The doctor’s role in liberation: an interview with Dr. Ghassan Abu-Sittah

Dr. Ghassan Abu-Sittah, a plastic and reconstructive surgeon based in London, has spent much of his professional life in the operating rooms of conflict zones. In his youth he hesitated to pursue a career in medicine. His father was a doctor, and he, like many children of physicians, thought he wanted something else, maybe a career in the social sciences. The Israeli invasion of Lebanon in 1982 first exposed Abu-Sittah to medicine’s possibilities and how these might extend past the individual doctor-patient interaction. He decided to become a surgeon, and his work in the intervening years led him to Mosul, to Yemen, to Damascus, and to Lebanon, where he founded the American University of Beirut’s first-of-its-kind Conflict Medicine Program. And again and again, his work led him, as much as he led his work, back to Gaza.

A documentary from 2003 titled “About Gaza” opens with footage of Abu-Sittah crossing a busy intersection, wearing a suit and with a leather briefcase in hand; seconds later, the frame cuts to piles of rubble amid cratered buildings. Abu-Sittah explains via voice-over that he’s taken a six-month leave to travel to Gaza because “as a diaspora Palestinian, I felt that this is where I belonged. Even though I had never lived in Gaza, it’s a place that I’ve always regarded as home. It’s where the two currents in my life meet: my profession and my sense of identity.”

Abu-Sittah was born in Kuwait to a Palestinian family that, along with hundreds of thousands of others living in southern Palestine, forcibly fled their homes in 1948 and sought refuge in Gaza. In sharing his family history in interviews, I’ve noticed more than once Abu-Sittah correct himself: he says, “my family were refugees” then, “made refugees,” as if to insist on the significance of linguistic precision, conscious of the aggression we normalize in everyday speech. His ancestral village, Ma’in Abu-Sitta, four short kilometers away from what the Israelis call the “border fence,” was taken over by settlers and developed into kibbutzim, among them Nirim and Magen. Abu-Sittah’s uncle, Dr. Salman Abu Sitta, an academic and the author of Atlas of Palestine, recently wrote in an article for Mondoweiss: “When you hear the names of these kibbutzim, you must recall on whose land they were built. You must remember that the owners of this land have never given up their right to return home.”

Dr. Ghassan Abu-Sittah was among the last group of people to enter Gaza through Egypt on the morning of Monday, October 9, immediately before the Rafah crossing was totally shut down and the territory was sealed off from the world. He started operating at al-Shifa Hospital, Gaza’s medical epicenter, as soon as he’d arranged safe passage to the medical complex. Within the first few days, as a result of a relentless, ruthless bombing campaign against Gaza’s civilian infrastructure and people, the wounded had exceeded the entire Strip’s total bed capacity (of 2,500). Abu-Sittah fielded interview after interview, appearing live on air to try and convince a world, seemingly unmoved by Palestinian death of the stakes of what he witnessed unfolding. He told CNN’s Christiane Amanpour on October 12, 2023, that basic medical equipment was unavailable mere days into the assault. He warned listeners of the far-ranging, catastrophic consequences of this war against the people of Gaza, “a man-made catastrophe,” he said, “almost like a perfect storm,” as Gaza’s healthcare system was “already on its knees” thanks to fifteen years of Israeli siege. Abu-Sittah was working at Al-Ahli Hospital during the massacre on October 17, 2023, and was among the physicians who testified, surrounded by a sea of blanket-shrouded bodies, in the hospital courtyard in the attack’s immediate aftermath. He later criticized a report released by Human Rights Watch on what they called an “explosion” for having failed to contact a single person on the ground in Gaza — not even the hospital director who had received evacuation orders and bomb threats from the Israeli forces — before releasing their preliminary findings with the incredible subheading, “Evidence Points to Misfired Rocket but Full Investigation Needed.”

Since leaving Gaza in November, Abu-Sittah has committed his days to fighting the “killing machine masquerading as a state” set on extinguishing life in Gaza. He has attended conferences, provided eyewitness testimony, and taken more interviews to advocate for a ceasefire however he can. With an eye for systems, he has called on the international community to start thinking about the day after to build the momentum and capacity it will require of us so that we are ready to rebuild as soon as the bombs stop. In recent weeks, he has launched the Ghassan Abu-Sittah Children’s Fund, a program committed to bringing injured children from Gaza to Lebanon to receive holistic, longitudinal medical and psychosocial care. 

