Part of the Series
Struggle and Solidarity: Writing Toward Palestinian Liberation
On June 1, approximately 50 medical students from Washington University in St. Louis, Saint Louis University, and others interested in the topic gathered at a public library in St. Louis’s Central West End near both campuses to hear neonatal specialist Yassar Arain describe the medical apartheid he experienced while volunteering in a neonatal intensive care unit in Gaza this spring. Some openly wept as he recounted tragedies he’d witnessed but was powerless to avert.
Arain is a Californian of Pakistani descent now practicing medicine in Fort Worth, Texas. He’s also a father of young children. In mid-April, he joined in a two-week medical mission under the aegis of the Palestinian American Bridge, a group of doctors that hosts foreign specialists to help provide care in Gaza in the face of their own drastically reduced numbers. Per the World Health Organization’s (WHO) latest monthly tally, since October 7, 2023, Israel has attacked 464 health care facilities, killed 727 health care workers, injured another 933, and damaged or destroyed 113 ambulances. Among the doctors, 55 specialists were killed, according to a Reuters report. Hundreds of bodies have been found in multiple mass graves at three hospitals. At the Neonatal Intensive Care Unit (NICU) in Gaza, Arain was the sole neonatologist.
One of Arain’s patients was an infant who’d been shot in the head during a surprise Israeli attack, while breastfeeding in his mother’s arms. The bullet entered and exited his skull, making two wounds that baby Mustafa somehow survived, but with an unknown developmental fate. He’s since had seizures and needs long-term medical care — and, Arain said, justice. “One of the hardest things that happens for me internally, in my own mind,” Arain told the gathering, “is how we reconcile this with what we promote here in America with newborn mothers, which is skin-to-skin ‘kangaroo’ care. It helps the baby’s temperature stay normal, develops bonding, delivers healthy bacteria to the gut — all these nurturing things. But [think about what] we’re putting Palestinian mothers and infants through.”
Babies in Gaza are dying needlessly due to supply shortages, babies that would not have died if hospitals had even 50 percent of the resources they had prior to October, Arain told the stricken audience.They’ve run out of surefire medications like surfactant to help prematurely born babies through respiratory ailments, and don’t have access to certain technologies like a cooling blanket needed to cool down babies’ brains when they experience oxygen deprivation. Israel has destroyed all Level 4 NICUs. One newborn in need of a special incubator was delivered at 24 weeks (typical gestation is 40 weeks) after her mother’s house was bombed, killing her mother’s family in the blast and sending her into preterm labor as a result of the shock. But with no place to send babies in need of specialized equipment and brain cooling, they are condemned to a life of neurological impairment or death. Arain called it “a crime against humanity.
In this exclusive interview for Truthout conducted on June 20, Arain provided updates on the functioning of the NICU since Israel closed the Rafah crossing in May and incinerated it on June 17, discussed the accuracy of vital records, his admiration for his hosts from the Washington University chapter of Medical Students for Justice in Palestine (MSJP) and the shocking silence of the American medical establishment on the mass destruction of Palestinian life.
Frances Madeson: How has the closing of the Rafah border to Egypt impacted the work at the NICU?
Yassar Arain: When the Rafah border was open, many more doctors and teams were able to cross, and we were able to bring medical supplies with us. Not only medical supplies, but kids’ clothes and kids’ shoes. More than half the kids I saw didn’t even have shoes on. So, we were able to bring in a lot of those supplies.
Now they have to go through two Israeli borders, one at Kerem Shalom and the second with Jordan through the Allenby Bridge Crossing. We’re only individually allowed to bring two bags that weigh 23 kilos a piece, and none of it can include medication. All medications have to go through the WHO shipments, and we know that’s not that efficient. And we’re not allowed to bring anything more than personal items.
It has also impeded getting children out for medical care. There hasn’t been any movement, to my knowledge, any active movement of children out of Gaza right now.
The other change is the Israeli authorities are saying that if you’re coming as a doctor or as a humanitarian worker, you have to come for a minimum of four weeks. Many of us cannot take four weeks off of work, and Israel knows that. I was supposed to go back on July 13. I was supposed to fly out to Jordan, but because they refused to shorten the duration from four to two weeks, I can’t.
We feel there’s this tightening of the grip on humanitarian aid, and that every week things get worse.
How has your reentry been to life in Fort Worth?
Coming back has been incredibly difficult, because I was surrounded by an abundance of resources, and I understand the value of those resources in Gaza. You can’t put a price on it, the things that we throw away in the hospital.
