With the partial reopening of the Rafah crossing between Gaza and Egypt this week, the world’s attention turned to the permitting process. small number Wounded and sick Palestinians from the besieged territory.
But while this medical evacuation is necessary, advocates say the top priority should be rebuilding the health system in Gaza, which has been devastated by Israel’s genocidal war against Palestinians in the Strip.
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“The Israeli occupation has deliberately and systematically destroyed the health system,” Gaza Health Ministry spokesman Zaher al-Wahidi told Al Jazeera in a phone interview.
He outlined five major challenges facing the health system after 28 months of blockades, bombings and mass killings. did not stop After the United States-brokered “ceasefire” took effect in October: the near absence of evacuation of patients, lack of medical equipment, shortage of medicine, destruction of facilities and need for medical workers.
He called on “the people of the free world and anyone who can lend a helping hand” to pressure Israel to fully open the Rafah crossing and allow special teams to bring medicine and medical equipment into Gaza, as well as aid health care workers.
Yara Asi, a Palestinian-American public health expert at the University of Central Florida, said the needs of the devastated health system in Gaza have not changed since the “ceasefire” took effect.
Describing how Gaza’s health and humanitarian sector is a “victim” of “little attention” from donors and international actors, she told Al Jazeera, “the issue is not much discussed anymore.”
“The ceasefire took off the throttle,” Asi said.
“A lot of the same needs and conditions still exist. All those ten thousand people are still hurting.”
Lack of medicine
Demolition and lack of medical care have killed thousands of Palestinians, experts say.
For example, before the war started in October 2023, there were 1,244 kidney patients in Gaza. Now the number is 622, Al-Wahidi said.
While 30 were documented to have been killed in the actual Israeli attack, al-Wahidi estimated that hundreds of others died due to lack of access. Dialysis services.
And the crisis continues.
Despite the “ceasefire,” Al-Wahidi said, thousands of people in Gaza are still at risk of dying from lack of medicine.
“With medicine, the deficit has increased since the ‘ceasefire’. Although the number of injuries has decreased relatively, the lack of medicine has increased, reaching 52 percent. This is a rate that we have not been able to reach throughout the war,” al-Wahidi told Al Jazeera.
He also said that the shortage of drugs for chronic diseases is 62 percent.
“That means 62 percent of people with chronic conditions cannot take their medications regularly, which leads to health deterioration, which leads to death,” Al-Wahidi said.
According to the Ministry of Health, there are 350,000 patients with chronic diseases in Gaza.
Al-Wahidi said people with chronic illnesses need regular medical attention, tests and doctor visits — services that have been inaccessible throughout the war due to frequent displacement and Israeli attacks on medical centers.
“I don’t think any hypertensive patient has been able to see a doctor regularly since the war started. And if they can get medical help, we don’t have enough drugs for everyone,” he said.
According to the Gaza government media office, the Israeli attack killed 22 people Hospitals in Gaza Service stopped and 211 ambulance damaged.
So, beyond the equipment and doctors, the physical medical buildings in Gaza have also been severely damaged.
Al-Wahidi said there are no functioning hospitals left in northern Gaza. “People have to come to Gaza City, often on foot, walking many kilometers to reach Al-Shifa Hospital Or Al-Ahli Hospital,” he said.
Medical evacuation important
Amid this widespread devastation, health advocates say rebuilding Gaza’s health system must go hand in hand with evacuating patients who need urgent care.
Mohammad Tahir, a trauma surgeon who Volunteered in Gaza during the wardescribed the health sector situation in the region as “horrendous”.
“Hospitals in Gaza have been destroyed. Doctors, nurses there have been killed, imprisoned, forced to flee,” he told Al Jazeera.
“The facilities are poor, really. There is a huge gap in the equipment needed for surgery – the ICU facilities, the dialysis machines, the diagnostic equipment there, the provision of drugs from antibiotics to painkillers needed to treat chronic conditions.”
Israeli officials and US President Donald Trump have repeatedly expressed plans Displacing all Palestinians From Gaza.
Tahir said that while concerns about ethnic cleansing in Gaza are valid, medical evacuation is necessary to treat people who need special care and reduce the burden on the medical system.
