According to the Ministry of Health in Gaza, since hostilities commenced after October 7, 2023, at least 23,469 Palestinians were killed in Gaza and close to 60,000 have reportedly been injured. Some 70 percent have been women and children. Many of the missing are presumed dead, buried under the rubble that was Gaza. This territory, smaller in area than the city of Detroit, is beginning to look more like an open-air graveyard than an open-air prison, as it was described by UN Special Rapporteur Francesca Albanese last summer.
More than 1.9 million people, representing 85 percent of Gaza’s population are internally displaced. About one million are crowded in the southern border settlement of Rafah with no place to flee safe from the daily bombings and sniper attacks. The UN Office for the Coordination of Humanitarian Affairs estimated that 65,000 homes have been completely destroyed and another 290,000 damaged. More than half of Gazans have been made homeless.
The Associated Press, using satellite data, found that more than two-thirds of all structures in northern Gaza have been razed and in southern Khan Younis area, 25 percent have been destroyed. The Financial Times observed that the destruction in northern Gaza was worse than that carried out in the firebombing of Dresden during World War II. Nearly the entire health system has been made inoperable with only 1,400 hospital beds remaining, all essentially in the south of Gaza. More than 104 schools have been destroyed or made irreparable accounting for 70 percent. According to the Guardian, the ones that remain standing are being used as shelters for internally displaced people. Water production is at seven percent of prewar levels and mass starvation is rampant.
Last week, South Africa’s High Court advocate, Adila Hassim, who gave testimony at the International Court of Justice in The Hague, essentially argued that Israel is guilty of perpetrating genocide in violation of the 1948 convention. In his remarks he said, “For the past 96 day, Israel has subjected Gaza to what has been described as one of the heaviest conventional bombing campaigns in the history of modern warfare.”
The World Socialist Web Site reached out to Dr. Yara Asi, an assistant professor of global health management and informatics at the University of Central Florida, a visiting scholar at the FXB Center for Health and Human Rights at Harvard University, and a Fullbright US Scholar to the West Bank. Her writings have been featured in the New York Times, the Guardian (where she discusses the impact of COVID pandemic on Palestine), and the Washington Post. Her upcoming book, How War Kills: The Overlooked Threats to Our Health, is due to be released later this month by Johns Hopkins University Press.
Dr. Asi has written extensively on war, health, and the Israeli occupation of Palestine. She was kind enough to accept our invitation for an interview. The transcript below has been edited for brevity.
Benjamin Mateus (BM): As a way of beginning, can you briefly tell us who you are and then speak about the current situation taking place in Gaza and the West Bank, from your perspective as a public health expert on Gaza and its history. What’s the situation on the ground?
Yara Asi (YA): I am Yara Asi, I am a Palestinian, born in Nablus in the West Bank. I am a currently an assistant professor in global health management and informatics at the University of Central Florida, as well as co-director of the Palestine Program for Health and Human Rights which is a partnership program between Harvard University and Birzeit University in the West Bank.
I have been studying Palestinian health my entire professional career and in the way that we all study things before we become professionals, simply by observing what’s happening, I think, without hyperbole, this may be the worst time in my lifetime in the occupied territories and that includes even the Second Intifada, the construction of the wall and all that happened in the early 2000s. It’s difficult to imagine a worse time than this.
I’ll try to leave the political side out of it. There are other people that would be better suited to talk about that.
But in terms of health, what we’re seeing is a complete assault on not just Palestinian health care in terms of how we consider a health care system, meaning the buildings, the resources that include the healthcare workers who are being killed, but every aspect of life needed to sustain life, food, water, medicine, etc. The siege is ongoing on the aid trucks that are waiting at the border. People are starving. People in Gaza are reporting a rise in infectious disease epidemics. People who had transplants or other important procedures scheduled for this time are not able to get them.
I had a former student whose father was getting his final chemotherapy in the beginning of October. Obviously, that’s all been shut down.