Dr. Abu-Sittah and I spoke over Zoom on the morning of February 20, London time. We talked about the liberatory potential of medicine and the complicity of Western media in the ongoing genocide in Gaza. We discussed Zionism and what to make of a settler colonial ideology that has flung itself over the precipice of genocide (and doesn’t seem to mind), necropolitics, and the obligation, when confronted with the cold, monstrous logic of elimination, to remain unwavering in our commitment to life.

Our conversation has been edited for length and clarity.

Mary Turfah: While in Gaza, you tweeted these words from James Baldwin:

For nothing is fixed, forever and forever and forever, it is not fixed; the earth is always shifting, the light is always changing, the sea does not cease to grind down rock. Generations do not cease to be born, and we are responsible to them because we are the only witnesses they have. The sea rises, the light fails, lovers cling to each other, and children cling to us. The moment we cease to hold each other, the sea engulfs us and the light goes out.

I remember reading your tweet, and I’m wondering if you remember tweeting it and where your mind was at the time.

Dr. Ghassan Abu-Sittah: I remember very clearly thinking about that quote because I absolutely love James Baldwin. I think he, more than any other writer, captures both the anger and the harshness of a revolutionary, and the tenderness and the kindness of a humanitarian thinker. Or a humanist thinker. And I was walking through al-Shifa Hospital, up the stairs of the burns unit, which is in a separate building within the compound of al-Shifa, and watching the families that had turned al-Shifa into an internally displaced camp, looking at the way they looked after each other. And the way they looked after their children. And the way they interacted. The way people had decided early on to resist the world of death that the Israelis had created by these continuous acts of love and tenderness.

And I’m wondering when you tweeted that, what the ‘light’ was.

The light is the acts of love that people are displaying towards each other, towards complete strangers, the way that the children who had lost their families and were wounded were being cared for by the families of other wounded children, the way—just, love as a form of resistance to the world of death.

So, in that sense, the light hasn’t gone out. A lot of people are trying to balance the immense despair of what we’re witnessing through our phone screens with the fact that people are persisting. And in that way, this quote captures both.

Absolutely. There was a story about this couple that decided they couldn’t wait anymore, and they decided to have their wedding in Rafah in a tent the other day as a kind of act of resistance. And you see that. You used to see that all the time. And you still see that all the time. What breaks your heart is how the world is watching for that light to be snuffed out so that then we can wring our hands and shake our heads and say, isn’t that awful how these things have been completely extinguished?

I’ve been shocked at people’s ability to speak about Gaza already in the past tense. Why are we talking about these people as if they’re not alive right now?

And as though this isn’t still reversible. We can’t bring back the dead, but we can stop the 150 to 200 that are being killed every day from dying. We can’t bring back the dead, but we can make sure people aren’t dying of starvation in the north. I mean, it’s still…you see, the problem with liberalism, with European-American liberalism, Western liberalism, is the way it washes its sins by historicism. 

White liberal thought in the West now is waiting for Gaza to die so that it can then engage in that washing away of its sins by historicizing the slaughter. Its investment in the system — in the global system that needs the people in Gaza to die and needs to sell the Israelis the weapons to kill them with — means that it’s incapable of stopping it preventatively. But at the same time, because of the way it replaced the racial superiority of the Victorian age and first half of the 20th century with a sense of moral or cultural superiority, it needs to historicize and then weep and then promise never to do it again.

Yeah. People are mournable when they’re no longer threatening.

Absolutely. When you don’t have to do anything.

It seems that the magnitude of what’s happening in Gaza, and specifically to the medical infrastructure in Gaza, is unprecedented. And then, at the same time, Israel has a long history — not like this, exactly — of targeting doctors, of targeting hospitals. And so in some ways, what we’re seeing is quite new, and in some ways, it’s not new at all. What to you is a rupture, and what’s more consistent with pre-existing patterns?

