Destruction of Gaza’s Health System Isn’t a Byproduct, It’s an Aim of Genocide

Part of the Series

Struggle and Solidarity: Writing Toward Palestinian Liberation

The past four months have exposed the global community to a reality that Palestinians have long known and have resisted for over 75 years: that the settler colonial project of the state of Israel is predicated ­— both in spirit and practice — on the elimination of the Palestinian people wherever they are on this earth. Since October 7, 2023, approximately 33,000 Palestinians have been killed in Gaza, over 13,000 of whom are children, many thousands are unaccounted for and potentially buried under the rubble of homes destroyed by Israeli bombs funded by U.S. taxpayer dollars.

The number of Palestinians killed and injured is updated daily (when possible) by the Ministry of Health in Gaza and by the United Nations Office for the Coordination of Humanitarian Affairs in a manner that now feels simply cold-blooded. Israeli Minister of Economy Nir Barkat has gone on record saying, “Israel has a very clear message to our enemies. We are saying to them, look what’s happening in Gaza — you are going to get the same treatment if you attack us. We are going to wipe you off the face of the Earth.” Indeed, one can find such proclamations of global genocidal intent in nearly every press conference and media appearance of Israeli government officials and spokespeople, from the prime minister on down.

The Israeli state has made the health care system of Gaza an explicit target of this annihilatory campaign. Of the 36 hospitals in Gaza, none are fully functional and only 14 are partially functional, all of them working at many magnitudes over capacity, according to the World Health Organization (WHO). The remainder have either been destroyed or can no longer operate due to lack of resources, including essential medical supplies and equipment, and a shortage of health care providers, many of whom have been killed or displaced along with their families due to the relentless onslaught. More than 300 health care professionals, including physician specialists who are among the few in Gaza, have been targeted and killed by the Israeli army.

The destruction of the health care system is thus not an unfortunate byproduct of the genocide campaign against Palestinians in Gaza, it is part and parcel of that campaign. By targeting the health care system, Israel intends to disable and prevent healing and provision of care in the short term and bring about mass death of the Palestinians in Gaza in the long term.

Consider the fact that on December 16, Al Jazeera reported that the Israeli military had entered the courtyard of the Kamal Adwan Hospital in northern Gaza, and using military bulldozers (“jarafa”), deliberately crushed patients and families gathered there, burying them under the rubble. When health care providers stationed there held a press conference, shots began to be fired at them from the Israeli military at what seemed to be close range. A day earlier, footage had emerged of a cat nibbling on the remains of a dead Palestinian child, killed by the settler state.

As Palestinian surgeon Ghassan Abu-Sittah has noted, such a campaign of destruction — with the health care system at the center of the bullseye — aims to ethnically cleanse Gaza of Palestinians and make it uninhabitable in the future. In other words, not only is the destruction of hospitals and targeting of health care providers a method for maximizing death in the present, it is also a prelude to a broader campaign to keep the project of elimination ongoing. The WHO underscored this assessment of the health conditions in Gaza by noting that those who do not die today may die later from communicable diseases and otherwise preventable illnesses whose treatments have now been denied across the board because the very system and the very people equipped to provide this care have been destroyed or killed.

In tandem with the destruction of sites of learning (all major universities in Gaza have been decimated and over 94 university deans and faculty have been killed), and of critical infrastructure such as telecommunication lines and roads that make training health care providers and communication between them possible, Israel has also targeted the entirety of the food system in Gaza by bombing bakeries, uprooting olive trees and torching farmlands. The World Food Programme recently noted that 80 percent of the world’s hungriest people now live in Gaza, a statistic that should make any health care provider (or patient, or public health practitioner, or indeed any believer in health as a human right) burn with rage. This is not a famine, as talking heads have euphemistically called it, this is a deliberate campaign of starvation of a besieged people living under the yoke of a settler-colonial state hell-bent on their erasure.

The goal of making Gaza unlivable seems more of a possibility than ever before. Most recently, in addition to aiding and abetting the genocide through direct aid in the form of funds, bullets, bombs and warships, the U.S. and other colonial powers have all allied to stop funding to one of the last remaining support systems available to Palestinians in Gaza, the United Nations Relief and Works Agency (UNRWA), under a pretext that appears to be manufactured at best, and genocidal at worst. UNRWA is a major provider of health care and other services to Palestinians, and it is also a major employer. Horrifyingly, 152 UNRWA employees have themselves been killed by Israel’s genocide since October.

Of the 36 hospitals in Gaza, none are fully functional and only 14 are partially functional, all of them working at many magnitudes over capacity

To be sure, the campaign targeting critical health infrastructure in Gaza began long before October 7. Nothing that enters or leaves Gaza does so without the approval of the state of Israel. Prior to the recent campaign of ethnic cleansing enacted by the apartheid regime, the health care system in Gaza was already teetering on the edge of collapse due in part to the 17-year-long economic siege and blockade enacted by Israel. Essential medicine shortages, including of cardiology medications, were reaching critical levels upwards of 50 percent. Access to specialist care such as oncology care often required patients to leave Gaza. In order to leave, these patients were required to apply for exit permits from Israel. Only 81 percent of these medical permit requests to leave Gaza were approved in July 2023, according to the WHO. Oftentimes, in cases where exit permits were issued to patients, companion exit permits were not approved. Only 49 percent of Gaza companion exit permits were approved in the same period. This means patients — sometimes children — had to leave home alone to seek care without the accompaniment of their families. This was the case with 5-year-old Aisha al-Lulu, whose parents were denied an exit permit to accompany her as she left Gaza to receive care in a Jerusalem hospital. She died one week after having brain surgery, reportedly calling for her Mama and Baba in the hospital. ­Like the thousands of Palestinians killed in Gaza since October, al-Lulu was killed by a settler state not only indifferent to the suffering of Palestinians but determined to accelerate such suffering and death at a mass scale.

But it is not only the destruction of the health care system and thus the foreclosure of life for Palestinians in Gaza that concerns the Zionist project. More than 380 Palestinians have been killed in the West Bank since October, and there are countless stories of ambulances being prevented from reaching the injured as well as Israeli military vehicles blocking the entrances of hospitals in towns such as Tulkarm and Jenin. This past week undercover Israeli military and security death squads further violated the sanctity of hospitals and killed three Palestinian young men, one of whom was already paralyzed, in the Ibn Sina hospital in Jenin. The dehumanization of Palestinians inherent to the Zionist project of erasure has also made its way beyond the shores of historic Palestine. In Chicago, Illinois, a 6-year-old Palestinian child, Wadea Al-Fayoume, was stabbed to death by his landlord, while three Palestinian undergraduate students were shot while out on a post-Thanksgiving dinner stroll in Burlington, Vermont. One of these victims, Hisham Awartani, a student at Brown University, is now paralyzed. These are only two instances of several documented attacks against Palestinians across the globe.

This annihilatory project thus requires (or perhaps is conditioned on) a war on all things living: from animals to olive trees to humans — and it goes without saying that Palestinians are indeed human. By attacking the very sites requisite to healing and care in the midst of a genocide, the Israeli regime has further rendered health care a weapon against the Palestinian people. Despite this attempt, Palestinians are steadfast in their insistence on remaining on their land and caring for their people by any means available. They have resoundingly called for a permanent end to the illegal blockade and siege, and an end to the occupation and Zionist settler colonial project of elimination it supports. They are calling for liberation for all Palestinians, from the river to the sea, and across the globe, so that they may realize their health, on their land, and may begin rebuilding a health care system for all in a free Palestine.