How can Palestinian medics 'cooperate' with Israeli health bodies during a genocide?
A recent editorial in the American Journal of Public Health (AJPH), one of the most prominent and widely cited public health journals in the United States, advocates for renewed cooperation between the Israeli and Palestinian public health sectors.
This appeal, authored by researchers from the Hebrew University of Jerusalem and other Israeli institutions, badly misrepresents the reality of Israel's systematic destruction of every aspect of Palestinian public health and the complicity of its healthcare institutions in that very process.
What is happening in Gaza today is not simply a failure of cooperation. It is a one-sided assault on its infrastructure and practitioners in more than 600 days of violence and terror enacted by one of the world's most powerful armies against a trapped civilian population.
Since October 2023, Gaza has been under near-total siege, as Israel has dropped over 100,000 tonnes of explosives, destroying local agriculture, bakeries, pharmaceutical stockpiles, solar panels and water desalination facilities - effectively making public health impossible.
As of March, the World Health Organization (WHO) reported 670 attacks by Israeli forces on legally protected healthcare infrastructure and personnel. At least 1,400 healthcare workers have now been killed by Israel in its war on Gaza.
Despite more than 100,000 injuries documented by the WHO as resulting from Israeli attacks, only 7,057 medical evacuations were permitted - largely because Israel refused to grant the necessary visas.
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Last September, an independent United Nations commission concluded that Israel had pursued a concerted policy to destroy Gaza's healthcare system. The AJPH editorial makes no mention of any of this.
Public health is further eroded when healthcare workers are mistreated in Israeli custody.
A UN commission found Israel was deliberately dismantling Gaza's healthcare system, yet the AJPH editorial makes no mention of this
Testimonies collected by Physicians for Human Rights-Israel describe not only medical neglect, but also cases in which healthcare staff failed to intervene in abuses - or actively took part in the torment of detained Palestinian healthcare workers.
In one affidavit, Dr MK, an orthopaedic surgeon from Gaza's Nasser Hospital, wrote: "Skin diseases, bacterial infections, asthma symptoms, and dermatitis are spreading among the prisoners. There is a doctor, but we never see him. There are detainees with illnesses, yet no doctor examines them. There is a clinic, but detainees aren't seen there."
Yet MK also described witnessing prisoners having their limbs amputated - evidence that the medical system is, in fact, quietly present throughout these accounts, corroborated by multiple sources.
Who must cooperate?
When the AJPH editorial calls for "renewed cooperation", it is not clear who, exactly, is expected to renew it.
Do they mean the paramedics who were killed execution-style and buried with their ambulances? Dr Alaa al-Najjar, the paediatrician whose husband and nine of her 10 children were killed in an Israeli air strike on their home? Or Dr Adnan al-Bursh, a beloved surgeon who died following torture in Israeli detention - torture, including sexual abuse, that has been extensively documented among medical and other detainees?
In Israel, one quarter of all doctors are Palestinian, as are nearly half of all new doctors and nurses.
Are they the ones now expected to demonstrate "renewed cooperation" on public health? Like advocates for Palestinian rights elsewhere, Palestinians inside Israel have been silenced – often by their own colleagues.
A Lancet correspondence last week described the international medical community's failure to condemn Israel's genocide - and, in the US, the "atmosphere of intimidation and silencing" that leads to professional retaliation against public health advocates for Palestinian human rights.
Yet the AJPH editorial frames the genocide as an unfortunate exchange of fire between equal parties.
In reality, it is more akin to shooting fish in a barrel: the fish being one million children and their families; the barrel, a shrinking territory where the population is forced into ever tighter spaces; and the gun, 910kg American bombs that vaporise human beings, tear off children's limbs, and obliterate healthcare facilities, ambulances and healthcare workers.
Genocide disguised
In their AJPH editorial, the authors' argument rests on past coordination among Israeli, Palestinian and global public health actors.
Media and scientific literature, they write, should highlight "that until about a generation ago, Israeli-Palestinian health collaborations thrived and directly benefited all populations".
