- ICJ finds Israel likely violating Genocide Convention
- Global health organizations silent on Gaza crisis
- MSF opposes Israeli attacks, loses staff
It has been more than six months since the International Court of Justice concluded in South Africa v Israel that the latter was likely in violation of the Genocide Convention for its treatment of Palestinians. Israel’s continuous, systematic strikes on Gaza’s health professionals and infrastructure have dominated the court’s discussions, bringing the unfolding carnage squarely under the purview of health researchers and institutions.
It is striking that practically all influential global health organizations based in the United States have disregarded what could be the world’s most severe and preventable global health crisis. From the massive Bill and Melinda Gates Foundation to the many smaller NGOs and academic centers that shape this field, these organizations have refused to take any meaningful stand against the systematic destruction of Gaza’s health infrastructure, which has been facilitated by the Biden administration’s provision of arms, funds, and diplomatic cover to Israel.
Given such organizations’ considerable lobbying and cooperation with the US government, funding from it, and close contacts and significant influence among many of its senior officials, this quiet is particularly distressing.
It also demonstrates the continued relevance of what Frantz Fanon witnessed in his 1959 article Medicine and Colonialism while working as a psychiatrist in French-colonized Algeria during its liberation fight. Doctors are an “integral part of colonization, of domination, of exploitation” when monetarily or professionally incentivized, he stated, and “we must not be surprised to find that doctors and professors of medicine are leaders of colonialist movements.”
This is also true for global health today, which has long been associated with colonial domination and white supremacist beliefs.
While Fanon witnessed organized medicine’s tendency to correlate with state brutality, he also thought and demonstrated through his own life that individual doctors and collectives might choose to do otherwise, becoming crucial contributions to movements for freedom, care, and justice.
Today, Palestinian health workers and organizations such as Doctors Without Borders (abbreviated MSF), created in France nine years after Algeria gained independence, most poignantly demonstrate Fanon’s findings. According to Fanon, Doctors can become genuine friends against tyranny rather than collaborators if they are “sleeping on the ground” and “living the drama of the people” alongside the oppressed.
Working alongside Palestinians, MSF staff members are doing just that, using their organization’s international influence not only to provide care for those injured by Israeli attacks on civilians but also to publicly document and condemn the crimes that Israel continues to commit using US-supplied weapons.
This decision has come at a high cost: six MSF staff members and numerous members of their families have been killed by Israeli strikes, as have approximately 500 other health workers, nearly all of whom are Palestinian.
MSF has not always strongly opposed the political actors and actions that cause injury and death among civilian populations. Since its inception, the organization has contested the employment of explicitly depoliticizing paradigms such as “neutrality,” “témoignage” (a French term for testimony or bearing witness), and “humanitarianism.” It has viewed them as a means for ensuring access to conflict zones and occupied areas while avoiding conflict with political parties that could attack MSF personnel or prevent the organization from reaching impacted populations.
These frameworks aid in avoiding offending philanthrocapitalists and formerly colonizing governments in the Global North, who are afraid of political criticism for their ongoing neocolonial policies and practices that maintain the economic imbalances from which they benefit during the global poor die.
However, over the last several decades, in response to both internal and external criticism, as well as the Rwandan genocide, which highlighted the untenability of neutrality, many within MSF have increasingly confronted the fact that political engagement is the only way to care for people or stop atrocities effectively, even if it offends donors and politicians.
In contrast, several medical organizations in the Global North refuse to follow suit. Although the Euro-American global health and humanitarian sector, like the US medical profession with which it is inextricably linked, is founded on evasion and denial of this reality, the fundamental truth is that political decisions determine human life and health from conception to death.
Most institutional leaders and rank-and-file doctors in the United States are once again abdicating their ethical responsibility to protect life by selectively appealing to political neutrality and depoliticizing ideologies such as “humanitarianism” and “crisis” to avoid the political-economic determinants of health amid an unfolding genocide.
The history of humanitarian organizations is fraught with hard decisions and severe ethical quandaries. This truth has, in turn, been used to provide several chances for organizations to hide behind the phrases that “humanitarianism” has developed to gain access under challenging circumstances.
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However, the well-established facts of Israel’s deliberate targeting of health workers and infrastructure, the killing of civilians in hospitals and refugee camps, and the use of famine as a weapon of war, combined with an open declaration of genocidal intent, do not present an ethically ambiguous choice for any organization honestly concerned with global health or the medical humanitarian act.
The medical profession, global health practitioners, and our institutions have repeatedly failed to uphold our fundamental ethical commitments, and we refuse to learn from our mistakes.
By remaining mute in the face of a politically motivated atrocity, we may avoid career dangers and funding losses associated with taking a principled stand against the violence of US imperialist and Israeli occupation. However, global health groups’ decision to stay “neutral” – or worse – in the face of genocide sacrifices something far more valuable and impossible to recover: any reasonable claim to ethical legitimacy.
