Every morning for more than three weeks, since the attacks on Gaza began, I wake up with a deep sense of dread at the thought of what I will see on my phone screen.
Last summer, I was studying public health in the occupied West Bank in a program sponsored by Harvard University. My classmates, many of whom were Palestinians from Gaza, had created a WhatsApp group so we could arrange transportation to the university or plan meetups after class.
Now, this WhatsApp group has a very different objective. Every evening, my former classmates share updates on their situation. “They are bombing our neighborhood, our house has been destroyed.” “We are doing well, but the lack of food and water is a real problem.” “They razed the bakery.” “Hospitals do not have the fuel to continue operating. »
Their messages fill me with intense, sometimes contradictory feelings. Every morning, I feel relieved to see their names on my phone – to confirm that they are still alive. But I also despair of reading about the new calamities they suffered while I slept.
Reading these messages describing the desperate situation in Gaza also reinforces my disappointment and frustration with medical and public health institutions in the United States.
The program I participated in in the West Bank this summer aimed to expose students to the social and structural factors that ultimately determine the health of Palestinians. During the course, we learned how the health of Palestinians is deeply linked to and affected by the illegal military occupation of their lands. Water, food security, access to green spaces, employment, education, violence, housing, quality of health care – all these and more are affected by the occupation Israeli health and contribute to significant health disparities for the Palestinian people.
The World Health Organization has also stated that social determinants of health like these account for up to 55 percent of population health outcomes. Contributing factors from non-health sectors may exceed those from the health sector in terms of their impact on health outcomes.
During my studies at the Harvard TH Chan School of Public Health, I realized how fundamental understanding – and resolving – these questions is to our discipline. As a physician, I know that when these external factors are not addressed, I am stifled in my ability to care for my patients to help them be healthier, regardless of my medical training.
That is why, as I receive message after message from my friends in Gaza about the siege, about the lack of electricity, water, fuel and medical supplies, about the numerous attacks on health facilities and the medical staff, I cannot help but be discouraged by the deafening silence from our public health institutions on the issue.
Today in Gaza, all socio-economic and structural determinants of health, including water, food, sanitation, access to medical care and housing, are intentionally undermined by Israel. Yet most medical and public health institutions seem to have little say in the face of this unprecedented humanitarian catastrophe.
In Gaza, health care facilities are being targeted, in violation of international law. Nursing staff, first aiders, in fact, the entire health system of the band is completely under siege. Doctors perform surgeries by the light of their cell phones. Hospitals lack dressings for burns. Medical providers do not have what they need to provide even the most basic level of care. Doctors, nurses, other health workers and medical students have been killed and maimed.
As someone trained in public health and working as a doctor, I know well that the death and destruction we witness today in Gaza will lead to new health problems tomorrow. Lack of sanitation will lead to the rapid spread of many infectious diseases. Many will develop respiratory problems from the explosive pollution and white phosphorus vapors. Some of those who survive the war will suffer severe psychological trauma and countless other medical problems for many years.
To be clear, the Palestinian health care crisis did not begin with this latest escalation. When I visited a community center in a West Bank refugee camp last summer, I saw many patients suffering from chronic respiratory problems, linked to the tear gas frequently used by the Israeli army in their community. Palestinians, like many indigenous peoples, already face higher rates of chronic diseases, including diabetes and respiratory problems, than non-indigenous populations. After Israel’s war on Gaza, managing these existing illnesses will be much more difficult for many Palestinians.
In Gaza and the occupied West Bank, a public health disaster of unprecedented proportions is occurring. And yet our medical and public health institutions remain silent.
If these institutions, including medical schools that train the next generation of health care professionals, continue to advocate and teach the importance of social justice, appropriate crisis response, and consideration of social determinants of health, then they must denounce the genocide that is taking place before our eyes. eyes in Gaza. They must condemn attacks on healthcare workers and infrastructure in Gaza and demand an end to collective punishment inflicted on a besieged population.
Remaining silent now, when advocacy and public opinion can influence the course of this catastrophe, constitutes a dereliction of our duty to respect medical and public health principles, especially in a health crisis.
Those of us who speak out have faced efforts to silence, repress, intimidate, and accusations of anti-Semitism. Students at Harvard and American universities fear for their jobs and personal safety simply because they speak out against the atrocities taking place in Gaza. Rather than creating a hostile atmosphere in which medical professionals are afraid to speak out against the collective punishment inflicted by Israel on the people of Gaza, our institutions should support us in upholding our commitment to the common good.
Health care professionals and public health leaders have a responsibility to advocate for the health of all people and address the systems and structures that cause unjust health inequities among individuals. We cannot remain silent while a genocidal campaign and illegal resource blockade continues in Gaza, knowing that it will harm the health of the Palestinian people for generations to come. We cannot hide in the ivory towers of academia or hide behind the bureaucracy of our public health institutions. We must collectively take a stand for the Palestinian people and demand their right to health. It is hypocritical of people with training in medicine and public health to ignore what is happening.
Now is the time for our medical and public health institutions to stand firm and advocate for an end to civilian casualties and an end to the blockade of Gaza. Support students and faculty who do the same. This is part of our duty, our philosophy and our work.
The opinions expressed in this article are those of the author and do not necessarily reflect the editorial position of Al Jazeera.