- The author is the UN Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, Co-chair of the O'Neill-Lancet Commission on Racism, Structural Discrimination and Global Health.

ISTANBUL

I am a child survivor [1] of a brutal colonial and apartheid regime. I grew up in Qwa-Qwa, a Bantustan created by the racist apartheid South African government in 1974, and I know first-hand the trauma both seen and untold, as well as the enduring inter-generational physical and mental health impacts of racism, structural discrimination, and violence. I grew up in Bantustan, South Africa, in the 80s, a racially segregated space for Black people. My core childhood memory is experiencing the presence of military vehicles in my neighborhood and moving through life under the constant threat of violence and a state of fear. Looking back at my upbringing, I know far too well the trauma of what children and people in Gaza will carry with them, not only from the current violence but also from the displacement and military occupation that they and generations [2] of their families have endured.

Israel attacks the right to health

As a practicing medical doctor and the United Nations (UN) Special Rapporteur on the right to health, I see the practice of medicine in and of itself as a powerful tool in the restoration of people’s dignity. The right to health [3] is an inclusive right, extending not only to timely and appropriate health care, but also to the underlying determinants of health, including an adequate supply of safe food, nutrition and housing, and access to safe and potable water and adequate sanitation. Violations of this fundamental right can have far-reaching impacts on the realization of economic, social, political, civil and cultural rights.

Having received concerning allegations related to violations of international human rights law and international humanitarian law in the ongoing conflict in Gaza, particularly alleged attacks on hospitals, healthcare facilities and healthcare workers since the escalation of the conflict on Oct. 7, 2023. I wrote an urgent letter of appeal to Israel, pursuant to Human Rights Council resolution 51/21 sent on the Dec. 4, 2023. International human rights law applies in full to the occupied Palestinian territory, and everyone has the right to the highest attainable standard of physical and mental health. The denial of an opportunity to equal access to health care, such as on the basis of ethnicity or race, is discriminatory and unlawful.

As a high contracting party to the four 1949 Geneva Conventions, in particular the Fourth Geneva Convention Relative to the Protection of Civilian Persons in Time of War, and as an occupying power, Israel is required under the Fourth Geneva Convention, "to the fullest extent of the means available to it," to maintain health services in the occupied territory. Article 56 [4] requires Israel to adopt and apply "the prophylactic and preventive measures necessary to combat the spread of contagious diseases and epidemics' in cooperation with national and local authorities."

I reminded Israel, as an occupying power and based on the violations alleged included, the prima facie violation of the right of every individual to life and security and not to be arbitrarily deprived of his or her life, and the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, inter alia, as set forth in international human rights law. An intentional attack on a hospital or an intentional attack on civilians may also constitute a war crime according to international humanitarian law. An occupying power has obligations under the right to health to ensure that all services, goods, and facilities must be available, accessible, acceptable and of good quality.

The practice of medicine is under attack and the healthcare infrastructure in the Gaza strip has been completely obliterated. The attacks were mired by obstruction to health care delivery, the killing and injuring of health workers and patients, and the damaging of health facilities and ambulances. More than 804 attacks on healthcare services have been recorded in the occupied Palestinian territory (oPt) since Oct. 7, 2023, including more than 439 health facilities and 332 ambulances. The death toll [5] is now more than the 693 deaths and 970 injuries in oPt from Oct. 7 to March 7.

Health conditions in Gaza

Conflict is the top driver of hunger, contributing to 80% of the world's worst food crises and parties to conflict continue to use food as a weapon of war by controlling food production and distribution and exploiting hunger [6] and poverty and victims are also struggling to find food and drinkable water. Gazans now make up 80% of all people facing famine or catastrophic hunger worldwide, marking an unparalleled humanitarian crisis in the Gaza Strip amid Israel's continued bombardment [7] and siege.

