Abstract
Amaç: Bu çalışma, Gazze Şeridi’nde sağlık hizmetlerine yönelik sistematik saldırıları medicide kavramı çerçevesinde ele almaktadır. Medicide, çatışma bölgelerinde sağlık sistemlerinin kasıtlı olarak yok edilmesini ifade eder. Çalışma, bu saldırıların uluslararası insancıl hukuk ihlalleriyle ilişkisini ve küresel sağlık güvenliği ile insan hakları üzerindeki geniş kapsamlı etkilerini vurgulamaktadır.
Yöntemler: Retrospektif nitelikte gözlemsel-tanımlayıcı bir tasarımın kullanıldığı çalışma, Dünya Sağlık Örgütü (WHO) ve diğer uluslararası raporlardan elde edilen verilere dayandırılmıştır. Saldırı sıklığı, altyapı hasarı, ölüm oranları ve acil sağlık hizmetlerindeki aksaklıklar arasındaki ilişkileri belirlemek için ileri düzey korelasyon ve regresyon analizleri yapılmıştır. Ayrıca, saldırıların zamansal eğilimleri ve desenleri değerlendirilerek sağlık sistemlerine yönelik birikimli etkiler incelenmiştir.
Bulgular: Bulgular, bir yıllık dönemde sağlık tesislerinin, ambulansların ve personelin sistematik saldırılara maruz kaldığını, bunun sonucunda ciddi altyapı hasarının ve kayıpların meydana geldiğini göstermektedir. İlk altı ayda saldırılarda keskin bir artış görülmüş ve bu durum ölüm oranları ile hizmet kesintilerinin artmasıyla ilişkilendirilmiştir. Güçlü istatistiksel korelasyonlar, bu saldırıların sağlık sistemlerinin işlevselliği ve sürdürülebilirliği üzerindeki derin etkisini doğrulamaktadır.
Sonuç: Bu çalışma, medicide kavramını, temel sağlık altyapısını kasıtlı olarak hedef alan bir strateji olarak tanımlamakta ve bunun savunmasız nüfuslar üzerindeki yıkıcı sonuçlarına dikkat çekmektedir. Çalışma, hukuki çerçevelerin güçlendirilmesi, koruyucu mekanizmaların iyileştirilmesi ve çatışma bölgelerinde sağlık sistemlerinin dayanıklılığının artırılmasını sağlamak için acil uluslararası eylem çağrısında bulunmaktadır. Sağlık, çatışma ve uluslararası hukuk arasındaki kesişim noktalarını ele alan bu çalışma, gelecekteki politika ve savunuculuk çabaları için kritik bir temel sunmaktadır.
Keywords
Acil sağlık servisleri cankurtaranlar Gazze şeridi sağlık çalışanları sağlık hizmetlerine ulaşılabilirlik sağlık kaynakları
References
- Garry S, Checchi F. Erratum to Armed conflict and public health: into the 21st century. J Public Health (Oxf). 2021;43(1):e110.
- Salem MZ, Ertz M, Sarigöllü E. Demarketing strategies to rationalize electricity consumption in the Gaza Strip-Palestine. Renew Sust Energ. 2021;143:110956.
- Leaning J, Guha-Sapir D. Natural disasters, armed conflict, and public health. N Engl J Med. 2013;369(19):1836-42.
- Salem MZ, Ertz M. Water consumption rationalization using demarketing strategies in the Gaza Strip, Palestine. Water Resour Econ. 2023;43:100227.
- Raab K, Mohammed S, Ralf W. Antecedents of daily disposal routines in the Gaza Strip refugee camps. Resour Conserv Recycl. 2021;168:105427.
- Abuhabib AA, Abu-Aita SN, Procter C, Al-Smeri I. Unique situation of Gaza Strip dealing with COVID-19 crisis. Int J Infect Dis. 2020;100:149-51.
- Elshami M, Bottcher B, Alkhatib M, et al. Perceived barriers to seeking cancer care in the Gaza Strip: a cross-sectional study. BMC Health Serv Res. 2021;21(1):28.
- Abudayya A, Bruaset GTF, Nyhus HB, et al. Consequences of war-related traumatic stress among Palestinian young people in the Gaza Strip: A scoping review. Ment Health Prev. 2023;32:1-15.
- Abudayya A, Abu Ghali K, Hargreaves S, et al. An urgent call to save and protect lives of vulnerable populations in the Gaza Strip. Lancet Reg Health Eur. 2023;35:100767.
- Ashour M, Zaqout G, Yaghi A, Bal’awi O. Emergency preparedness and response of the Palestinian health system to an Israeli assault on the Gaza Strip, occupied Palestinian territory, in 2012: a qualitative assessment. Lancet. 2013;382:np.
- Kınık K, Dag N, Caliskan C, et al. Assault on healthcare in conflict: A critical examination of attacks on medical facilities and personnel in occupied Palestinian territories and Gaza post-October 7 under the lens of international law. Anatol Clin. 2024;29(1):1-6.
