Vol IX, Issue 2 Date of Publication: April 21, 2024
DOI: https://doi.org/10.20529/IJME.2024.004

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War on healthcare services in Gaza

Thalia Arawi
This article looks at the October 2023 war on Gaza in the context of the effects of wars on healthcare systems. I will begin with a brief historical overview of the so-called Israeli-Palestinian conflict to clarify the special status of the Gaza Strip and the hostilities since October 7, 2023. This will be followed by a description of the major distinguishing characteristic of this war, namely, the systematic assault on the healthcare system. Finally, I will attempt to explain the conduct of this war using a necropolitical lens.

Copyright and license
©Indian Journal of Medical Ethics 2024: Open Access and Distributed under the Creative Commons license ( CC BY-NC-ND 4.0),
which permits only non-commercial and non-modified sharing in any medium, provided the original author(s) and source are credited.

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  1. Michael Galvin
    MEDACT, Doctors for the NHS, Keep Our NHS Public , UK
    23 January 2024

    Frames the issues in terms that question how we regard our own humanity

    • Affiliation: MEDACT, Doctors for the NHS, Keep Our NHS Public
    • Country: UK
  2. David R Curry
    GE2P2 Global Foundation , USA
    23 January 2024

    We express concern that while commentaries published by this journal are subject to external peer-review [Review Process – https://ijme.in/submission-guidelines/%5D, we find a number of troubling representations in the text that presumably should have been challenged (and potentially revised/excluded) by this process. We acknowledge a continuing collaborative relationship with the author.

    • Affiliation: GE2P2 Global Foundation
    • Country: USA
  3. Ghaiath Hussein
    University of Dublin , Ireland
    24 January 2024

    I salute Dr Arawi’s courage and well-cited and well-written piece and to the Journal for their courage in publishing it amid all the fearmongering taking place against any portal that dares to challenge the genocide taking place under the plain sight of the whole world.

    • Affiliation: University of Dublin
    • Country: Ireland
  4. Aya Hajj
    None , Lebanon
    25 January 2024

    And still the whole world watches and brags about Human Rights and SDGs, while humanity is being shattered in Gaza…It’s a twisted ruthless world we live in where humanity is double faced… Gaza will haunt them.

    • Affiliation: None
    • Country: Lebanon
  5. Thomas Pogge
    Yale University , United States
    26 January 2024

    This essay raises a highly significant question: is it morally and legally (under international law) permissible to bomb hospitals and ambulance vehicles when one has reason to believe that enemy combatants may be in or underneath them (e.g., in tunnels)?
    Do we judge that belligerents should have such discretion?
    Or do we judge that they must pursue their war aims differently, i.e. while respecting the sanctity of designated health care facilities?

    • Affiliation: Yale University
    • Country: United States
  6. Layth Mula-Hussain
    Ninevah University , Iraq
    04 February 2024

    This is an excellent commentary by an experienced neutral bioethicist. It is very well written and describes the historical background of the conflict and the reality of the civilians and healthcare personnel in Gaza. The imagination of what is going on there is unbelievable.

    • Affiliation: Ninevah University
    • Country: Iraq
  7. Stanislav Birko
    Universite de Montreal , Haudenosaunee Confederacy (temporarily occupied by Europeans)
    06 February 2024

    Professor Arawi correctly points out that Israel’s current intentional targeting of Gaza’s healthcare system is an escalation when measured even by the yardstick of brutality we have come to expect from Israel towards the Palestinians living under colonial occupation for over half a century now. It is this escalation among others that has also resulted in a different response from the world’s population, a population that as a whole has not been historically supportive of the cause of Palestinian liberation. We have even seen some governments and their officials come out in defense of Palestinians facing the current onslaught, even a few European government officials. Arawi identifies the current moment as “a Nietzschean moment in history”, when the mask of the so-called democratic regimes has come off all the way, “unreservedly reject[ing]” human rights as “slave moralities hostile to life, espoused by the ‘weak’ and thus need[ing] to be replaced by those that are based on the will to power” (Arawi, 2024). Indeed, it is at this moment that the ruling classes of those countries who still dominate the world economy (or at least still believe to be dominating it) do their utmost to show that it is Netanyahu who best embodies the values of the West when he says “The weak crumble, are slaughtered and are erased from history while the strong, for good or for ill, survive.” (Netanyahu, 2018). Of course, to anybody paying attention to the history of colonial conquest and genocide over the past half a millennium, it is no surprise that these are the underlying values.