So you’re right. On the 4th of June, 1982, the Israelis started the invasion of Lebanon by targeting every Palestine Red Crescent Society hospital in Lebanon with air raids. And it’s always been a component of that kind of necropolitics of Israeli wars on Palestinians, the targeting of the health system. 

What has happened is this: The logic of elimination that Patrick Wolfe spoke about, which is the logic that binds the relationship between the native and the settler, the logic of elimination has moved from expulsion, transfer, and separation, using genocidal tools such as massacres and wide-scale killing, into a full genocide as the form of elimination. And therefore, we will see lots of tools that the Israelis have used in the past now converging into a complete strategy. The tools of targeting the health sector became a central tenet of the military strategy of this war because the aim now is a genocidal aim; rather than using genocidal tools to further the idea of elimination in addition to other tools, such as separation and quiet expulsion, now Israeli society has transitioned into genocide as the form of elimination of the native.

So in terms of the Zionist regret that ‘we didn’t get rid of all of them,’ now’s the time.

From the very beginning I was saying this is Benny Morris’s war. You know, remember Benny Morris wrote his first book, and then a few decades later, he came out in Haaretz and said that the biggest mistake that the Zionist movement committed was not expelling the Palestinians in the West Bank and the Gaza Strip. And unless it does that, the Zionist project will fail and be defeated. 

And you feel it now with the resistance of the Israelis to stop the war. There’s a bumper sticker that’s everywhere in Israel that says, “Finish them off.”

When you were in Gaza, I imagine the volume of penetrating trauma you were taking in and trying to manage required some level of emotional detachment just so that you could keep going. At the same time, the things that you were sharing of what you were seeing and the level that you were able to perceive revealed a person who was open to being vulnerable who was paying close attention. How did you manage that? 

So it’s not the gore and the bodies that affect you. It’s the stories of the people, the lives that have been shattered, the glimpses of lives before the injury that really completely overwhelm you. You’ve been used to dealing with the clinical aspect of it in a detached way because, in your mind, you’ve been trained to go through the process, the mental process: This is a limb injury. There’s exposed bone. This is what I need to do. I need to take out the dead tissue. I need to clean this wound. I need to plan for this reconstructive procedure. But it’s what happens before and after these cases, when you are hit by glimpses of that life that was, before this moment where that body was broken, and that life was shattered. I mean, that’s what you can’t stop yourself from being completely, initially winded by, and then overwhelmed with a great sense of sadness about.

How do you then keep going? I mean, you have no choice —

You have no choice because you’re trying to keep your head above water. There’s a tsunami of injuries that have come through. And you know that unless you get your 10 or 12 cases done that day, these patients will never get a chance to go back to the operating room because, in that day, you’ve had 400 or 500 wounded come into the hospital.

Part of what we’re seeing, and we’ve seen historically too, is that doctors play a significant role in people’s liberation movements. We have many historical examples. Why do you think that is?

Particularly for Palestinians, more so than for the ANC, more than in Latin America. Health has always played a much more central role in the Palestinian liberation movement and the ideas of Palestinian self-determination than in other places. And you can see that from the 1950s, with the emergence of the free clinics by people who are coming out of universities like the American University in Beirut and Cairo University. Or the centrality of the Palestine Red Crescent Society and its health centers in the Lebanon experience of the PLO. And then, during the First Intifada, the Medical Relief Committees and the Union of Health Work Committees how central they were to the idea of mobilization. 

I mean, I just came back from Doha, and at that meeting were Abdelaziz Allabadi, who was one of the two young doctors at Tel al-Zaatar during the siege, and Mustafa Barghouti, who had, with a group of other young doctors, set up the Medical Relief Committees during the First Intifada. And you can see that centrality is critical. Part of the resistance of the health system and these doctors today finds its roots in that current within Palestinian liberation ideology.

How does that happen? Because my medical training is not like that. And I imagine in the UK, it’s not like that either. 

It’s not about the medicine, but rather about what medicine allows you to do, that immediate ability to reach into people’s lives and to reach into their struggle and to see up close. Medicine allows you to stand at the coalface, and politics allows you to see what you are looking at. That’s what shapes that kind of medical activism if you want to call it that, or medical liberation ideology.