“What we want to do is take these patients to other health care systems that need to be evacuated from Gaza and create a system to bring them back to Gaza,” he said.
Tahir emphasized that transferring people with complex injuries and conditions would free up medical resources for regular health services in the region.
“It allows the people of Gaza to treat normal, routine conditions,” he said. “People still walk the streets. They fall; they break their hips; they break their ankles; they need treatment, and we need to empower them to manage these everyday situations.”
Tarik Jasrevic, spokesperson for World Health Organization (WHO), beyond Rafah, said referral routes must be opened from Gaza to Jerusalem, the occupied West Bank and around the world.
“The focus now should be on rebuilding the health system in Gaza, so we don’t rely too much on refugees,” Jasrevic told Al Jazeera in a TV interview.
‘De-healthification’ of sludge
In addition to attacking hospitals in Gaza, the Israeli military regularly ordered evacuations of medical centers And the Palestinian group Hamas raided them under the baseless claim that they were being used as command centers.
Public health experts say a task medical system It is more than a place where people can seek treatment; This is the theory of a viable society – and that is what Israel sought to destroy.
One of the acts that constitutes genocide according to the 1948 United Nations Convention on the Prevention and Punishment of the Crime of Genocide is the deliberate imposition on a target group of “conditions of life calculated to bring about its physical destruction in whole or in part”.
Asi, a public health expert, pointed to footage of Israeli soldiers filming themselves Smashing Hospital equipment as evidence of systematic targeting of health sector in Gaza.
She said the Israeli campaign against the health system should be seen as part of an ongoing effort to create conditions for the extermination of the Palestinian people.
Asi added that researchers know from past conflicts that many people are forced to leave their homes and neighborhoods when the last clinic or hospital closes.
“People know they can’t live without healthcare. So it’s a tool for displacement. It’s a tool to make sure that rebuilding, rebuilding people going back to certain areas is very difficult, if not impossible,” Asi said.
The health ministry’s al-Wahidi said the region’s medical system acted as a “safety valve” for the public throughout the war.
“In any area, people were finding safety in working hospitals. Medical staff would stay in hospitals until the last moment until they were forcibly removed or detained by the Israeli army,” he told Al Jazeera.
“Thus, attacking and raiding hospitals was an act of displacing the people. The resilience of the hospitals became the resilience of the people. As long as the hospitals stood, the people remained on their land.”
Leith Malhis, a graduate student at Georgetown University, recently wrote a report Al-Shabaka A think tank on what it calls the “de-healthification” of Palestine – a long-standing Israeli policy aimed at making “Palestinian life unhealthy and perishable”.
Malhis told Al Jazeera that the Israeli attack on health care workers – a symbol of knowledge and social mobility – was aimed at psychologically and physically harming Palestinians in Gaza.
“What we saw in the genocide was that the Israelis treated doctors and nurses and their organizations as combatants — because they realized that if you really want to evict the Palestinians and remove them from their land, you have to get rid of what’s keeping them alive and resistant and resilient,” he said.
Reconstruction
Despite the enormous challenges, Al-Wahidi said, the health sector in Gaza is trying to recover.
“By current standards and data and conditions, it all looks chaotic, but we are still providing services to the best of our ability,” he said.
Al-Wahidi said the Ministry of Health is starting to restore medical buildings with local efforts and materials available in the market.
He added that authorities are starting vaccination drives and opening new clinics and expanding services in hospitals that are functioning daily.
“For the first time since the start of the war, we resumed open-heart surgeries at Al-Quds Hospital. This is an achievement in these difficult circumstances,” Al-Wahidi said.
“We also became active Childbirth services At 19 medical centers throughout the Gaza Strip. Humble efforts, but with available resources we are trying to rebuild the health care system. “
ASI said Palestinian health workers embody the best of the profession and expressed frustration that people in the global medical community have largely ignored the plight of their comrades in Gaza.
“The health sector is a microcosm of Palestinian resilience,” she said.
“It’s beyond comprehension for most of us that we could ever go through that situation and have the motivation to rebuild when so many of their comrades have been killed and the threat to them still exists. I think it’s amazing. I think it’s incredible.”