Deliberate destruction of Gaza's healthcare system must end

Irish healthcare workers want the Government, professional organisations, and educational institutions to insist that Israel halts its egregious assault on the population of Gaza

Hussam Abu Safiya, centre, supervises the treatment of a Palestinian man at Kamal Adwan Hospital in North Gaza last year. Healthcare workers are calling for the doctor’s immediate release. Picture: AFP via Getty Images

As Irish healthcare workers, we understand the fragility of a health system. We see the impact of pandemics, resource limitations, the high prevalence and toll of cancer and cardiovascular illnesses, the impact of deprivation on health, yet we are privileged to work in a health system which is not under constant threat of violence.

We have never witnessed the continuous, incessant, and deliberate destruction of an already fragile health service as we have done over the past 15 months in Gaza.

On New Year’s Eve, the United Nations Office of the High Commissioner for Human Rights (OHCHR) published a report on the “catastrophic effect on Palestinians’ access to health and medical care” from the assaults by Israel.

That report outlines the devastating effects of the decimation of the healthcare system in Gaza since October 2023.

In particular, it focuses on the attacks on hospitals, healthcare facilities, and personnel

“The repeated attacks on hospitals … operations within the vicinity of hospitals … has led to the destruction of most hospitals in Gaza, and the almost complete collapse of the health system,” the report asserts.

It has been compiled through verification of a variety of sources, and presents its conclusions based on assumption of reasonable grounds in relation to breaches of international human rights and humanitarian law.

In November 2023, the largest hospital in Gaza, Al-Shifa, was under siege — resulting in the deaths of at least 179 people. We witnessed the harrowing images of babies in incubators being swaddled together for warmth as the power supplies were cut off.

By mid-2024, 22 out of 38 hospitals across Gaza had been rendered non-functional, according to Palestine’s ministry of health.

Hussam Abu Safiya is treated by colleagues for his injuries following an Israeli strike hit the medical compound in Beit Lahia, in the northern Gaza Strip, late on November 23, 2024. Picture: AFP via Getty Images

Every hospital, every healthcare facility in Gaza, has been attacked by the Israeli military. We are relieved when we hear that a hospital has reopened, or is partly functional. But then we see photographs of broken windows, rubble in the corner of an intensive care unit, surgeons operating by the light of a mobile phone, and we realise what “partly operational” means in Gaza.

Most recently, we have witnessed the 85-day long siege of Kamal Adwan Hospital in North Gaza — which was the only facility providing any healthcare in the northern area.

Staff provided humanitarian assistance and whatever treatment they could to the population.

Extensive communication from the director, Dr Hussam Abu Safiya, showed the devastating impact of the siege, including the abduction of most of the staff, and the injury and death of several health care workers and patients.

Dr Safiya, a paediatrician who fulfilled his dream of setting up the first and only neonatal intensive care unit in North Gaza, was detained by the Israeli military along with his staff in October 2024. He was interrogated and released, but the Israeli military killed his son Ibrahim.

He himself was injured when an Israeli quadcopter exploded inside the hospital. Through all of this, he stayed with his patients. He called repeatedly for international intervention to stop the siege.

However, on December 27, the Israeli military launched a further assault — rendering the hospital nonfunctional — and Dr Safiya was taken.

Reports of his abduction reached Irish healthcare workers on December 28

While his whereabouts are not confirmed, evidence suggests he is detained in Sde Teiman.

This prison is notorious for torture and abuse of detainees. Eyewitness testimony, including that of Israeli doctors who have worked at Sde Teiman, indicate that the abuse of Palestinian detainees there — including torture, rape, and medical neglect — is routine.

The destruction of hospitals and medical facilities is not merely corrosive due to the impact on the physical infrastructure. Through these assaults, provision of healthcare for chronic illnesses — for the frequent presentations of malnutrition and injury — are impossible.

There are escalating cases of renal failure due to the lack of potable water and outbreaks of communicable diseases.

In recent days, seven babies — two as young as 20 days old — have died of hypothermia.

Israeli soldiers gather at the gate to the Sde Teiman military base, where soldiers are being questioned for detainee abuse on  Monday, July 29, 2024. Picture: Tsafrir Abayov/AP

In response to these impacts, there have been efforts to evacuate medically compromised patients and those dependent on regular medical care for survival.

However, this has been painfully slow and hindered by the restrictions on movement, the closure of borders, and the lack of safe access to patients.

Humanitarian aid — including food, water, medicine, and shelters — have also been restricted by the occupying forces, according to the report.

In addition to these assaults on hospitals by Israel, there has been evidence of arbitrary detention, enforced disappearance, and ill-treatment of medical personnel and civilians — including internally displaced persons taken into custody from inside hospitals, which has been reported in previous UN report from July 2024.

More than 500 healthcare workers have been confirmed killed, with another 500 reported detained.

The losses of qualified personnel have contributed to the collapse of the healthcare system.

The impact of the ongoing onslaught on the population of Gaza is immense, with over 45,500 people confirmed killed and over 100,000 confirmed injured.

Many believe these figures to be far below the true casualty numbers. The Lancet reported that by June 19, 2024, there were potentially 186,000 deaths in Gaza if the bodies remaining under the rubble and impossible to identify were included in the count.

Preventable deaths, the impact on pregnant women, and children of this barbaric war is incalculable. The impact is likely to last generations

This office’s paper states: “A fundamental rule of international humanitarian law (IHL) is that the wounded and sick shall be collected and cared for. All wounded and sick persons, including civilians and persons hors de combat, are afforded protection.

“Furthermore, IHL provides specific protections to medical personnel and medical units where the wounded and sick are cared for — including hospitals.”

As Irish healthcare workers, we are calling on our Government, our professional organisations, and educational institutions to insist that Israel halts this egregious assault on the population of Gaza and its healthcare system, to abide by humanitarian law, and to ensure the survival of all in Gaza.

We are calling for the release of Dr Safiya and all healthcare workers, hostages, and abducted persons.

We are calling for an immediate ceasefire and access to humanitarian aid for the people of Palestine.

We are calling for humanity to prevail for our generation but more importantly for future generations.

• Dr Aoife Twohig, Dr Angy Skuce, Maca Hourihane, and Emma Kirk are members of Irish Healthcare Workers for Palestine.