In early 2025, headlines around the world detailed stories of horrific medical suffering and punishment in Gaza:
- ‘“Hospitals have become battlegrounds”: Gaza’s health system on brink of collapse’ – United Nations
- ‘“No rules”: Gaza’s doctors say they were tortured, beaten and humiliated in Israeli detention’ – The Guardian
- ‘Israeli Authorities Block Health Care Workers from Entering Gaza’ – Human Rights Watch
Sadly, these headlines are not novel but rather represent a continuation of more than a year of the Israeli military’s systematic targeting of Gaza’s medical and healthcare infrastructure. In short, it is a clear example of medelacide.
Naming the crime in Gaza: Medelacide
I define medelacide as the intentional and systematic destruction of healthcare infrastructure. Healthcare infrastructure includes not just hospitals and clinics, but also the organisations that help a society maintain safe and sustainable healthcare access for its people.
So, how can medelacide be identified? In my research, I found myriad reports that demonstrate Israel’s medelacide in Gaza, from October 2023 to October 2024. This includes:
- hospitals besieged and/or under occupation by military forces;
- ambulances intentionally targeted for attack;
- hospitals intentionally targeted by military forces;
- medical staff kidnapped, forced out of hospitals, indefinitely detained, and/or tortured;
- medical staff arbitrarily humiliated and/or threatened with sexual assault;
- mass graves found at hospitals.
The intentional targeting of medical infrastructure: A clear violation of international law
In armed conflict, there is an expectation of ‘medical neutrality’. Medical facilities, personnel and patients are to be protected. The Geneva Convention outlines how ‘fixed establishments and mobile medical units of the Medical Service may in no circumstances be attacked but shall at all times be respected and protected by the Parties to the conflict’.
But what happens when a military claims it needs to attack medical infrastructure, saying so-called ‘enemy combatants’ are taking refuge or planning attacks inside of, or beneath a hospital? This is a common claim of the Israeli military, but requests for documentation to corroborate these assertions are rarely acknowledged.
For example, the Israeli military raided northern Gaza’s Indonesian Hospital in late 2023. Then, as AP News reports, ‘after besieging and raiding the hospital, the military did not mention or show evidence of the underground facility or tunnels it had earlier claimed. When asked if any tunnels were found, the military spokesman’s office did not reply’.
No accountability for attacks on healthcare infrastructure
The medical journal The Lancet outlined an ‘uncomfortable truth’ in 2023, stating that ‘attacks against health facilities and staff in conflicts can be committed largely with legal impunity’. Several years earlier, lawyers and human rights experts outlined how ‘criminal prosecutions of alleged [International Humanitarian Law] offenders are infrequent and generally take years to complete, [so] the international community should utilize other accountability mechanisms, such as launching public advocacy campaigns to end impunity for offenders’.
In Gaza, the targeting of the healthcare sector is totalising. If you’re lucky enough to survive, the punishment tracks you down. For example, when British-Palestinian doctor Ghassan Abu-Sittah worked in a Gaza hospital in late 2023, he told the world of the horrors he saw, and has since been harassed by law enforcement across Europe for trying to speak about Israel’s crimes.
Dr Hussam Abu Safiya, the Director of Gaza’s Kamal Adwan Hospital, was detained by Israeli forces in December 2024, placed in solitary confinement and subsequently subjected to torture. These are just two examples of healthcare workers being harassed, tortured and ‘disappeared’ in Gaza since 2023.
The increased frequency of the targeting of healthcare infrastructure in current conflicts, coupled with the lack of political will to hold the responsible parties accountable, is precisely why new social imaginaries are needed to mobilise for social change.
Mobilising against medelacide
The envisaging of new ways to mobilise for political action, or social imaginaries, creates opportunities for people to name a problem, identify the culprits that created it, and mobilise to solve the issue.
After the United States waged chemical warfare in Vietnam, the concept of ecocide emerged. Ecocide describes the intentional and widespread destruction of a region’s environment and remains a popular legal and activist term more than five decades after its coinage.
I argue that the term medelacide can play an equally important role, naming a disastrous phenomenon that requires social, political and legal mobilisation to stop it from occurring.
There are many admirable people and organisations around the world working to call out Israel’s destruction of Gaza’s healthcare system and to end their own country or profession’s complicity in these actions.
The group Irish Healthcare Workers for Palestine identifies and calls out ‘a pattern of inaction, delayed, weak, or equivocating statements, and, in some cases, complete silence’ coming from its professional organisations, in regards to their lack of commitment in demanding an end to the Israeli assault on Gaza.
Likewise, US healthcare professionals Joelle M. Abi-Rached and Eric Reinhart describe ‘the Palestinian challenge to US medical ethics’. They outline how ‘the most influential medical professional organisations, journals, and lobbies have been disturbingly reluctant to take any meaningful stand against the systematic obliteration of health systems in Gaza’.
These calls to action from the Global North must be amplified, given the lack of willingness among major healthcare institutions to denounce the destruction of their peers’ medical infrastructure in Gaza.
Just two months into Israel’s genocide in Gaza, following Hamas’s attack on 7th October, a collection of Gazan health sector unions released an ‘urgent call to health care unions worldwide’. They followed with a simple request: ‘We seek your solidarity and immediate assistance’. Gaza Medic Voices offers first-hand testimony of the extraordinarily challenging conditions that health workers in Gaza are encountering. The burden cannot solely be placed on medics in Gaza, facing such dangerous circumstances, to bring awareness to the issue of medelacide.
Yes, there is ample documented evidence of attempts to silence, intimidate, harass and retaliate against scholars, students, professionals and activists in Western countries who speak out against the Israeli government’s crimes in Gaza.
Just as there are myriad reasons to be fearful of speaking out, there are also many reasons for action. As Omar El Akkad writes, ‘alongside the ledger of atrocity, I keep another’. That is a ledger of all the brave people worldwide who choose to act against the violence they deem unacceptable in the world system.
For El Akkad, this involves realising ‘that there are more people interested in solidarity than annihilation’. This is a crucial observation. And, as Rafeef Ziadah notes, ‘silence and claims to institutional neutrality are important mechanisms for maintaining the status quo’. So, if the status quo is one of enabling the annihilation of a people’s ability to maintain their health and safety, how could one opt for so-called ‘neutrality’?
When Doctors Without Borders describes Gaza as a ‘death trap’, why would one opt to remain silent in the quest to alleviate that collective punishment on Palestinian civilians?
Calling out and mobilising against acts of medelacide should not be confined to healthcare professionals. It is a task open to all those who seek a healthier, safer, socially just world.
Jason C. Mueller is an Assistant Professor of Sociology at Kennesaw State University.
Medelacide: the intentional and systematic destruction of healthcare infrastructure by Jason C. Mueller is available to read open access in the Global Social Challenges Journal on Bristol University Press Digital.
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