It’s been incredibly depressing, quite frankly, to see the lack of response from the international medical community regarding what is an obvious health catastrophe or feeling as though they have to frame it in these kinds of anodyne political terms rather than simply do what we’re supposed to do, which is describe what we’re witnessing, which is horrific. Horror all around.
And that’s not to mention the West Bank, of course, where settlers have essentially taken to the streets almost daily to harass and attack Palestinian families. Israeli soldiers are now conducting almost daily raids on refugee camps.
Almost every day I see another dead person, often a child or young adult from the West Bank, on social media. I don’t even see it on Western media at all. Of course, there too the health implications are very dire.
People are afraid to leave their towns and homes because of the attacks. They’re not going to hospital appointments. Or their doctor can’t make it to their appointment. Resources are becoming extremely limited due to lack of ability to transport of the goods the population needs. And moreover, there is another layer of assault that is impossible to describe even for people who have thus far escaped physically unscathed and that is the psychological torture of living through this.
Yes, of course, in Gaza, anyone who’s alive at this point has lived through three months of hearing almost daily bombings, hearing of this person is dead. This person is in the hospital separated from families. But in the West Bank as well, this kind of feeling that nowhere is safe. “I’m not even safe in my home or my shop” because people have seen videos of homes getting raided and there was a shopkeeper that got shot in the head, standing right in front of his shop next to his young daughter.
There are drones constantly flying around the big cities. There are soldiers and settlers everywhere and the impunity that they come with. Honestly, I could just go on and on about the horror of this moment. It’s about the worst we’ve seen. And that is saying a lot considering we’ve been talking about how bad it is since for almost a century.
BM: I wanted to ask about your forthcoming book, which is coming out this month, titled, How War Kills: The overlooked threats to our health. Maybe you can discuss the central themes and to what extent the current events in Gaza are substantiating the concerns you raise?
YA: The book is not focused on Palestine. But because of my own personal experience and simply because of where Palestine fits in contemporary armed conflict, it features heavily in the book. The book makes three arguments. One is what one would expect from this type of book. I don’t know if you’ve read Barry Levy’s work or Leonard Rubinstein’s, these kind of books that look at what health is like in a war zone. I discuss the direct violence from war, from bombings, from snipers, from physical violence, what we associate with war, the spectacle of war.
I then talk about the second killer of war-torn populations. And it is this indirect violence which we are seeing in the siege of Gaza; this feeling of unsafety, dying from starvation, dying from infectious disease, dying from receiving surgery without proper protocols, these ways of dying that, if this continues in a place like Gaza, it will soon overcome the death toll by airstrikes, as hideous as that has been.
And we don’t even really hear much about this because we don’t see this as a death from war. [Emphasis added by YA] We see this as an unfortunate unavoidable outcome from these poor souls that live in this war environment. We are not yet adept at seeing this as a form of warfare, of indirect violence as a form of warfare.
And if we look at Yemen, if we look at Syria, if we look at other war-affected contexts, we see this same kind of indirect violence playing a huge role in mortality and injury. Had I written the book now Gaza would feature quite prevalently.
But then the third argument is where I think the book differs a little from these preexisting books, which is about how for the rest of us, those of us that don’t live in Gaza, don’t live in Syria, consider ourselves immune to it all. I’m not going to be bombed sitting here in Florida and you’re not going to be bombed sitting there in Chicago. So, how does this affect us?
What I argue in the book is this culture of militarism and this intense emphasis that security means only national security. It means having bigger bombs, having updated drones, having unfettered access to any funding anytime war springs up. This affects all of us. We all suffer. And this is another way that war kills.
Look at the outcomes in this country—homeless rates, prescription drug prices. Again, you’re a physician in the US. I don’t have to list the maladies of not just our healthcare system, but the complete ignorance of the social determinants of health in terms of practice. How do we make people healthier? There’s simply no force for pushing these kinds of health-related forces and yet there’s constantly billions of dollars for war. The Pentagon often receives more funding than it asks for, even though they have essentially failed every audit or simply ignored them. All of us need to recognize that we are not safe simply because we’re not suffering from the violence of bombing. We are all victims of warfare. And I thought this would be a way to bring these issues to the forefront of the discussion.
