The war in Gaza: A humanitarian crisis

M A Sathar

Dr Mahomed Aslam Sathar is an independent medical scientist and bioethicist, and a member of the Medical Rights Advocacy Network (MERAN). There is no conflict of interest. The author is not sponsored by any private enterprise. The opinions expressed are those of the author, and where they are not, they are referenced. Dr Sathar is the author of the book Human Biological Materials in Collaborative Research-Ethical Issues.

Corresponding author: M A Sathar (

Justice, sovereignty and self-determination for all human beings are fundamental foundations for healthcare and human rights. In any civilised society, the balance between medical ethics and human rights is critical for the delivery of healthcare. War is a deeply ethical issue. Combatants, whose violations of international conventions, laws and codes of ethics during war and political conflict are detrimental to civilian non-combatants, including healthcare workers, commit crimes against humanity. The war in Gaza is a humanitarian crisis.

S Afr J BL 2014;7(2)76-77. DOI:10.7196/SAJBL.356

After the murder of Stephen Bantu Biko, the iconic dissenting voice of the South African (SA) liberation struggle, in which apartheid medicine was complicit, SA academics and healthcare professionals vowed never to remain silent when such human rights abuses are committed not only against our fellow countrymen and women but against humanity at large.1 It is painfully difficult to write something about the war in Gaza, for no matter what I say, it will be denounced by one side or the other. However, to remain silent would suggest support for the violation of international law. While most medical journals, including those in SA, have not commented on the war in Gaza, a prestigious medical journal, The Lancet, bravely published a commentary on the war.2 The publication elicited several responses from academics, clinicians and ethicists, some of whom expressed sympathies with the Palestinians,3 , 4 while others were openly personal and defamatory, accusing the authors and the editors of bigotry and of being biased, political, anti-Semitic, unscientific, unprofessional, etc.5-8 In response, the journal defended its editorial policy and declared that: ‘It is surely the duty of doctors to have informed views, even strong views, about these matters; to give a voice to those who have no voice; and to invite society to address the actions and injustices that have led to this conflict. Our responsibility is to promote an open and diverse discussion about the effects of the war on civilian health ... the role of the doctor is to protect, serve, and speak up for life. That, too, is the role of a medical journal.’9

War zones are not easy places to collect statistics, because they are subject to change. After 50 days of conflict in Gaza, from a population of 1.8 million, 2 143 Palestinians were dead (including 577 children, 263 women and 102 elderly), 11 230 were injured, 10 800 buildings had been destroyed and 8 000 partially destroyed, 40 000 homes had been damaged, and more than 350 000 people had been displaced from their homes.10-12 Among the buildings that were damaged were 277 schools, 11 hospitals, 14 clinics, 70 mosques, 2 churches and 10 hospitals.10-12 On the Israeli side, there were 71 dead, among them 66 soldiers, 2 civilians and 1 child.10-12 It is estimated that it will take decades to rebuild Gaza and its infrastructure. The war in Gaza is a humanitarian crisis.

Justice, sovereignty and self-determination for all humans are fundamental foundations for health and human rights. In any civilised society, the balance between medical ethics and human rights is critical for the delivery of healthcare. The killing of civilian non-combatants, impeding healthcare workers in their attempts to deliver care, interrupting and destroying civilian infrastructure such as hospitals and clinics, and deliberately targeting services that support healthcare, such as electricity and sanitation, is criminal and flagrantly illegal. These are in direct contravention of the Geneva and Hague conventions,13 the Rome Statute,14 occupational law,15 and international and humanitarian law,16 all of which assure protection and respect for civilians, non-combatants, healthcare personnel and healthcare facilities in occupied territories and conflict zones. Combatants, whose violations of international conventions, laws and codes of ethics during war and political conflict are detrimental to civilian non-combatants, including healthcare workers, commit crimes against humanity.13-16 At the Nuremberg Trials, the Nazis were tried for war crimes, for carrying out the intentional killing of civilians and for the destruction of civilian infrastructure. Likewise, the International Criminal Court (ICC) is obliged to investigate and prosecute all those who allegedly commit or are complicit in war crimes, irrespective of who they are, if the ICC wishes not to be seen as being ‘biased’ or ‘partisan’.17

Medical journals often take sides on issues such as medical male circumcision, euthanasia, healthcare, etc. Why not war? Because war is a deeply ethical issue and not just a utilitarian calculus. The Lancet was brave, perhaps right, in inviting and encouraging comments on the war in Gaza, while other medical journals may have been remiss, even cowardly, in ignoring it. Critical and untempered debate is a central pillar for academic discourse. It must be encouraged and continued without fear of academic reprisals and loss of scholarly autonomy, if we are serious about advancing human knowledge and improving the human condition.

‘If you are neutral (silent) in a situation of injustice, you have chosen the side of the oppressor ...’

(Archbishop Desmond Tutu, Nobel Peace Laureate)


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‘War is the continuation of policy (governance) by other means

(violence instead of peace).’

(Carl von Clausewitz)

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