    I want to bring attention to a different kind of replacement of values, not the colonizers’ rejection of the façade of human values by an openly Nietzschean will to power (a will that has always been behind the façade), but rather to the decolonizing replacement: “la décolonisation est très simplement le remplacement d’une « espèce » d’hommes par une autre « espèce » d’hommes. Sans transition, il y a substitution totale, complète, absolue.” (Fanon, 2002, 39) However, this replacement is of a different register altogether. The colonized dreams “non pas de devenir un colon, mais de se substituer au colon”. (idem. 54) This absolute replacement, of not replacing, but going beyond, is well exemplified in the discourse surrounding the interpretation of the call to free Palestine “from the river to the sea”. Is this a simple substitution of Israel’s genocidal “there will only be Israeli sovereignty from the river to the sea” or is it a Fanonian refusal of colonial mastery? Of course, for the racist colonizers, “from the river to the sea” is nothing but a rebranding (to the local geography) of Anglo-American violent colonial dispossession slogan “From sea to shining sea”. It calls for an eradication of “the Palestinian” from the entirety of the territory. Therefore, it is unsurprising that the colonizers view the opposing call to free Palestine “from the river to the sea” as also a call for genocide. However, if understood decolonially, it is simply a call for refusing to place humans in a hierarchy – of “not need[ing] Other in order to understand Self” (Tamale, 2020, 38) – in the whole space between the river and the sea (and ideally beyond, as well). It is a call for equality for all its (human) inhabitants, which by definition excludes the possibility of calling for a genocide against any group, unless, of course, not all humans are acknowledged as worthy of the zone of (human) being.

    As An Yountae so helpfully summarizes: “Fanonian theodicy rejects the Manichaean good-and-evil paradigm, the life-and-death cycle in which the triumph of good over evil involves sacrifice and exclusion or the replacement of one world by another”. (An, 217)

    An, Y. (2021). On violence and redemption: Fanon and colonial theodicy. In An, Y., & Craig, E. (Eds.). Beyond man: race, coloniality, and philosophy of religion. Duke University Press. (204-225)
    Arawi, T. (2024) War on healthcare services in Gaza. Indian Journal of Medical Ethics, [S.l.], v. 0, n. 0, p. , jan. 2024. ISSN 0975-5691. Avaialble at: . Date accessed: 06 Feb. 2024.
    Fanon, F. (2002). Les Damnés de la terre. Paris: La Découverte.
    Netanyahu, B. [@IsraeliPM] (2018) Twitter, 29 Aug. 2018, https://twitter.com/IsraeliPM/status/1034849460344573952
    Tamale, S. (2020). Decolonization and Afro-feminism. Daraja Press.

    And JFC at the pro-genocide comments. If you come here to say that “a number of troubling representations in the text should have been challenged” [I could just hear your pedantic annoying male voice], then challenge them or shut up.

    • Affiliation: Universite de Montreal
    • Country: Haudenosaunee Confederacy (temporarily occupied by Europeans)
  8. Abdul Rahman Fares
    non , Germany
    21 March 2024

    The article succeeded in highlighting the suffering of health personnel in Gaza during the war and the incorrectness and unfairness of the logic of the end justifying the means. Moreover, the article leads us to the importance of international medical and legal solidarity to stop attacks on health facilities in Gaza.

    • Affiliation: non
    • Country: Germany
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