On Monday, March 18, Israeli Occupying Forces (IOF) raided Al-Shifa Hospital in Gaza for the fourth time. The raid ended with the kidnapping of at least 80 people, including the hospital’s medical staff, and further displacement and killings among the thousands of people seeking shelter inside the complex. Reports poured in about arrests and physical attacks on journalists reporting from the hospital, in addition to the violence directed against doctors, nurses, and other health workers.
Since October 7, 2023, the world has been shocked by the brutality of Israel’s genocide against the Palestinian people. Over 31,000 Palestinians have been killed and over 72,000 injured in the nearly six months of Israel’s onslaught.
The targets chosen by the IOF reflect the deliberate cruelty of Israel’s genocidal strategy. In addition to the attacks on schools and refugee camps, Israel’s bombs and snipers have targeted health centers, hospitals, ambulances, and health workers. While Israel first denied responsibility for such attacks, the bombing, raiding, and forced evacuation of health centers in Gaza has become commonplace, impeding access to care, terrorizing health workers, killing patients and workers, and destroying the enclave’s capacity to provide healthcare to the people at a time of great need.
One of the first attacks on healthcare happened on October 17, when Israel bombed Al-Ahli Hospital, killing 500 people. A few days later, Al-Shifa, Gaza’s biggest hospital, was targeted. On November 11, Israel laid siege to Al-Shifa with 1,500 patients and workers inside and tens of thousands of displaced people taking refuge in its courtyard. On January 22, Israeli snipers shot senior physician Hossam Hamada on the street. During these attacks, the IOF also kidnapped and arrested health workers, including Ahmed Muhanna, head of Al-Awda Hospital.
What impact do these incessant attacks have on Palestinian healthcare and the health of Gazans? How have health workers responded around the globe?
Sophia Assis from the Zetkin Forum for Social Research spoke to Hanne Bosselaers, a general practitioner of Médecine Pour le People [Doctors for the People, MPLP] and a Palestine solidarity activist to address these very questions. They also spoke about the spirit of resistance still permeating health activism in Gaza.
Sophia Assis: Dr. Bosselaers, could you start by telling me about yourself and your experience as a doctor in Palestine? At what point in your training as a doctor did you realize the need for having this internationalist experience?
Hanne Bosselaers: I am a general practitioner working for Médecine Pour Le Peuple [Medicine for the People, MPLP] in Molenbeek, Brussels. Ten years ago, I went to Palestine, to Gaza, to establish a twinning project between our medical center here, and Al-Quds, a medical and cultural center in Beit Hanoun in the north of Gaza. It is one of the centers of AWDA Health & Community Association, a local Palestinian health and community organization that we have worked with in the West Bank for a long time, but we didn’t have contact with their Gaza branch at the time. I went there to work as a general practitioner. I worked in prenatal consultations in the hospital, and then in general practice, with all kinds of problems, in the medical center in Beit Hanoun.
When did I realize that international experience is important? I had a few experiences abroad during my education as a doctor, including an internship in Ecuador, where I worked in maternity and pediatrics at a public institution in Guayaquil. There I realized to what extent the difference between an unfunded public system and a private health system can go. Three blocks from me was a very bright and fancy hospital, while the public maternity ward was visited by people who had to queue to buy their medicine before coming to deliver. They were already in pain, standing at the pharmacy and waiting to buy their medicine, and only then could they receive the drugs. I understood then that it’s important to have different experiences of medical work to analyze the different health systems. At that time, I didn’t have any political experience. It was more from an interest in how care and health in other countries are organized.
After that I came to MPLP, and after I finished my studies, they proposed that I go to Gaza to establish the twinning program. I realized at that point how important it is to go for real solidarity, helping fellow doctors, but also learning from them, and coming back and advocating based on that experience. In the case of Palestine, it’s really essential to take back your experience of working under occupation, what you lived there on the ground, and bring it back to Belgium to sensibilize people through activism. That’s one of the most important things I learned from my colleagues over there.
SA: From your experience as a doctor and activist, what are the most important lessons you would single out from your experience with health professionals in Palestine?
HB: I was truly impressed by the quality of their education and care of people. They really have a good view of health. There are not many technological facilities: for example, there is only one MRI in Gaza. But while health workers in Palestine may have less technology than European countries, they are better doctors. They are really close to their people. They understand community health and the effects of the occupation and violation of basic rights on health. That is what we discussed a lot at the hospital, we talked about the violations of such rights and the implications for the population’s health. This is something they have really integrated in their work, they are very highly skilled and quality professionals. They also have this real dedication to their people, which is also a form of resistance: staying close to people, protecting their health, making life easier and healthier. It is a real mission for them and they don’t let go of it.
