Gaza genocide: How Israel's healthcare system became an instrument of state violence

Middle East Eye

21-05-2025

In recent years, Israel's defenders have increasingly pointed to the significant presence of 'Arab Israeli' doctors and their integration into the country's healthcare system as evidence against accusations of apartheid.
They highlight examples, including Jewish patients treated by Arab doctors, to promote a narrative of equality and coexistence. But for those familiar with the lived realities of being a Palestinian citizen of Israel - and particularly how it manifests within the healthcare system - this narrative is deeply misleading.
In the weeks following the Hamas attack of 7 October 2023 and Israel's ensuing genocidal war on Gaza, hundreds of Palestinian healthcare workers have been subjected to harassment, disciplinary summonses, suspension or dismissal - often for simply acknowledging or expressing sympathy for the suffering of civilians in Gaza. Actions as minor as liking a post, or the rediscovery of old content, have triggered punitive measures.
In a recent study I conducted for the Haifa-based Mada al-Carmel, the Arab Center for Applied Social Research, I gained a profound and intimate understanding of the daily realities faced by nine Palestinian physicians working in hospitals and health clinics across diverse geographical areas in Israel.
Through in-depth interviews, they shared their personal experiences and reflections on both the Israeli healthcare system and their relationships with Israeli colleagues amid the war. What emerged most powerfully was a deep sense of dehumanisation, as intimidation and racism against them has intensified significantly since October 2023.
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Palestinian doctors make up nearly a quarter of Israel's medical workforce. Despite this, they remain structurally marginalised.
In hospitals and clinics, they work closely alongside Jewish doctors, members of the dominant and racially privileged group, and are often instrumentalised to project an image of equality. This aims to deflect international criticism and to support internal campaigns promoting the rights of 'Arab citizens'. At times, these doctors are celebrated as symbols of coexistence or hailed as heroes, masking the deeper repression they face.
Climate of fear
In the interviews I conducted, doctors described a climate of fear and silencing, where even minimal expressions of grief for Palestinian victims are treated as support for 'terrorism'.
From the outset of the genocide, doctors told me, their managers warned staff against criticising the war or referring to Israeli military actions as 'war crimes', stating that anyone who made such remarks had 'no place' in their institutions.
In the early days of the war, a letter was circulated among medical staff, stating that any expression that could be interpreted as 'support for terrorism' would be handled under Israel's anti-terrorism law and could result in disciplinary measures, including dismissal.
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Several interviewees spoke about colleagues who were summoned by hospital management or faced disciplinary threats over social media posts or casual remarks. Staff meetings became spaces of collective suspicion, with Palestinian doctors implicitly portrayed as potential supporters of terrorism, or asked to condemn the events of 7 October.
Interviewees also recounted hearing racist statements that broadly dehumanised Palestinians - for example, generalised claims that 'all Arabs are terrorists'. This atmosphere kept them from expressing empathy or taking meaningful action against the war in Gaza, turning hospitals into sites of repression and racialised control.
The Israeli Medical Association continues to justify the logic of military strikes on health infrastructure, rather than condemning it. This is not a defence of medical ethics, but an abdication
The Israeli healthcare system has long been shaped by the broader structures of repression and racial hierarchy that define the state's treatment of its non-Jewish citizens, including Palestinians, whose political agency is often perceived as a threat to the Jewish majority.
Several Israeli hospitals have segregated Arab and Jewish women in maternity wards at the request of Jewish families, while a prominent Israeli doctor has referred to the 'Arab womb' as a demographic threat, citing Palestinian birthrates as a danger to the Jewish majority.
These are not isolated incidents, but part of a broader pattern of racism in healthcare - from prejudiced comments by staff, to patients refusing treatment from Arab professionals, a behaviour often tolerated or excused by hospital administrators.
To assume that this same system, so deeply embedded in state ideology and built on structures of exclusion, would somehow function as a sterile and protected space for Palestinian health professionals is not only naive, but dangerously detached from reality.
Heavy silence
