Australian Doctors Cannot Remain Silent on Gaza

What does it mean to be a doctor…?

We, a group of Australian medical professionals, have been asking ourselves this question over the last few weeks with increasing urgency. And we implore you, our colleagues, to ask yourselves this, as we watch events unfold and escalate in Gaza.

Our fellow Palestinian healthcare workers are working, living and dying in nightmarish conditions. Firsthand accounts detail doctors in Gaza pushed beyond the brink, attempting to stem the haemorrhage of critical injuries and deaths in non-functioning hospitals. Caesarean sections and amputations are being performed without anaesthetic and morgues overflow with the dead—all while a siege and Israeli military raids are imposed on Al-Shifa  and Indonesian Hospitals.

We know, better than anyone, that their efforts are near futile in a system under constant bombardment. Without electricity, fuel, clean water or telecommunications we would barely recognise our own hospitals.

As indiscriminate airstrikes by Israeli forces continue, the choices forced on our colleagues are impossible. Which premature babies, dying as the electricity powering incubators fails, can be saved? Which patient can receive treatment for severe burns, or undergo surgery for life-threatening injuries? And how do you protect yourself from the threat of injury and death whilst fighting for the inalienable right of your patients to life? It appears you cannot. More than 200 healthcare workers have been killed in Gaza since 7 October, with over 130 attacks on healthcare centres reported.

Palestinian doctors working on the frontlines of the conflict sleep, eat and work in hospitals around the clock. Many are unable to return home, and some are sheltering with their families in the very hospitals where they work, often under threat of constant attack. As they are forced to witness the deaths of their colleagues, friends and families, they continue to work—an act both unimaginable and extraordinary.

So where does our duty of care as Australian doctors begin and end? Does it terminate at colleagues and patients we can see and touch in front of us? At our local community, or our national borders?

It is unequivocally our role to advocate for equitable healthcare delivery. The question of where and for whom doesn’t diminish this.

Health infrastructure, its workers and patients are inextricably linked to the geopolitical forces surrounding them. The impact of conflict on healthcare is not a secret. The direct casualties of violence and mass displacement are compounded by food insecurity and lack of clean water. Infectious diseases outbreaks then ensue, as is being documented in Gaza. Fractured healthcare systems significantly affect those living with chronic diseases; treatments such as dialysis, chemotherapy and insulin that tether them to life are severely restricted or denied.

Death, poverty, malnutrition, housing destruction and significant trauma intertwine to form a catastrophe like the one we see unfolding in Gaza.

Essential health infrastructure cannot amount to collateral damage. The safety of patients and healthcare staff is not an exchangeable commodity. Their protection is enshrined in international law.

Every patient in Al-Shifa Hospital’s Intensive Care Unit has died, and Gaza’s only centre for cancer treatment has been bombed and ceased operations. These are no longer theoretical possibilities, but a horrifying reality for Palestinian healthcare workers and their patients.

We cannot ignore that healthcare facilities in the occupied Palestinian territory were being attacked long before 7 October. And we cannot pretend to be unaware that Palestinians living in the Occupied Territories already faced a disproportionately high burden of chronic disease prior to the escalation of the current conflict. Increased child and maternal mortality and reduced life expectancy are the inevitable outcomes for a colonised people living under militarised occupation.

If we know all of this, as professionals who understand the intrinsic relationship between public health and advocacy, why do we remain silent?

Many of us, in Australia and abroad, are raising our voices to ask this of our healthcare institutions, associations and professional colleges. However, we face retribution for speaking out. We have received threats and incidents of being reported to our healthcare regulator (AHPRA) merely for posting on social media about the dire humanitarian crisis unfolding in Gaza. We have been termed ‘liars’, ‘unfit doctors’ and ‘anti-Semitic’ for expressions of sympathy for our colleagues on the frontline or of horror at the catastrophic death toll (more than 13,000) in Gaza. In medical discussion forums, we have seen the promotion of secular, medical organisations such as Médecins sans Frontières gagged, an unprecedented action and one discordant with the response to the ongoing conflict in Ukraine. Disturbingly, even amongst our fellow doctors, we note incidents of racism and hate speech directed at our advocacy efforts. We are warned by our medical indemnity providers not to express opinions about the situation in Gaza, and reminded to behave in a ‘manner befitting our profession’.

