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Gaza: Israeli airstrikes kill doctors and damage healthcare facilities

BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1300 (Published 20 May 2021) Cite this as: BMJ 2021;373:n1300

Rapid Response:

Standing in solidarity with our medical colleagues in Gaza

Dear Editor

In the aftermath of the devastating 11-day Israeli bombardment of Gaza and the resultant exacerbation of the ongoing humanitarian crisis, we express solidarity with our colleagues in the Occupied Palestinian Territory (OPT) and condemn the ongoing violation of human rights and contravention of UN resolutions by Israel. We call against a return to the ‘normality’ of occupation and blockade.

We mourn the loss of civilian life and our medical colleagues. Dr Ayman Abu Al-Auf, the head of internal medicine at Al-Shifa, the main hospital in Gaza, and the head of its coronavirus response, and Dr Mooein Ahmad Al-Aloul, Head of Neurology and one of Gaza’s few neurologists were killed. Access roads to Al-Shifa Hospital were bombed and the Hala al-Shawa Covid-19 testing and vaccination centre, the only one available in the whole of Gaza, was destroyed.

The civilian fatalities, attacks on hospitals and medical personnel have come to an end but the people of Gaza continue to suffer from restricted access to clean water, food and essential medical supplies due to Israel’s 14-year blockade, in violation of international law. Gaza has been rendered uninhabitable and the “world’s largest open-air prison” with over two million people living in one of the most densely populated parts of the world.

Gaza’s civilian infrastructure was already severely decimated by Israel’s previous military campaigns, such as its significant air and ground assault in 2014, and its sustained blockade on the movement of people and goods including building materials. These have crippled Gaza’s ability to rebuild its infrastructure denying its population consistent access to their basic needs. In 2020 the BMA medical ethics committee and international committee chairs wrote to the Israeli government expressing alarm regarding the treatment of Palestinians in Gaza, specifically the availability of medical care and individuals’ ability to seek treatment which have been severely curtailed.[1] The recent bombardment has aggravated this situation and will have untold consequences on those with both physical and mental health conditions in the coming days, weeks and months leading to further preventable loss of life and disability.

In the context of the long-standing occupation and blockade, the trigger for the latest events was the looming eviction of Palestinian families from their homes in Sheikh Jarrah, an East Jerusalem district which falls within the OPT.[2] The forced displacement of people in occupied territory is a potential war crime under the International Criminal Court Statute. The Israeli police prevented Palestinians from gathering outside the Damascus gate, a landmark of Jerusalem’s old walled city and main public space. Rubber-coated metal bullets and stun grenades were deployed by the Israeli military against peaceful worshippers in prayer within the Al-Aqsa complex on one of the holiest and busiest nights of Ramadan. Medical colleagues in Jerusalem treating the wounded report they have sustained serious head and eye injuries. There were subsequent protests across the West Bank which were met by the widespread use of excessive force against Palestinians including the use of live fire.

In 1967 Israel occupied East Jerusalem, the West Bank and Gaza, annexing East Jerusalem and parts of the West Bank. In a policy of dispossession, Israel has expropriated the land of Palestinians and prevented Palestinian landowners from reclaiming properties they owned before 1948. In East Jerusalem alone, it forcibly housing more than 220,000 Israeli settlers, while in the West Bank there are 647,800 settlers in 170 settlement locations.[3] The UN Security Council has repeatedly condemned the annexation and settlements as illegitimate under international law and demanded the Israeli government stop evictions, demolitions and forced removals.[4]

The recent Israeli bombardment of Gaza killed at least 248 people, including 66 children and more than 1,900 people were injured. 500 families have been displaced by the bombings.[5] In Israel, 12 people were killed by the Hamas rocket fire from Gaza, including 2 children. The root cause of this cycle of violence is ultimately the Israeli military occupation and restrictions placed upon the Palestinian population. Without an enduring solution, there is little hope that such tragic scenes will not play out again. Military action against any civilian population, whether in Israel, Gaza or the West Bank is deplorable. We must acknowledge the disproportionate impact on Palestinians living under occupation due to the degree of destructive violence by the Israeli military, depleted health resources and restrictions imposed on freedom of movement.

