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I saw a lot of death in Gaza. Not natural death. Brutal, methodical killing. But there is something particularly horrific about digging up medics buried in their uniforms that has stayed with me.
Last year, I was working as a senior United Nations official coordinating humanitarian aid in Palestine when Palestine Red Crescent Society (PRCS) and Civil Defence first responders went missing in southern Gaza.
For a week after they were killed, we did not know if they were dead or alive. Every day we tried to reach them. Israeli forces denied us access. We encountered blocked roads and troops firing on people fleeing.
On March 30, my colleagues and I stood over a mass grave in Rafah marked with the light from one of the ambulances that Israeli forces had crushed and dumped nearby.
There was no way that Israeli forces did not know that these were medics. The lights of their ambulance were flashing. It was marked with internationally protected Red Crescent symbols, and they were wearing uniforms and gloves. It made no difference. They were killed, some executed at close range. Forensic analysis of video and audio recordings has reconstructed the last moments of their lives.
After investigating, the Israeli army dismissed the deputy commander of the Golani Brigade for filing an incomplete report. Another commander received a letter of reprimand. No one was charged. That was the accountability for massacring medics.
The PRCS had been targeted before, including during the rescue attempt of Hind Rajab, a six-year-old girl who bled to death in a car riddled with 335 bullet holes, surrounded by the bodies of her family. The medics sent to save her were killed by troops in the area, despite obtaining prior coordination to allow the ambulance to arrive at the scene.
Coordination with Israeli forces did not protect the medics trying to reach Hind. Yet the absence of such coordination was used by Israeli forces in their justification for killing the ambulance crews in Rafah. An evacuation order for Rafah was issued by Israeli forces after we had lost contact with the ambulance crew in Rafah. But even if the ambulances were knowingly driving into an area of military operations, it is the Israeli army’s responsibility not to target civilians.
We had put in place a coordination system – as we do in many places in the world – to help parties to the conflict fulfil their obligations. But in Gaza, the system was twisted by Israeli authorities to control where aid reached and to enable a free-fire approach from Israeli forces, unless it was coordinated otherwise. The humanitarian community was essentially coordinating movements in an effort to opt out of being killed by default.
In Gaza, survival itself was under attack. Once people were ordered out of an area, everything needed to survive was destroyed. Hospitals were never spared. We walked through the ruins of al-Shifa, where bodies lay in the courtyard and family members combed through rubble looking for their loved ones. We evacuated patients from the Nasser and Indonesian hospitals, where street cats sat on the ICU beds of patients left to die and where Israeli forces took a wounded man out of our ambulance, mocking him while he screamed in pain.
My colleagues and I spent two years negotiating exceptions – not the rule – to receive fuel, medicines, surgical supplies. Every item that entered Gaza was a concession, possible only after intense political pressure from governments with more leverage over Israel than international law itself.
The UN Commission of Inquiry confirmed in 2025 that Israeli authorities knew that blocking the entry of humanitarian aid into Gaza would lead to the deaths of Palestinians. I can confirm that they knew because I was one of the people who told them. Insufficient aid wasn’t a logistical problem; it was a repeated political choice made with full knowledge. While we spent months negotiating for Palestinians to be allowed to survive, we were presented daily with the evidence that the intention was in fact for them to die.
This is what genocide looks like. It is not only the killing – though the killing has been vast and documented. It is also the deliberate dismantling of everything a population needs to survive: their hospitals, their water, their food supply, their civil registry, their police, their medics.
Surviving an air strike means dying in the rubble. Surviving the rubble means bleeding out while ambulances wait for a clearance that doesn’t come. Surviving injury means arriving at a hospital bombed into a shell. Surviving hospital means being discharged into a tent that can’t keep out the rain.
I have spent most of my adult life watching attacks on healthcare become normalised. Fourteen years with Doctors Without Borders took me through conflicts where hospitals were bombed and staff killed. In Kunduz, Afghanistan, in October 2015, 42 people were killed – patients burned in their beds, staff shot from the air as they fled a compound whose GPS coordinates had been shared with US forces. The United States called it a mistake. But the legal environment in which that so-called mistake was possible had been deliberately constructed – and Israel was one of its architects.
A 2006 Israeli Supreme Court ruling laid the groundwork for legally justifying civilian harm by widening the definition of “direct participation in hostilities”, creating a grey zone that expanded in the US-led “war on terror” to loosen the rules of war for anyone proximate to resistance.
The UN Security Council responded to a growing number of attacks on hospitals with Resolution 2286 in May 2016, reaffirming the protected status of the medical mission. In the decade that followed, the World Health Organization (WHO) documented attacks on healthcare rising year after year. In most cases when a state was responsible, the justification was a war against “terrorism”.
Gaza is where this history arrives at its conclusion. A documented pattern, pioneered by the perpetrator, renders the word “mistake” meaningless.
The policy did not pause after we dug up those bodies. Within days, Israeli forces struck al-Ahli Hospital, destroying its emergency department. The European Gaza Hospital was put out of service, eliminating the only neurosurgical, cardiac and cancer treatment in Gaza. Kamal Adwan Hospital, the sole malnutrition treatment centre in northern Gaza, was forced to close. A double-tap strike on Nasser Hospital killed 22 people, including four health workers and five journalists.
I was expelled from Palestine in July for saying publicly what I had witnessed. But removing witnesses does not remove the crime. In August, two UN special rapporteurs referred to the attacks on the health system as “medicide”.
The systematic assault on healthcare was not reserved for Gaza only. Israeli forces killed at least 222 medical and emergency relief workers in Lebanon from October 2023 to November 2024, attacking 67 hospitals, 56 primary healthcare centres and 238 emergency medical teams. This year, in the span of less than a month, there were at least 128 Israeli strikes on medical facilities and ambulances in southern Lebanon. According to the WHO, 51 health workers have been killed, with nine more paramedics killed on Saturday, and more than 120 wounded.
The worst single moment for such attacks came on March 13 when Israeli forces bombed the healthcare centre in Burj Qalaouiyah, killing 12 doctors, paramedics and nurses on duty. The Gaza doctrine had arrived in Lebanon.
The pattern is clear and undeniable. But without accountability, impunity fuels the killing machine. With each passing day, the precedent strengthens – and civilians everywhere are less protected.
The views expressed in this article are the author’s own and do not necessarily reflect Al Jazeera’s editorial stance.
