Israel has created a medical apocalypse in Gaza
Injured Palestinians, including children, are brought to Nasser Hospital to receive medical treatment following Israeli attacks in Khan Yunis, Gaza, 22 January 2024
Mary Turfah writes in The Nation:
Before October 2023, I was under the naïve impression that medicine was something like a universally sacred institution during wartime. I thought that the explicit targeting of medical infrastructure would not be tolerated or would, at least, be unequivocally condemned.
I had come to expect this based on a general pattern I’d observed. An American gunship attack against a Médecins Sans Frontières trauma hospital in Kunduz, Afghanistan, in 2015, which killed 42 people, was denounced by MSF and other international actors. When the United States apologized and called it a “mistake,” the MSF president expressed her doubts, insisting the organization “need[ed] to know what happened and why it led to an airstrike on a hospital which has been known in the region for the last four years, which has been treating thousands of people,” and whose coordinates the US military had been provided. Western media outlets covered, to some extent, this inconvenient rebuttal.
In 2022, Russia attacked a children’s hospital and maternity ward in Mariupol, Ukraine, killing three people. The bombing made news headlines for days. Journalists flatly accepted the idea that the strike was deliberate in advance of any independent investigation, because, frankly, why else would you bomb a hospital? NPR, for instance, reported that “the World Health Organization (WHO) decried the Russian airstrike that devastated [the medical complex].” Verbs like “decry” and “devastate” capture the appropriate reflexive response to assaults on healthcare.
Yet for the past four months in Gaza we have witnessed an attempt to dull this response. Israel’s assault on medical infrastructure amounts to one of the few discernible military objectives of this war. This makes sense, as medicine’s commitment to life compromises the effective implementation of genocidal intent.
According to a WHO report from January 30, 2024, only 13 of 36 hospitals in Gaza remain partially functioning. (There are around 6,120 hospitals in the United States. Per a crude calculation—ignoring the incredible variability in what counts as “partially functioning”—this is the equivalent of 4,080 American hospitals being damaged or destroyed.) The same report said that 13 of 77 primary healthcare facilities are operational and that 342 attacks on healthcare infrastructure have been reported, although the actual number is likely much higher, as reporting from northern Gaza is increasingly limited.
Six hundred and twenty-seven healthcare workers have been killed by Israeli forces so far, according to the WHO. Forty-seven ambulances have been damaged or destroyed through direct targeting, often while bringing victims of the most recent Israeli air strike to the hospital. Women in active labor sometimes rely on donkeys for transport to medical facilities, although even these animals are not safe from targeting.
This devastated infrastructure is meant to cope with one of the worst humanitarian crises of modern times. On October 9, Israeli Defense Minister Yoav Gallant infamously ordered a “complete siege” of Gaza, adding, “There will be no electricity, no food, no fuel, everything is closed.” As a result, 95 percent of the 600,000 people facing starvation around the world right now are in Gaza, according to the UN. Communicable diseases are rampant due to the measured annihilation of Gaza’s civilian infrastructure, including the most basic means of sanitation and the concentration of millions of people into ever-dwindling pockets of land. (Impossibly here, I’m asking the reader to ignore the trauma and the bombs, and instead focus on epidemics, whose spread at least one retired Israeli general has lauded as a crucial tool of battle.)
In late December, the WHO reported that there was one toilet for every 480 persons in Gaza. Eight thousand new cases of hepatitis A and almost 45,000 new skin rashes have been reported, along with tens of thousands of new respiratory infections and 165,000 new cases of diarrheal infections, including more than 85,000 cases in children less than 5 years old.
Today, because of the Israeli prohibition on diagnostic tools and, more importantly, the prevention of safe access to hospitals, many infectious diseases can’t be formally diagnosed. If people can reach a healthcare facility at all, there is often no available treatment, even for things like cholera (which causes profuse watery diarrhea) whose treatment is fairly simple: rehydration.
Many Gazan hospitals are running out of IV fluids, the most basic essential in a doctor’s resuscitative tool kit. Even if someone were to attempt oral rehydration in Gaza, they’d likely struggle, as Israel is limiting the entry of water into Gaza to around a liter per person (this includes water for showering, cooking, etc.; the WHO recommends a minimum of 15 L per person per day, although 300 L is closer to what the average American consumes daily). Gaza’s three desalination plants were targeted by Israel early in the war, and, even before October, 97 percent of the tap water in Gaza wasn’t fit for consumption.
This is by no means a comprehensive list of the medical horrors in Gaza. For interested readers, the WHO has been publishing this data since the start of the assault against Gaza, with recommendations included at the end of each document. On October 8, the first recommended intervention read, “immediate end to hostilities.” On January 30, “immediate cease-fire.”