As doctors and healthcare workers, we have a professional and ethical duty to uphold the right to health for all. We applaud the BMA’s previous principled stance on these issues and urge it to continue to express our concerns to the Israeli and UK governments. We call on our government to demand Israel lifts the blockade on Gaza so that there are no restrictions on the movement of people, medical equipment and basic supplies. We urge British medical institutions to demand Israel upholds the basic human right to health enshrined in international law for the people of the OPT; which as the occupying power, Israel has the duty of ensuring.[6] We stand in solidarity with our Palestinian colleagues and encourage our institutions to support the reconstruction of healthcare infrastructure, services and development in the OPT to ensure access to healthcare for all.

1. John Chisholm & Terry John. Medical treatment in Gaza. https://www.bma.org.uk/media/3099/bma-letter-regarding-medical-treatment... (2020).
2. Rupert Colville. Press briefing notes on Occupied Palestinian Territory. https://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=27067&... (2021).
3. Six-Month Report on Israeli settlements in the occupied West Bank, including East Jeru salem Reporting period January-July 2020. https://www.un.org/unispal/wp-content/uploads/2021/03/EUSETTLERPT_120321... (2021).
4. Israeli annexation of parts of the Palestinian West Bank would break international law – UN experts call on the international community to ensure accountability. https://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=25960&... (2020).
5. Escalation in the West Bank, the Gaza Strip and Israel. https://reliefweb.int/sites/reliefweb.int/files/resources/flash_update_3... (2021).
6. Geneva Convention (IV) relative to the Protection of Civilian Persons in Time of War. https://ihl-databases.icrc.org/applic/ihl/ihl.nsf/ART/380-600063?OpenDoc... (1949).