At what point is it that we are permitted to speak—to advocate in the manner that truly is befitting this profession? Australian doctors and healthcare professionals have a long history of calling for the protection of human rights, particularly among vulnerable groups. Our actions advocating for refugee and asylum-seeker welfare, against youth incarceration and recently for the Indigenous Voice to Parliament stand as testaments to this—and in stark contrast to the silence of many of those advocates at present. Palestinian doctors in Gaza despair that the international community has abandoned them as their healthcare system crumbles, and as they face death carrying out the same job we perform daily.

We, their colleagues and counterparts, cannot fail them now.

Our voices are rising, and our movement is gathering momentum. As we petition and rally our government to support an immediate ceasefire in Gaza, we address you, our fellow doctors. To remain silent in the face of the mounting man-made catastrophe in Gaza is to ignore the foundational tenets of medicine and healthcare.

The Long Siege of Gaza

Timothy Erik Ström, 26 Oct 2023

The long-term, systematically planned nature of the siege needs re-emphasising as a fundamental aspect of the causation of the massacres that have taken place on either side of Israel’s militarised border.

About the authors

Nilanthy Vigneswaran

Dr Nilanthy Vigneswaran is an infectious diseases doctor who has studiedwith a Masters degree in of Public Health and Tropical Medicine. She is a refugee health and human rights advocate.

More articles by Nilanthy Vigneswaran

Sana Pathan

Dr Sana Pathan is psychiatrist based in Sydney. She has experience in trauma-informed care and is a human rights advocate.

More articles by Sana Pathan

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Comments

The abhorrent disregard for human life, for the human need to access medicine and medical care is utterly disgraceful of the Israeli, Australian and all western governments who are sitting silently on this human issue.

Health workers are sacrificing their lives in Gaza while Western governments sit on their hands and refuse to condemn the war crimes that are taking place in Gaza and the West Bank.

Thank you for writing this article.

Thank you for writing this. Now more than ever, we need to use our voices as doctors to speak on an extraordinary health and humanitarian crisis.

Well said. Our duty to care for others near and far, including advocating for health care and health care workers, is incumbent upon all doctors. We need an immediate and permanent ceasefire in Gaza and protection of all health care staff.

Thank you for your advocacy for this humanitarian cause which should be totally uncontroversial. Neutral expert bodies are stating the facts. There is no excuse for silence, and yet we are suppressed.

Thank you for writing this article. I pray Palestine will be free. Torture never continues forever, there is always an end to any form of tyranny…
Victory will be theirs.

The silencing and threatening of healthcare workers speaking out against the huge loss of life in Gaza is chilling. Never before have we been frightened to amplify the facts from humanitarian organisations (UNICEF, MSF). Never before have we seen doctors reported for standing up for international humanitarian law around healthcare facilities.
The situation in Gaza is indeed a healthcare emergency as well as a human tragedy. As people who spend our days nurturing people in safe environments; we must be able to speak out around desecration of both life and healthcare facilities

We all need to lend our voices to support the health care professionals working in life threatening conditions and those writing about this human catastrophe. We cannot be silent

I have never felt so ashamed to be part of a medical community who can not speak up for the voiceless. I truly give people the benefit of the doubt and always assume my medical colleagues value all human life. The silence over the last few weeks has shown me otherwise.
Thank you for speaking out for humanity.

Fantastic fellow colleague s standing up for humanity in the face of blatant bullying, silencing and defaming . Continue to save lives despite the misinformation and demonisation.

It is hard to fathom that doctors are being reprimanded, threatened and silenced for speaking out against the killing of people. This is indeed a human tragedy. The sanctity of life must be upheld at all times, especially by healthcare workers. Thank you for speaking out and hopefully more people can gain the courage they need to speak truth to power, and those in power will wake up and see the truth of what is happening.

So happy to see fellow healthcare professionals standing up for the innocent civilians in Gaza. We need more voices like this in our community. There is no justification for genocide.