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- Office for the Coordination of Humanitarian Affairs (OCHA). Hostilities in the Gaza Strip and Israel Flash Update #160 [Internet]. Geneva: OCHA; 2023 Jan [cited 2024 Dec 21]. Available from: https://www.unocha.org/publications/report/occupied-palestinian-territory/hostilities-gaza-strip-and-israel-flash-update-160-enarhe
- Palestine Red Crescent Society, Emergency operations room report-Gaza strip. Palestine Red Crescent Society Response Report As of Saturday, October 7th 2023 [cited 2024 Dec 21]. Available from: https://www.palestinercs.org/public/files/image/2024/latestResponse/en%20302%202024.pdf)
- ElMokhallalati Y, Alaloul E, Shatat M, et al. The Symptom Burden and Quality of Life in Cancer Patients in the Gaza Strip, Palestine: A Cross-Sectional Study. PLoS One. 2022;17(1):e0262512.
- Clair, Jeffrey ST. Medicide in Gaza: the Killing of Dr. Adnan al-Bursh. CounterPunch. 2024. [cited 2024 Dec 21]. Available from: https://www.counterpunch.org/2024/05/10/medicide-in-gaza-the-killing-of-dr-adnan-al-bursh/)
- Abu-El-Noor NI, Aljeesh YI, Radwan AS, et al. Post-Traumatic Stress Disorder Among Health Care Providers Following the Israeli Attacks Against Gaza Strip in 2014: A Call for Immediate Policy Actions. Arch Psychiatr Nurs. 2016;30(2):185-91.
- Mahase E. Gaza-Israel conflict: Hundreds of medics are killed or arrested after intense attacks on healthcare facilities. BMJ. 2024;384:q203.
- Farhan K, Burhan Tariq M, Kumari J, Bibi L, Salomon I. Famine and disease escalate: Gaza’s humanitarian nightmare. Ann Med Surg (Lond). 2024;86(12):6923-5.
- Hamshari S, Hamadneh S, Ghneem M, et al. Barriers faced by primary healthcare providers in addressing emergencies in the Northern region of Palestine before and during the Gaza war. BMC Prim Care. 2024;25(1):261.
- Alser K, Mallah SI, El-Oun YRA, et al. Trauma care supported through a global telemedicine initiative during the 2023-24 military assault on the Gaza Strip, occupied Palestinian territory: a case series. Lancet. 2024;404(10455):874-86.
- Arawi T. War on healthcare services in Gaza. Indian J Med Ethics. 2024;IX(2):130-5.
- Khatib R, McKee M, Yusuf S. Counting the dead in Gaza: difficult but essential published correction appears in Lancet. 2024;404(10449):237-38.
- Qandil M. Gaza: providing emergency care under fire. Emerg Med J. 2024;41(4):272-3.
Abstract
Aim: This study critically examines the systematic targeting of healthcare services in the Gaza Strip, positioning these attacks as a deliberate form of medicide. This concept, defined as the intentional destruction of healthcare systems in conflict zones, highlights violations of international humanitarian law and underscores the broader implications for global health security and human rights.
Methods: Employing an observational-descriptive retrospective design, the study utilized data from the World Health Organization (WHO) and other international reports. Advanced correlation and regression analyses were conducted to identify the relationships between attack frequency, infrastructure damage, mortality, and disruptions in emergency medical services. Temporal trends and attack patterns were further analyzed to assess the cumulative impact on healthcare systems.
Results: The findings reveal that over a one-year period, healthcare facilities, ambulances, and personnel in the Gaza Strip were subjected to systematic assaults, resulting in extensive infrastructure damage and significant loss of life. A sharp escalation in attacks was observed in the first six months, coinciding with increased mortality rates and service disruption. Strong statistical correlations confirm the profound impact of these attacks on the functionality and sustainability of healthcare systems, exacerbating the region’s humanitarian crisis.
Conclusion: This study identifies medicide as a systematic strategy to dismantle essential healthcare infrastructure, with devastating consequences for vulnerable populations. It calls for urgent international action to reinforce legal frameworks, enhance protective mechanisms, and prioritize the resilience of healthcare systems in conflict settings. By advancing the discourse on the intersection of healthcare, conflict, and international law, this study provides a critical foundation for future policy and advocacy efforts.
Keywords
Ambulances emergency medical services Gaza Strip health resources health services accessibility medical staffs
References
- Garry S, Checchi F. Erratum to Armed conflict and public health: into the 21st century. J Public Health (Oxf). 2021;43(1):e110.
- Salem MZ, Ertz M, Sarigöllü E. Demarketing strategies to rationalize electricity consumption in the Gaza Strip-Palestine. Renew Sust Energ. 2021;143:110956.
- Leaning J, Guha-Sapir D. Natural disasters, armed conflict, and public health. N Engl J Med. 2013;369(19):1836-42.
- Salem MZ, Ertz M. Water consumption rationalization using demarketing strategies in the Gaza Strip, Palestine. Water Resour Econ. 2023;43:100227.
- Raab K, Mohammed S, Ralf W. Antecedents of daily disposal routines in the Gaza Strip refugee camps. Resour Conserv Recycl. 2021;168:105427.