Undersigned:
• Dr Swee Ang, Orthopaedic Surgeon, London & co-founder for Medical Aid for Palestinians (UK Charity Registration No: 1045315), UK
• Dr Andrew Ferguson, GP and Director of Programmes for Medical Aid for Palestinians (UK Charity Registration No: 1045315), UK
• Dr Hina J Shahid, GP, London, UK and Chair of Muslim Doctors Association
• Dr Nadya Rahman, GP, London, UK
• Dr Perviz Asaria, Cardiologist, London, UK
• Dr Jamila Sherif, GP, London, UK
• Dr Shameq Sayeed, GP, Oxford, UK GP, Norwich
• Dr Sharif Kaf Al Ghazal, Consultant Plastic Surgeon, Bradford, UK and President of British Islamic Medical Association
• Mr Tony Laurance, Ex CEO of Medical Aid for Palestinians and ex Head of WHO for oPt
• Dr Ann Louise Kinmonth, Emeritus Professor of General Practice, University of Cambridge, Fellow, St Johns College Cambridge, UK
• Dr Gene Feder, Professor of primary care, Bristol
• Dr Amanda Howe, GP, Norwich, UK
• Dr Anita Berlin, GP, London, UK
• Dr David Jewell, Retired GP, Bristol, UK
• Prof. em. Jan De Maeseneer, GP, Department of Public Health and Primary Care, Ghent University, Belgium
• Dr Marlene Laeubli Loud, Public Health Evaluation Consultant, Switzerland
• Dr Enam Haque, GP, Chair of AskDoc, Manchester, UK
• Dr John Launer, GP, London, UK
• Dr Naureen Bhatti, GP, London, UK
• Dr Osman Bhatti, GP and GP VTS programme director, London, UK
• Dr Annette McCulloch, GP, Dunoon, Scotland
• Dr Gregory Tanner, GP Somerset, UK.
• Dr Sabir Zaman, GP, London, UK
• Mr Shabi Ahmad, Consultant Urologist, Birmingham and Secretary General Association of Pakistani physicians of Northern Europe (APPNE)
• Mr Ghulam Abbas, Consultant Spinal Surgeon, Bedfordshire and President of the Association of Pakistani Physicians and Surgeons of the United Kingdom (APPS UK)
• Dr Omon Imohi, GP Manchester and President of Black Women in Health
• Dr Mohammad Alhadj Ali, Chairman of Syrian Welsh Society, UK
• Dr Rafid Aziz, GP, Iraqi Medics Association of the UK & Ireland
• Sajidah Ahmad and Sabina Hafesji, co-founders of the NHS Muslim Women’s Network
• Dr Abdul Lakhdar, Consultant Endocrinologist, London, UK
• Dr Nicki Spicer, Retired GP, South Devon
• Dr Aaminah Verity GP, London, UK
• Dr Anwar Ali Khan, GP, London, UK
• Dr Saania Baig, GP, London, UK
• Dr Rajesh Chadda, GP, UK
• Dr Anthony Collins, GP, Reading, UK
• Professor Riyaz Patel, Consultant Cardiologist, London, UK
• Dr Kula Ranjadayalan, Consultant Cardiologist, London, UK
• Dr Fabrizio Ricci, Assistant Professor of Cardiology, Chieti, Italy
• Dr Anwar Chahal, Consultant Cardiologist and Assistant Professor, Pennsylvania, USA
• Dr Mohammed Yousuf Karim, Immunologist and Allergist, Doha
• Dr Geeta Das, Retired Associate Specialist in Paediatrics, Manchester, UK
• Mr Wael Awad, Consultant Cardiothoracic Surgeon, London, UK
• Mr Sher Aslam, Consultant Ophthalmologist, Oxford, UK
• Dr Emma Wiley, Microbiology Consultant, London, UK
• Dr Hosnieh Djafari-Marbini, Consultant Anaesthetist, Oxford UK
• Professor Ross Hunter, Consultant Cardiologist, London, UK
• Dr Charlotte Manisty, Associate Professor, Consultant Cardiologist, London, UK
• Dr Jacob Grinfeld, Consultant Haematologist, Leeds, UK
• Dr Mohammed Khanji, Consultant Cardiologist, London, UK
• Dr Andy Walker, Clinical Lecturer in Cardiology, Leeds, UK
• Mr Jonathan Bird Consultant Orthopaedic Surgeon, London, UK
• Dr Waqas Ullah, Consultant Cardiologist, Southampton, UK
• Dr Samia Latif, Consultant in Communicable Disease Control, UK
• Dr Ahmed Sabra, Cardiology, Cardiff, UK
• Dr Massimiliano Lorenzini, Consultant Cardiologist, London, UK
• Dr Peter Said, Anaesthetist, Swansea, UK
