After three weeks of Israel’s war, the devastation in Gaza has surpassed anything I have seen in 30 years as a plastic and reconstructive surgeon working in conflict. The sheer numbers of wounded and dead are overwhelming. To date in Gaza, there are over 21,000 people wounded and over 8,000 people killed by Israeli attacks, 4,000 of them children. More are expected to be under the rubble as entire families are wiped out. Health care systems are failing as Israel targets hospitals and health care workers. From firsthand accounts that I have gathered, Israeli bombs have killed more than 24 doctors and 18 nurses. One of them was a physician with us in the plastic surgery unit—Dr. Midhat Saidam—who was killed when his house was hit.
Al-Shifa Hospital, which is the largest in Gaza, is bursting at the seams. Its maximum capacity is 700, yet there are about 1,700 wounded and ill people on mattresses on the floors. There are thousands seeking shelter in the corridors, the stairwells, and the emergency department. Israeli media has now announced that Hamas’ center is under the hospital, manufacturing a justification to annihilate patients and medical staff alike.
Israel has completely cut off electricity, fuel, clean water, and food to civilians. This comes after a 16-year blockade that already severely restricted access to these necessities. Everything we need in order to take care of wounded patients—dressings, IV fluids, and medicines—has run out. Water-borne diseases are now spreading, and over 650,000 people are facing a critical water shortage.
The hospitals are operating in blackout as the fuel has been cut off, which means surgeries are happening by the light of candles and phones. Because the blockade has prevented necessary medicines, we are forced to improvise, for instance using vinegar to treat deadly pseudomonas infections. Operating without anesthesia brings more trauma to patients and to surgeons. Any lull in the breakneck pace in the operating room is not because the killings have eased up: It’s because the ambulances are at a standstill with no fuel to run.
This is an engineered catastrophe designed to maximize human suffering. Israeli Prime Minister Benjamin Netanyahu made this intention clear when he wrote, “This is a struggle between children of the light and children of the darkness, between humanity and the law of the jungle.” Channeling Joseph Conrad’s 1899 novella, Heart of Darkness, which describes the horrors of colonialism, Netanyahu’s words echo a parallel framing of Israel’s fraught dynamic in Palestine.
Zionist thinker Ze’ev Jabotinsky laid the foundation for this dynamic a hundred years ago in his essay, “The Iron Wall,” where he outlined the Zionist intent to colonize Palestine. He wrote, “The native populations, civilized or uncivilized, have always stubbornly resisted the colonists, irrespective of whether they were civilized or savage.” The characterization of “savage natives” is a trope that is hard to break in the Western mind and was recently invoked by Israeli Defense Minister Yoav Gallant when he called Palestinians “human animals.”
The use of dehumanizing language prepares the mind for the brutality the world is now witnessing in Israel’s relentless bombardment of the imprisoned population of Gaza. Such language switches on neural circuits that bypass our cognitive centers, steering our minds in ways that fix beliefs over time—proving difficult to change even in the face of contradictory evidence.
Nazi propaganda used such language to prepare the German population for mass violence against Jews, gay people, and others they deemed undesirable. Dehumanization is a part of the colonial process, and is the prelude to massacre. The use of this language is the heralding event we must recognize in order to intercept and collectively intervene to prevent genocide.
“Decolonization”—a term that is thrown around loosely in academic circles and popular culture—is a precise descriptor of the liberation struggle in Palestine, as colonized people reclaim their right to land, sovereignty, and their own humanity. Jewish claims to Indigeneity in this region are no justification for Israel’s actions, which have manifested in a brutal colonial force with a 75-year history of erasure and ethnic cleansing of Palestinian people.
Rehumanizing the people of these struggles is an important exercise for the world to engage in. Whereas dehumanization trains our neurons to accept atrocity, rehumanizing can expand our vision to see healing realities that lie beyond the current limits of our imaginings.
When Hamas released 85-year-old Israeli hostage Yocheved Lifshitz, she emphasized the care she received from her captors. She shook their hands when she was transferred to the ambulance, a move that confused onlookers. Lifshitz explained that she and other hostages were treated with “sensitivity.” With that small gesture, this elder showed us the path to another possible world. This does not undo the violence of the abduction she experienced. But it does show what healing looks like, and, ultimately, what rehumanizing is centered on.
As physicians we have a duty to take on the work of rehumanizing, which James Baldwin described as the moral exigency of artists. Our work in medicine has always been a balance of science and art. Baldwin wrote, “The precise role of the artist, then, is to illuminate that darkness … so that we will not, in all our doing, lose sight of its purpose, which is, after all, to make the world a more human dwelling place.”
To see the unseen is to identify how power shapes our realities and ultimately our health. To remember how to see the humanity in those who have been dehumanized is a critical step in our collective healing from the crimes of the present and the past—both legacies of colonialism. We are physicians committed to the healing of humanity, and we urge the world to unite in calling for an immediate ceasefire and an end to the brutal oppression of Palestinian people. The work of rehumanization is the medicine we urgently need.
Rupa Marya is a Professor of Medicine at the University of California, San Francisco and co-author with Raj Patel of Inflamed: Deep Medicine and the Anatomy of Injustice. Follow her on Twitter @DrRupaMarya
Ghassan Abu-Sitta is a plastic and reconstructive surgeon and the Co-Director of the Conflict Medicine Program at the Global Health Institute at the American University of Beirut, Medical Center. He was at the Al-Ahli hospital when it was hit and is currently at the Al-Shifa Hospital in the Burns Unit. Follow him on Twitter at @GhassanAbuSitt1