Pregnant women are not receiving adequate nutrition and health care, putting their lives at risk, and all children under 5 — 335,000 — are at high risk of severe malnutrition, placing a whole generation [8] in danger of suffering from stunting, which causes irreparable physical and cognitive impairments. World Health Organization (WHO) surveillance reveals a reality we have feared since this latest escalation: high rates of infectious diseases. The immediate concerns include open wounds, respiratory tract infections, viral and bacterial and fungal infections, and diarrheal diseases. The risk of further spread is worsened by overcrowding, inadequate water and sanitation, and severe constraints for coordinated and sustained health system response, including a severe shortage of medicines and surgical supplies.

The preventable collapse of the health system created by this crisis is incompatible with the realization of the right of everyone to the highest attainable standard of physical and mental health. Israel has continued to commit an immeasurable number of violations of the special protection afforded to civilians, children, and medical personnel under international humanitarian law, alongside widespread violations of international human rights law.

Despite all of the international cries for an immediate cease-fire, the shameful war has continued on with allies continuing to support the occupying power, disregarding the loss of civilian lives and the irreparable damage to Gaza. In this regard, I have written public letters to UN Secretary General [9] Antonio Gutters, Human Rights Commissioner [10] Volker Turk and the president [11] of the General Assembly, Dennis Francis, reminding them that we bear witness to continuous attacks on people seeking food, aid efforts blocked from gaining ground access to the areas in need of immediate medical and rescue support, and that they must use all powers and authority vested in them to ensure a cease-fire and liberation of the Palestinian people in order to have lasting peace.

Substantive equality, an approach that underscores the need to ensure true equality in outcomes, is rendered unattainable where violence prevails. Any peace mediation process must not perpetuate the prevailing power imbalances and must consider the false narratives of equivalency between occupied people and an occupying nuclear power. All interventions must center the dignity, sovereignty, and reparative justice of all people of the occupied Palestinian territory.

I continue to appeal to the Israeli government to immediately cease fire [12] and to adhere to all the laws, norms and standards enshrined within international human rights law and international humanitarian law, applicable during times of armed conflict, and adhere to the court order of Jan. 26, 2024 on the Application of the Convention on the Prevention and Punishment of the Crime of Genocide in the Gaza Strip (South Africa v. Israel) [13] of the International Court of Justice (ICJ).

[1] https://mg.co.za/health/2023-03-10-what-chatgpt-wont-tell-you-about-d-tlaleng-mofokeng/

[2] https://www.apa.org/topics/trauma/trauma-survivors-generations

[3] https://www.ohchr.org/en/special-procedures/sr-health/about-right-health-and-human-rights

[4] https://www.ohchr.org/en/press-releases/2021/01/israelopt-un-experts-call-israel-ensure-equal-access-covid-19-vaccines

[5] https://extranet.who.int/ssa/Index.aspx

[6] https://www.ohchr.org/en/documents/thematic-reports/a78185-food-nutrition-and-right-health-report-special-rapporteur-right

[7] https://www.ohchr.org/en/press-releases/2024/01/over-one-hundred-days-war-israel-destroying-gazas-food-system-and

[8] https://www.ohchr.org/en/press-releases/2024/01/over-one-hundred-days-war-israel-destroying-gazas-food-system-and

[9] https://www.ohchr.org/sites/default/files/documents/issues/health/sr/20240228_UN_SG_SR_Health_letter.pdf

[10] https://www.ohchr.org/sites/default/files/documents/issues/health/sr/20240229-HC_SR_Health_letter.pdf

[11] https://www.ohchr.org/sites/default/files/documents/issues/health/sr/20240304_UN_PresidentGeneralAssembly_SR_Health_letter.pdf

[12] https://www.youtube.com/watch?si=Wu_Ai30MzsYWTttQ&v=smwLItdhfYg&feature=youtu.be

[13] https://www.icj-cij.org/case/192

*The views expressed herein are personal and do not necessarily reflect the views of the United Nations.

*Opinions expressed in this article are the author’s own and do not necessarily reflect the editorial policy of Anadolu.