People are used to this argument of “the humanitarian catastrophe in war zones” as though they’re not human-made, as though an earthquake ransacked the place. And there’s this humanitarian catastrophe and let’s be the good guys and send a bunch of money and help these people.
And that is part of war, but that’s a very small bit. We haven’t even begun talking about the entire ecosystem of warfare, of militarism, and how it is detrimental for populations around the world and is the single most disruptive, expensive force against humanity. I won’t be interviewing a politician anytime soon, but they are never questioned about whether these are the right choices or whether this is making America safer.
We have the same voices who supported and funded and enabled the Iraq war on TV telling us about the wars we should be in now. We should bomb Iran. We should bomb China. We should do this or that with the Palestinians. Frankly, it’s an unhealthy culture, and I wanted to call that out in the book.
BM: How was life for Palestinians in Gaza before October 7? The health system has been severely impacted by decades of under-funding and blockades imposed by Israel.
YA: What happened on October 7, the Hamas militants attacking civilians in Israel, was the impetus for this current military campaign. But to pretend that on October 6 the situation in Gaza was acceptable to anyone who had been paying attention—and I realize some people may have just started paying attention after October 7 and they have a lot of catching up to do—is simply ludicrous. There have been countless reports about the disastrous situation in Gaza for decades.
Yes, Israel imposed this very strict siege on October 8, or maybe even the evening of October 7, and that got a lot of press for a few days. But Gaza has been under siege since 2007. Gaza has had shortages in medicine, shortages in gauze, shortages in IV bags. Patients in Gaza who want advanced medical care must apply to this incredibly complex and arbitrary medical permit system for permits approved by Israel to be able to leave their own territory to get chemotherapy or brain surgery. Even a pregnant mother with complications who needs care that’s unavailable in Gaza, because Israel does not allow certain medical equipment and resources into Gaza, must apply for a medical permit to see a specialist.
Israel controls every border in Gaza. It does not allow an airport. It doesn’t even allow a seaport. Aside from the five major bombing campaigns since 2007, there are an endless number of one to two days of bombings by Israel that barely make the news. There was the Great March of Return in 2018, where, without bombing, Israeli snipers killed and maimed thousands of Palestinians who were peacefully protesting at the border.
Gaza has extremely high food insecurity. Again, let’s pretend this is October 6 and we’re just talking about Gaza. High food insecurity, high unemployment, high poverty, conditions all made by Israel’s perpetual siege. And this is not a controversial point. It’s not just the UN and the World Health Organization and all these humanitarian agencies saying this. Government reports from the US, from Germany, from the UK, all of them have pointed to the blockade and the siege of Gaza as the number one cause of humanitarian misery.
When we consider what’s happening today, no place on earth would be able to sustain itself after what Gaza has been through, the level and the intensity of the bombings. But when you layer that on top of what was already an under-resourced, overcrowded, skewed to an extremely young population [About 40 percent of Gaza’s population is 14 years old or younger], and then factor in that people can’t even leave … I always hear people say why don’t they just leave? They cannot! They must apply for, and Israel must approve, a permit for them to leave. These people are trapped by their perpetrator who didn’t just recently start bombing them but has been dropping bombs on them for years.
To understand how dire the situation was before October 7, even though we don’t think twice about drinking water from our homes, waterborne disease was the number one killer of Gaza’s children long before October 7.
And so, I think we really have to be clear-eyed about what we’re seeing, which is not an accidental destruction of a health care system because of war, but as a continuation of a policy that seeks to de-develop Palestinian life in every sector and motivate Palestinians to leave either forcibly or voluntarily because the situation is so bad, or they have no home to come back to at this point. We have to consider Israel’s broader territorial aims which many Israeli politicians and military forces have not been shy about saying publicly.
