
Handala, the cartoon by Palestinian cartoonist Naji Al-Ali, the personification of the Palestinian people.
17 October 2023. In the middle of a hospital courtyard, strewn with bodies, mangled and dismembered, stands a lectern. Behind the lectern a man with a dazed look wearing his blue scrubs, surrounded by other healthcare workers, addresses the world, telling us what he has seen. The worst of the worst. The man is Dr Ghassan Abu Sittah, a British-Palestinian surgeon who quickly becomes equal parts spokesperson and hero to many. This is how the world learnt of the Al-Ahli Baptist Hospital massacre, one of many to follow, and a definitive sign of what was to come: a complete and systematic targeting of the medical system on the besieged Gaza Strip. Genocide.
They say that you can’t process grief when still in the midst of the event, or as Isabella Hammad put it “mourning requires an afterwards.” For 15 months there was no afterwards. Then the bombs stopped and suddenly I found myself sorting through the endless thoughts and questions that had dominated my mind all this time. Taking the space to reflect seems awfully indulgent when in the very heart of the West, away from the immediacy of the violence but by no means less part of it – perhaps even more so when taking into account our material support for it. Nevertheless, reflection was where I found myself and I returned time and time again to a question both particular and somewhat of a through-line of my blog: what do these past 15 months tell us about our values and the role of the doctor and the medical scientist in our broader global structure?
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Mary Turfah, Palestinian-American surgeon and writer, wrote in a January 2025 article for The Baffler about the principle of neutrality upheld by Doctor’s Without Borders/Medecins Sans Frontieres (MSF). In her article she discusses how, in the past, MSF’s neutrality bled into outright complicity and that the MSF-model of bearing witness often proved insufficient. The MSF-model, so writes Turfah, ends up discussing “what doctors are treating” more than discussing what “people are fighting for.” Similarly, Dr Ghassan Abu Sittah and his colleagues in an article in the journal Conflict & Health decry this very same supposed neutrality. They write: Structures of genocide, colonialism, and imperialism are all-consuming, and physically, materially and ideologically define relations between people, groups, nations, land and resources. They should therefore define how we understand and engage in all aspects of our moral and intellectual lives,” adding that there is an imperative for us to demand justice. The decontextualised and incomplete approach of neutrality allows us to paper over what is actually at the crux of the matter, whether in Gaza or in other parts of the world: a struggle for liberation and an end to our unjust world system.
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The view of medicine as a vehicle for liberation is not a new one. In fact, it is one I have discussed before on this very blog. Medicine, most notably in Cuba, has often been viewed as one aspect of the people’s liberation. Simultaneously, it is no surprise that medicine has equally often been used as a tool for power, imperialism and colonisation. In any colonial context, there is a constant tension between the coloniser and the colonised. A dynamic that according to Fanon often plays out in the colonial hospitals, and not entirely without reason. The native feels a sense of distrust towards colonial medicine and the colonial doctor, however well-meaning they might be, exactly because medicine has been used as a tool of conquering, oppression and instilling a sense of inferiority in the native. The well-meaning doctor – or NGO – from a hegemonic country trying to deliver healthcare without ever addressing the underlying injustices that are an important root cause, will not inspire much confidence over the long-term within the native. The assumption of morality because of the ubiquitous association of medicine and medical science with “moral goodness” is not enough.
The late Chilean president (and former doctor) Salvador Allende, addressing students at the University of Guadalajara, spoke on the social responsibility that comes with their profession. He encouraged them to become physicians who will raise their voices for the poorest amongst us. This requires something beyond the humanitarianism that we are used to. It invites us to ask how one can heal when deprived of the very means to live. What does healing mean when de-development, destruction of your very being and a lack of sovereignty reign supreme? Being a doctor or a scientist means you are working on a social process that is intrinsically political. What people are fighting for and the social responsibility that comes with their profession are things that the healthcare workers in Gaza know acutely; many of them lost their lives refusing to leave their patients even under the threat of a gun (or a bunker-buster bomb). Numerous healthcare workers, like Dr Abu Salmiya, the director of Al-Shifa Hospital, were tortured in prison. After he was released he testified of the horrors he had witnessed and experienced and then immediately returned to work. Others are still languishing in prison, like the paediatrician Dr Abu Safiya, without charge or trial. Still others, like Dr Adnan Al-Bursh, were tortured to death. When so much is at stake, taking a position of passive neutrality rather than addressing what people are fighting for renders our analysis and the conclusions we draw incomplete.
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Richards Levins and Lewontin write in The Dialectical Biologist that:
The tubercle bacillus became the cause of tuberculosis, as opposed to, say, unregulated industrial capitalism, because the bacillus was made the point of medical attack on the disease. The alternative would be not a ‘medical’ but a ‘political’ approach to tuberculosis and so not the business of medicine in an alienated social structure. Having identified the bacillus as the cause, a chemotherapy had to be developed to treat it, rather than, say, a social revolution.
This quote illustrates the failures of our focus on how to treat rather than what people are fighting for. The fear of venturing out of the comforts of our neutrality, of having to make a decision and aligning with a cause (or as Levins and Lewontin would put it, to acknowledge that science is not beyond social influence) seems to paralyse us. Perhaps we fear the implications that addressing structures and injustices – systems that many of us are socialised to buy into by virtue of our class position or aspirations – create. What it asks of us. How it requires more than the immediacy of prescribing medication or even travelling to conflict zones to provide medical care to those in need, however noble or necessary it may be.
In his 1969 short story, Return to Haifa, Ghassan Kanafani writes about a family that were displaced in the 1948 Nakba who returned to their hometown of Haifa for a visit after the ‘67 war. During the commotion of the Nakba – a human sea enveloping both Said and his wife Safiyya – caused the couple lose their son Khaldun quite literally. The boy ends up being raised by an Israeli family as Dov. The couple, twenty years after the Nakba, encounter their son Khaldun – now known as Dov – and a tense interaction between Said and his long-lost son occurs. Dov meets his biological parents with hostility and states that he does not consider himself to have any blood ties to them, nor a natural affinity with their plight. In fact, he states boldly that Said and Safiyya are “on the other side.” Said and Dov, however, both end up agreeing that “after all, in the final analysis, man is a cause.” This story reminds us that it takes more than blood ties or relations for a person to be moved to action. It is the conscious taking up of a cause that makes a person; the Cause that makes Man. Therefore we cannot expect a mere proximity to conflict or the decision to become a doctor, scientist or humanitarian to move us towards action and away from neutrality.
It is easier to bear witness without ever addressing the root cause or pointing at the elephant in the room. However, if bearing witness as a practice is to have any sharpness or teeth at all, it must move beyond the bluntness of feigned neutrality. If our humanitarianism, medical practice or scientific research is to mean anything at all, it will have to side with the oppressed wherever they are found. It is important for us to ask ourselves how we respond to seeing Dr Abu Sittah address the world in a hospital courtyard strewn with mangled bodies, or how we respond after witnessing the systematic targeting of a healthcare system and its workers. What does it take for us to be moved beyond neutrality and towards action? It is time for us to stop blindly focusing on what doctors are treating and start asking what people are fighting for. After all, in the final analysis, man is a cause.










