U.S. medical and public health institutions are complicit in genocide

On November 3, 2023, Georges C. Benjamin, the executive director of the American Public Health Association, the largest organization of public health professionals in the United States, released a statement on the “public health implications” of what they named the “Israel-Hamas War.” Released almost one month after the escalation of the Israeli settler colonial regime’s relentless attacks on Gaza, the statement’s purpose was to make clear that the organization “condemns the brutal assault by Hamas and recognizes Israel’s right to exist and defend itself.”

A genocide is unfolding before our eyes. Israeli Occupation Forces have murdered over 11,000 Palestinians and injured tens of thousands more as of November 14. Entire generations of families have been wiped out. Parents are inscribing their children’s arms with their names in order for them to be identified in case they are martyred. Bodies lay in the street and under rubble, unable to be buried or recovered. Nowhere and nobody is safe from this horror — not those seeking refuge in schools or refugee camps, not children or the elderly, not medical personnel, not journalists or United Nations Relief and Works Agency staff. Outside of Gaza, hundreds of Palestinians are being arrested or murdered in the West Bank by the Israeli Occupation Forces or by settlers. The sheer scale of violence is unimaginable.

The exact numbers of death and destruction do not matter. What does matter is that in the face of genocide, U.S. medical and public health institutions have chosen to either remain silent or actively endorse Israel’s mass murder of Palestinians.

Beyond vague lip service expressing sympathy for the “human suffering happening in the region,” for instance, the APHA made no mention of the horrific public health crisis worsening in Gaza by the day. After sharp backlash to their original statement, and the hard work of APHA members who organized to introduce a last-minute statement at the APHA’s annual meeting, a resolution was passed on November 14 demanding “an immediate cease-fire” and a “de-escalation of the current conflict,” with 90% of the vote as students and supporters stood in the back of the meeting in silent protest and support. Yet neither of their statements addressed the larger context under which the events of October 7 transpired — 75 years of ethnic cleansing, occupation, and apartheid rule carried out by the Israeli government against the people of Palestine.

American Medical Association

The APHA is not alone in passing such an ahistorical and shameful statement. Other health institutions — including hospitals, academic medical centers, universities, government agencies, and non-profit organizations — have followed suit. On November 11, the American Medical Association’s House of Delegates declined to pass a resolution supporting a ceasefire in Gaza. Andrew Gurman — a former AMA president — cited that passing such a resolution would involve the AMA in “geopolitical issues,” which he stated was “in no way the purview of this house.” Yet just last year, the AMA passed a resolute statement calling for an “immediate ceasefire” regarding the Russian military’s attacks on Ukraine. Such attacks, they said, were “unconscionable” — creating a “humanitarian crisis” in the region that could no longer be ignored by physicians across the globe. Further, the AMA went on to state that “it is critical that international humanitarian and human rights laws are upheld and that we protect civilians and medical personnel at all costs.”

When it comes to Palestine, the AMA’s supposed care and concern for civilians, medical personnel, and international law grinds to a halt. We need not rehash a detailed list of the public health crises that have emerged from Israel’s attacks nor the litany of international humanitarian and human rights laws that have been shattered. Hospitals are being bombedone after the other. A group of Israeli doctors have openly advocated for these bombings in an open letter, published just two days after the APHA statement. As I write this, Al-Shifa is actively under siege by Israel. Doctors, patients, and others are being shot and killed as they try to leave the hospital. Those inside are being massacred. Ambulances have been targeted. The sounds of gunfire fill the halls. Individuals lucky enough to survive gunshots and artillery blasts are dying due to power outages and shortages of medical supplies. Food, water, oxygen, and fuel are non-existent. Newborn babies have been killed, and others are being moved out of incubators and wrapped in foil in a desperate attempt to save their lives. Doctors are digging mass graves. As one health official stated, “[Israel] is sentencing everyone inside Al-Shifa hospital to death.” 

