Since Israel’s genocidal onslaught slowed its pace after Trump’s circus in Sharm El-Sheikh in early October, we’ve seen a wave of reflection about the conduct of international humanitarian organisations, not just over the past two years, but across the entire architecture of occupation.
Palestinians and their comrades have long called out the hierarchical, often openly dehumanising rhetoric that these organisations deploy. This is a rhetoric that obscures the political core of our struggle and tries to recentre the “humanitarian crisis” as the primary frame, rather than Palestinian liberation.
Root of the problem
On October 9, Palestinian and international medical practitioners released the Gaza Health Declaration, which laid bare decades of complacency, complicity, and collusion by humanitarian and development actors whose work has consistently propped up the occupation, undermined Palestinian resistance, and weakened Palestinian agency and sovereignty. The declaration did what these organisations refuse to do: name the root cause, articulate the political determinants of health, and define what real health solidarity looks like in a liberation context.
Since its release, nothing about the humanitarian sector’s behaviour suggests that a lesson has been learned.
Colleagues across Gaza and the region continue to describe, with painful clarity, how the same organisations responsible for years of bureaucratic suffocation and political evasion are now colluding, quietly and procedurally – but unmistakably – with the very entity that has destroyed more than 90% of Gaza’s infrastructure and killed roughly a quarter of its population.
This is not new. Since the Nakba, humanitarian organisations have built a caricature of the Palestinian, in Dr. James Smith’s words a ‘humanitarian Human’, a figure who exists only as a recipient of aid, a receptacle for charity, a human vessel emptied of agency or history. From UNRWA donor pamphlets in the 1960s boasting about vocational training for “refugee boys,” to the endless stream of images of malnourished Palestinian children with empty pots circulating on social media, these institutions have used Palestinian suffering to expand their networks, budgets, and footprint in Palestinian life and on Palestinian land.
And it goes far beyond imagery. The operational hierarchies these institutions build make the Palestinian both the fuel and the object that justifies the institution’s existence. And all of this sits atop something even darker: Palestinians are already dehumanised by a genocidal order that labels every man a combatant, that insists only women and children can be victims, that turns survival itself into suspicion.
Humanitarianism is supposed to counter this. Instead, it becomes a second layer of dehumanisation - the softer, bureaucratic version that still strips Palestinians of autonomy, dignity, and sovereignty.
Palestinian workers
Inside Gaza, this second layer is clearest in how humanitarian institutions treat Palestinian workers. For the last two years, international staff have entered Gaza wearing military-grade helmets and bulletproof vests. Palestinian doctors - who have been killed in staggering numbers, often alongside their entire families - are given nothing. No protective gear, no safety assurances, nothing beyond the bare medical tools available in emergency rooms, drowning in blood and shrapnel. This disparity is not incidental but the moral universe that has underpinned humanitarianism. Western staff are outfitted like soldiers entering a battlefield, while the native Palestinian staff – the holders of absolute knowledge – are left exposed to disease and the colonial bullet inside their own hospitals and homes.
And yet it is Palestinian clinicians and aid workers who have held Gaza together. From curating treatment algorithms for malnutrition and hepatitis A under siege, to mapping a counter-cartography of supply routes into besieged and death zones within the biosphere of genocide, they rewrote protocols daily to adapt to shortages, bombardment, and the constant collapse of infrastructure.
Speaking to countless healthcare volunteers, every single one said the pathways they were trained to use in hospitals of abundance meant nothing in the context of occupation and Israel’s biosphere of genocide. The expertise held by Palestinians carried the system, even as their knowledge was co-opted and repackaged by humanitarian bureaucrats in Geneva, London and New York.
It is this system - this cycle of stealing Palestinian excellence and repackaging it under the humanitarian cloak of the Western saviour - that deprives Palestinians of the sovereignty they are owed.
What the last two years have shown, brutally and without ambiguity, is that no system inside Palestine today operates outside the cooperation, labour, and brilliance of Palestinians themselves. And yet the structure Palestinians are forced to navigate demands a violent equation: if they are to survive, they must surrender their labour to the Western humanitarian machine.
