Health justice in Gaza is vital for Palestinian liberation

On 7 October, the world witnessed Palestinians in Gaza break apart the fences that had seen them imprisoned in the besieged strip for decades.

In response to the unprecedented Hamas attack, Israel has escalated the decades of violence, causing even more unimaginable collective suffering in its ongoing onslaught on Gaza. More than 9,000 Palestinians, including more than 3,700 children, have been killed.

This latest incursion has brutally and indiscriminately targeted civilians and civilian infrastructure, particularly health infrastructure.

On 17 October, Israeli forces targeted the al-Ahli Hospital in an airstrike. This represents one of the most horrific attacks on a healthcare facility in our collective memory, killing nearly 500 Palestinians who were taking shelter in the hospital after fleeing their homes.

In the past 27 days, Israel has targeted Gaza’s health facilities 107 times, and killed more than 100 medical staff, while threatening to bomb more hospitals. It has also cut off all water, food, and fuel from reaching Gaza and almost all humanitarian aid. 

"For decades, there has been a growing tidal wave of violence directed at Palestinian healthcare from the Israeli occupation"

Just days ago, the Ministry of Health in Gaza announced that the health system, including its hospitals, have ‘totally collapsed’ - this means Israel and its allies have completely annihilated Palestinian capability to provide the basics of healthcare under constant bombardment.

Still, doctors, nurses and paramedics continue to work around the clock. 

Doctors are operating in the dark without basic supplies, patients are being operated on without anaesthesia, blood banks are running out, and staff have resorted to vinegar to treat infections in the absence of antiseptics.  

Israel’s attacks on healthcare do not only take the form of direct aggression, but also use colonial borders to deny access to basic healthcare by obstruction, increasing disability and mortality in occupied Palestine through slow, cruel violence. 

This legacy should be seen for what it is: an essential tool used to reinforce Israel’s system of apartheid against Palestinians by cutting them off from healthcare in as many ways as possible.

Gaza's hospitals are breathing their last breath. Israeli airstrikes have set their sights on Gaza's healthcare infrastructure and ambulances and paramedics have been targeted. Overcrowded and under-staffed, the situation on the ground is dire ⬇ https://t.co/CDp0bOlv3Z

— The New Arab (@The_NewArab) October 21, 2023

A legacy of brutality

This is not the first time Israel and its allies have employed these tactics. For decades, there has been a growing tidal wave of violence directed at Palestinian healthcare from the Israeli occupation.

In 2017, the World Health Organisation (WHO) reported that 54 Palestinians in Gaza died as a result of having their permits delayed or denied by the occupation. Medical Aid for Palestinians has highlighted that the denial of medical care constitutes cruel, inhuman and degrading treatment, amounting in many cases to torture.

For example, in 2019, Layth Abu Zayad, a young human rights activist, was denied a permit to accompany his mother to her chemotherapy treatments just fifteen minutes from their home in the West Bank. This deliberate cruelty ultimately prevented him from being with her in the last days of her life.

Also in 2019, the parents and grandmother of 5-year-old Aisha A-Lulu were denied permits to travel with her for brain surgery in Jerusalem only an hour from their home in Gaza. Awakening from her surgery, she cried out for her parents. Aisha deteriorated, and was returned to Gaza unconscious, dying a week later.

In May 2021, Israel dropped hundreds of bombs on Gaza damaging healthcare facilities. During the course of that year alone, the Safeguarding Health in Conflict Coalition (SHCC) recorded 169 attacks on healthcare in the occupied Territories.

19 medical centres were damaged or destroyed, including the Palestine Children’s Relief Fund, an NGO providing cancer treatment and prosthetics to children unable to receive care due to Israeli blockades. This extreme aggression wreaks havoc on a health system already under intense strain from a brutal years-long siege.

In 2022, the WHO recorded 187 attacks on healthcare in Palestine, including attacks on ambulances, hospitals and staff. The WHO’s Surveillance System for Attacks (SSA) on Healthcare has documented over 1519 violent attacks since 2017, 372 of those occurring this year.

As well as direct aggression, Palestinian patients and health workers are forced to navigate a labyrinthine system of both administrative and geographic barriers to treatment.

This includes hundreds of Israeli-controlled checkpoints where they are routinely humiliated and denied free movement as well as a punitive permit scheme designed to restrict their access to essential medical care.

The Israeli stranglehold on Gaza in particular, as well as its repetitive violent incursions, both create and exacerbate unending public health crises in the strip. Doctors, nurses and paramedics work incredibly hard in precarious, under-resourced conditions but are often prevented from doing their jobs by the everyday violence of siege.

This level of brutality is indefensible under international law, and yet the vast majority of world leaders consistently either overlook or outright deny it.

No other country in the world would be afforded complete impunity to act in contempt of humanitarian law, yet for Israel this carte blanche is the status quo.