Despite a year and a half of genocide in Gaza and the systematic collapse of the territory's healthcare system, the Israeli Medical Association (IMA) has remained largely silent.
On only a couple of occasions did it feel compelled to speak out, and even then with reservations. After 100 Israeli doctors in November 2023 signed a letter calling for Gaza hospitals to be bombed, the IMA responded to this letter by stating: "Israeli doctors have refused to be dragged into the moral and ethical deterioration that the enemy has reached. We will continue to uphold our role and remain committed to healing, and to improving the quality and longevity of our patients' lives. Doctors of the Israeli Medical Association (IMA) will not encourage crimes against humanity". The original letter was published in Doctors Only, a platform accessible exclusively to members of the Israeli Medical Association (IMA). However, it was reported publicly.
And last year, it issued a statement highlighting doctors' obligation to provide care to 'Hamas terrorists' - but only after public protests erupted outside hospitals over the treatment of detained Palestinians.
In neither instance did the IMA acknowledge the destruction of Gaza's healthcare system, the killing of medical personnel, or the war crimes committed against hospitals.
Now, after more than 19 months of genocide, the IMA has issued a short statement that notes the 'serious conditions' in Gaza and calls for humanitarian aid to be allowed in, but otherwise echoes the military's narrative.
By framing humanitarian aid as something that must be protected from 'misuse' and warning against hospitals being commandeered as 'terrorist quarters', the IMA continues to justify the logic of military strikes on health infrastructure, rather than firmly condemning it. This is not a defence of medical ethics, but an abdication.
The IMA, which represents the vast majority of doctors in Israel, has played a central role in aligning the medical sector with state objectives. While claiming to be a neutral professional body, it has actively defended Israel's military actions, lobbied against international condemnation, and promoted pro-war narratives under the guise of medical diplomacy.
Intensified surveillance
The militarisation of Israel's healthcare system is deeply entrenched, both structurally and symbolically - and this has significantly intensified since 7 October. Senior hospital staff often serve as army reservists, and medical professionals regularly shift between clinical roles and military service.
This has led to the normalisation of military values within hospitals, where displays of nationalism, armed personnel and institutional support for the war effort have become common.
This alignment goes beyond rhetoric. Physicians have been seen carrying weapons inside hospitals, and family doctors have helped facilitate the arming of settler civilians. One Israeli doctor publicly expressed excitement about entering Gaza with a rifle and taking part in assassinations, framing it as part of his role as a physician. Dozens of Israeli doctors endorsed the bombing of hospitals in Gaza, without facing any professional consequences.
Coerced into silence: The reality of being a Palestinian doctor in an Israeli hospital Read More »
Palestinian medical teams within the Israeli healthcare system have been facing persecution, silencing and exclusion. Medical staff who express political opinions or demonstrate solidarity with Palestinians in the occupied West Bank and Gaza have been targeted and confronted by their Israeli counterparts, and subjected to institutional monitoring.
Such persecution, often masquerading as neutrality or depoliticisation of the health system, has induced a climate of fear among Palestinians, leading to self-censorship and restricted expression of their views.
The surveillance has intensified since 7 October. Hospitals now often preemptively scan social media, flagging Palestinian staff who have not posted condemnations of Hamas or have shown concern for Gaza's victims.
There are documented cases in which hospital staff - and, in some instances, patients - monitored healthcare workers' social media activity, including past posts. These were reported to hospital management and, in some cases, led to disciplinary measures or dismissal.
Additionally, several doctors I interviewed for my research stated that their social media activity was being surveilled. As a result, many chose to deactivate their accounts or stopped posting altogether. Some healthcare workers have been suspended or fired without due process.
Such developments reflect not mere complicity, but active participation in the war effort. Some health professionals have even been implicated in the neglect of injured Palestinian detainees. The blending of military and medical roles - alongside the repression of Palestinian voices - exposes the healthcare system not as a neutral domain of care, but as an instrument of state violence.
The views expressed in this article belong to the author and do not necessarily reflect the editorial policy of Middle East Eye.