Yeah, we’re taught to keep politics outside of medicine in a way that would be laughable for any other field, the expectation that you not invest in the people that you’re working with. And it seems there isn’t that same hang-up somehow in Palestine.

I saw the National Health Service prior to this creeping corporatization and privatization, and I think this idea, this laughable idea about politics and health, is a way to ensure the commoditization of health, which is an anathema and a bizarre concept which corporatization of medicine relies on—it goes unchallenged. You can’t bring politics into medicine, but medicine is all about politics. Whether the consequences of politics in terms of people’s health or the consequences of politics in terms of what you can deliver to whom—it’s a critical component of medicine.

What then do you think is the doctor’s role in liberatory struggle in Palestine?

I think the provision of health care, particularly in times of crisis, be it during the Tel al-Zaatar siege and massacre or the siege of Beirut in ‘82, or the First Intifada, or the Second Intifada, or this war. It is to be there for your people and to provide for your people. What we’ve learned from the Israelis and from the Palestinian doctors in this war—and I think that’s a critical component for the rest of the world to learn from—is the centrality of demolishing the health system as a precondition to ethnic cleansing. You cannot ethically cleanse people from an area without destroying the health system. 

The Israeli military has insisted on dismantling and then destroying every aspect of the health system—not just the physical destruction of hospitals, but the killing of 340 doctors, nurses, and paramedics, and destruction of the medical schools, prevention of access to medication and to fuel, all of these things, they’re taking away the health system brick by brick–is an indication that in the modern era, you cannot ethnically cleanse areas without destroying the health system, because the health system anchors people in their communities. And yet, Palestinian health workers and Palestinian hospitals have refused the threats of evacuation that the Israeli army has made from the very beginning of the war.

Yeah, medicine is a barrier against death. And the doctors present themselves as such. That’s on a macro level. On a micro level, something I’ve noticed—and this has been over the past decades, not just now— in major American medical journals is the presentation of the Israeli doctor as willing to give medical care to all-comers, whether they are Palestinian or not, militant or not, this benevolence that is characteristic of a doctor, a willingness to treat humanity. Versus the Palestinian doctor who’s not only not a benevolent actor, not going to treat an Israeli, hateful, spiteful, whatever, but also not a doctor—

They’re an activist in a white coat. A political actor in a white coat. One of the interesting things about this war is how Western media went from silencing Palestinian voices to having to censor Israeli voices to protect Zionism from the declarations of Israelis. The fact that at the beginning of the war, 400 Israeli doctors signed a petition calling on the IDF to target hospitals was not commented on or reported in the Western press. The fact that for weeks and weeks until the ICJ ruling and the ICJ deposition, a lot of statements by Israeli politicians, genocidal statements, statements talking about the intent to ethnically cleanse Gaza, were not reported. So Western media not just silences Palestinian voices but also silences rabid Israeli voices, with the aim of protecting the image of Zionism from them. Because these people are now drunk on 75 years of impunity, and so just say things that their co-conspirators in the West don’t want them to say.

I have a hard time calling it exactly ‘psychosis’ because then, in some ways, you’re taking away the agency of the actor.

Absolutely. It’s the psychosis of the Germans in the ‘30s and the ‘40s. It’s the psychosis of really thinking—the psychosis of the white South African Boers in the ‘80s. It’s when you really think that there’s nothing wrong with what you verbalize because nobody’s taking you to tax on it. It’s the normalization of the unspeakable. And so you start to verbalize the unspeakable. And what they don’t realize is Western liberalism relies on hypocrisy, on that complete diametrical opposition, that what you say and what you do should not be the same. You do want it, but you have to say something completely different.

The tough part for me, though, is when–let’s say you’re assessing a patient for capacity, for example, you need to know if they have insight. These people, they can’t hear themselves.

They have no insight. I mean, their obsession with TikTok videos about blowing people up or stealing people’s belongings, or blowing people’s homes up. Was it Haaretz that ran a whole story about the cooking skills of Israeli soldiers inside Palestinian kitchens? I mean, literally, this is a society that now lives in a genocidal bubble. They have so dehumanized Palestinians that the Palestinians, for them now, are not subhuman. They’ve become invisible. And so it’s not someone’s kitchen. No, it’s your son practicing all of the lovely cooking skills that you’ve taught him while he’s in the field. He’s not in someone’s house. He has most likely just killed these people.