We love and support doctors and healthcare workers who advocate for our brothers and sisters in Gaza. Long live the resistance 🇵🇸❤️‍🩹

Thank you for this article.
We as health professionals have a duty of care to advocate for and support those in need. People of Gaza need us more than ever and what is happening now is tragic and is an emergency situation.
Never have I ever heard of someone being reported to AHPRA or have had their license suspended for trying to provide medical health and for doing what we made an oath to do; help those in need!
We will not be silenced by zionists and those who support genocide.

As health care workers and doctors we abide by the creed of “do no harm”, and part of this entails not remaining silent while harm beyond imagining is inflicted on the vulnerable children in Gaza. Any child is a child we must protect, no matter what country they call home. They are our children. We are obligated to stand up for them and their future. I cannot, must not, and will not call myself doctor and watch passively while they die by the thousands, and neither should any other doctor. Immediate and permanent ceasefire now.

Thank you for speaking for the people who cannot, the zionists are an international gang of thugs who have a support base of blind followers, no humaninity. For gods sake let people live in peace, australia used to have something called freedom, we now have zionists silencing every word we speak. When people need to be told to stop killing children and bombing hospitals, then we know we have a serious problem in this so called modern world.

Thankyou for expressing so clearly our duty as doctors to care for the welfare of our fellow doctors in Palestine and the almost impossible task they have to care for their people in a health system that has been destroyed. In doing their job so many lives have been lost just because the hospitals have been a target.

Thank you for your bravery in speaking out in the face of such horrible devastation and disregard for human lives. We need our politicians and leaders to call for an immediate ceasefire to end this genocide.

So proud of you all for stating the facts on the ground. So embarrassing for us that this could cost health professionals their careers.

Well said. The protection of civilian lives and hospital infrastructure is a cornerstone of international humanitarian law, but has suddenly become controversial. If anyone should be able to provide perspective and reason here, it should be the healthcare professions.

Ceasefire now!
Medical students and trainees are forced to jump right into the role using minimal and outdated resources due to the vast number of injured civilians.
This has to stop!
Ceasefire NOW!

Thank you to the doctors who have already spoken up. To stay silent on this is to be complicit in genocide. I pray for freedom for the Palestinian people.

Thank you for this article. It is so important to speak out and to keep speaking out about the injustices we are witnessing. It is also really important to start cultivating an environment in which people feel safe to do this. I have heard time and time again people say that they are supportive of Palestinian rights but are afraid to speak up for fear of vilification, of being labelled anti-Semitic, of losing their employment or their livelihoods. Perhaps if we had more articles like this published we might eventually reach a stage where calling for a permanent ceasefire and end to civilian deaths, calling for unfettered access to aid and calling for an end to an illegal occupation are no longer controversial statements.

There were many survivors story saying how Israeli soldiers killed their loved one while Hamas was trying to take them as hostages alive. Many of them were deleted from facebook within an hour of posting. Unfortunately it’s hard to win this propaganda war where Facebook, social media and most news outlet’s are controlled by Zionist.

Israel just killed 15,000+ innocent civilians, 7000+ missing under the rubbles. They indiscriminately bombed hospital, schools and refugee camps to score the numbers. This is not the first time, they did similar killing many times in the past. Yesterday they shot two children at West bank dead. Yet many of us failed call Israel a terror state 🤔. Can you see/feel something is not right here?

After the first few hostages released and talk nice things about Hamas ,now they hostages are not allowed to talk straight after release. They may be forced in near future to say bad things about Hamas by Israeli government.

However when you see the hostages released by Hamas just look into the eyes of hostages that will tell you the truth.

Footage of Two child shot dead at westbank

https://youtu.be/mh6eJHBkVEk?si=RYfczGd7dHCQHa3P

How children were tortured in Israeli jail

https://youtu.be/JATTM_BfKvE?si=6bTzzUQH0fg_BJjP

Hostages released by Hamas

https://www.facebook.com/reel/662754012714594?s=yWDuG2&fs=e&mibextid=Nif5oz

I thank you for your bravery to come forward and express yourself. How strange are these times when a doctor who is supposed to stand up and care for their patients and all humanity is silenced today by using threats, reporting to higher bodies, bullied, gaslighted into looking like anti semetics , just so someones political agendas are fulfilled

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