[War and peace are the two ends of a continuum when disagreement is present. When methods to resolve conflict by peaceful means appear ineffective or there is not sufficient agreement on all sides to use peaceful means, the movement toward using arms continues. Once a decision is made to use arms to resolve a conflict, those initiating war expect that killing will occur. There are moral principles that anchors war, for example: minimal killing of civilians, targeting less populated areas, maintaining humanitarian structures (water supply, sanitation, hospitals, educational centers), maintaining human rights for prisoners of war. Maintaining these types of moral principles are in line with International Humanitarian Law which provides legal mandates for human rights during war time.]

Peace Walk by Plum Village groups in Washington DC, June 23 2024

Increasing data on the current war on Gaza by the Israel military, following the attack on Israel by Hamas resulting in killing and kidnapping of civilians, question whether the intention of the Israel government is to inflict greater ‘revenge’ harm on the Palestinian people. This is evidenced by reports of little adherence of Israel’s military to the International Humanitarian Law to protect civilians and humanitarian structures. Several research articles published in the last 4 months provide data showing the devastating public health impact due to these human rights violations.

Major public health impact:

Humanitarian structures in Gaza targeted and destroyed

“The first phase of the Israeli military campaign in the Gaza Strip from 7 October through 22 November 2023 resulted in widespread damage to critical civilian infrastructure protected under IHL, including health, education, and water facilities. Spatial statistical analysis suggests widespread damage to critical civilian infrastructure that should have been provided protection under IHL. These findings raise serious allegations of Israeli military violations of IHL, especially in light of Israeli officials’ statements explicitly inciting violence and displacement and multiple widely reported acts of collective punishment against the Palestinian population in the Gaza Strip.”  Asi, Y., Mills, D., Greenough, P.G. et al. ‘Nowhere and no one is safe’: spatial analysis of damage to critical civilian infrastructure in the Gaza Strip during the first phase of the Israeli military campaign, 7 October to 22 November 2023. Confl Health 18, 24 (2024). https://doi.org/10.1186/s13031-024-00580-https://conflictandhealth.biomedcentral.com/articles/10.1186/s13031-024-00580-x#Tab3

Indiscriminate killing of women and children in war on Gaza (since October 2023)

“While large numbers of children and women have been killed in attacks on Gaza over the last 15 years, the proportions during the initial phase of the latest offensive are conspicuously higher (figure 2). Women and children were 30–41% of those killed in attacks on Gaza in 2008–2009, 2012, 2014 and 2021, but they make up 67% killed from 7 October to 24 November. This striking increase in mortality, which suggests an indiscriminate approach to civilian targets, is concordant with the investigative report (11) and Poole and colleagues’ study demonstrating a lack of special protection for hospitals.” Wispelwey B, Mills D, Asi YM, et al. Civilian mortality and damage to medical facilities in Gaza. British Medical Journal Glob Health 2024;9:e014756. doi:10.1136/bmjgh-2023-01475

Aid to Gaza obstructed resulting in widespread starvation of adults and children

“Nearly the entire population of the Gaza strip, or 96% of the population, are facing acute food shortages, with more than 495,000 people including children facing starvation due to an extreme lack of food, according to figures released today by the Integrated Food Security Phase Classification (IPC).”  Devastating new figures reveal Gaza’s child hunger catastrophe. June 25 2024. Save the Children. https://www.savethechildren.net/news/devastating-new-figures-reveal-gaza-s-child-hunger-catastrophe

Structural racism as major determinant of Palestinian health inequities

“The structural violence⁹ against Palestinians is rooted in settler and indigenous dynamics that are further complicated by anti-Muslim racism,⁸ serving as mutually reinforcing forms of structural racism. Structural racism is defined as “the totality of ways in which societies foster [racial] discrimination, via mutually reinforcing [inequitable] systems…(e.g., in housing, education, employment, earnings, benefits, credit, media, health care, criminal justice, etc.) that in turn reinforce discriminatory beliefs, values, and distribution of resources”.¹⁰ As with other forms of racism, a system meant to both “structure opportunity” and “assign value” based on the social construct of race,¹¹ this dynamic results in a devaluation of Palestinian life that illuminates widespread Western support for ongoing indiscriminate killing and the withholding of the bare necessities for survival.

Decades of structural violence, racialized discrimination, and human rights violations have stunted Palestinian health care systems across the territories and perpetuated health disparities across populations. The geographical fragmentation of Palestinians has created a hierarchy of Palestinian health outcomes—best among Palestinian citizens of Israel (PCI), worse for Palestinians in the West Bank, and significantly worse for Palestinians in the Gaza Strip. For Palestinians in the occupied territories, life expectancy is nearly a decade shorter than Israelis’, and child, infant, and maternal mortality are several times higher. Regular exposure to violence, dehumanization, humiliation, and hopelessness creates a significant Palestinian mental health burden.¹² Yet evidence also illustrates discriminatory health access and resulting health disparities for the underserved PCI.¹³ These Palestinians report shorter life expectancies than their Jewish counterparts, higher infant and maternal mortality rates, and greater risk of chronic disease, despite ostensibly having access to the same Israeli health system.^14,15 Although Palestinian refugees are not included in this discussion of Palestinians living in Israel and the occupied territories, their racialization has prevented many from returning to their homes in Palestine and has cemented their fragmentation…resources are not allocated equally, nor by need, but by race, even within the same geographies. Israel is the only sovereign entity in the area between the Mediterranean Sea and the Jordan River. While the international community continues to recognize Israel as the occupying power of the Palestinian territories, rendering the nation with certain obligations toward Palestinian health and well-being, these obligations remain unfulfilled. Palestinians report significant disparities in terms of health care access, with lower per capita health expenditure ($3,145 in Israel vs. $306 in Palestine in 2017, a 165% difference) and disproportionately fewer physicians, nurses, hospital beds, and facilities for health specialties.” Asi YM, Sharif MZ, Wispelwey B, et al. Racism as a Threat to Palestinian Health Equity. Health Equity. 2024.8,1. https://www.liebertpub.com/doi/10.1089/heq.2024.0027

These studies/reports call into question the intention of the Israel government and military and whether its actions is for greater harm, mass genocide, against the Palestinian people in Gaza. Further investigation is required to assess and act on: the lack of protection of civilians through the International Humanitarian Law and its enforcers, the short and long term plan to rebuild Gaza for return of its Palestinian citizens, the short and long term plan for addressing the trauma of war, displacement, and structural determinants of health inequities on the Palestinians of Gaza and the region, and the short and long term plan for addressing the trauma of war on the Israeli people.

The continuum is still available between war and peace, more or less harm. How do we assure action toward peace, least harm, between the Jewish people of Israel and the region and the Palestinian people of Gaza and the region. Here are some: Donating to “Go Fund Me’ campaigns to help Palestinians in Gaza; here is one example, soup kitchen in North Gaza. Donating to different international organizations providing humanitarian support for the people affected by war in Gaza/writing letters of support to your political leaders for support to be sent to them; one example is the United Nations support arm for Palestinians. Write your political leaders about stopping aid to fund the war. If the US stopped sending funds and war machinery and ammunition to Israel the conflict would change to less harm. Calming yourself through prayers and meditation to see more clearly what is yours to do; and sending healing energies/prayers to those suffering in this conflict. Organize a listening circle to listen with friends and family to support each other in their action toward peace. If you are able to walk, take 20 – 100 steps throughout the day and invite in someone in the conflict zone to walk with your steps in peace and compassion.