In late December, South Africa filed a historic complaint with the International Court of Justice, alleging that Israel had committed multiple “genocidal acts” against Palestinians in Gaza, including an “attack on Gaza’s health system , which makes life unbearable.”
The destruction of a health system is indeed an act of genocide – especially in a besieged territory where more than two million displaced, desperate and hungry people face relentless, indiscriminate bombing and sniper fire. Once the health system is destroyed, injuries can no longer be treated, primary care cannot be provided, and starvation can no longer be managed – in other words, life can no longer be sustained.
Although it will likely take a few years for the ICJ to issue a final verdict in the case against Israel, it should be clear to anyone interested in the health care situation in Gaza that the Gaza Strip is on a path scandalous move towards complete ethnic cleansing.
Since October 7, Israeli forces have blocked the entry of essential medical supplies and medicines into the Gaza Strip, bombing hospitals and other medical facilities, killing and kidnapping medical personnel, and targeting ambulances. Even Gaza’s only pediatric cancer ward was attacked and destroyed by the Israeli army.
It is difficult to view these sustained and deliberate attacks on health care in Gaza as anything other than a strategy of ethnic cleansing aimed at creating a major health crisis that would kill thousands of Palestinians and render the territory uninhabitable for survivors.
Since the start of its latest war on Gaza, Israel has carried out more than 400 attacks on health facilities in the Gaza Strip, including on every one of its hospitals, leaving the majority of them out of service. As of February 13, only 11 of Gaza’s 36 hospitals were partially functioning – five in the north and six in the south. According to the WHO, hospital bed capacity across Gaza has been reduced from 3,500 to just 1,400. In many cases, Israeli authorities have attempted to justify these attacks by claiming, without providing any evidence independent and conclusive, that the hospitals were used by Hamas or that there were “Hamas command centers” under their authority.
At this stage of the conflict, the few partially functional hospitals are only capable of providing desperately needed trauma care and there is no treatment for other critical primary care needs, such as chronic diseases. .
In addition to attacks on health facilities, we know that 374 health workers have already been killed, some in targeted killings. By the end of December, the number of health workers killed in Gaza already exceeded the total number of health worker deaths recorded in all other conflicts in the world last year and in any year since 2016. Many health workers have also been kidnapped, including Dr. Muhammad Abu Salmiya, director of Gaza’s largest hospital, al-Shifa, remains missing.
Ambulances have also been the target of attacks in Gaza, with around 120 completely destroyed. There have been numerous incidents where ambulances have been prevented from reaching seriously injured patients. In one case, an Tel Aviv Tribune journalist injured by Israeli bombing bled to death after the ambulance trying to reach him came under fire. In another case, Israeli forces bombed the Palestinian Red Crescent ambulance that was trying to rescue a six-year-old child trapped in a car with the bodies of her family members, killing the two paramedics on board. It was later revealed that Israeli forces had also killed the child they were trying to save.
Antenatal and maternal care throughout the territory – care crucial to the long-term survival of Gaza’s Palestinian population – is also extremely limited.
An estimated 183 women give birth every day in Gaza, but access to care for a safe pregnancy depends on access to a facility still capable of providing prenatal care. Few women are able to do this and the facilities that still offer care to pregnant women are extremely overcrowded and subject to conditions described as catastrophic – lack of basic hygiene products, fuel, water , anesthetics, medications, blood products and other supplies. In the absence of fully functioning maternal hospitals, many women are forced to give birth in one of the few health facilities that are still partially operational. However, these are not suitable for maternal care and the risk of complications is very high for all mothers and babies.
In November 2023, al-Hilo hospital, which served as a maternity ward after all other specialized facilities collapsed, was bombed by Israeli forces. A Palestinian doctor later reported that “the ear is a common ailment among all pregnant women” in Gaza.
The looming famine in Gaza – caused by the near-complete siege imposed on the territory by Israel since the start of the war – also poses a threat to pregnant women.
Today, half of all pregnant women in Gaza suffer from anemia and at least 50,000 pregnant women face extreme hunger, affecting not only the current generation of people living in Gaza, but also the next. There are also reports of an increase in the number of miscarriages.
Health workers in Gaza work under conditions of immense stress and difficulty, having to carry out amputations, cesareans and other procedures without anesthesia, electricity and basic medical supplies. UN experts have portrayed the war on Gaza’s health system as having resulted in the complete destruction of health infrastructure.
Presented with evidence of all this and more, on January 26 the ICJ issued a preliminary ruling in the genocide case against Israel, explaining that it had seen enough evidence of dispute for the case to proceed. moving forward and ordering Israel to take measures to prevent these acts. genocide in Gaza and provide humanitarian aid to the Palestinians.
And yet, despite the ICJ’s interim order, the Israeli military assault on the health system has continued unabated. In fact, attacks on Gaza’s remaining health facilities have intensified significantly in recent weeks.
On January 27, just one day after the ICJ announced its interim orders, Médecins Sans Frontières (MSF) announced that “in the context of ongoing heavy fighting and bombing in Khan Younis, southern Gaza, Palestine /TPO, vital medical services have collapsed at Nasser Hospital, currently the largest functional health facility in the enclave.”
Since then, the hospital has faced numerous other air, land and sea attacks and has been under siege by Israel for weeks. On February 9, Israeli snipers killed at least 21 displaced civilians trying to reach the hospital.
In just over four months, the Israeli military attack on Gaza has killed more than 28,000 people and injured more than 60,000 others. Most of Gaza’s more than two million residents are now displaced, waiting in fear for the next attack in flimsy tents and buildings damaged by freezing temperatures. The decision by several Western countries to suspend funding to UNRWA, the main UN agency providing humanitarian aid and essential services to Palestinians in Gaza, has amplified the looming threat of famine.
With remaining health services teetering on the brink of collapse and health workers under constant attack, there is little hope that Palestinian lives will continue in Gaza unless the international community takes urgent action. .
The evidence we have – evidence reported by courageous Palestinian journalists on the ground, evidence presented to the ICJ by the South African legal team, evidence we see every day on our social media in videos shared by the people of Gaza – are clear: Israel is carrying out a sadistic campaign of ethnic cleansing in Gaza, a genocide, aimed at ridding the strip of its indigenous population.
Sustained attacks on Gaza medical personnel are perhaps the most effective element of Israel’s relentless campaign to make life in the Gaza Strip unbearable for Palestinians. Once this war is over, surviving Palestinians can theoretically rebuild their destroyed homes, schools, businesses and hospitals within months, but the human capital lost to Israeli bombs and bullets – doctors, surgeons, paramedics, nurses and teachers killed and You are. mutilated by Israel’s actions – cannot be replaced for many, many years. Israel’s actions have not only physically and psychologically traumatized the Palestinians, but have also deprived them of the resources that could help them heal and rebuild their lives in their desert-turned land.
The international community, which created the conditions for this humanitarian catastrophe with its indifference to Israel’s violations of international law and crimes against the Palestinians, must take urgent action.
It must take steps to protect what remains of Gaza’s health system, as a first step in ending Israel’s blatant ethnic cleansing efforts and genocide.
The views expressed in this article are those of the authors and do not necessarily reflect the editorial position of Tel Aviv Tribune.