Palestinian healthcare workers are teaching us what it means to take a medical oath

“And if I go, who treats my patients?” This is the painful question posed by a Palestinian nephrologist, Dr Hammam Alloh, who was expressing his determination not leave his Gazan hospital following an Israeli military evacuation order in October 2023. Two weeks later, Dr Alloh was killed by an Israeli airstrike on his home near the hospital.

For more than fifteen months, our Palestinian healthcare colleagues have risked their lives to serve the sick and injured amid a campaign of unrelenting destruction that many UN experts say rises to the level of genocide. Healthcare workers in Gaza had to withstand attacks on healthcare infrastructure and personnel. They did their work without adequate food, rest, shelter or the opportunity to grieve for family members and other loved ones who were killed. They carried out their duties despite scant resources, necessitating operations without pain medicines or anaesthesia and impossible choices of which babies to save.

Despite all this, our healthcare colleagues have stayed and persevered in Gaza. In September 2024, Al-Shifa Hospital’s emergency ward was reopened five months after ruinous damage from an Israeli siege which occasioned the death of dozens of healthcare workers and sick and wounded people. In December 2024, Al-Wafa, a rehabilitation and geriatrics hospital, was targeted as a group of medical students sat their exam, injuring several and killing eight people. The next day, the students courageously sat their exam in an alternate venue.

For decades prior to the current onslaught, Palestinian healthcare workers maintained a system weakened under Israeli occupation — a medical system that suffered from chronic underfunding, the blockade of medical supplies, and damaged infrastructure due to military operations.

As news emerges of each detained, tortured or killed healthcare worker, the global medical and health community has rallied in solidarity through collective advocacy. Where our healthcare institutions have responded with apathy, silence or, worse, suppression of those who have spoken out, we have found moral courage in our Palestinian colleagues who have narrated their stories and endured caring despite extraordinary personal risks. Where we have faced our own moments frozen with overwhelming sadness, we have been buoyed by the supererogatory acts and leadership of our Palestinian colleagues who have barely stopped to rest or grieve.

From October 2024, Kamal Adwan Hospital was besieged for several weeks by the Israeli military. Paediatrician and hospital director, Dr Hussam Abu Safiya, provided daily live updates on the situation in the North Gazan health governorate, issuing pleas for support and pledging continued commitment to serve his patients: “I will stay inside the hospital until the last moment.” Footage of a white-coated Dr Abu Safiya leaving his hospital and walking towards Israeli tanks is an indelible symbol of peaceful resistance and medical steadfastness. Dr Abu Safiya remains arbitrarily detained by Israel alongside hundreds of other Palestinian healthcare workers. Information as to their whereabouts and access to legal counsel have heretofore been withheld in violation of international humanitarian law.

^{An interior view of the destruction at Kamal Adwan Hospital after the Israeli Defense Forces withdrew following the ceasefire agreement between Hamas and Israel, 30 January 2025. (Photo by Khalil Ramzi Alkahlut / Anadolu via Getty Images)}

Even before the temporary ceasefire came into effect on the morning of 19 January 2025, exhausted and grieving Palestinian medical staff were already emphasising their commitment to rebuild. “We now start a different kind of battle, but at least without the mass extermination, thank God”, said one emergency doctor. “God willing, we can rebuild and rehabilitate the health sector, but that will be a second war in itself.”

While representatives of Israel allege that Palestinian armed groups have been operating within almost all of the Gazan healthcare facilities besieged by the military — claims, it should be said, that have neither been substantiated by the United Nations and medical non-governmental organisations such as Médecins Sans Frontières (whose facilities and workers have themselves come under fire), nor from the individual eyewitness accounts of numerous healthcare volunteers including from the UK and the United States — there are nevertheless moral and legal lines that must never be crossed under any circumstances, by any warring party. Denying access to healthcare and endangering the lives of the sick and wounded, their families and the healthcare workers who continue to care for them takes those lines into crimson red. As Physicians for Human Rights – Israel, who have been advocating for the release of Dr Abu Safiya, posted on X:

if you attack healthcare professionals, you attack a whole society, you attack civilians who need medical attention, people with chronic illnesses, people with injuries …

As healthcare workers — one of us with personal and professional connections to Gaza — we affirm our ongoing solidarity with our Palestinian colleagues and in the pursuit of truth-telling of the Palestinian healthcare experience. We condemn Israel’s egregious attacks on healthcare infrastructure and personnel which we regard as violations of the principle of medical neutrality, and join global calls in demanding the immediate release of all healthcare workers unlawfully detained.

We call on nations to support the task of rebuilding the healthcare system in Gaza, to intervene to assure the future protection of Palestinian healthcare under international humanitarian law, and to support the investigation and prosecution of war crimes committed by Israel.

Above all, we agree with UN human rights experts: “The heroic actions of Palestinian medical colleagues in Gaza, teach us what it means to have taken the medical oath.” It is these actions that must go down in the teaching and history books of medical ethics around the world.

Dr Rachel Coghlan is a humanitarian health researcher in the Nossal Institute for Global Health at the University of Melbourne, and a practising physiotherapist. She has obtained a PhD on palliative care in Gaza and has travelled to Gaza to support palliative care education and training.

Dr Safiyyah Abbas is a paediatric rehabilitation physician based in Sydney.