"History has repeatedly shown that systemic racism and colonisation wreak havoc on the health of the oppressed and Israel has certainly mastered the wielding of this inhumane weapon"

Healthcare as resistance

In 2018, 20-year old nurse Razan al-Najjar was murdered by Israeli sniper fire. In the days after her death, Israel tried frantically to paint her as a terrorist in a desperate attempt to justify her killing.

Eventually, a New York Times investigation confirmed she had posed no threat to the heavily armed soldiers responsible for her death and Israel quietly admitted culpability.

Yet while she of course posed no direct threat, her killing - and that of dozens more Palestinian medics - highlights the existential threat that healthcare provision poses to Israel’s regime of cruelty and destruction.

The health of Palestinians is intrinsic to Palestinian liberation and must be recognised as such. Israel intentionally targets the health of Palestinians, not just in Gaza but across occupied Palestine, for the purpose of crippling the population as a whole.

History has repeatedly shown that systemic racism and colonisation wreak havoc on the health of the oppressed and Israel has certainly mastered the wielding of this inhumane weapon.

"In the West, our image of Gaza’s healthcare catastrophe is wickedly skewed. Israel’s 16-year blockade does more than control Palestinian movement; it dictates Gaza’s collective inhumanity," says Al-Shifa Hospital's Ghassan Abu-Sittah https://t.co/pYvcnf7bIz

— The New Arab (@The_NewArab) October 31, 2023

Health justice is undeniably a proxy for social justice because good health grants people and communities the freedom to flourish and grow.

The mainstream narrative around Palestinian health commonly frames it as a “humanitarian issue”, requiring donations and volunteer efforts to solve.

However, while these things are undeniably valuable in the struggle for health under occupation, this humanitarian framing absolves Israel of its role as oppressor while simultaneously casting Palestinians as victims to be saved by the international community.

Instead, a justice-focused and historically rooted approach would see the situation for what it is: an Indigenous population resisting a colonial regime intent on causing them suffering and death while it appropriates their land.

In this context, healthcare provision becomes part of an ecosystem of resistance, radically reaffirming the right of the colonised to life, to joy and to care.

A time to speak up

With the above in mind, it is evident that the health community ought to be on the frontlines of resistance to Israeli occupation around the world. We should all be loudly condemning the occupation and highlighting the high price Palestinians are paying for the world’s indifference.

But despite an abundance of justice-focused literature in the fields of global health and medicine, many of our thought leaders have allowed their cowardice to make them complicit in Israeli crimes by not denouncing the violence at its root.

As health professionals, we know that treating symptoms without treating their root causes is bad medicine. So why are so many in our community unwilling to name the root cause of violence in Palestine as Israel’s ongoing project of settler colonialism, occupation and apartheid?

Thankfully, despite the apathy of many leaders, younger scholars, researchers and especially students have been defiantly leading the fight, resisting censorship and scare tactics in a bid to overturn the status quo.

In the UK, thousands of healthcare professionals signed a letter against the actions of our Department for Health and Social Care (DHSC), which recently declared unwavering support for Israel, even flying the Israeli flag on the DHSC building.

"As health professionals, we know that treating symptoms without treating their root causes is bad medicine. So why are so many in our community unwilling to name the root cause of violence in Palestine as Israel’s ongoing project of settler colonialism, occupation and apartheid?"

This symbolic complicity with genocide is abhorrent coming from any government department, but from an agency dedicated to health and care seems particularly egregious.

Global Health Against Occupation have also mobilised global health actors with a conscience to sign a letter condemning Israel’s deliberate attacking of Palestinian health infrastructure, but also highlighting the ongoing dehumanisation and dispossession of the Palestinian people.

Last Saturday, an estimated 500,000 people marched through central London in solidarity with Palestine. In New York, tens of thousands have protested. In Lagos, a mega-rally mobilised 50,000 people.

From Santiago de Chile to Cape Town thousands more marched against occupation and apartheid. In Paris, protesters defied a government ban on pro-Palestine gatherings and showed up in their thousands. In Cairo, Tahrir Square was filled with revolutionary spirit for the first time since the Arab Spring uprisings.

The worldwide solidarity on display is immense and we are clearly witnessing a global raising of consciousness about Palestine. Global health institutions, academics and practitioners are uniquely positioned to understand the heavy morbidity and mortality burden of occupation.

We must assume this responsibility, resisting attempts to silence or censor us and using our position to advocate for Palestinian liberation through the lens of health justice.

Beauty Dhlamini is a Tribune columnist. She is a global health writer with a focus on health inequalities and co-hosts the podcast Mind the Health Gap.

Sara el-Solh is a physician-anthropologist, writer and organiser using health as a lens through which to radically reimagine a just world.

Have questions or comments? Email us at: editorial-english@newarab.com

Opinions expressed in this article remain those of the author and do not necessarily represent those of The New Arab, its editorial board or staff.