• Mr Gurjeet Jutley, Consultant Ophthalmologist, Oxford, UK
• Dr Assad Shamallakh, Anaesthetist, Swansea, UK
• Dr Yousef Alkhatib, Radiologist, Liverpool, UK
• Dr Yasmine Kamhieh, ENT, Cardiff, UK
• Dr Ausama Atwan, Dermatologist, Newport, UK
• Dr Mona AlTalatini, Obstetrics, Swansea, UK
• Dr Bilal Al-Sarireh, Surgeon, Swansea, UK
• Dr Adel Saboba, Orthopaedic, Swansea, UK
• Dr Hazem Al Aaraj, Radiology, Swansea, UK
• Dr Mohamed Hashem, Anaesthetist, Swansea, UK
• Dr Ezzidin Gouta, Paediatrics, Barnsley, UK
• Dr Sajid Aslam, Consultant Cardiologist, Blackburn, UK
• Dr Amer Hamed, Cardiology Consultant, Manchester, UK
• Dr Naziha Khawaja, GP, London, UK
• Dr Subohi Alam, GP, London, UK
• Dr Shahrukh Islam, GP, London, UK
• Dr Naila Khan, GP, London, UK
• Dr Omar Hussain, Consultant Anaesthetist, London, UK
• Dr Imrana Siddiui, GP, London, UK
• Dr Umbreen Hussain, GP, London, UK
• Dr Salma Suri, Consultant Child and Adolescent Psychiatrist, UK
• Dr Saima Ahsan, Consultant Paediatrician, London, UK
• Dr Souhad Yousef, Cardiology fellow, London, UK
• Dr Shiraz Makda, GP partner, UK
• Dr Zein Toukan, GP, MDA Health Promotion Lead, UK
• Dr Fawziya Huq, Psychiatry and Mental Health Lead for MDA, St Helens
• Dr Amir Shahzad, GP, UK
• Dr Montathar Msayib, GP, UK
• Dr Shehla Imtiaz-Umer, GP, Derby, UK
• Madeeha Rahim-Rasool, Clinical Effectiveness Manager, UK
• Marylin Frost, Nurse, Leicester, UK
• Dr Hisham HAQ GP Partner Leicester, UK
• Miss Zahra Ameen, Consultant Obstetrician and Gynaecologist, UK
• Dr Irfan Ahmed, Consultant Interventional Radiologist, London, UK
• Dr Faisal Sattar, GP Partner, West Essex, UK
• Dr Sophia Khan, GP, London, UK
• Dr Ferhat Uddin, GP, Surrey, UK
• Dr Bushra Yousuf, GP, Bromley, UK
• Dr Nadia Rahman, GP, London, UK
• Dr Faisal Bin-Reza, Consultant Microbiologist, Essex, UK
• Dr Sabina Hashmy, GP London, UK
• Dr Ranna El Khairi, Consultant Paediatric Endocrinologist, UK
• Dr Shafaq Hussain, Dentist, UK
• Mr Ased Ali, Consultant Urologist, UK
• Dr Uzair Khan, Cardiologist, London, UK
• Dr Shabaz Ahmed, GP, UK
• Dr Abbas Zaidi, Consultant Cardiologist, Cardiff, UK
• Miss Hamira Ghafoor, NHS Nurse, UK
• Dr Sofia Ahmad, GP, UK
• Dr Shahid Latif, Consultant Psychiatrist, UK
• Dr Sofia Ahmed, GP Registrar, UK
• Dr Jamila Begum, GP, London, UK
• Mr Badrul Hussain, Ophthalmologist, London, UK
• Dr Iram Ali, GP Newham, London, UK
• Dr Aliki Tsagkridi, Cardiology fellow, London, UK
• Dr Aaliya Goyal, GP, Birmingham, UK
• Dr Kawther Al-Shahib, GP Partner, Buckinghamshire, UK
• Mr Amir Qureshi. Consultant Trauma and Orthopaedic Surgeon, Southampton, UK
• Dr Farogh Mahmood, GP, Walsall, UK
• Dr Zeeshan Arfeen, Consultant Geriatrician and Stroke, Hampshire, UK
• Dr Nick Child, Consultant Cardiologist, Chichester, UK
• Mr Syed Neshat Anjum, Consultant Orthopaedic Surgeon, Southampton
• Dr Deen Mirza, GP Extensivist, London, UK
• Dr Ayesha Siddiqi, GP, London, UK
• Dr Afrosa Ahmed, GP, Author & Mindfulness Coach, London, UK
• Dr Imran Malik, Consultant Psychiatrist, UK
• Dr Siema Iqbal, GP, Manchester, UK
• Dr Akmal Shakoor, NHS Medical SHO, UK
• Dr Maisun Elftise, GP, Coventry, UK
• Dr Amir Hannan, GP, Hyde, UK
• Dr Aaminah Verity GP, London, UK
• Dr Hafiz Syed, Consultant Physician, London, UK
• Dr Ruzi Syed, GP Partner, Tower Hamlets, London, UK
• Dr Waleed Muhammad, Consultant Physician, London UK
• Dr Abdul Ismail, GP, Leicester, UK
• Dr Ilona Zakare, GP, Leicester, UK
• Dr Sophina Hissaund, GP, Leicester, UK
• Dr Mohammed Abugazala, GP, Leicester, UK
• Dr Asma Bokhari, GP, UK
• Dr Irfan Malik, Consultant Neurosurgeon, UK
• Dr Asra Siddiqui, Consultant Neurologist, London UK
• Dr Husain Shabeeh, Consultant Cardiologist, London UK