That’s what their grandparents did in ‘48, though. They moved into people’s houses (after ethnically cleansing the inhabitants). It was totally fine.

Absolutely. They moved into people’s houses. And they stole their furniture. There’s that book that came out a few years ago, talking about the amount of looting that they did from houses to the point where, I think it was Ben-Gurion who said, ‘I can’t bear to think that we will have to live in the same country as these people.’

I can’t wrap my head around the behavior of these people towards other human beings. I did not know that humanity could go—

For me, because I review a lot of the medical reports of kids trying to get out for treatment. The number of kids who’ve been shot by snipers—children, children shot by snipers. And the thing about the sniper is the intimacy that the periscope, the telescope, gives them. This individual knew. 

When I was in Al-Ahli, towards the end, we were getting a lot of people shot by these quadcopters, these drones that have sniper guns attached to them. And I remember, I mean, on one day, we had over 20. And I remember thinking about that 19, 20-year-old, 18-year-old on the other side of that video game, deciding to shoot a nine-year-old boy and his mother. I mean, it beggars belief and exhausts language for you to try to understand how he got to that point.

And I keep telling myself it’s not our job to psychologically accommodate it. It’s to try to stop it.  

We have to. There’s no accommodation. We have to defeat it. This is a genocidal ideology. You have to defeat it. The Israelis now crossed to the point of the Khmer Rouge. You can’t then sit and say, which wing of the Khmer Rouge are we going to try to accommodate? And what we see in Israeli society is it’s doctors, taxi drivers, academics. When you talk to Palestinian academics who work in Israeli universities and hear what they are being subjected to—and I’m talking about people who work in human rights departments and legal departments, what they report their Israeli colleagues saying. This is a—it’s up to the Israelis to decide to claw their way back into humanity. But what the rest of the world needs to do is defeat them.

You’ve been going to Gaza for a long time. Dr. Ang Swee Chai mentions traveling to Gaza with you in her book, From Beirut to Jerusalem. She explained that the role of visiting surgeons in Gaza was not to perform operations so much as to provide further training and supplies. Palestinian doctors on the ground are capable. They’re being killed, but there’s no deficiency in terms of skill. And so then, what do you see as your role as a doctor there?

This time around, it was the sheer number of the wounded meant that…the number of beds in Gaza before the war was 2,500. By the end of the first week, we’d already had more than 2,500 wounded. And so when I made the decision to go on the 7^th of October, I made that decision because I knew that the number of wounded far exceeds not the skill set but the sheer number of people on the ground able to do this work.

There’s a sense from doctors here of wanting to go to Gaza to help, and then a hesitation because if aid isn’t getting in, if medical supplies aren’t getting in, what can we do?

Nothing. I mean, this is the problem: Where do you go? There’s only the European Hospital that’s left in the whole of Gaza to accommodate visiting teams. What the Israelis have done by the destruction of the system is that there’s actually a relative surplus of medical staff because all of Gaza now functions on nine operating rooms at the European Hospital. And the Israelis are preventing new field hospitals from coming in with new capacity.

I just don’t…I don’t understand how—

No, it is genocide. It’s genocide. You see, the problem is we have been academically talking about genocide as if it’s a metaphoric or an ideological construct. But what is happening in Gaza is literally a genocide. It is mathematically a genocide. It is a place with two and a quarter million people that has had probably around 40,000 to 50,000 killed because of the number of people under the rubble, the number of people who’ve been killed and not reported, the number of people who are dying silently from the epidemics and the starvation—you’re looking at 40,000 to 50,000. Of two and a quarter million, mathematically, that’s a genocidal percentage. 13,000 children is mathematically a genocidal number. So there is the logistics of genocide that is unfolding, and this is part of the logistics of genocide.

It’s so barefaced. That’s the part that’s confusing.

It’s impunity. It’s when you’re drunk on 75 years of impunity. You start the war by confessing. Before you start the war, you confess to the whole world what you’re planning to do. You continue to confess verbally what you’re planning to do. And in those places where you don’t find a camera, you video-record yourself committing crimes because you’re so dissociated as a result of these 75 years of impunity. You’re so dissociated from a world where actions have consequences. 

