[Editor’s note: As the Israel-Hamas war unfolds in Gaza, its effects are felt here in Canada. Dr. Fozia Alvi is a physician who runs a family practice in Calgary, Alberta. She is the founder of Humanity Auxilium, a health-care non-profit that serves marginalized communities around the world.
Dr. Alvi is connected with health-care workers on the ground in Gaza, and she shares her reflections on the health impacts of the Israel-Hamas war in this personal essay.
Content warning: This piece contains depictions of medical crises and the deaths of children and infants. It may be triggering to some readers.]
In med school ethics classes, we often come across vague scenarios that we might never come close to seeing in the real world. Things like what to do if a patient of ours is in a burning room. We are hammered about the importance of our unique obligation as medical practitioners to society, even though in the real world most of the time we just end up being employees like anyone else.
That’s not the case with the doctors and nurses in Gaza. They have upheld the noblest of physicians’ principles underlaid in the Hippocratic Oath, and they have died for it.
Israel’s unrelenting assaults on hospitals in Gaza took a system that was impoverished to begin with into complete dilapidation.
A Nov. 30 report in +972 Magazine details how the Israel Defence Forces have deliberately destroyed many so-called “power targets” amongst the civilian infrastructure of Gaza. These are places that don’t hold any military value but instead are important to the functioning of any society: universities, highrise infrastructure, power generators and hospitals. These strikes have been largely successful, with nearly 80 per cent of Gaza’s population displaced.
Among that number stand the nurses and doctors who refused to abandon their patients under bombardment. Due to lack of water, these medical staff resorted to drinking IV fluids to stay hydrated within the first two weeks of the assault, and since then have performed their duties as best as they could with limited to no supplies.
There are children being treated for third-degree burns and caesarean sections being performed with no anesthesia. As of Nov. 16, according to a report by NPR, over 200 health-care workers had been killed. Since then the attacks on medical facilities have only increased, as have infectious diseases. There are U.S.-made bombs meant for a conventional war being used on maternity wards.
Doctors Without Borders, who have lost several staff members in attacks they claim were purposely directed by the Israeli army, have stated the utter disregard for the laws of war in this conflict is unique to the organization’s 51-year history.
The same organization posted a picture to its Instagram of a message written on a surgical whiteboard at al-Awda hospital on Oct. 20. “Whoever stays until the end will tell the story. We did what we could. Remember us.”
The man who wrote those words, Dr. Mahmoud Abu Nujaila, was killed along with two of his colleagues by a strike on Nov. 21. The message was found crumpled in the rubble.
Most of Gaza’s population of 2.3 million, about half of whom were under 18, are now homeless and lacking safe drinking water. This is unacceptable. Canada, along with the rest of the international community, needs to call for a ceasefire now.
There are those asking how we can discuss the possibility of a ceasefire with an organization like Hamas, whom Israel accuses of using hospitals as bases to launch attacks in violation of international law. Israel uses this argument to justify its attacks against Palestinian civilian infrastructure, often based on dubious evidence. One need only look to its brutal assault on Gaza’s largest hospital, al-Shifa, in November.
The Israeli government defended the attacks because of its long-standing claims that the hospital is a Hamas command centre.
After the assault, the IDF released a picture of several guns it claimed were recovered from the attack that left countless medical personnel and patients dead, and babies dying in incubators.
If there were Hamas sites under the numerous hospitals the IDF has destroyed, that still would not have justified the scale of atrocities we are seeing today.
In international law, it is not justified to strike even legitimate military targets if the civilian casualties are far disproportionate to any military gain.
As an example, the IDF took credit for a strike on the Jabalia refugee camp that killed at least 195 Palestinians who had been sheltering there. The stated goal of the attack was to kill one Hamas commander who had been visiting. A 195-to-one ratio is a war crime.
I must make it clear that I am not pro-Hamas. As a medical professional, I value all human life. And I mourn all the lives lost in Israel.
If I think about what I'll remember in years to come from this time, I will remember the nobility and sacrifice of Dr. Abu Nujaila. I will remember every picture of burned and dismembered children over the last several weeks.
I will remember the doctors who had to provide surgery without anesthesia and the pain experienced by those who survived, and those who died from the shock.
But I will not forgive myself if I don’t do everything in my power to pressure my government to stop letting this go on. I urge you all to do the same.