The truce in Gaza has come to a bloody end. Resumed bombardment by Israeli forces has unacceptably killed so many Palestinians already. It is just as incessant and indiscriminate as before the seven-day truce. Relentless death and destruction have been once again unleashed by Israeli forces in response to Hamas’s brutal October 7th attack, broadcast for all the world to see.
The continued assault is inflicting an unprecedented rate of killing and injuries on the 2.2 million people of Gaza, in a land area not even twice the size of Cork city. More than 1.7 million people have now been forcibly displaced to cramped and chaotic conditions in Gaza’s south where intensive air strikes continue and people face further evacuation orders. People increasingly seek shelter in hospitals. Nowhere in Gaza is safe.
In our 51-year history, the staff of Médecins Sans Frontières/Doctors Without Borders (MSF) have borne witness to many military campaigns of cruel and punishing violence that have decimated civilian populations. In the horrific manmade catastrophes of Srebrenica, Rwanda, Chechnya, Darfur and Aleppo, we have seen political inaction repeatedly fail the victims of war. Now Gaza can be added to this tragic list. The suffering of civilians trying to survive earth-shattering violence is prolonged and worsened by those with power and influence to stop the carnage choosing not to do so.
In these bleak times in human history, when the very fabric of humanity is tested, the universal principles, systems and rules intended to limit extreme suffering of civilians caught up in war can fail too. The rules of war, regarding proportionality in combat, protection of civilians, forced displacement and the imperative for civilians to access basic humanitarian assistance are agreed and should be non-negotiable. Devastatingly for the people of Gaza, they have been largely ignored – by Israeli forces, the international political system and governments of countries that provide political cover for the continuation of carnage.
From the start of its military campaign, a “complete siege” has been enforced on Gaza, banning the entry of water, food, medical supplies, and fuel – vital to run incubators and dialysis machines. Added to this, unyielding restrictions have been put on humanitarian access and are preventing badly needed aid from reaching people in Gaza. Humanitarian assistance and medical supplies that have crossed in fall egregiously short of meeting the overwhelming needs.
The World Health Organisation has recorded 164 attacks on healthcare-related facilities in Gaza since October 7th
It horrifies me that in the same hospitals and clinics where I have worked extensively as a specialist plastic surgeon in Gaza, MSF teams continuing to provide care to the sick and injured could be considered “legitimate targets”. Writing in The Irish Times in October, MSF’s head of mission for the Palestinian Territories, Léo Cans, called for medical facilities to “be respected”, a demand which “should not have to be negotiated”.
Outrageously, attacks on hospitals and indiscriminate warfare since then have been the norm rather than the exception. The World Health Organisation (WHO) has recorded 164 attacks on healthcare-related facilities in Gaza since October 7th.
Israeli forces are seemingly guided by a military doctrine that defies both basic humanity and the rules of war. Contrary to what Israel has claimed, war is being waged on all of Gaza and its people; including its doctors, medical workers and hospitals.
On November 21st, our colleagues Dr Mahmoud Abu Nujaila and Dr Ahmad Al Sahar and a third ministry of health doctor, Dr Ziad Al-Tatari, were killed at Al Awda hospital in northern Gaza. They were at work at the MSF Limb Reconstruction Unit in the hospital when it was hit by a strike. On November 18th, a nurse volunteer and a family member of an MSF staff were killed when our clearly marked evacuation convoy was attacked. All elements point to the responsibility of the Israeli army.
Attacks on hospitals and medical workers are attacks on humanity. There is no justification – legal or moral – for the violent strikes on civilians and hospitals that we have seen in Gaza. We demand that hospitals, medical centres, ambulances and the patients and staff in them are respected by all parties to the conflict.
In the hours before the temporary truce started on November 24th, an MSF colleague who had arrived to treat burn patients and support the emergency room in the southern city of Khan Younis reported a hospital overflowing with more than 1,000 emergency patients. The corridors were crowded with patients needing emergency medical assistance and families sheltering in the hospital. An injured child who needed a major surgical operation after losing a limb woke up from anaesthesia, asking to see her family. But they had all been killed. This ongoing living nightmare for Gaza’s civilians must stop.
The MSF teams in hospitals in the south are attempting to serve the health needs of huge numbers of people forcibly displaced there by Israeli forces. The displaced are living in squalid camps, exposed to bombing and facing the potential of severe disease outbreaks and now a return to war.
In the West Bank, incursions by Israeli forces into Jenin refugee camp are hindering the work of our medical teams and stopping people from seeking urgent medical care. Several hospitals have been unacceptably blocked by the army from accepting patients. Ambulances are prevented from collecting injured people and moving around the camp; some have been shot at when trying to do so.
The Irish Government has shown clear support for a scale-up of humanitarian assistance in Gaza and has expressed the need for the protection of civilians and the medical mission. It has called for an immediate ceasefire. Ireland should now ramp up diplomatic efforts with counterparts in Europe and the United States to convince the government of Israel that the death sentence it has handed the people of Gaza is indefensible.
An injured child who needed a major surgical operation after losing a limb woke up from anaesthesia, asking to see her family. But they had all been killed
The indiscriminate and relentless attacks must stop. The forcible displacements must stop. The assaults on hospitals and medical staff must stop. The siege and restrictions on aid must stop.
An immediate cessation of hostilities respected by both parties to the conflict is the only way to stop the unacceptable killing of thousands more civilians and to allow for the adequate delivery of desperately needed humanitarian aid.
Empty words and inaction have so far failed to stop the relentless bloodshed and atrocities being committed in Gaza. Political action is now needed to uphold our shared humanity.
The dedication of my colleagues killed at Al Awda was captured on a whiteboard used for planning surgeries at the hospital, on which was written: “We did what we could. Remember us.” When the bombs, munitions and guns eventually fall silent, and the true scale of devastation in Gaza is revealed, will we all be able to say the same?
Dr Eve Bruce is chair of Médecins Sans Frontières (Doctors Without Borders) Ireland board of trustees