Western control
The message is unmistakable. If Palestinians want the continuity of their presence on their own land, it must be through the Western bureaucrat who heads the operation, who speaks to the media, who issues the press releases, who is granted the legitimacy that Palestinians are systemically denied.
This is not an accident. It is not a quirk of organisational culture. It is the architecture through which humanitarianism extracts Palestinian knowledge as the indigenous peoples, while denying Palestinians the sovereignty to lead their own liberation.
We write against this equation as we seek to rupture it entirely. This equation is malicious in its intent and effect, for it strangulates Palestinian survival by tying it to a total absence of sovereignty - the very absence the humanitarian industry helps maintain. This is why Israel negotiates almost exclusively with organisations headquartered outside the Arab world, why it approves visas for Western staff while blocking the entry of Arab and Palestinian practitioners.
Any expression of Arab or Palestinian sovereignty inside Palestine is treated as a threat to Zionism’s project. And that is precisely why sovereignty must be reclaimed, not outsourced to humanitarian intermediaries who benefit from its destruction and reconstruction.
We find it fundamentally dangerous that most humanitarian organisations serving Palestinians do not work toward their own obsolescence. They do not build structures meant to end, or imagine a future in which their presence in Palestine is unnecessary. Instead, they treat Palestine as a market, a sort of place from which they can extract images, donations, and narratives of “service” to sustain their projects both inside and far beyond Palestine.
They capture Palestinian suffering to keep the money flowing, to expand their footprint through the spectacle of giving and charity, rather than of mutual aid and solidarity.
However, the conjuring of such a system is not misguided, but an active assault on Palestinian sovereignty. Humanitarianism, as it functions today, makes Palestinians dependent, which is the weakest political position anyone can inhabit. This is because it negates one’s voice, hollows words, and traps people in shackles held by the sponsor.
Liberation
Palestinians do not want dependency. They do not want indefinite management, nor to be trapped in a world where their survival hinges on whether a foreign organisation chooses to renew a grant cycle or deploy another team.
Palestinians want sovereignty, and they have been building it, even under the worst conditions imaginable.
During Israel’s military administration of the West Bank and Gaza from 1967 to 1994, Palestinians created counter-institutions and popular committees that ran schools, clinics, agricultural networks, and social service systems. They did this because the Israeli military deliberately degraded infrastructure and weaponised neglect as a governing tool. Palestinians responded by building forms of care, governance, and collective life that were independent of the occupation’s machinery.
This yearning for sovereignty has never disappeared. It remains the pulse of their every struggle: sovereignty over historic Palestine; the return of refugees; reparations; and a political existence where movement is tertiary, not the primary obstacle to dignity and life.
Humanitarianism cannot deliver any of this. It was never designed to.
The work ahead for liberation, return, and sovereignty demands the dismantling of the very structures that made humanitarianism necessary in the first place: occupation, blockade, racial capitalism, and the international order that feeds off managed Palestinian suffering.
It also demands rejecting the lie that Palestinians must remain dependent, that they must ask, appeal, negotiate in order to survive. In light of the genocide, dependency is no longer a temporary condition of crisis but a political tool of erasure. Humanitarianism has perfected this erasure by administering life just enough to keep Palestinians alive, but never free.
The world does not need more humanitarian management of Palestinian life. It needs the end of the conditions that make management possible. And anyone who claims to stand with Palestinians must accept the truth that sits beneath every Palestinian act of endurance and every Palestinian institution built under fire: freedom cannot be administered, and a people cannot be liberated by those invested in their dependency.
Dr. Yipeng Ge is a primary care physician and public health practitioner based on the traditional, unceded, and unsurrendered territory of the Algonquin Anishinaabeg whose presence reaches back to time immemorial (also known as Ottawa, Canada).
Layth Malhis is a graduate student at Georgetown University’s Center for Contemporary Arab Studies, where he studies settler colonialism and Palestinian health. His research advances the concept of dehealthification to describe how healthcare systems in Palestine have been systematically dismantled, obstructed, and weaponized as part of a broader colonial strategy. Currently he serves as a researcher at the Institute for Palestine Studies (IPS), where he contributes to the Healthcare Destruction Database.
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