I acknowledge the suffering in other regions in the world, such as the Ukraine and Sudan. Caring about friends, colleagues, and students I know in Palestine forces me to focus there.

Faced with the tragedy, now well over 100 days in length, which may rapidly be expanding to a much larger conflict, I ask myself what more I can do?

One only read the Christian Bible, the Jewish Torah, or the Islamic Quran to understand the centuries of violence that have racked the region. When there is no open conflict like today, frequent terrorist acts have made normal life impossible. Populations have long histories of trauma and loss that affect their health and mental health and shape the lives of younger generations.

Journalists have called October 7th the worse assault on Israel since the Holocaust. The loss of life, use of rape, and the taking of hostages with over 100 not yet returned, is horrific.

What is less well covered is the reality of life prior to October 7th for Palestinians in Gaza and the Occupied West Bank and what has happened since. Palestinians call the days in 1948 when they were forced off their land to establish Israel, the Nakba, the catastrophe in Arabic. The UN established refugee camps throughout the West Bank, the Gaza strip, East Jerusalem and in surrounding countries such as Jordan, Syria and Lebanon. Now three to four generations of Palestinians have lived their entire lives in these camps. The original tents became concrete block buildings and cities integrated into their surroundings, with the largest ones located in Gaza, with populations over 100,000. UNRWA provides education, health, relief and social services, microfinance, and emergency assistance through voluntary funding from the UN.

Since the Oslo Accords in 1993, life for Palestinians has grown increasingly restrictive. Before October 7th, normal life for a West Bank physician involved traveling through checkpoints to move in and out of cities, where they may be stopped to have their car and all occupants searched, not being permitted to use freeways unless they qualified for a yellow (Israeli) license plate. One needs Israel’s permission to travel to a meeting outside the West Bank or Gaza which may or may not be granted, and if so, comes at the last minute. Patients referred to specialist hospitals within Israel need Israel’s permission which may or may not be granted. Flying internationally is not permitted at Tel Aviv, but only through Amman Jordan, which adds a travel day on each end of the flight. Health care is provided by the government which has a formulary and offers basic services. Most primary care physicians work for the Ministry of Health and see as many as 150 patients a day. Salaries are intermittently paid by the government because Israel withholds payments to the Palestinian Authority. To make a reasonable salary, physicians run a private clinic in their homes in the evenings. Parents of teenage sons worry for their safety because the army often targets and arrests them.

Part of my response is to partner with West Bank researchers to interview physician colleagues in Gaza and the West Bank to understand how October 7th and the ongoing war has affected them.

Family physicians in Gaza who continues to work LINK

A physician Intern in the northern West Bank  LINK

Interview with staff about kidney failure patients LINK

I recognize the profound suffering in both Israel and Palestine. It is a complex situation that the media presents in soundbites, which do not fully represent the nuances that make solutions acceptable to all nearly impossible. Jews fear that Hamas wants to erase them. Palestinians have lived under occupation for 56 years and fear that this is another Nakba, where they are pushed from their current homes and land, once again. Settlers threaten to take over more of the West Bank and Gaza. There is little trust in the leaders of Israel, Hamas, or the Palestinian Authority who are perceived as corrupt.

I am working with my UK colleagues to encourage each other to resist the demonization of others on the basis of national, ethnic, religious, or political affiliation—and instead spread narratives of friendship, collegiality, shared learning, and all other bonds that challenge the stereotypes of inevitable differences or conflict.

I believe we should call attention to what our government is doing to support the ongoing and worsening humanitarian crisis and call for more efforts to address the needs of the war’s victims. I join my UK colleagues who plea for the preservation of public health amid war. Good nutrition, clean water, adequate (at least) housing, and education are essential to health and life and currently shattered in Gaza today.

Finally, I pray for grace as we watch what happens next, and consider the costs to humanity from these atrocities will cause for generations to come.  

For additional education on the Middle East go to Middle East Resources