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But for decades before October 2023, Israel strictly controlled everything and everyone entering or leaving Gaza - medical equipment, medicines, calories, even patients – a process the UN Conference on Trade and Development in 2015 described as "de-development and impoverishment".
That is the real context behind examples often cited as success stories of past collaboration, such as the polio vaccination campaign - initiatives carried out under conditions of occupation and total Israeli control.
Even more egregiously, the authors trumpet the November 2024 vaccination campaign in response to a polio outbreak caused by forced displacement and Israel's destruction of Gaza's healthcare sector, sewage infrastructure and waste management systems - but fail to mention that Israeli forces threw a stun grenade into a polio vaccination clinic during a so-called "humanitarian pause".
They similarly cite cooperation to bring in aid, but omit Israel's targeted strike that destroyed desperately needed medical supplies; multiple strikes on a hospital during a carefully negotiated medical evacuation; or the 335 bullets fired by Israeli forces into the car from which six-year-old Hind Rajab begged emergency services for rescue.
Aid workers spent hours coordinating with the Israeli military to retrieve the child, whose family already lay dead beside her, before both Hind and her paramedic rescuers were killed.
What does cooperation mean under these circumstances?
Eliding crimes
The authors call for cooperation on specific areas of public health - sanitation, hospital infrastructure, water safety, and environmental health - while consistently eliding Israel's unrelenting attacks on each.
They avoid directly condemning Israel's repeated violations of international law in these areas, or the increasingly lethal siege that, even last year, saw midwives cutting newborns' umbilical cords with razor blades and tying them off with string from a face mask.
The authors include four Israeli doctors and academics, as well as one American former adviser to Israel's Ministry of Health. Not one is Palestinian
With no disinfectants, soap or clean water, patients' wounds were left crawling with maggots.
It continues: last week, reports circulated on social media that Israel had informed the WHO it was suspending medical coordination for Palestinian boys over the age of 12.
Meanwhile, medical evacuations were denied for weeks before Dr Alaa al-Najjar and her surviving child were finally evacuated - along with just 15 other young patients, out of 10,000 in urgent need of evacuation, including more than 4,000 children.
So, what is the real purpose of this editorial?
A press release from the Hebrew University of Jerusalem makes it plain: it describes the piece as "a strong rebuttal to current calls to isolate Israeli academia and science". It condemns "such boycotts" and "efforts to cut academic ties".
Protecting power
The editorial's vague reference to "extremist rejection of cooperation and 'normalisation' between Palestinians and Israelis" appears to be a veiled critique of academic boycotts.
The boycott called by the Palestinian-led Boycott, Divestment, Sanctions (BDS) movement explicitly targets institutions, not individuals.
It is a form of economic and social pressure, inspired by similar academic boycotts of apartheid-era South Africa.
And it is a direct response to the complicity of Israeli institutions - from nearly 100 doctors who, in November 2023, publicly called for the bombing of Gaza's hospitals, to the deafening silence, including from the authors of this editorial, as the Israeli military bulldozes every remaining aspect of public health in Gaza.
The authors of the AJPH editorial include four Israeli doctors and academics, as well as one American former adviser to Israel's Ministry of Health.
Not one is Palestinian.
Yet the forces driving what they euphemistically call "the tragic example of Gaza" are clear.
The overwhelming evidence shows that Israel, with the participation of its healthcare community, has systematically eradicated public health in Gaza.
By smoothly evading Israel's unilateral devastation of Gaza's healthcare system - and its literal elimination of those who staff it - the AJPH editorial promotes continued silence among American public health bodies, even as the US actively supports Israel's war.
It reads as an attempt to deflect attention from the complicity of Israeli public health in genocide, and to shield Israeli academia from economically significant boycotts and divestment campaigns - even as the world watches 2.3 million people starve before our eyes.
The views expressed in this article belong to the author and do not necessarily reflect the editorial policy of Middle East Eye.
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