Just the other day, I did a procedure on a baby, and as part of the supplies, there’s a bottle of lidocaine that we actually don’t use, but it’s part of this kit so we just throw it away. That lidocaine could make a huge difference over in Gaza, because I saw us doing procedures without lidocaine. I saw us pulling chest tubes out of a 10-year-old kid, and putting stitches in him, and he could have used that lidocaine instead of us taking the bottle out and literally throwing it in the trash.
It sounds like your experience was life-changing.
Very much so, because of the people. You don’t hear them really speak ill of their situation. They may complain to the extent of: why is this still happening? But they don’t engage in self-pity to the point of becoming immobile or incapable of carrying on. They continue to carry on their tasks and their responsibilities day after day, for themselves, their families and their greater society at large. They bear the pain knowing from their perspective, they are very much on the right side of history. It’s pretty incredible to see.
When you talk to the people of Gaza, they know they were born into this very tense situation from a geopolitical standpoint. But they also know their history, regardless of how the history of Palestine has been attempted to be manipulated. They’re under no pretense of the Nakba not happening.
I wish everyone here in the U.S. could have shared at least a few minutes of what I experienced there, of what Palestinians, especially Palestinians of Gaza, are actually like. Because their love for humanity and their love for peace and the pursuit of justice is inspiring, especially when you have this physical environment that is just devastated.
What would happen when a patient of yours would perish? How did deaths get reported?
The most impressive thing was they still kept paper documents; medical documentation still happened and it happened diligently. So within the hospital, things do get documented, and they do go up the chain, so that deaths and births are reported if they happen in the medical facility.
But the challenge is the vast majority of medical facilities have been either literally destroyed by the IDF, or there’s nobody to staff them. If a family member dies, and this family member is in the middle of a refugee camp that’s kilometers away from the nearest medical facility, they might just bury the person right there, and it won’t get reported.
The first night I got to Gaza, I met one of the doctors, and he was telling me he was a surgeon and he lives at the hospital now because his home was destroyed. He was saying how when his house was destroyed, his parents perished in the building, and at one point he just went back and dug through the rubble, found their bodies, and there and then, buried them. Did they get reported? Probably not, and how many bodies are still under the rubble? I’ve heard 100 to 200,000. And once you see the destruction with your own eyes, it becomes very clear, yeah, that’s easily fathomable.
You were invited to St. Louis by Washington University student organizers with MSJP, and your program was their first public event. In fact, they recorded it and have made it available online [Part One and Part Two]. Why did you think it important to come? And, knowing the dangers, why in your talk did you encourage medical workers and students to go to Gaza?
They thanked me, but it’s me who thanks them. It gives me hope and keeps me going. Especially as first year medical students, a majority of them, and their ability to be cognizant of these injustices and to care enough to do something. I think the youth and their youthful exuberance towards seeking justice for Palestinians nationally is enlightening — it feels like a Vietnam War [resistance] moment.
There’s so many of us that are dying for an opportunity to do something more than just speak up in the U.S. We’ve been aching and yearning for an ability to do more than just chant during a protest, not that that’s not important. But to actually put our hands and our minds to work to help them to alleviate their pain.
You’ve criticized the American medical establishment for its silence. Why are you so adamant that they should speak up on behalf of Palestinian life?
Gaza is exposing a lot of hypocrisy that maybe wasn’t exposed before, or maybe people hadn’t confronted within themselves and within their profession, or society at large. From a medical perspective, as a physician, I see the hypocrisy being exposed within physicians as well as our practice.
The overarching job of a physician is to save lives, and saving lives does not come with restrictions — geographically, ethnically, religiously — it comes with no restrictions.
For physicians to see the atrocities, to know of the atrocities occurring in Gaza and to not feel the need to advocate for their lives to be preserved, is hypocrisy manifesting itself.
When you see children dying, dead, limbless or incapacitated from the war, does that not tug at a physician’s standard of morality? If they’re still not able to advocate for a ceasefire or to preserve the lives of children, then I really question their ability to provide care in the U.S. to any patient that walks in.
If a Palestinian child somehow escapes Gaza and shows up in the U.S., now all of a sudden, they can treat that child and their family with justice. But if asked to sign a petition or to speak up about not having that child killed in Gaza, they’re silent. How do you reconcile those two things? How do you reconcile the silence of the American Medical Association in not adopting a ceasefire resolution?
If we put aside any sense of empathy and compassion, and we take the most coldhearted approach towards the genocide in Gaza, then we should ask: How does it make sense for us to continue to support Israel? What shared values are we preserving?
Because what is happening is truly a genocide. It is a destruction of a people, not only from a life perspective, but it is destruction of their ability to educate themselves, to grow and cultivate the land. It is a destruction of the American sense of morality. It’s the self-destruction of our own country’s reputation on an international scale.
This interview has been lightly edited for clarity.