For the Israelis, actions have never had consequences because the West has built this infrastructure to ensure impunity that extends from the editorial boards of medical journals to the BBC, to CNN, to the Royal College of Physicians and Surgeons. There is a whole infrastructure of impunity that is beyond the political leadership, that has ensured Israeli impunity and has helped Israelis come to that dissociative state, where they cannot see—or they don’t need to see, or they cannot see, who cares? But they don’t see that what they do has any bearing on the rest of the world because it has never had any bearing on the rest of the world. Because the whole of the invasion of Lebanon, with 35,000 killed, was passed off by Western academia and Western media to be related to some spurious assassination attempt of the Israeli ambassador in London and the need to destroy the PLO. Every Israeli act of genocide has always been whitewashed by the West. And so you come to a point in 2023, 2024 where there are no consequences for these acts. Why would the Israelis think that there are going to be consequences for acts that they have been committing for 75 years?

And the condemnations are always asterisked as if to say, ‘this doesn’t represent what the majority of the Israeli population wants.’ Some Israelis will do this or that. Or settlers are doing such and such. That’s always the framing to exceptionalize what we’re seeing. You’re never allowed to draw broader conclusions or patterns from the behavior.

No, regardless of how many and their positions. There was an Israeli pediatrician who was taunting her Arab colleagues, that every morning, she wakes up and puts on Al Jazeera to see Palestinian kids being killed before she can go to work.

It’s disturbing, but there’s this pervasive sadistic pleasure.

Yeah. Yeah, yeah. Absolutely. Absolutely.

But we try to focus on the humanity that we’re seeing on the other side, and especially from the people of Gaza. I hear things like, ‘the people in Gaza are defending their humanity.’ No, they’re defending humanity for the whole world. 

What has Gaza taught you about the potential of medicine?

I went into medicine after I had started to make almost an accommodation: The invasion of Lebanon was a very formative moment in my life as a teenager. And because my father was a doctor, I had wanted—in the UK, there’s a course called PPE, ‘Politics, Philosophy, and Economics.’ I didn’t want to do medicine. And it was me coming to the realization that medicine allows you the position to be inside people’s lives because they allow you to be in their lives in a way no other profession does. And to impact their lives on a macrocosmic and a microcosmic scale in a way no other profession does. If you equip yourself with the analytical skills and the lenses to be able to better see what you’re looking at in the clinic, then it becomes a much more enriching life because, from the microcosm, you can then draw out the macrocosm and the big picture. If you ensure that you have the analytical skills, if you look at your medicine as a social science and not as a purely scientific endeavor, then it allows you to see every patient as a piece of the bigger puzzle.

And then it allows you to bear witness to people’s suffering that happens behind those doors, people who have had their voices robbed of them. And it allows you to agitate in a way that the system is not prepared for you to agitate because you are the scion of respectability in Western professional life. You’re a doctor. And so when you start to agitate, then you’re more likely to be heard. 

Now, the whole irony of ironies is that you have to keep insisting that you’re a British-Palestinian doctor because, God forbid, if you’re just purely a Palestinian doctor, then your testimony doesn’t carry the same weight. And your testimony is not as strong as if you were blond and blue-eyed, a fully British doctor. So you know, it’s all about trying to find the cracks in this wall that they’ve created to protect the Zionist project so that your voice can get through and so that you bear witness to the victims that you’ve treated because you owe them. You owe your patients to ensure that their stories get told.

On the framing of the doctor as British, or that you have to be a hyphenated identity to have credibility: almost every essay I’ve seen published in a major news outlet here about medicine in Gaza has some kind of…like, The Los Angeles Times just ran an article about Gaza that went viral. And the headline starts, ‘I’m an American doctor.’ 

Yeah, I’ve seen that! ‘I’m an American doctor.’‘I am not as hysterical as these brown people, and therefore, I will tell you the truth.’ But you’re so desperate for the truth to get out that you don’t mind it anymore.

I’ve noticed I’ve almost…not quite stopped registering the politics of it, but I don’t care. I just want the story out. They don’t see us as people. And it’s very obvious. As you said, you are seen as a person only if you’re willing to distance yourself from your own people.

