I started training to be a doctor in the aftermath of the gulf war. It was a dark time to commit to a career of healing. U.S. sanctions and relentless bombings had decimated our medical infrastructure and endangered our access to medical supplies. Surrounded by devastation, we fought to heal, to operate, to comfort — often with the barest of resources. Every day was a battle in itself, trying to save lives as our facilities crumbled around us.
The U.S. invasion of Iraq in 2003 pushed a teetering health care system to the brink. Bombings and counterinsurgency operations relentlessly flooded hospitals with injured civilians. Overwhelmed with patients and scrambling for time, doctors and other medical workers around the country were forced to make heart-wrenching decisions about whom, realistically, they could save. Direct attacks on hospitals perhaps dealt the final blow to Iraq’s crumbling health care capabilities, once a source of pride across the Middle East.
Now the world is witnessing another war in which a health care system that was already under distress is being destroyed. I see alarming parallels between what I witnessed in Iraq to what is happening in Gaza, from widespread shortages of essential supplies to soaring infection rates to military targeting of hospitals. When health care services, infrastructure and expertise are destroyed during war, they are often lost forever. In their absence, a permanent public health crisis threatens the lives of survivors who have nowhere else to go. As someone who has devoted much of his career to documenting the grave consequences that come from attacking health care, I cannot help but feel a haunting déjà vu in Gaza.
Although targeting hospitals and health care facilities during war is illegal under the Geneva Conventions, with very narrow exceptions, these attacks have increased sharply over the past two decades, especially under the aegis of fighting terrorism. In 2021 the World Health Organization reported that at least 930 health care workers were killed in 600 attacks during the Syrian civil war. Syrian and Russian forces have seemingly attacked hospitals under the claim that they were striking terrorist targets.
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