‘Healthocide': experts warn of rise in targeting of health services in conflict
Health services are increasingly deliberately under attack and medics are facing violence and abuse in conflict zones around the world – in particular in Gaza, but also in Lebanon, Ukraine, Sudan, Syria and El Salvador.
This is despite the longstanding principle under international humanitarian law of medical neutrality, which protects healthcare workers and facilities during armed conflict and civil unrest, enabling them to provide medical care to those in need.
In a commentary published in the British Medical Journal, Dr Joelle Abi-Rached and colleagues of the American University of Beirut, Lebanon wrote: 'Both in Gaza and Lebanon, healthcare facilities have not only been directly targeted, but access to care has also been obstructed, including incidents where ambulances have been prevented from reaching the injured, or deliberately attacked.
'What is becoming clear is that healthcare workers and facilities are no longer afforded the protection guaranteed by international humanitarian law.'
The authors cite data from Israel's full-scale invasion of Gaza, which has resulted in at least 986 medical workers' deaths. Recent figures from the Healthcare Workers Watch show that 28 doctors from Gaza are being held inside Israeli prisons without any charge, eight them senior consultants in surgery, orthopaedics, intensive care, cardiology and paediatrics.
The World Health Organization's representative for the West Bank and Gaza stated at the UN security council in January that hospitals in Gaza had 'turned into battlegrounds', while the healthcare system was being 'systematically dismantled and driven to the brink of collapse'.
Healthcare workers in Gaza who were among the hundreds detained by the Israeli military who spoke to the Guardian for the Doctors in Detention project in early 2025 believed they were targeted because they were doctors.
They shared harrowing testimonies of torture, beatings, starvation and humiliation, including being constantly beaten and kept in stress positions for hours at a time, and having loud music played nonstop to prevent them from sleeping. They were also denied food, water, showers and changes of clothes.
Lebanon's ministry of public health has found that between 8 October 2023 and 27 January 2025, 217 healthcare workers were killed by the Israel Defense Forces, 177 ambulances were damaged, and 68 attacks on hospitals were recorded.
Figures from the Safeguarding Health in Conflict Coalition recorded 3,623 attacks on or obstruction of healthcare in 2024, the highest number ever documented.
These attacks included doctors, nurses and allied healthcare professionals who were beaten, arbitrarily arrested, kidnapped, tortured and killed; patients shot in their beds or dragged to detention centres; and hospitals that were deliberately bombed and raided.
The authors of the BMJ article are calling on doctors to 'forsake the principle of medical neutrality' and speak out against 'healthocide' or face emboldening future violators. This might include advocating for enforcement of justice and international humanitarian law, and documenting and exposing abuses of medical neutrality.
Writing in the Guardian, Maarten van der Heijden, a global health lawyer and researcher at the London School of Hygiene & Tropical Medicine, noted that the international humanitarian laws, the Geneva conventions, leave 'considerable room for interpretation and forgoes accountability', allowing hospitals to be bombed if it is considered 'harmful to the enemy'.
The British Medical Association's medical ethics committee chair, Dr Andrew Green, said: 'In recent years, doctors have been devastated to see the appalling increase in attacks on healthcare, patients and staff in conflict zones, and the disregard for medical neutrality and international humanitarian law.'
He noted that although there were examples around the world, Gaza was the most severe given that 'the population is both at risk of imminent famine, while health systems necessary to look after the starving have been systematically obliterated and health workers killed and arbitrarily detained.'
He urged international medical associations, NGOs, governments and the UN to 'call out when we see human and health rights abused, and hold those breaking international humanitarian law accountable'.
'Those with power must use all levers at their disposal to ensure the provision of humanitarian aid and urgent healthcare to the world's most vulnerable. One clear step would be the establishment of a UN special rapporteur on the protection of health in armed conflict,' he added.
The Foreign, Commonwealth and Development Office minister Hamish Falconer has previously said that the UK government is urging the Israeli authorities to ensure that 'incidents are investigated transparently and that those responsible are held to account and lessons learned'.
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