We are the victims of what’s happened since the end of the ‘60s to now. We can no longer talk about national liberation of the South as an equal to the North. We can no longer talk about solidarity but charity, and we can no longer talk about steadfastness but resilience, and we can no longer talk about a host of other things. We’ve had our National Liberation language robbed from us.

When you arrived in Gaza in October, what were you expecting?  

I was thinking it was going to be a worse version of the 2014 war. It’s not a worse version of anything. This is a different war. This is a genocidal war. The difference between it and other wars is the difference between tsunamis and floods. They’re both made out of water, but that’s where the similarity ends.

I imagine you feel that you’ve been changed by what you’ve seen.

Absolutely. I’ve been changed as everybody else has been changed. I mean, I’ve changed because of my experience, but I don’t think there’s anyone else who hasn’t been changed. I don’t think there is a single non-white person living in the West who has been keeping an eye on what’s happening, who hasn’t been changed. When you listen to Lula talk, you realize that this war has changed the South in its relationship with the North.

Where do we go from here? How do you feel like you’ve been reoriented or your sense of your role has changed?

For me, I do want to spend the rest of my working life trying to serve those whom I wasn’t able to serve. I mean, for me, my life even more will be completely bound with the fate of Gaza. I believe that our duty, our covenant with those who were killed, is to rebuild Gaza.

The thing about this war…although there’s a lot of pain, this war has exposed Israel to be nothing but a killing machine—it’s not even a fighting machine, it’s just a killing machine. Other than killing all of these people, what have they achieved? They’re unable to hold onto the land. Israel is unable to reoccupy the Gaza Strip. It’s able to enter the Gaza Strip, but it’s unable to reoccupy the Gaza Strip. And the whole idea that the Palestinians left their land in ‘48—the Palestinians have stayed in Gaza despite a genocidal war. Despite the genocidal war, there are 700,000 in the north. Despite the genocidal war, people remain in Gaza. I defy any other nation on Earth to go through a quarter of what the Palestinians have gone through and not end up leaving. 

And the Israelis, in order to conduct this genocidal war, they have had to slaughter a lot of their holy cows, a lot of their founding myths have had to be jettisoned. And states do not survive the slaying of founding myths. The founding myth that the state will do everything to save Israeli lives has been obviously shown to be untrue. The myth that technology is infinitely proportional to power has been completely debunked. $5 million Merkavas are being destroyed by $500 locally made versions of the RPG. 

Israelis have decided—and forget about the families of the hostages—Israeli society has decided it wants to conduct this genocidal war more than it wants to save the lives of these hostages. We’re coming to the point where all of the hostages are being killed by the Israelis.

There’s no image of victory. I don’t think it’s possible. No matter how long this lasts, all that’s possible is sustained killing.

I mean, when you hear about what they’re doing to Dr. Mohammed Abu Silmiyeh, the Medical Director of al-Shifa Hospital whom they’ve arrested, to try to get him to go on TV and say that there were tunnels underneath al-Shifa. They broke both his arms. They made him walk on all-fours with a chain around his neck and eat from a plate on the ground in front of the other doctors because he had refused to come out on TV and say that the Israelis were right. 

The Israelis were hoping for an image at al-Shifa, a victory photo-op in front of al-Shifa Hospital, and they didn’t get it. And they haven’t gotten an image of victory.

It’s largely optics at this point. But there is a specific obsession with the doctor: arresting doctors, desecrating doctors, impersonating—which is new, I think—doctors. So they must be aware, too, of what a doctor means for Palestinians.

It’s all about the necropolitics central to the politics of Israeli settler colonialism. One of the possibilities about the centrality of medical care and health care within the Palestinian liberation movement that we discussed earlier is that, even before we had the name for the Israeli necropolitics, the politics of life were instinctively for Palestinians the antidote for the politics of death of the Israelis. And so this is part of the politics of death trying to fight the politics of life.

That’s the most distilled version of what we’re seeing. 

I’ve heard that you are launching a project to help children access reconstructive surgery in Lebanon. I was wondering if you could speak to what that project involves.