- Abuhabib AA, Abu-Aita SN, Procter C, Al-Smeri I. Unique situation of Gaza Strip dealing with COVID-19 crisis. Int J Infect Dis. 2020;100:149-51.
- Elshami M, Bottcher B, Alkhatib M, et al. Perceived barriers to seeking cancer care in the Gaza Strip: a cross-sectional study. BMC Health Serv Res. 2021;21(1):28.
- Abudayya A, Bruaset GTF, Nyhus HB, et al. Consequences of war-related traumatic stress among Palestinian young people in the Gaza Strip: A scoping review. Ment Health Prev. 2023;32:1-15.
- Abudayya A, Abu Ghali K, Hargreaves S, et al. An urgent call to save and protect lives of vulnerable populations in the Gaza Strip. Lancet Reg Health Eur. 2023;35:100767.
- Ashour M, Zaqout G, Yaghi A, Bal’awi O. Emergency preparedness and response of the Palestinian health system to an Israeli assault on the Gaza Strip, occupied Palestinian territory, in 2012: a qualitative assessment. Lancet. 2013;382:np.
- Kınık K, Dag N, Caliskan C, et al. Assault on healthcare in conflict: A critical examination of attacks on medical facilities and personnel in occupied Palestinian territories and Gaza post-October 7 under the lens of international law. Anatol Clin. 2024;29(1):1-6.
- World Health Organization (WHO). Evacuation orders by Israel to hospitals in northern Gaza are a death sentence for the sick and injured [Internet]. Geneva: WHO; 2023. [cited 2024 Dec 21]. Available from: https://www.who.int/news/item/14-10-2023-evacuation-orders-by-israel-to-hospitals-in-northern-gaza-are-a-death-sentence-for-the-sick-and-injured
- Office for the Coordination of Humanitarian Affairs (OCHA). Hostilities in the Gaza Strip and Israel Flash Update #160 [Internet]. Geneva: OCHA; 2023 Jan [cited 2024 Dec 21]. Available from: https://www.unocha.org/publications/report/occupied-palestinian-territory/hostilities-gaza-strip-and-israel-flash-update-160-enarhe
- Palestine Red Crescent Society, Emergency operations room report-Gaza strip. Palestine Red Crescent Society Response Report As of Saturday, October 7th 2023 [cited 2024 Dec 21]. Available from: https://www.palestinercs.org/public/files/image/2024/latestResponse/en%20302%202024.pdf)
- ElMokhallalati Y, Alaloul E, Shatat M, et al. The Symptom Burden and Quality of Life in Cancer Patients in the Gaza Strip, Palestine: A Cross-Sectional Study. PLoS One. 2022;17(1):e0262512.
- Clair, Jeffrey ST. Medicide in Gaza: the Killing of Dr. Adnan al-Bursh. CounterPunch. 2024. [cited 2024 Dec 21]. Available from: https://www.counterpunch.org/2024/05/10/medicide-in-gaza-the-killing-of-dr-adnan-al-bursh/)
- Abu-El-Noor NI, Aljeesh YI, Radwan AS, et al. Post-Traumatic Stress Disorder Among Health Care Providers Following the Israeli Attacks Against Gaza Strip in 2014: A Call for Immediate Policy Actions. Arch Psychiatr Nurs. 2016;30(2):185-91.
- Mahase E. Gaza-Israel conflict: Hundreds of medics are killed or arrested after intense attacks on healthcare facilities. BMJ. 2024;384:q203.
- Farhan K, Burhan Tariq M, Kumari J, Bibi L, Salomon I. Famine and disease escalate: Gaza’s humanitarian nightmare. Ann Med Surg (Lond). 2024;86(12):6923-5.
- Hamshari S, Hamadneh S, Ghneem M, et al. Barriers faced by primary healthcare providers in addressing emergencies in the Northern region of Palestine before and during the Gaza war. BMC Prim Care. 2024;25(1):261.
- Alser K, Mallah SI, El-Oun YRA, et al. Trauma care supported through a global telemedicine initiative during the 2023-24 military assault on the Gaza Strip, occupied Palestinian territory: a case series. Lancet. 2024;404(10455):874-86.
- Arawi T. War on healthcare services in Gaza. Indian J Med Ethics. 2024;IX(2):130-5.
- Khatib R, McKee M, Yusuf S. Counting the dead in Gaza: difficult but essential published correction appears in Lancet. 2024;404(10449):237-38.
- Qandil M. Gaza: providing emergency care under fire. Emerg Med J. 2024;41(4):272-3.
Details
| Primary Language | English |
|---|---|
| Subjects | Emergency Medicine, Health Services and Systems (Other) |
| Journal Section | ORIGINAL ARTICLE |
| Authors | |
| Publication Date | May 29, 2025 |
| Submission Date | January 21, 2025 |
| Acceptance Date | March 29, 2025 |
| Published in Issue | Year 2025 Volume: 30 Issue: 2 |
This Journal licensed under a CC BY-NC (Creative Commons Attribution-NonCommercial 4.0) International License.