More than six months have passed since the International Court of Justice ruled in the case of South Africa v. Israel that Israel is likely to have violated the Genocide Convention in its treatment of Palestinians. Israel’s ongoing, systematic attacks on health workers and infrastructure in Gaza have played a central role in the Court’s deliberations, and the unfolding violence is squarely located within the jurisdiction of medical scholars and institutions.
Astonishingly, nearly every influential U.S.-based international health organization is ignoring what may be the most serious and most preventable global health catastrophe in the world today. From the enormous Bill & Melinda Gates Foundation to many of the smaller NGOs and academic centers that shape the field, these organizations have refrained from taking a meaningful stance against the systematic destruction of Gaza’s health infrastructure, actively enabled by the Biden administration’s provision of weapons, funds, and diplomatic protection to Israel.
This silence is particularly disappointing given that these organizations engage in extensive lobbying and collaboration with the U.S. government, receive government funding, and have close ties and considerable influence with many senior government officials.
It also testifies to the enduring relevance of Frantz Fanon’s 1959 essay, “Medicine and Colonialism,” written while he was working as a psychiatrist during French-colonial Algeria’s struggle for independence. Physicians, when they have economic or other professional motivations, are “an integral part of colonization, domination and exploitation,” he wrote, and “we should not be surprised to find physicians and professors of medicine leaders of the colonial movement.”
This is true today of global health, a field once known as colonial medicine, tropical medicine, and international health, which has always been in collusion with colonial and white supremacist ideologies.
But while Fanon bore first-hand witness to the tendency of organized medicine to align with state violence, he also believed, and demonstrated through his own life, that individual physicians and groups could make other choices and be vital contributors to the movements for freedom, medicine, and justice.
Today, Palestinian medical workers and organizations such as Doctors Without Borders (MSF), founded in France nine years after Algeria’s independence, demonstrate the truth of Fanon’s observation most poignantly: When doctors themselves “sleep on the ground” and “live the drama of the people” alongside the oppressed, Fanon wrote, they can become true allies against oppression, not collaborators with it.
MSF staff work side by side with Palestinians and use the organization’s international influence not only to provide medical treatment to those wounded in Israeli attacks on civilians, but also to publicly document and denounce the crimes Israel continues to commit with US-supplied weapons.
This decision came at a high cost: Israeli attacks killed six Doctors Without Borders staff members and several of their family members, along with around 500 other medical workers, almost all of them Palestinians.
MSF has not always taken such a strong stance against the political actors and decisions behind the infliction of maiming and death on civilians. Since its inception, the organization has argued for the use of explicitly apolitical paradigms such as “neutrality,” “testimony” (French for “testimony” or “witness”) and “humanitarianism.” The organization has seen these as tools to ensure access to conflict zones and occupied territories without antagonizing political groups that might target MSF staff or prohibit MSF from reaching affected people.
These frameworks help avoid incurring the ire of philanthrocapitalists and former colonial governments in the global North who are wary of political criticism of the ongoing neocolonial policies and practices that maintain the economic inequalities from which they profit while the world’s poor die.
But over the past few decades, in the wake of external and internal criticism, and the Rwandan genocide which vividly demonstrated the impossibility of maintaining neutrality, many within MSF have become increasingly confronted with the fact that they cannot care for people effectively or stop atrocities without political commitment, even if this angers donors and politicians.
In contrast, other health organizations in the Global North refuse to follow suit. The Western global health and humanitarian industry, like its closely intertwined US counterpart, is built on the avoidance and denial of this reality, but the simple fact is that human life and health, from birth to death, are determined by political decisions.
By selectively appealing to political neutrality and depoliticizing ideologies such as “humanitarianism” and “crisis” as a way to avoid the political and economic determinants of health in the midst of an ongoing genocide, most institutional leaders in the United States and physicians in general are once again evading their ethical responsibility to do all they can to protect life.
The history of humanitarian organizations is full of impossible choices and real ethical dilemmas. This truth has been used to create ample opportunities for organizations to hide behind “humanitarian” invented terms to navigate access in difficult circumstances.
But the established facts that Israel deliberately targets medical workers and infrastructure, murders civilians in hospitals and refugee camps, and uses starvation as a weapon of war while openly declaring genocidal intent, do not present any ethically ambiguous choice for organizations genuinely concerned with global health and medical humanitarian action.
Medical professionals, the global health workforce, and our institutions have time and again betrayed their most basic ethical responsibilities, and yet we continue to refuse to learn from our sordid past.
Remaining silent in the face of politically determined atrocities may avoid the professional risks and loss of funding that come with taking a principled stand against the violence of US imperialism and the Israeli occupation. But today, the decision of international health organizations to remain “neutral” or better in the face of genocide comes at the expense of something far more valuable and difficult to recover: a plausible claim to ethical credibility.
The views expressed in this article are the author’s own and do not necessarily reflect Al Jazeera’s editorial policy.