Within reconstructive surgery, war injuries are a very different group of trauma. And so you need a level of expertise and experience that, unfortunately, doesn’t exist except in Lebanon because in Lebanon, as a result of the civil war and then the 2006 war, and then the fact that Lebanon became the hub for Iraqi patients and then Syrian patients. There is a level of experience and expertise within the health system, even the private sector, in dealing with war injury that doesn’t exist elsewhere. Maybe in Jordan because most doctors come through the army, but that’s about it. 

The idea is that these children are going to need between 8 and 12 surgeries during their childhood and that these are complex injuries and complex treatment pathways that will require integrated multidisciplinary care that brings in the psychosocial with the rehabilitation with the surgery. And bringing the experience that I had as an academic who has been interested—when I was at the AUB, I used to run the only program that was dedicated to war injuries in children, with an organization called INARA (dedicated to providing reconstructive surgery for Syrian war-wounded children). And so it’s bringing that in, that experience and expertise, and providing that kind of holistic care through the whole of the pathway. So not just the reconstructive surgery, but the psychosocial too, and ending not just at wound healing, but beyond that at rehabilitation, and then working with these kids at reintegration back into Gaza. And so trying to bring in that expertise, to provide these kids with complex injuries the treatment that they need.

The infrastructure, it sounds like, is mostly in place. It’s a matter of executing for a different population.

And having people who share that experience and expertise and that view of the complexity and the needs.

A note I wanted to end on—not exactly hope, but I feel like this moment has clarified a lot of things for a lot of people.

A moment of clarity rather than a moment of hope.

Yeah. I was wondering what is required of us within and without medicine to meet the moment—as in, what people should be doing.

I think what we need to be doing is defeating the genocidal project. And as the genocidal project is an intrinsic part of the war, the Israelis will try to institute it as an intrinsic part of the ceasefire. The Israelis always try to achieve in the ceasefire what they don’t achieve in the war. And so the Israelis are going to try to prolong the siege. They’re going to try to increase the number of people being killed as a result of the epidemics, as a result of their wounds. The genocidal project will continue. Our struggle has to be to defeat the genocidal project of the Israelis.

On all fronts.

Absolutely. It’s interesting. Because we’re watching something unfold that hasn’t happened before. We see the components of a genocidal project. A genocidal project is not just the physical elimination of individuals, but also there’s sociocide: the destruction of the universities, the schools, the cemeteries, the historical buildings in Gaza, and historical parts. And then the genocide is the physical elimination, and they go hand in hand. And rebuilding that, defeating that project—for people who are outside of medicine, rebuilding the schools, rebuilding the universities, rebuilding the cemeteries, rebuilding the historical sites that have been destroyed, is as critical a component of defeating genocide, which does not end when—genocide does not end when the war ends.

The thing about genocide and settler colonialism, as we’ve seen with the Canadians and the Australians, is that once settler societies cross over to genocide as a form of elimination, they can never step back. So we saw how the Canadians kept killing native children in the ‘70s and burying them in the schoolyards. And we saw how the Australians in the ‘80s were trying to poison the wells of Aboriginal communities. So the thing about this is that not only does it have implications for the West Bank and Palestinians inside ‘48, and Lebanon, and Syria, and Jordan, and Egypt. Settler societies, once they cross that Rubicon into genocide, they never cross back. They never go back to other forms of elimination.

It is existential in that way. The Israelis are not wrong in perceiving this as existential. It’s just that their side is the side of death—

—which seeks to exist in the absence of others.

Yeah, and I think we need to proceed with that awareness that this is what the Israelis are thinking right now. There’s this toeing around the exterminatory intention. And this idea of a two-state is being circulated—

Yeah, absolutely. But it was circulated to justify killing the Iraqis during the Madrid Conference —the Americans will bring it out every time they get into trouble. And that’s the historical mistake that the Palestinians have made. You see, the ANC was prepared to negotiate on everything other than the dismantlement of the ideology of Apartheid. The failure of the Palestinians to centralize the destruction of Zionism as an ideology, without which there is no possibility of negotiation or coexistence—now we’re paying the price. It’s a failure to accept the nature of settler colonial ideology.

One last question: where are you anchoring hope?

Oh, in Gaza. Absolutely.

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Mary Turfah
Mary Turfah is a writer and medical student.

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