Israel’s assaults on public health infrastructure amount to war crimes

Nowhere was the human toll of Israel's May 2021 aggresssion felt more acutely than at Al-Shifa Hospital, which was frequently overwhelmed and chronically understocked (Naaman Omar - APA Images)

Emily Hacker

The Electronic Intifada  / June 2, 2022

In May 2021, the Israeli military dropped hundreds of bombs on the Gaza Strip, destroying houses, schools, businesses, and health care facilities.

Perhaps nowhere was the human toll of that month more apparent than at Al-Shifa Hospital, the “only hospital in Gaza equipped for emergency assistance.”

Doctors worked for days on end, rarely sleeping or eating and unable to see their families as they frantically treated hundreds of wounded Palestinian patients – at least, those patients who could actually reach the hospital.

Outside the hospital grounds, streets were so badly damaged by Israeli airstrikes that paramedics struggled to bring patients directly to Al-Shifa.

In the span of those 11 days in May, Israeli occupation forces wreaked havoc on Gaza’s already precarious public health system, damaging or destroying 19 medical centers, including the offices of the Palestine Children’s Relief Fund, a nonprofit that provides cancer treatment and medical prosthetics to children who are unable to seek care outside of Gaza due to Israeli blockades.

The Israeli military’s actions in 2021 were, unfortunately, nothing new. Numerous Israeli bombing campaigns have damaged or destroyed primary health infrastructure in the occupied Gaza Strip, including clinics and hospitals as well as key public health services like water treatment facilities, sewage treatment plants, and electrical grids.

This is not accidental. Israel relies on – among other strategies – the destruction of Palestinian health infrastructure, the targeting of medical personnel, and inhibiting Palestinian access to health care to enforce its regime of apartheid.

Yet Western health officials often overlook these acts, which are nothing short of war crimes, and this passive complicity violates our promise as health care professionals to do no harm. The physical and mental health of the Palestinian people is a central component of Palestinian liberation and must be discussed as such.

A health care void

Israel’s military offensives against Palestine have both created and exacerbated existing public health concerns within the occupied Gaza Strip and West Bank. Beginning with the Nakba in 1948, Israel has made it a matter of policy to destroy not only Palestinian homes and communities, but clinics, hospitals, and other health infrastructure.

Israeli airstrikes on Gaza in 2021 damaged or destroyed numerous clinics, a water treatment facility, and infrastructure related to COVID-19 testing and treatment. Nearly 2,000 Palestinians in Gaza were injured during Israel’s May 2021 military assault and hospitals were overwhelmed.

The outright destruction of Palestinian health infrastructure, such as the bombing of a clinic operated by Doctors Without Borders, is accompanied by direct physical violence against health care personnel.

The Israeli military have killed medical professionals, including doctors Ayman Abu al-Ouf and Muin al-Aloul in 2021 and paramedic Razan al-Najjar, who was killed by Israeli snipers in 2018.

Often leaders and pillars of their communities, doctors killed by the Israeli military leave behind both a physical and psychological void of health care and security.

The actions of the Israeli government and occupying military forces are indefensible by any interpretation of international humanitarian law, yet they are ignored at every opportunity by world leaders. In no other country and in no other war would such actions be left unaddressed by the Western medical community.

Since the Russian invasion of Ukraine, the American Medical Association has issued no shortage of press releases calling the targeting of civilians and healthcare workers “unconscionable.”

To be sure, the actions of Russia are unconscionable, but so too is the inaction of Western doctors and health care personnel to stand in solidarity with our Palestinian counterparts.

Bodily health is resistance

Along with the destruction of Palestinian health infrastructure and the targeted killings of Palestinian health care workers, the Israeli government imposes draconian restrictions on the movement of Palestinians seeking health care in Gaza and the West Bank.

Medical travel permits are often delayed, lost or ignored by Israeli occupation forces operating checkpoints out of Gaza. Figures from the World Health Organization estimate that the Israeli government and military accepted only 54 percent of medical travel permits in 2017.

Blockades and checkpoints operated by Israeli occupation forces grossly impede not only the day-to-day freedoms of Palestinians, but prevent ambulances from transporting critically ill and injured patients.

Despite the close proximity of the Israeli and Palestinian populations, infant and maternal mortality rates remain markedly higher for Palestinians, and life expectancy is almost 10 years shorter. The rates of stroke, hypertension, coronary artery disease, diabetes, and neonatal disorders range from three to seven times higher for Palestinians as compared with Israelis.

This is by design.

The Israeli government has removed or prevented the construction of systems of care and residences – denying building permits and demolishing homes. Living under a regime of occupation and apartheid carries with it a heavy physical toll, one that cannot be adequately expressed through statistics.

Bodily integrity and bodily health are identified as key components to individual prosperity. The right of self-determination and Palestinian liberation are incumbent upon the general health of the Palestinian population, both of which the Israeli government aims to destroy.

The health care workers and public health personnel living and working under Israeli occupation are a testament to Palestinian strength and resistance, and public health officials in Palestine must have their calls to action echoed by their colleagues internationally.

Outside of Palestine, health care professionals should be among the first to apply pressure to Western governments to end funding absent a change of Israeli behavior and to condemn and uncover Israeli war crimes.

Targeting the health care sector is a grave crime against humanity and in further analysis of global health policy, it is imperative we address Israel’s action as such.

Emily Hacker received her MPH degree from the University of Utah; her research interests focus on public health infrastructure and emergency medical services in the context of war zones and refugee settings