The Epidemiological War on Gaza
Jan. 20—Maya Rosen, a graduate student in history at Hebrew University, pulled together a needed overview of her “The Epidemiological War on Gaza,” published in Jewish Currents. It picks up on the Nov. 28 comment of WHO’s spokesperson Margaret Harris: “Eventually, we will see more people dying from the disease than we are even seeing from the bombardment.” It opens: “Since Oct. 7th, Israel has severely reduced the entry of food, water, and fuel into Gaza, successfully creating what global health expert Yara Asi described as ‘a dire human-made humanitarian catastrophe,’ characterized by mass hunger, thirst, homelessness, and lack of medical services. As months pass without any meaningful relief, these conditions have produced ‘the perfect storm for disease,’ in the words of United Nations Children’s Fund spokesperson James Elder.”
At the beginning of January, WHO had already logged 424,639 cases of infectious diseases, meaning 1 out of 5 Gazans was known to be carrying an infection. Without even the feeble medical care available prior to Oct. 7, and with, at best, 20-25% of the trucks allowed into Gaza as before, as Asi put it: “You don’t need overt bloodshed to cause significant violence that ends people’s lives,” she told Jewish Currents. “Many people will die unnecessary deaths due to deprivation.”
Rosen adds: “This concern has a firm historical basis: In most wars, including in Iraq, the Democratic Republic of the Congo, Yemen, and Darfur, far more people die of disease and starvation than through direct military assault…. Public health scholar Devi Sridhar recently estimated that barring a dramatic shift which includes a resuscitation of the health system, half a million people—a quarter of Gaza’s population—could die from preventable health causes in the coming year.”
Israel’s Defense Minister Yoav Gallant’s official wartime advisor, Gen. Giora Eiland (ret.) stated that “severe epidemics in the southern Strip will hasten our victory.” And Likud Knesset member Tally Gotliv argued that “hunger and thirst among the Gazan population” recruit desperate collaborators to Israel’s side. Netanyahu has opposed making such an official policy, but, as Asi put it: “When you cluster people and keep them away from medical care and water … it doesn’t take an epidemiology degree to know what’s going to happen…. [I]f you wanted to [spread disease], you would do exactly what Israel is doing.”
At the beginning of Israel’s blockade of Gaza over 16 years ago, the IDF calculated, from a minimum caloric intake, what would be allowed into Gaza to prevent a catastrophe. The 2008 document established a red line. So, the predictable consequences, first of completely cutting off and then, under pressure, merely greatly restricting, the 500 trucks/day of supplies that Gaza has lived on have been known.
Further, Israeli diplomats had been quoted, in a U.S. diplomatic cable made public last year by WikiLeaks, saying they wanted to “keep Gaza’s economy on the brink of collapse.” Rosen quotes a summation by the Israeli advocacy group Gisha: “The official goal of the policy was to wage ‘economic warfare’ which would paralyze Gaza’s economy and, according to the Defense Ministry, create pressure on the Hamas government.”
As of a couple of weeks ago, the independent Famine Review Committee had 80% of the 2.2 million Palestinians in Gaza at its two most extreme classifications, “emergency” and “catastrophe,” with little hope for the remaining 20%. Severe overcrowding and unclean water are the rule. The cold and rain compounded the lack of winter clothing, as so many had been forced from their homes unable to carry all they needed. The lack of sanitation and sewage services has all forms of waste piling up. There is one toilet for every 486 people at the UN shelters, where most (around three-quarters) of the 1.9 million displaced Palestinians shelter. The constant bombardment has released toxic substances into the air. Aside from the many dead under rubble, more dead out in the open have not been buried.
Formerly treatable diseases such as viral diarrhea, influenza, and lung infections spread. Over two weeks ago, there were already 136,400 cases of diarrhea, with around half of them in children under 5—a deadly situation. Further, epidemiologists “say that this unprecedented situation could lead to the emergence of deadly and highly contagious diseases not currently found in Gaza, such as measles and cholera, as well as typhoid and polio.” Hepatitis A is known to have broken out (and is now also spreading through Israel). Israeli hospitals are now seeing the first signs of drug-resistant infections from bacteria in Gaza, with at least one soldier dying from such “a fungal infection, likely contracted due to sewage.” The IDF reported “an outbreak of gastrointestinal illnesses, with some cases involving shigella—a bacteria that causes dysentery…. Israeli public health experts have become particularly vocal … writing in a Haaretz op-ed that pandemics ‘do not know borders’ and that diseases in Gaza will ‘spread without disruption and lead to sustained outbreaks among the civilian population’ in Israel as well.”
Rosen wrapped up: “Public health experts have noted that Israel’s decision to create unlivable conditions in Gaza falls under the definition of genocide, which includes not just direct military violence but also ‘deliberately inflicting on the group conditions of life calculated to bring about its physical destruction.’ Every public health expert with whom I spoke agreed that a ceasefire is the first step towards addressing the health crisis in Gaza.” Aseel Aburass from Physicians for Human Rights-Israel is cited on the simple point that a ceasefire is needed “so that the hospitals will go back to functioning, so that aid—food, water, sanitary items, medicine—can reach everyone.” But, as Yara Asi put it: “We have now reached the point where a ceasefire in one minute would not end the suffering of many for weeks if not months.”
Finally, Rosen’s proper conclusion: “Fighting infectious disease, public health experts agree, requires allowing in food, medicine, and vaccines; building houses to shelter Gaza’s nearly 2 million displaced people; and investing in infrastructure—water treatment, sewage systems, and power grids.” She ended with a quote from a Palestinian doctor, on condition of anonymity: “If the world can tolerate this amount of Palestinian death by direct bombardment, it will be much more able to tolerate future reports of how many Palestinians died from diseases. If you can burn people with phosphorus bombs, then of course you can crowd them together and let diseases do the rest.”