W.H.O. Chief: Doctors and Patients Face Impossible Choices in Gaza

Today, Al Shifa Hospital, the largest health care facility in the Gaza Strip, is emblematic of an unfolding humanitarian catastrophe in Gaza. Already underresourced and overcrowded, it is now home to thousands of people who have sought refuge from Israeli airstrikes that rained down on their neighborhoods after the horrific and unjustified attacks by Hamas on Israeli civilians on Oct. 7.

Al Shifa Hospital has always been under tremendous strain. When I visited in 2018, I met with patients and health workers and toured a dialysis unit and a neonatal intensive care ward, full of newborns in incubators. Their tentative grasp on life was sustained by diesel generators that powered the hospital when the electricity went off, as it did for several hours every day. Staff members, patients and their families faced difficult choices to make daily.

These choices are now seemingly impossible in the fallout from Oct. 7 — not just at Al Shifa Hospital but at northern Gaza’s other hospitals and clinics as well.

With no electricity and fuel running out in Gaza, within days hospital generators will fall silent, and the incubators, dialysis machines and other lifesaving medical equipment will shut down. Many of the most critically ill patients, including babies, whose lives have only just begun, will probably die. Attempting to move them is equally hazardous. Water scarcity is a grave concern for struggling patients, especially newborns.

Israel’s order to empty 23 hospitals treating over 2,000 patients in Gaza presents health workers with a horrifying choice: Force those in their care to make a journey that for many will be their last or stay and treat their patients under the impending threat of bombardment.

Health workers should never have to make choices like that, nor should they ever be targeted. Under international humanitarian law, all armed actors are obliged to proactively protect health facilities from intentional or collateral attack. But in this conflict, health facilities and health care have been struck repeatedly.

I deplore the attacks on health facilities in both Gaza and Israel, which have led to the deaths and injuries of health workers on both sides. The deaths of colleagues from the United Nations Relief and Works Agency in Gaza brought even closer to home the dangers faced by humanitarian workers, including those providing health relief.

There’s still time and opportunity to prevent the worst-case scenario. The World Health Organization calls for the immediate and safe release of hostages seized from Israel and taken into Gaza by Hamas. According to the Israeli military, some 199 hostages seized from Israel that day — children, adults and older people — remain hostage in Gaza, many in need of medical treatment. And we hope for attacks on Israeli hospitals to cease as well; Barzilai Medical Center in Ashkelon, which has treated both Israelis and Palestinians for years, has been hit by Hamas rocket attacks, damaging one of the few medical reference centers available to the people of Gaza.

We continue to appeal to all parties to abide by their obligations under international law to protect civilians and health facilities. We appeal to Israel to restore supplies of electricity and water and to support the establishment of a humanitarian corridor into Gaza.

In Cairo last week, I met with President Abdel Fattah el-Sisi of Egypt, who generously agreed to facilitate the delivery of medical supplies to Gaza through the Rafah border crossing with the help of the Palestinian Red Crescent Society.

On Saturday, the W.H.O. delivered a planeload of supplies to Egypt from our logistics hub in Dubai, and we are working to move these supplies into Gaza as rapidly as possible.

We appeal for sustained, unhindered and protected humanitarian access. This will help civilians to move to safety in Gaza, health facilities to be restocked with medicines and other supplies, fuel to reach hospitals to keep generators and the lifesaving equipment they support running, and clean water and food to arrive to sustain the weak and weary.

To be clear, as a United Nations agency, the W.H.O. is politically impartial and is committed to supporting the health and well-being of all Israelis and Palestinians. To that end, the agency established an official presence in Israel in 2019, adding to our existing office in the occupied territory. On my visits in 2018 and last year, I met with the ministers of health of both Israel and the occupied territory to discuss how the W.H.O. can better support both governments to promote, provide and protect the health care of their people. This included a visit to the Sheba Medical Center near Tel Aviv, where I was encouraged by Israeli health specialists developing digital health initiatives in partnership with Palestinian communities.

Since Oct. 7, however, so many horrifying choices have been made — abhorrent attacks on civilians in Israel by Hamas and other armed groups, the seizing of hostages, the attacks on populated areas of Gaza.

What is needed now is another kind of decision making, one that ensures hospitals are kept operational, supplies are safeguarded and health workers and civilians in Israel and Gaza are protected and sustained.

Nelson Mandela once said, “May your choices reflect your hopes, not your fears.” At this fearful time, I appeal to all who have the power to make decisions that affect the health and well-being of so many people to choose, as Mr. Mandela implored, the way of hope.

There is still time.

Tedros Adhanom Ghebreyesus (@DrTedros) has been the director general of the World Health Organization, the world’s leading public health agency, since 2017.

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