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South African Journal of Bioethics and Law

On-line version ISSN 1999-7639

SAJBL vol.16 n.3 Cape Town  2023 



Israel desecrates the sanctity of healthcare with its attacks



On 16 January 2009, Muhammad Shurrab (aged 68) and his two sons, Ibrahim (aged 18) and Kassab (aged 28), were injured when Israeli soldiers shot at their vehicle as they were returning from the family farm to their home in Gaza. The car was fired upon during the daily three-hour ceasefire (known as the 'humanitarian corridor') as the war 'Operation Cast Lead' was ongoing. Repeated calls for help by Muhammad to the soldiers in the nearby building remained unanswered. Muhammad contacted the emergency ambulance services, but none were allowed to come to their rescue. Israeli NGO Physicians for Human Rights contacted the Israeli army but was told that the rescue could not go ahead. Having been forced to watch his two sons bleed to death and himself injured, Muhammad had to spend the rest of the night and the following morning in his car. An ambulance was eventually allowed to rescue Muhammad and collect the bodies of his two sons, 22 hours after they had been shot.[1]

The following is a direct excerpt (among many) from a 120-page research paper published by human rights organisation Amnesty International in 2009, titled 'Israel/Gaza: Operation Cast Lead: 22 Days of Death and Destruction'.[1] The team collected evidence of the destruction meted out against the civilian population of Gaza at the time, collating first-hand accounts, hospital statistics and documented events, as part of a larger fact-finding mission on the attack by Israel. Various aspects were investigated, but under the heading "Attacking and Obstructing Medical Workers'; Amnesty International concluded the following: 'The Fourth Geneva Convention relative to the Protection of Civilian Persons in Time of War of 12 August 1949 (Fourth Geneva Convention) obliges to respect and protect the wounded, to allow the removal from besieged areas of the wounded or sick, and the passage of medical personnel to such areas.[2] The deliberate obstruction of medical personnel to prevent the wounded from receiving medical attention constitutes "wilfully causing great suffering or serious injury to body or health", a grave breach of the Fourth Geneva Convention, and a war crime.'

This was not the first, nor last, human rights report that has found Israel guilty of overstepping the boundary regarding medical workers and the healthcare system, falling under the category of war crimes as per international law. These human rights violations have been systematically and independently documented against Israel over the past 75 years.

In May this year, the WHO launched two reports, 'Right to Health 2019 - 2021'[3] and 'Palestinian Voices 2022 - 2023.[4] The reports outline how fragmentation of the Palestinian people, implementation of a permit regime, physical obstacles to movement, and protection gaps have resulted in health inequities and created substantial barriers to healthcare provision and health access in the occupied West Bank, including east Jerusalem and the Gaza Strip. 'Enjoyment of the highest attainable standard of health is a fundamental right of every human being,' said Dr Richard Peeperkorn, WHO Representative for the occupied Palestinian territory. 'The Palestinian health system suffers the consequences of longstanding displacement, refugeehood and occupation.[3]

In 2023, WHO's reports' show longer-term trends, with 750 health attacks documented in the occupied Palestinian territory between 2019 and 2022.[3] These attacks resulted in the fatality of a healthcare worker and 568 health worker injuries, with 315 ambulances and 160 health facilities affected. Ajith Sunghay, Head of the Office of the United Nations High Commissioner for Human Rights (OHCHR) in the occupied Palestinian territory, expressed deep concern at this: 'This trend has only accelerated in 2023. OHCHR and WHO documented that Israeli forces have frequently prevented access to medical care, including for first response teams to reach persons with life-threatening injuries. We are deeply concerned about failures to ensure protection against health attacks and the impact that this has on the rights of Palestinians.[5]

Bar the politics that govern the Israeli-Palestinian conflict, we cannot ignore the human rights impact that the Israeli military force has had on the largely civilian Palestinian population. Human Rights Watch published a 220-page fact finding report on the human rights violated by Israel in 2021, titled 'A Threshold Crossed'.[6] They concluded that Israeli authorities are committing the crimes against humanity of apartheid and persecution, and that they have deprived millions of people of their basic rights by virtue of their identity as Palestinians.

While these may simply read as statistics to most, I am flabbergasted, particularly by the abolishment of the sanctity that traditionally accompanies being a healthcare worker and that a hospital should have. This issue has extended far beyond that of religion and politics, and the basic human rights abuses simply cannot be ignored any longer. In the week of 16 - 22 October, videos emerged of a scene of horror in Gaza: the bombing of Al-Ahli Hospital. The Palestinian Ministry of Health reports that up to 500 patients were instantly murdered. The lack of outrage at such an attack is deafening. While Israel has denied bombing the hospital (despite all evidence suggesting otherwise), a quick look at their history of documented attacks on places of healthcare and patients would support no impunity on their part in having done so again. Professor Ilan Pappe, an Israeli professor, said last week that we are on the brink of a genocide in Gaza, yet the opportunity still exists for us to stop it by speaking out against the inhumanity of Israel. As physicians and healthcare workers who have dedicated our lives to service, this duty lies even heavier on our shoulders, especially given the effects our fellow Palestinian healthcare workers must endure on a daily basis.

Aayesha Soni

MB BCh (Wits), DipPEC(SA), DA(SA), MMed (UCT), FC Neurol(SA) Department of Medicine, Division of Neurology, Groote Schuur Hospital Neuroscience Institute, University of Cape Town



1. Amnesty International. "Operation Cast Lead": 22 Days of Death and Destruction. United Kingdom: Amnesty International Publications, 2009 (July).

2. Geneva Convention Relative to the Protection of Civilian Persons in Time of War. 1949:6.

3. World Health Organisation. Right to Health: Barriers to Health and Attacks on Health Care in the Occupied Palestinian Territory, 2019 to 2021. Cairo: WHO Regional Office for the Eastern Mediterranean, 2022.         [ Links ]

4. World Health Organisation. Palestinian Voices, 2022-2023. Cairo: WHO Regional Office for the Eastern Mediterranean, 2023.         [ Links ]

5. World Health Organisation Press Release. WHO reports underline barriers to the Right to Health in the occupied Palestinian territory. 2023. (accessed xx)

6. Human Rights Watch. A Threshold Crossed: Israeli Authorities and the Crimes of Apartheid and Persecution. United States: Human Rights Watch Publications, 2021.         [ Links ]

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