of Inquiry on the Occupied Palestinian Territory, including East Jerusalem, released a report highlighting the systematic pattern by which Israel has targeted and destroyed healthcare facilities during the past year in Gaza, declaring these actions to constitute war crimes and the crime against humanity of extermination.11 We believe that the presence of international aid workers and medical teams, despite being repeatedly killed by Israeli airstrikes in the past, served to some extent as a sort of buffer, or stalling measure, against more targeted larger-scale operations in the areas where they were present.12 Indeed, local Palestinian healthcare workers, displaced families, and individuals, have frequently communicated to us that they shelter near hospital grounds with an active international NGO presence in the hopes of added protection stemming from the presence of foreign-origin workers. A recent opinion piece published in The New York Times describing a pattern of gunshot wounds in paediatric cases received a litany of criticism, wherein an NYT Opinion Editor weighed in, stating that “we stand behind this essay and the research underpinning it”. Such accounts by international healthcare workers serve to reveal the grim reality of what is unfolding in Gaza, at a time when several Palestinian testimonies are suppressed and cast aside despite being available.13

In response to a request for comment, the Coordinator of Government Activities in the Territories (COGAT), stated that Israel “does not limit the number of humanitarian teams that can enter Gaza on behalf of the international community, subject to technical arrangements required for security reasons,” as per the Washington Post. Our experiences have revealed this to be a categorically false assertion, as individual medical personnel have been repeatedly denied entry on arbitrary grounds without explanation, and severe limitations have been imposed upon the medical equipment and medications we carry, terming them as ‘dual-use’ goods. These include but are not limited to crutches, anaesthetics, external fixators and field hospital boxes.

It is imperative for the medical community, humanitarian organizations, and global leaders to take a principled stand on this issue.141516 We call upon our colleagues to champion their respective governments and civil society organizations to urge Israel to rescind its decision and allow these medical NGOs entry into Gaza to continue coordinating life-saving medical missions and providing critical humanitarian relief. The context needs no further contextualization: war crimes have already been committed against healthcare infrastructure and personnel in Gaza in violation of the core ethics of our profession. We cannot fail or remain silent at this stage, with the alarmingly horrific developments across the Strip, especially northern Gaza. If we are unable or unwilling to act now, it may become impossible for our medical community to recover from this dereliction.17 Failing to act is complicity in the crimes being committed, and a death sentence for the vulnerable in Gaza.

Acknowledgements

The following individuals contributed to the ideas behind this piece: Mohammad Tahir, Lana Abugharbieh, Jawad Khan, Elias Nasser, Muaaz Wajahath, Mohamed Fawaz, Abd al-Karim Sammour, Omar El-Taji, Yassar Arain, Monica Johnston, Ali Qadeer, Hamza Akram Abudaqqa, Hirron Fernando, Feroze Sidhwa, Mark Perlmutter, Muhammad Junaid Sultan, Ali Elaydi, Adam Hamawy, Abdallah Abu Shammala, Anas al-Shembari, Karim Fikry, Osaid Alser, Nour Alshaer, Zena Saleh Glia, Muzammil Nusrath, Majd Mohammed Abu Ghaben, Walid Yassir, Basir Tareen, Sarah Badran, Amr Abdelgawad, Tariq Nayfeh, Haseeb Khawaja, Taha Mur, Osaama Khan, Ahmad Hasan, Mohammed Irmieh Mosab Nasser, Khaled J. Saleh

NOTES

  1. Israel must rescind latest ‘evacuation’ orders for North Gaza, allow unhindered humanitarian access. Amnesty International. 2024; published online Oct 15. https://www.amnesty.org/en/latest/news/2024/10/israel-opt-israel-must-rescind-latest-evacuation-orders-for-north-gaza-and-allow-immediate-unhindered-humanitarian-access/ (accessed Oct 19, 2024). ↩︎
  2. Israeli attack on Gaza hospital tent camp kills four, ignites fire. Al Jazeera. https://www.aljazeera.com/news/2024/10/14/burned-and-charred-bodies-as-israel-hits-tents-at-central-gaza-hospital (accessed Oct 19, 2024). ↩︎
  3. Israel bars six medical NGOs from entry to Gaza, WHO says – The Washington Post. https://www.washingtonpost.com/world/2024/10/18/israel-gaza-war-aid-hospitals-doctors/ (accessed Oct 19, 2024). ↩︎
  4. Israel: Palestinian Healthcare Workers Tortured | Human Rights Watch. 2024; published online Aug 26. https://www.hrw.org/news/2024/08/26/israel-palestinian-healthcare-workers-tortured (accessed Aug 31, 2024). ↩︎
  5. Qtati N. Home – Healthcare Workers Watch. 2024; published online Sept 7. https://healthcareworkerswatch.org/ (accessed Oct 20, 2024). ↩︎
  6. Nigeria NA of. WHO accuses Israel of blocking medical specialists from entering Gaza. Peoples Gazette Nigeria. 2024; published online Oct 18. https://gazettengr.com/who-accuses-israel-of-blocking-medical-specialists-from-entering-gaza/ (accessed Oct 20, 2024). ↩︎
  7. FAJR Scientific (@fajrscientificus) • Instagram photos and videos. 2024; published online Oct 18. https://www.instagram.com/fajrscientificus/ (accessed Oct 21, 2024). ↩︎
  8. AJR Scientific (@fajrscientificus) • Instagram photos and videos. 2024; published online Oct 19. https://www.instagram.com/fajrscientificus/ (accessed Oct 21, 2024). ↩︎
  9. Israel bans at least six medical aid missions from entering Gaza. Middle East Eye. https://www.middleeasteye.net/news/israel-bans-at-least-six-medical-aid-missions-entering-gaza (accessed Oct 19, 2024). ↩︎
  10. Wispelwey B, Mills D, Asi YM, Hammoudeh W, Kunichoff D, Ahmed AK. Civilian mortality and damage to medical facilities in Gaza. BMJ Glob Health 2024; 9: e014756. ↩︎
  11. UN Commission finds war crimes and crimes against humanity in Israeli attacks on Gaza health facilities and treatment of detainees, hostages. OHCHR. https://www.ohchr.org/en/press-releases/2024/10/un-commission-finds-war-crimes-and-crimes-against-humanity-israeli-attacks (accessed Oct 19, 2024). ↩︎
  12. Gaza: Israelis Attacking Known Aid Worker Locations | Human Rights Watch. 2024; published online May 14. https://www.hrw.org/news/2024/05/14/gaza-israelis-attacking-known-aid-worker-locations (accessed July 23, 2024). ↩︎
  13. Asi YM, Sharif MZ, Wispelwey B, Abuelezam NN, Ahmed AK, Samari G. Racism as a Threat to Palestinian Health Equity. Health Equity 2024; 8: 371–5. ↩︎
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  16. Shah MH. The global oath: physicians, politics, and professional integrity. The Lancet 2024; 404: 123–4. ↩︎
  17. Abi-Rached JM, Reinhart E. The Palestinian challenge to US medical ethics. The Lancet 2024; 403: 2285. ↩︎