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‘These Are Not Natural Deaths’: A Doctor Comes Home from Gaza

Calgary physician Fozia Alvi reflects on her recent medical aid mission. A Tyee interview.

Jeevan Sangha 28 May 2024The Tyee

Jeevan Sangha is the 2024 Hummingbird journalism fellow with The Tyee. She has written for CBC Music, Billboard Canada and Shado Magazine.

[Editor’s note: This piece contains graphic descriptions and photographs of injury and medical crisis.]

It’s been three months since Fozia Alvi got back from her medical aid mission in Gaza, but what she witnessed there continues to haunt her.

“Every space was overcrowded [and] we were rationing medical supplies,” Alvi told The Tyee in an interview. “A mile away, thousands of humanitarian aid trucks were and still are being obstructed from entering Gaza.”

The Pakistan-born, Calgary-based physician has been vocal about what she and many international scholars have referred to as a genocide in Gaza.

Last December, she published an op-ed in The Tyee about the health crisis in Gaza. “I must make it clear that I am not pro-Hamas,” she wrote. “As a medical professional, I value all human life. And I mourn all the lives lost in Israel.”

Earlier this year, Alvi spent 10 days in February stationed at medical health points across southern Gaza, including the Gaza European Hospital in Khan Younis and the Tel al-Sultan health centre in Rafah.

She went to Gaza with Humanity Auxilium, the charity she founded in 2017 that is devoted to providing humanitarian aid to people in conflict regions and areas affected by natural disasters around the world. Since its inception, the organization has supported Rohingya refugees in Bangladesh, Pakistan flood survivors and more.

Alvi’s trip marked her first time providing medical care in an active war zone. Like other physicians, groups of medical professionals like Médecins Sans Frontières and world leaders like the humanitarian co-ordinator for the United Nations, Alvi is calling for an immediate ceasefire.

According to the World Health Organization, of the original 36 hospitals across Gaza, only 15 are partially functional and 21 are out of service. Additionally, just 29 per cent of United Nations Relief and Works Agency for Palestine Refugees health centres are operational, with more than half of the primary health clinics across the region not functional.

Originally, Alvi’s team was assigned to provide aid at Nasser Hospital — at the time one of the largest operating hospitals in the region. But just after they arrived in Cairo, they were reassigned across southern Gaza after the Israel Defense Forces raided the hospital.

Last month, Gaza civil defence crews uncovered mass graves of over 300 people at the hospital, including patients and medical staff.

“It could have been us,” said Alvi. “It makes me very angry. The destruction of the health-care infrastructure, the killing of health-care workers, is unprecedented.”

The Nasser Hospital incident is one of multiple documented and ongoing hospital raids in Gaza carried out by the Israeli government. Last Tuesday, medical staff and patients fled Kamal Adwan Hospital in northern Gaza following Israeli airstrikes that hit their emergency department.

As of May 22, 2024, the United Nations Office for the Coordination of Humanitarian Affairs is reporting 35,709 Palestinian fatalities since Oct. 7, 2023, when the militant group Hamas killed an estimated 1,200 people in Israel. The chief prosecutor of the International Criminal Court, Karim Khan, recently announced that he has applied for arrest warrants for top leaders of Israel and Hamas whom a panel of international legal experts suspect of committing crimes against humanity. Among them, the ICC’s official report argues there are reasonable grounds against Israeli Prime Minister Benjamin Netanyahu and Defence Minister Yoav Gallant for the crime of intentionally starving civilians of food, water and medicine as a method of war.

On May 24, the International Court of Justice called on Israel to end its operation in Rafah. But Al Jazeera journalists Justin Salhani and Mat Nashed note that “enforcement relies on members of the court to uphold their obligations under international law and on the UN Security Council.”

Resources in the hospitals and health centres where Alvi was working were limited, she told The Tyee, making it difficult for patients to receive any form of pain management.

Without proper access to medical supplies, doctors were often forced to conduct amputations without anesthetic. She saw hundreds of patients during her time there, including children suffering from starvation, shrapnel and burn wounds, and those with chronic health conditions that intensified without regular treatment.

“We met people who are the only surviving members of their entire family.” she said. “It’s a generational trauma that has been inflicted on the civilian population.”

The situation in Gaza continues to escalate as Israel expands its military campaign out into the southern city of Rafah. During the week of May 20, the UN suspended food operations in the city due to lack of supplies and insecurity.

At the time of our interview earlier this month, Alvi said her team of doctors, who were carrying large amounts of medical and surgical tools, were denied entry into Gaza through the Rafah crossing.

Though the horrors of what she witnessed in Gaza will stay with Alvi, so too will her commitment to calling on institutions and professionals to provide concrete support to Gazans and the memories of remarkable displays of resilience by Palestinians. “I was thinking that I have gone [there] to help people of Gaza. But I feel that they have helped me.”

“On a personal level, it deepened my understanding of the human experience, exposing me to the raw realities of a genocide and the resilience of the human spirit.” she said. “I have never met a group of people more resilient than those in Gaza.”

This interview has been edited for length and clarity.

The Tyee: What drove your decision to go to Gaza to provide medical aid?

Fozia Alvi: As a physician, my fundamental calling is to help those suffering when it’s most needed. Since the military assault happened in October, we were witnessing atrocities against a besieged civilian population in real time.

Every day, I would wake up and bear witness to a more horrific reality than the previous day. It became very clear that simply writing letters and advocating for a ceasefire from the comfort of Calgary wasn’t enough.

I knew that I had made the decision to go to the ground. I knew the risks and that my skill could make a difference. It wasn’t a matter of professional obligation. It was a deeply personal commitment to humanity.