BM: Since the Israel occupation in 1967, more than 800,000 Palestinians have been imprisoned by Israel and these include children as young as 12. I think I read somewhere, maybe in your report, at least 7,000 Palestinians are currently detained.
YA: UN Special Rapporteur Francesca Albanese said in a July 10, 2023, statement that “Israel’s military occupation has morphed the entire occupied Palestinian territory into an open-aired prison, where Palestinians are constantly confined, surveilled, and disciplined. He had made the comment that this is a condition of an open-air prison. Over 56 years, Israel has governed the occupied Palestinian territory through stifling criminalization of basic rights and mass incarcerations.”
She added, “Under Israeli occupation, generations have endured widespread and systematic arbitrary deprivation of liberty, often for the simplest acts of life and the exercise of fundamental human rights.” Not only did she call Israel’s occupation illegal and compared the occupied territories to an open-air prison, but she also said that the criminal convictions of Palestinians “have resulted from a litany of violations of international law, including due process violations, that taint the legitimacy of the administration of justice by the occupying power.”
She goes on later to state, “Palestinians are often presumed guilty without evidence, arrested without warrants, detained without charge or trial, and brutalized in Israeli custody. Mass incarceration serves the purpose of quelling peaceful opposition against the occupation, protecting the Israeli military and settlers, and ultimately facilitating settler-colonial encroachment.”
BM: This was written just a few months ago. Can you comment on this within the current genocide taking place that has the support of the US government and the European Union. One can’t help but to see the events of October 7, under such inhuman conditions, as a rebellion against the decades of social and democratic oppression.
YA: Certainly. Israel has had a long history of quelling Palestinian opposition to unjust circumstances. And this includes imprisoning them, killing them, making life so difficult for them to move that they’re not even to go between the West Bank and Gaza. A Palestinian from Gaza cannot go to Jerusalem. And essentially nobody can go into Gaza, quite frankly.
Just to be clear on your question, do you mean in terms of how these fit into Israel’s broader systems of oppression? Or did you want me to comment specifically on prison or broader trends?
BM: The question was intended to be open ended so that you can take the direction you want rather than it being specific.
YA: I think it was two or three years ago, there was this minor international story when Israel deemed these six very prominent Palestinian NGOs to be terrorist organizations and shut them down. In some cases, they raided their facilities, including those of the Health Work Committees. In that case, they arrested the director, Shatha Odeh, a nurse, without a warrant and imprisoned her for 16 months [Mrs. Odeh’s lawyers were able to get a court approved early release order after she served 11 months in Damon prison in arbitrary detention following her arrest by Israeli Occupational Forces in July 2021] without charges or trial. Her crime was being the director of the health committee, one of the primary political health actors in the West Bank that delivers care, because of her supposed affiliation with a political party that Israel has deemed a terrorist organization.
This was not seen [by the outside world] as a continuation of Israeli repression or as a bad faith interpretation by Israel. What instead happened was many European countries cut off aid to these organizations and completely accepted Israel’s view. Investigations found that there was nothing to these charges, but by then it was already too late and didn’t matter, right?
And this is how Israel functions. On the surface, a lot of Israeli statements and Israeli actions are indefensible. So, the only way that they are made defensible is by painting every Palestinian, from child to elderly, from a teenager that goes to the corner store to get candy to the director of a health work committee, as a potential threat, a potential terrorist that is worthy of restriction, violence, and even death. And Palestinians have been saying this for decades. My grandmother, who was alive in 1948, said this. She’s no longer with us. But Palestinians recognize what Israel is doing with this repression. They understand why Israel would want to. But what they don’t understand is why the rest of the world buoys up these systems.
Everyone recognizes that the Israeli carceral system is unjust to Palestinians. Everyone recognizes that the restrictions of occupation violate human rights, have very little to do with security, the settlements, the wall. Everyone recognizes this. So, I think the question is not why does Israel do this? The question is why there is no accountability whatsoever, after decades of evidence, testimonies, reports, data, statistics, many released by entities paid for by the same governments that also give Israel diplomatic and financial cover?