Gaza’s public health crises extend beyond attacks on hospitals and medical personnel. The “true” number of Palestinians killed — the “true” extent of the violence — is much higher than the people directly martyred by Israeli Occupation Forces’ bullets and airstrikes. People are being starved and are dying from dehydration. Clean water in Gaza has always been scarce, given Israel’s blockade, de facto occupation, and enactment of water apartheid. According to the United Nations World Food Programme, “100%” of the 2.3 million people in Gaza are currently food insecure and face the risk of malnutrition. With more hospitals on the brink of collapse, people who are pregnant are experiencing greater numbers of miscarriages, premature births, and are undergoing Cesarean sections without anesthesia. People with periods are using period-delaying pills in the absence of water and menstrual hygiene products. Individuals with disabilities such as hearing loss and physical impairments have been trapped in their homes or in hospitals during bombings, unable to flee or access life-giving assistive services. And the psychological terror and trauma of Israel’s attacks for survivors cannot even be comprehended. 

Without water, food, fuel, sanitation, and medical care, cases of infectious diseases such as diarrhea and respiratory infections have skyrocketed alongside the risk of contracting an infection in health facilities. Human Rights Watch has verified that Israel is using white phosphorous against people in Gaza and Lebanon — a substance with severe short and long-term health impacts, and the use of which is considered a war crime under Protocol III of the Convention on the Prohibition of Use of Certain Conventional Weapons. As Amal Zaqout, an aid worker with Medical Aid for Palestinians put it in a heart-wrenching statement: “We are waiting for death and nothing more, as the silence from the world around us reflects that they do not consider us human beings.” 

Ignoring root causes

What accounts for this silence by public health institutions in the United States amidst a genocide financially and ideologically supported by their own government? For one, despite its emphasis on the social determinants of health, the field of public health fails to address the root causes of poor health. Understanding the health of populations today requires an analysis of the ways in which colonialism, imperialism, and racial capitalism structure our healthcare systems and produce vast health disparities across the world. For example, the Johns Hopkins Bloomberg School of Public Health — which has at least acknowledged that there exists a public health crisis in Gaza — goes only as far as to call Israel’s genocide a “humanitarian” issue stemming from “one of the longest unresolved conflicts in the world.” The language of “humanitarianism” deliberately obfuscates and misrepresents responsibility and power — transforming ​​Israel’s decades-long project of settler colonialism into a two-sided “conflict.” 

But the truth of their silence runs deeper. U.S. medical and public health institutions serve as tools of empire. The histories of medical involvement in perpetuating harm against predominantly Black and brown bodies, minds, and spirits are long — from contributing to the genocide and forced sterilization of Indigenous peoples, to the use of scientific racism as a justification for chattel slavery, to the development of “colonial” and “tropical” medicine to legitimize and implement European imperial projects. In the aftermath of September 11, 2001, medical professionals sanctioned by the United States C.I.A. and Department of Defense designed and conducted programs to torture individuals held captive by the state — a practice routinely undertaken by Israeli doctors against Palestinian prisoners. Indeed, the first person to be abducted and tortured under the United States’ so-called “War on Terror” was a Palestinian man named Abu Zubaydah, who still remains in bondage at Guantánamo Bay detention camp. 

Further, medical institutions are invested in the same systems of oppression that worsen communities’ health in the first place. On November 9, students at the Columbia University Irving Medical Center (CUIMC) staged a die-in to protest Columbia’s collusion with the Israeli settler colonial regime. As a neoliberal academic institution, a portion of Columbia’s $13.6 billion endowment is invested in weapons manufacturers such as Lockheed Martin, Elbit, and Boeing — companies that are actively contributing to Israel’s massacres of Palestinians. Instead of divesting from its economic stakes in Israel, Columbia responded to weeks of pro-Palestinian campus actions by outright suspending student groups such as Students for Justice in Palestine and Jewish Voices for Peace. When faced with speaking out against public health atrocities in Gaza or maintaining their allegiances to capital, CUIMC made its choice clear.  

In the face of silence from medical and public health institutions, health professionals, workers, students, and public health and medical faculty across the country have organized mass protests, walk-outs, rallies, vigils, demonstrations, teach-ins, and statements of support to stand in solidarity with the people of Palestine. Despite their mandate to “do no harm” and advocate for the health of individuals and communities around the world, it is abundantly clear that medical and public health institutions are complicit in genocide. The AMA, the APHA, and all others that either support Israel’s war crimes or remain silent at this moment have lost all moral and ethical authority and credibility. To these institutions — your hypocrisy is on full display, and your actions now speak volumes. If you continue to choose silence, your complicity will never be forgotten. 

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