PARIS/NEW YORK—One year after the 51-day war in Gaza, neighborhoods destroyed during the fighting have not been rebuilt and hundreds of Palestinians with devastating injuries stemming from the Israeli assault still fill the waiting rooms of the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF), many of them needing complex reconstructive surgeries and physical rehabilitation. With the continued blockade and siege of Gaza, it is as if the war had just ended, MSF said. Today, MSF sees, perhaps more than at any time in its 20-year history of providing medical and psychological care in Gaza and the West Bank, how the suffering wrought by the Israeli occupation has become normalized and how the status quo will only lead to more of the same.
The human toll of the latest Gaza war was appalling: more than 2,200 people were killed and more than 11,000 were wounded, including almost 7,000 women and children. “Eight-year-old children in Gaza have known nothing but the blockade and war since they were born,” says Erwan Grillon, MSF head of mission for Gaza and the West Bank. “And they’ve already lived through four offensives, two of which were absolutely devastating and indiscriminately killed a shocking number of civilians. The majority of our patients who still require war-related surgeries and physiotherapy are children under 18.”
In MSF clinics, Palestinians still dealing with the complications of their war injuries are now packed alongside new patients, most of them young children, who have suffered severe burns from home heating and cooking accidents as a result of being forced to live in makeshift or damaged homes. More than 12,000 houses were damaged or destroyed during the war, as were more than 70 hospitals or health structures.
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The Israeli military blockade of Gaza continues to starve the territory of desperately needed supplies, including building materials that could help rebuild some of the neighborhoods that were reduced to rubble by the Israeli military. Israel has put severe restrictions on cement and other building materials, which are considered “dual-use” items that could be used to create weapons, leading to few houses being repaired in the strip.
“Living conditions keep on deteriorating,” says Grillon. “In our post-operative clinic in Gaza, the majority of our patients were treated for burns from explosions caused by the use of unsafe home heating products or in household cooking accidents in homes damaged during the war. Sixty percent of them were children.”
As a consequence of the blockade, people are still living in terribly unsafe conditions and almost entirely dependent on outside aid. Unemployment is at a record high—more than 40 percent overall and more than 60 percent among the young—and 80 percent of the population is at least partially dependent on humanitarian aid.
While the devastation of the war in Gaza and the ongoing blockade of the strip have garnered the most international attention, the occupation of the West Bank also has widespread public health consequences. The Palestinian population in the West Bank is subjected to indignities, threats, and humiliations on a daily basis. Today, due to settlements, byways, checkpoints, and military deployments, Palestinians can only inhabit less than 40 percent of the West Bank. MSF mental health programs are filled with patients suffering from psychological disorders as a result of being subjected to endless harassment, frequent (and unpunished) settler violence against individuals and property, night raids, administrative detention, or other acts.
“The stories our teams tell us are such that merely stating the facts should be enough to denounce them,” says Grillon. “On a daily basis we see patients, a third of whom are younger than 13, in a constant state of anxiety and terror because of night-time incursions by Israeli soldiers and settler attacks. We’ve been treating the same families presenting the same symptoms for the past 10 years. Nothing has changed.”
As a direct result of the perpetuation of the occupation and the complete failure of any political process, Palestinians in both Gaza and the West Bank are trapped in a never-ending cycle of violence that must be addressed frankly and urgently.
Within Israel, blaring air raid sirens and building codes that require homes to have bomb shelters speak to the very real concerns Israelis have about potentially deadly rocket fire coming from Gaza and the ongoing threat of tunnel-enabled attacks in border areas. But these and other security fears cannot justify the devastating medical and psychological consequences of barriers, checkpoints, bombing campaigns, blockades, and incursions. The measures and policies Israel carries out in the name of security must be judged and reconsidered in terms of the humanitarian fallout and the starkly disproportionate outcomes.
The Palestinian leadership in the West Bank and Gaza must of course do likewise, and understand the consequences of their tactics and rhetoric for Israelis and other Palestinians alike. But as the occupier, as the far stronger and bigger power, the onus falls on Israel. And the governments and international institutions explicitly or tacitly supporting these policies and the broader normalization of the occupation must do the same, given the undeniable devastation it has wrought.
MSF has been working in Gaza since 1989, providing medical care according to people’s needs, addressing specific medical needs that cannot be met by Gaza’s health service, and responding to the direct or indirect consequences of violence. Medical activities have included surgery, post-operative care, dressing care, psychological care, occupational therapy and physiotherapy, including specialized physiotherapy for the hand.
In the West Bank, MSF has been running mental health programs in East Jerusalem since 2011 and in Jenin, Hebron, Nablus, and Qalqilya governorates since 2000.