Guest Viewpoint: On Gaza: What Does Public Health Call Us to Do in This Moment?

A Palestinian boy transports his bird on a bicycle past a destroyed building in Rafah in the southern Gaza Strip on November 6, 2023

[This article was originally published on the website of the Boston University School of Public Health (BUSPH) here. It solely represents the views of the authors and does not necessarily represent the views of the institution.]

Viewpoint by Jacob Bor, Walae Hayek, Fady Shanow, and Michael Siegel

Viewpoint articles are written by members of the Boston University SPH community from a wide diversity of perspectives. The views expressed are solely those of the authors and are not intended to represent the views of Boston University or the School of Public Health. We aspire to a culture where all can express views in a context of civility and respect. Our guidance on the values that guide our commitment can be found at Revisiting the Principles of Free and Inclusive Academic Speech.

Responding to Dean Galea’s call on January 4th for “shared reflection and deliberation,” and his most recent note on February 29th, we believe public health calls us to observeunderstand root causes, and take action amidst the ongoing devastation in Gaza.

Observe. First, public health calls us to be methodical in our analysis of population health while recognizing the biases that may eclipse our ability to do so effectively and equitably.

In the past 140 days, Israel has killed over 30,000 Palestinians in Gaza. Forty percent of those have been children. Israel has dropped more than 45,000 bombs on Gaza, targeting densely populated areas, even those declared “safe.” This campaign has damaged nearly 70% of all homes and displaced 85% of Gaza’s population.

Many public health experts fear that the worst of the crisis is to come. Israel has bombed most of Gaza’s hospitals and imposed a complete siege, cutting off access to food, electricity, and medical supplies. According to the UN, 2.1 million residents of Gaza face food insecurity and lack access to water and sanitation, raising the potential for outbreaks of diarrheal illness. Beyond the current state of emergency, Israel’s attack will have enormous intergenerational impacts.

These facts have been widely documented but are obscured by propagandarepression of journalists, and biased reporting. The US-based pro-Israel lobby has successfully equated criticism of Israel with antisemitism, persecuting critics and silencing debate. However, many Jews do not support Zionism and are deeply critical of Israeli policy. Criticism of Israel does not imply anti-Jewish prejudice, yet repression stifles free expression on academic campuses and in society at large.

Understand root causes. Second, public health calls us to investigate the root causes of the population health crisis in Gaza. The Israel-Palestine conflict did not begin on October 7, 2023.

Dating back to its founding and accentuated under the current government, Israel has pursued policies to expand Jewish settlement and state control “from the river to the sea,” creating an apartheid system in which Palestinians in occupied territories lack equal rights.

Zionism emerged in the late 19th and early 20th century as a response to rising antisemitism and persecution in Europe. In the words of its founder, Theodor Herzl, Zionism was a “colonial” project to resettle Jews in Palestine and create a Jewish ethnic nation-state. As many as 750,000 Palestinians were violently displaced in the Nakba or “catastrophe” to create a Jewish ethnic majority in the nascent state of Israel in 1948. Many current residents of Gaza are the descendants of Palestinian refugees from the Nakba.

Israeli occupation and settlement of Palestine continue against international law. The occupation has turned Palestine into an archipelago of small islands existing within apartheid infrastructure, with roads segregating Palestinians and citizens of Israel, settler control over water, food, and other natural resources, and violent military surveillance and prosecution. Gaza has been under a 15-year Israeli blockade that restricted movement and immiserated the population. Israel’s assault on Gaza aligns with the long-term Zionist effort to marginalize, remove, and reduce the Palestinian population. In January, the International Court of Justice ordered Israel to “take all possible measures to prevent genocide.”

Israeli officials have justified Israel’s policies and practices towards Palestinians by dehumanizing them. Members of Israeli government speak of Palestinians with virulent racism and hate. In its military decisions—dropping large numbers of non-precision bombs, targeting residences and cutting off basic necessities of life—Israel is inflicting terror and population harm. Statements from Israeli officials suggest that their attacks on Palestinians are not collateral damage, but collective punishment, in what one scholar described as “epidemiological” warfare.

The U.S. is an active contributor to this public health crisis: Israel’s assault on Gaza is directly enabled by U.S. military and diplomatic support and funded by U.S. taxpayers. U.S. Congress and the Biden administration continue military support for Israel’s attack on Gaza despite a majority of voters supporting a permanent ceasefire and international calls for the cessation of Israel’s attacks—including three UN resolutions, which the US has vetoed.  This has enabled Israel to maintain its barrage while preventing meaningful humanitarian aid from reaching Gaza.

Take Action. Lastly, public health calls us to dismantle the policies, programs, and practices that contribute to the poor population health outcomes and develop alternatives to support healthier communities, centering those most impacted.

Following these principles, the public health community must begin with:

1. Creating forums that center Palestinian perspectives, while protecting them and their allies from censorship and repression;

2. Pressuring the US government to end its military support for Israel, as others have in this national letter; and

3. Joining the Boycott, Divestment, and Sanctions (BDS) movement, inspired by the one that aided in ending apartheid in South Africa.

Dean Galea has written that “public health is about making the acceptable unacceptable” and refusing to normalize suffering. On Gaza, the call of public health is clear.

Jacob Bor is an associate professor of global health and epidemiology at BUSPH. 

Walae Hayek is a public health policy advocate and BUSPH class of 2021 alumnus.

Fady Shanow is a healthcare marketing professional, BUSPH class of 2022 alumnus.

Michael Siegel is a professor in the Department of Public Health and Community Medicine at the Tufts University School of Medicine and formerly on the faculty of BUSPH from 1995-2021.

Photo: Said Khatib/AFP