The war in Gaza will determine not what is right, but what is left…

Every morning since 7 October and Israel’s revenge attacks on Gaza started, I begin each day apprehensive that my phone is going to be flooded with images and videos of more atrocities. Even as a medical professional, I’ve seen images of more dismembered children than I thought I ever would in my life, and it will happen over and over again, day after day until this nightmare ends, if it ever does.

Never in my life did I think that I would see such utter disregard that the world has shown for my fellow health workers, let alone the patients and people they’re trying to help. One of my colleagues was crying last night because his friend Dr Hamam Allouh, Gaza’s last remaining nephrologist, was killed alongside members of his family in an Israeli airstrike. Dr Allouh, like so many of his colleagues, had refused to leave Gaza’s remaining hospitals (nearly half of which have already been destroyed), out of a sense of duty of care towards their patients who could not be moved. They’re being slaughtered for their professional dedication; for following to the letter the same Hippocratic oath that I and millions of other health professionals swore on the day we started to practice.

My recent interactions with colleagues and students in the region have painted a harrowing picture of the healthcare challenges they are facing, compounded by the current conflict. Just two days ago, 39 infants died in the neonatal intensive care unit in Gaza’s largest hospital due to the lack of oxygen. Since then, more deaths have been reported. Doctors are sending SOS messages asking for the bombing of hospitals to stop. As of yesterday, all ICU patients had died in Al-Shifa Hospital, and dead bodies are piling up in hallways. There’s no water, no electricity, no fuel to run the generators or run ambulances. Israeli tanks are surrounding healthcare facilities and snipers are shooting through windows and at anyone who tries to leave. Patients are dying due to dehydration, lack of medication and a lack of ventilators. Surgeons are performing surgery without anaesthesia, doing limb amputations on children with unsterilised instruments and without any pain medication. Surgery is being performed on the floor in hospital hallways and under the lights of mobile phones. There are many burns patients, wounded patients, dialysis patients, new born babies, pregnant mothers and diabetic patients all needing care that just isn’t available any more.

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As of 11 November, 50 per cent of Gaza’s 36 hospitals and two-thirds of primary healthcare centres are not functioning, and those that remain open are operating well beyond their capacity due to Israeli bombardments. The following Gaza hospitals have been targeted or are under siege: the Indonesian Hospital, Nasr Children’s Hospital, Awda Hospital, Rantisi Paediatric Hospital, Al-Shifa Health Care Compound, Eyes Specialty Hospital, and the only mental health facility in Gaza. Many of these have already lost whole departments to Israeli bombs.

ICU patients and neonatal ICU patients… cannot be moved and will die

What is the impact on health now in Gaza? According to the World Health Organisation, more than 11,000 civilians have been killed, 70 per cent of whom were women and children. ICU patients and neonatal ICU patients are being ventilated manually, which is not sustainable; these patients cannot be moved and will die. There are more than 20,000 patients with acute injuries such as penetrating and blunt trauma, and burn injuries. Surgery, including amputations and caesarean sections, is being carried out without anaesthesia. Infectious diseases are spreading: there are 33,500 cases of acute diarrhoea (the baseline rate is 2,000/month); 54,800 cases of viral respiratory tract infection; 12,600 cases of skin infection; over 1,000 cases of chickenpox; and over 8,900 cases of parasitic infections. Cancer patients have not received lifesaving chemotherapy and radiation treatment for over a month now. Patients with kidney failure may die within 1 to 2 weeks if dialysis treatment is unable to be restored. Gaza has a very high chronic mental health burden and this acute exacerbation of trauma is resulting in mental health crises.

Reuters has reported that this destruction of healthcare infrastructure has resulted in the killing of 160 healthcare workers while on duty. One child has been killed every 10 minutes in Gaza over the past four weeks. Indeed, more civilians have been killed in the past few weeks in Gaza than in two years in Ukraine. Nearly 5,000 of those were children. This number grows by an order of magnitude when accounting for all the injuries suffered by civilians, many of them life-changing. Children are being pulled up from bombed-out residential complexes, surrounded by the corpses of their families and being rushed into besieged hospitals to be treated for lost limbs, and then immediately discharged without any post-op care or medications because there simply isn’t any.

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The UN has warned of a “catastrophic” situation for children in Gaza to a degree that contravenes international and humanitarian law. Médecins Sans Frontières, Human Rights Watch and Amnesty International have all demanded an immediate ceasefire and condemned the bombing of hospitals. Israeli bombs, developed by the US Air Force and designed to hit military targets, are being used to carpet bomb UN-run schools, refugee camps, hospitals, ambulances transporting patients for humanitarian aid at the Rafah border and places of worship.

I’ve been active in humanitarian work for the past six years and founded Humanity Auxilium after witnessing the crimes against humanity committed against the Rohingya back in 2017. Our team in Gaza was working until three days ago, when we lost our connection. I’m not sure if they are alive or dead. For the past four weeks, I received message after message from them about the siege; about the lack of electricity, water, fuel and medical supplies; about the many attacks on health facilities and medical personnel; and I cannot help but be disheartened by the deafening silence of our public health institutions on the issue.

The government of Canada has consistently lacked the moral courage to call out these blatant war crimes, and has been one of the sole votes along with the United States and Israel against condemning any of the atrocities occurring, or even condemning the breaches of international law that most global rights groups now say are happening. However, it is our duty as medical professionals to say something about the crimes against our profession and the humanity we have vowed to serve. The onus is on us to say something and put pressure on our government representatives to act.

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If this military offensive ends tomorrow, it won’t be over for the people of Gaza, who were already among the most impoverished in the world even before the bombardment started. The war in Gaza will determine not what is right, but what is left, and that isn’t going to be much. The lack of sanitation will lead to the rapid spread of many infectious diseases. Many will develop respiratory conditions from explosive pollution and white phosphorus fumes. Some of those who survive the war will suffer from severe psychological trauma and countless other medical problems for many years to come. The Israeli government, whose ministers and parliamentarians have consistently spoken of driving the Palestinians out of Gaza or making life so miserable and difficult that they’ll leave on their own, will be unlikely to help. Nevertheless, that doesn’t excuse our silence now, and it doesn’t excuse every life taken while we take time deciding what to say about it.

We must call for a ceasefire and for the lifting of the Israeli blockade to allow humanitarian aid into the Gaza Strip without delay. As I’m writing this, babies are fighting for their lives at Gaza’s largest hospital now that power to their incubators has been cut. I don’t know if any will be alive by the time anyone reads this, and that thought haunts me, as it should haunt our politicians who have the power to stop this genocidal assault on our fellow human beings. Enough is enough: stop this war now.

The views expressed in this article belong to the author and do not necessarily reflect the editorial policy of Middle East Monitor.