75 years of occupation have instilled a strong sense of resistance and resilience among health workers in Palestine. They have a strong collective organization and vision, they always find new ways to be together, to care for each other and to preserve health. Imagine Al-Awda hospital: after two weeks of siege, the health personnel were locked with patients, without electricity, without medicine, without enough water and food. Then they [the IOF] raided the hospital and captured a few of their colleagues. And on the next day they still go on to provide health services to the patients? They are still standing and receiving patients? I can’t imagine myself being put in Al-Shifa or any other hospital which has been besieged, bombarded, raided by Israeli soldiers, and then continue working like that.
When I was there, you had huge organizations that organized cultural activities that went into the neighborhoods to see what could be improved. Can we make a little green space? Could we build a sports field? They take a lot of actions that are not directly linked to health, but are aimed at making living easier and, in this sense, healthier. Everybody is in an organization, either a youth, cultural, or health organization; a lot of people have notions of Basic Life Support (BLS) and can give first aid, needed in bombardments. When a catastrophic event happens, so many people are skilled and know what to do. This level of organization and collective thinking I never saw anywhere else in the world. It is one of the most inspiring things about Palestine.
SA: Could you explain how the healthcare system is organized in Palestine?
HB: Well, of course it is underfunded because the Palestinian Authority doesn’t have a lot of funds to offer quality healthcare services. There are different systems: a public healthcare system, financed by the Ministry of Health of Palestine; a system of public insurance to which not all Palestinians have access to; and another from the United Nations Refugee Agency for Palestine (UNRWA), which takes care of the refugees in Gaza (70% of the population)… They have a lot of primary health care clinics all over Palestine. You have basic pharmacies, first-line care, dentists which are available for the refugees under UNRWA… And then you have international NGOs that provide healthcare services, as well as Palestinian NGOs, like AWDA, which we support. Awda is a Palestinian NGO funded by international partners and offers some services with the Ministry of Health. Overall, it’s a system that is quite fragmented, underfunded in general, and depends a lot on NGOs and on money coming from external partners.
SA: What is the relationship between the health workers and their people? In this sense, what is the concept of health put into practice in Palestine?
HB: The concept of health in Palestine is that health doesn’t only depend on having a disease and being able to access healthcare but has a global dimension, through its social determinants. I had already learned about the social determinants of health with MPLP, but it became a lot more concrete in Palestine, where you see how people suffer from an economic system that is completely destroyed by occupation. There is no freedom, people don’t have work, they don’t even have clean water…Their social determinants are catastrophic and have a lot of effects on health, and these doctors are really conscious of it. They try not only to cure, but also to prevent and do community actions.
They have a really holistic view of health. They also care a lot about mental health, which is very difficult to put into practice because there is a lack of availability of psychiatrists and psychologists. There is a very high level of collective trauma because of the bombardments, occupation, and constant fear. A big part of the population is suffering from mental health issues, and they are well-documented. They do their best to treat them and also to find a collective way to deal with the situation.
For example, they do a lot of activities with children. I feel so proud when I see these Palestinians even now, in Rafah, in the camps, organizing activities for the children. They manage to find circus materials. They manage to find books. And they put tens of children together to make them think of other things and give them the right to be free, to play and be children, which is essential. I don’t know if, in Western societies, which are highly individualistic, we would manage to organize this if we were put in this sort of situation now. I really don’t think so. I think we would hardly survive.
SA: It is when health, solidarity, and resistance all meet…
HB: Yes, healthcare workers are a very important part of [resisting occupation]. They go, they push their limits further. I don’t know if you saw the video of this female gynecologist in the courtyard of Nasser Hospital. Some snipers shot a man at the other side of the courtyard, he was bleeding on the ground. The snipers were still there, and she took off her coat and ran to the patient to protect him. This is their real spirit; health workers don’t fear for their own lives. They are focused on helping as many people as possible to survive, in a real collective way.
At this point in Gaza, under genocide, just surviving is an act of resistance. The mission is to save as many people as possible. And health workers do it in a very brave and dedicated way. That’s truly inspiring. The concept of health that is practiced is the right to health, the right to live free from occupation, rights that should be universal. This vision is present in all of the health work and that’s how the workers organize themselves, even if there are different political currents. Being Palestinian and defending health for all is something that is really spread among the whole Palestinian society.
People’s Health Dispatch is a fortnightly bulletin published by the People’s Health Movement and Peoples Dispatch. For more articles and to subscribe to People’s Health Dispatch, click here.