So, what Israel is doing is quite understandable. This is what these kinds of regimes do and have done historically. But Israel is consistently seen as a good faith actor. Why? It’s always seen as Palestinians being the intransigents that won’t allow for two states. That I don’t know the answer to. I think that’s the tough question that maybe your readers can consider.
BM: I think the answers to these questions are rooted in history. We must go back to the formation of the state of Israel and, and then even before that, explain Zionism as a political entity and imperialism in general to address the trajectory of this genocidal campaign launched by Israel with the complete support of the US and world leaders. I’d contend that the World Socialist Web Site more than any other media has taken great efforts to address this. Without a grounded historical context based on a socio-economic analysis, we get entangled in the quagmire of rapidly shifting events.
YA: Right.
BM: So, what are your thoughts of the mass demonstration taking place across the globe in support of Palestine? There appears to be a clear class distinction between students and workers against the onslaught against the population of Gaza and the ruling elites that control the media health systems and academia and the entire state apparatus that lends support to the genocidal operations.
Not only is this censorship but anti-democratic. Would you like to comment?
YA: I will say that people in Gaza and in Palestine have seen the protests and they feel heartened by them. But does it create a tangible improvement on the ground for them immediately? No.
The tendency is to think, “If people could see us, they would help us. But they don’t see us, or they don’t see us as human. They don’t see us as worthy of intervention.”
I think any effort on international streets, especially in a major city like Chicago, New York, or London … we’ve also seen huge demonstrations throughout the global South. I think it is very heartening and I do support these demonstrations. They show politicians that there is not one agreed answer to this that the politicians keep parroting, which is for unequivocal support of Israel.
On the other hand, this has been happening for so long. I remember there were all these conversations about if the tide was turning in May 2021 when Israel was bombing Gaza. We had similar conversations in 2018 and 2014 and 2009. I think at this point, we need to turn this grassroots action into political action.
But every day that this continues, brings fresh horrors to Palestinians that we cannot imagine. My God, I saw a video of what couldn’t have been a more than six-month-old child with both legs amputated due to bombing. How do we process that? That’s not a sight that your brain is meant to see. That’s not a thing that’s meant to exist in the world.
We really like to point to the Middle East and say those people, that region, it’s just been so complex, and they can’t just get it together and there’s all these ancient hatreds, this kind of clash of civilizations argument that’s quite racist. And this comes from the position put forth that those people in the Middle East are “other” people.
I think what people are looking for is justice. If these demonstrations can bring us closer to that, that’s great. But that can’t be the end of our action. We have a lot of work to do. Those of us with physical security that feel moved by this have no choice but to take further action to make a tangible change for these people. Fight for a ceasefire and genuine justice.
BM: Being an outspoken person, particularly in Florida and the right-wing reaction that is so present, are you safe? Are you facing any threats?
YA: It would be hard for me to center my own safety considering what’s happening in Gaza. But I would say I feel very fortunate to have a supportive network and I hope that continues.
BM: Any final comments?
YA: I hope that there is no business as usual after this.
I’m someone who has had Israeli soldiers rifle through my suitcase when I was six years old. And yet even I feel very changed by this experience through witnessing it. I have heard this sentiment from a lot of others, and I urge people who do feel changed by this to allow that to seep into their understanding of other situations of oppression. I think we need to de-exceptionalize these violent forces, and not just see them as things that happen to those people over there, but as forces that are in our own lives, no matter how financially comfortable we are, whether we feel like we live in a very safe community.
I’m talking about these structures that prioritize some lives over others. And I think Palestine has been a gift to me in that sense, because it has allowed me to view oppression not just as an accident or as a thing that has to happen, that it’s human nature, but as a very purposeful tool that is not just meant to oppress, but is meant to distract and is meant to take up time and energy while these forces are allowed to continue.
I really want people in the “developed world” to stop seeing this as something that just happens over there and start looking into our own lives and seeing how lack of care, lack of dignity, lack of seeing other people as humans that deserve basic rights and dignities, affects all of us.