• Dr Sohail Ahmed, GP, Reading, UK
• Mr Mohammed Abdus-Samee, Consultant Trauma & Orthopaedic Surgeon London UK
• Dr Tariq Haque GP, Manchester, UK
• Dr Ali Majid, GP, Lancashire, UK
• Dr Irfan Bhatti, GP, Lancashire, UK
• Dr Maqsood Motala, GP, Nuneaton, UK
• Dr Shohreh Honarbakhsh, Cardiology and Electrophysiology Specialist Registrar, London, UK
• Dr Misbah Ali, GP, Buckinghamshire, UK
• Dr Mohammed Sohail Ahmed, GP Partner, Aylesbury, UK
• Dr Nasreen Imrit, GP, Buckinghamshire, UK
• Dr Nusrat Ahmed, GP, Slough
• Dr Maha Ahmad, GP, Southampton, UK
• Dr Wania Qureshi, GP, Oxford, UK
• Dr Khalika Hasrat, GP, Oxford, UK
• Dr Almas Rehman, GP, London, UK
• Dr Imran Zaman GP, Birmingham, UK
• Dr Robina Mohammad, GP, Kent, UK
• Dr Nabeela Karim, Cardiology Registrar, London, UK
• Dr Sophia Fatima Khawaja, GP, UK
• Mr Faisal Jawad, Cardiothoracic Registrar, West Midlands, UK
• Dr Bilquis Shafi, GP, Reading, UK
• Dr Farooq Siddiqui, GP, Manchester, UK
• Dr Anshu Sengupta, Consultant Cardiologist, Leeds, UK
• Dr Afrah Al-Maliki, GP, Sutton, UK
• Dr Mehreen Adeel, GP, UK
• Dr Sajida Masood, GP, UK
• Dr Tania Whala, GP, UK
• Dr Lubna Nishath, GP, UK
• Dr Anila Malik, GP, UK
• Dr Ayesha Fatima, GP, UK
• Dr Humera Hussain GP, UK
• Dr Aruna Junaid, GP, UK
• Dr Hosnieh Djafari-Marbini, Consultant Anaesthetist, Oxford, UK
• Dr R Karim, GP, St Albans, UK
• Mr Arfan M Malhi Consultant Trauma & Orthopaedic Surgeon, London, UK
• Dr Waqas Khaliq, Consultant Intensivist, London, UK
• Dr Muniba Khan, GP, London, UK
• Dr Farhan Sardar GP Lancashire, UK
• Dr Sami Khan, GP, Lancashire, UK
• Dr Ismat L, GP, Lancashire, UK
• Dr Hina Siddiqi, GP and AskDoc Trustee, Manchester, UK
• Dr Farah Farzana, Academic Foundation Doctor, Manchester, UK
• Dr Athina Chasapi, Consultant Cardiologist, London, UK
• Dr Qasim Khan, Anaesthetic Trainee, UK
• Dr Rizwan Irshad, Clinical Lead GP, London, UK
• Dr Usha Sengupta, Retired Paediatrician, Kilmarnock, UK
• Dr Priyadarshi Sengupta, Retired Elderly Physician, Paisley, UK
• Mr Mohammed Patel, Specialist Pain Pharmacist, Preston, UK
• Dr Kashif Ali, GP, Glasgow, UK
• Mr Usman N Bhatty, Specialist Trainee, Trauma & Orthopaedic Surgery, Manchester UK
• Dr Abdullah Albeyatti, GP, Yorkshire, UK
• Dr Mohammad Mahmud, Neurology Registrar, London, UK
• Dr James Foley, Consultant Interventional Cardiologist, Wakefield, UK
• Dr Aref-Ali Gharooni, Core Allergist Trainee, UK
• Dr Amina Masood, GP, Farnborough, UK
• Dr Sunna Aslam, GP, Manchester, UK
• Dr Usman Mohammed, GP, Manchester, UK
• Dr Sarah Jawad, Infectious Diseases Registrar, London, UK
• Dr Awais Alvi, GP, UK
• Dr Ahsan Mirza, Dentist, UK
• Dr Kashif Ali, GP, Glasgow, UK
• Dr Farah Hussain, GP, Hertfordshire, UK
• Dr Sahira Dar, GP, UK
• Dr Shahed Islam, Consultant Cardiologist, Berkshire, UK
• Dr Kahidur Rahman, GP, Pendle, UK
• Dr Jabran Ali GP, Pendle, UK
• Dr Ahsan Mirza, Dentist, UK
• Dr Kashif Ali. GP, Glasgow, UK
• Dr Farooq Ahmad, GP, London, UK
• Dr Azhar Ala, GP, London, UK
• Dr Nazir Hussein, GP, UK
• Dr Laila Caunhye, GP, UK
• Dr Ismat Latif, GP, Lancashire, UK
• Dr Nadeem Faruq, GP, London, UK

Competing interests: Dr Ann Louise Kinmonth, Emeritus Professor of General Practice, University of Cambridge, Fellow, St Johns College Cambridge, UK declares: I am a trustee of Foundation for International Development of Family Medicine in Palestine (FIDFMP). FIDFMP is supported by Medical Aid to Palestinians and the British Council. All other authors declare no competing interests.

24 May 2021
Jamila Sherif
GP
Dr Nadya Rahman, GP, London, UK; Dr Perviz Asaria, Cardiologist London, UK and 210 signatories
London, UK