How did going there impact you as a health professional?

I had to very quickly adapt to a resource-constrained environment. The hospitals were not just full of patients; there were displaced refugees lined up in hallways seeking shelter inside the hospitals. Every space was overcrowded. We were rationing medical supplies.

The memory of this continues to haunt and distress me.

How did this experience differ from your times serving in refugee camps and natural disaster areas?

There is nothing like the experience that I can recall. It’s a modern-day genocide being committed in real time. I don’t have the words to describe the number of amputee children I saw. Thousands and thousands of them were permanently disabled. And there’s no collateral damage in this military assault; it’s simply the deliberate targeting of the children, women and the civilian population through bombs and sniper drones.

I feel that I cannot fulfil my obligation as a physician without advocating for a ceasefire because I’m witnessing a complete decimation of society at multiple levels.

We are seeing the deliberate targeting of the civilian infrastructure, every hospital, every school, every residential building, mosques, churches, bakeries, even the graveyards have been bombed. Even the dead cannot rest in peace.

A woman with a blue head covering looks towards the right of the frame, her head resting on her hand. She has tears in her eyes.
In a health centre in southern Gaza in February 2024, a woman looks on in grief. Photo courtesy of Fozia Alvi.
A school-aged boy with short brown hair, medium skin and a blue sports T-shirt sits on a white plastic chair in a corridor with white walls and fluorescent lighting. One arm is in a cast and the other is held straight with a splint.
A young boy rests after being treated for injuries in a southern Gaza health centre. Photo courtesy of Fozia Alvi.

You’ve been calling for governments, post-secondary institutions and public health leaders to take a concrete stance on this issue through being more vocal in solidarity with Palestinians and through providing tangible support such as funding programs to international aid organizations. Why is this important to you?

Lots of my friends [and] my colleagues were afraid to talk about it; they were silent. And I kept on saying that being silent on this issue is being complicit. We have seen our Jewish allies be harassed for calling an end to the occupation.

Institutions of higher education should condemn the destruction of the universities in Gaza. I’m deeply saddened to see our democratic governments greenlight the dehumanization of Palestinians.

How has the response been from the health-care sector, in your opinion?

The hospitals, universities, academics, they’re so silent about it. It makes me very angry.

The destruction of health-care infrastructure, killing of health-care workers is unprecedented. We have not seen this in history ever, in any war, how the health-care infrastructure has been deliberately bombed. Every hospital has been bombed.

In the Ukraine war, Afghanistan war, the Syrian war, whenever a hospital was bombed, accidentally or intentionally, there was outrage. There was an uproar from the West, but how silent are we now?

Fozia Alvi wears a white lab coat and a dusty rose head covering. She leans over a child wrapped in blankets in a hospital bed. The child has wounds on their face.
Fozia Alvi: ‘It’s a generational trauma that has been inflicted on the civilian population.’ Photo courtesy of Fozia Alvi.

There are many people who have faced harsh consequences for speaking out in solidarity with Palestine. What effects can those outcomes have on individuals and institutions?

I feel that those who have spoken in solidarity with the Palestinian cause will be remembered as advocates for justice, equality and human rights in the ongoing struggle for peace and self-determination.

I feel that the systemic oppression of our voices of dissent will not be successful. The veil of western democratic values has come off and those who oppose this genocide know that a more beautiful world, a safer world, a world without occupation is possible. And that is the right of our children, to honour the students who are putting their futures on the line.

Fozia Alvi, right, wears a white lab coat and sage green head covering. She touches the cheek of a school-aged girl seated on a rolling office chair. She is wearing red and her leg is wounded. Behind her an older boy stands looking at her in a blue winter jacket.
Fozia Alvi treated many children during her medical aid mission in southern Gaza. Photo courtesy of Fozia Alvi.

One counter-argument that some make in response to calls for ceasefire in Gaza is that since the Hamas attack on Oct. 7, 2023, Israel has the right to defend itself. Given what you’ve seen in Gaza, what is your response to people who make that argument?

I am a physician, an educator and a humanitarian. I don’t think this question is one that I can entertain for publication.

What, in your opinion, happens to a society or community when they don’t have access to hospitals and health-care infrastructure?

Before this week, 85 per cent of the health-care infrastructure [in Gaza] was damaged and bombed. It’s only due to the heroic actions of Palestinian doctors and nurses that they were able to provide some sort of care. But without proper care, we are killing them in a very painful manner.

The only dialysis centre was in Khan Younis. [An example of one currently in operation is at Al-Aqsa hospital in the central Gazan city of Deir al-Balah. Dialysis treatment at the hospital is currently in jeopardy due to extensive power outages caused by a fuel shortage, impacting hundreds of patients.] It’s not working now because the IDF asked the doctors to leave.

The stats that we are getting from the ministry of health and the UN of how many people have been killed, the actual number is way higher.

Lots of people, [who] have diabetes, who have high blood pressure, who have heart disease, they are not able to access any medication because there are no pharmacies open. So people are dying quietly.

They’ll say, ‘They’re dying a natural death.’ But actually these are not natural deaths. These are preventable deaths.

We have seen pregnant women who are malnourished having low-birth-weight babies. They are dying from postpartum hemorrhage. If the nutrition of the mother is good, then they can survive, they can have healthy babies. Those women are delivering babies in tents in the dark because they cannot travel; it’s too dangerous at nighttime.

There aren’t many hospitals left. If they get to the hospital, beds are unavailable. All these deaths are preventable.

What are some of the solutions you envision? How do we get there?

The only solution is an end to the occupation and a free Palestine. [This occupation has been] not for one year, or two years, but for the last 75 years.  [Tyee]

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