( Middle East Monitor ) – As the toxic dust begins to settle, it is hard to even fathom the complex feelings of our Palestinian friends and colleagues, many of whom have families in Gaza who are beginning the arduous task of returning home and rebuilding, having survived 15 months of Israeli genocide. Since October 2023 Gaza has been pummelled, relentlessly, through aerial bombing campaigns, supplemented by ground offensives that, far from eradicating the resistance, have laid waste to entire towns and cities.
Whilst local authorities have estimated the current death toll to be in the region of 47,000 there is a growing consensus that this figure is a mere fraction of the overall total number of Palestinian men, women and children killed. These figures are catastrophically incomplete, capturing only those for whom we have evidence of their martyrdom being a direct result of Israeli air strike, bomb blast, or bullet fired, a point that has been noted in the globally respected Lancet medical journal.
The true number of Palestinian lives lost will only become clearer when the rubble is finally cleared, and the bodies are recovered. Despite the cyclical nature of Israeli military assaults on Gaza, the long-term implication on Palestinian health is vastly under-researched, with much more work needed to consider the long-term impact of sustained exposure to prolonged hunger, the effect of inhalation of toxic fumes and heavy metals – the by-product of military bombardment – or the effects of poor sanitation and water contamination on public health.
According to the Watson Institute for International and Public affairs, in the 12-month period from October 2023 to September 2024, approximately 62,413 Palestinians died from starvation alone. As a result, in July 2024 the Lancet tentatively suggested that a more accurate depiction would be to say that the death toll attributable to the genocide lies somewhere in the region of 186,000. Following this logic through to the moment that a temporary cessation came into effect, the number of deaths caused as a result of the Israeli genocide could well stand at over 250,000.
Whilst this temporary ‘ceasefire’ (a term we use advisably) allows for a modicum of relief for those in Gaza, as comrades and colleagues, we remain resolutely focused on the material reality which is the fact that Gaza remains besieged. The Israeli state maintains its collective punishment of the Palestinian population through its ongoing blockade, limiting the control of essential goods including aid and medicine, and continuing to fully control the movement of over two million Palestinian survivors of genocide. The difference now is that these practices of subjugation and colonial control take place amidst a Gaza which has been completely destroyed.
Therefore, our work has only just begun.
“Toxic,” Digital, Dream / Dreamland v3 / Clip2Comic, 2024
Israeli policy for those living in Gaza has long been focused on meticulous management of the Palestinian population, creating a situation in which health and life may be sustained, but just barely. To paraphrase Fanon, this gnawing at the existence of the colonised tends to make of life something resembling an incomplete death. Policies such as limiting the calorie intake of those living in the Strip, using a calculation designed to maintain minimum intake but only just prevent starvation, have long been documented. By 2012, around 10 per cent of children under five years of age across the Strip had stunted growth due to prolonged malnutrition. Increased rates of anaemia were reported, with 37 per cent of pregnant women, 58.6 per cent of Gaza’s schoolchildren and 68 per cent of children aged nine to 12 months all suffering from the condition.
The deliberate targeting of healthcare facilities and medical personnel over the last 15 months has meant that chronically ill patients have had almost zero access to much needed medications, significantly worsening their condition and unquestionably leading to an increase in the likelihood of mortality. Over 1,200 dialysis patients and over 10,000 cancer patients have been denied access to lifesaving treatment, and the fate of these patients remains unknown, with many waiting to receive assurances of getting access to treatment abroad.
Research in other war-torn contexts has shown that famine and food shortage will have both short term and dire long-term consequences. Those who have experienced famine in the womb can develop significant health issues across their adult lifespan, including a decreased immune function and increased rates of heart disease, stroke and diabetes. Men who suffered starvation between the ages of 9-15 are more susceptible to high blood pressure as adults, with excess mortality noted from associated heart disease and stroke. Women who have experienced famine have greater prevalence of breast cancer. Thus, surviving the genocide in Gaza will undoubtedly have long term consequences for many.
Prior to 7 October 2023, the baseline prevalence of non-communicable diseases including ischaemic heart disease, stroke and diabetes was alarmingly high across the Gaza Strip. According to the Palestinian Ministry of Health, approximately 71, 000 in Gaza live with diabetes and 225, 000 with high blood pressure. Whilst little is known about the connection between heightened levels of food insecurity and the impact on such health conditions, what is likely is that those in Gaza will experience a pandemic of non-communicable disease in the coming decades should the colonial status quo remain the same.
With over 70 per cent civilian infrastructure destroyed, the dust that is in circulation, the toxic remnants of asymmetrical and wanton Israeli destruction of Gaza, includes cement, metals, silica, asbestos and other synthetic fibres. As an active carcinogen, when inhaled as dust particles, asbestos is associated with an increased risk of lung cancer, in particular mesothelioma. When we consider that, according to the UN, over 800,000 tonnes of the bombed-out debris has been generated in Gaza since 7 October 2023, the likelihood of significant exposure to asbestos is high. Research done in the aftermath of the World Trade Centre collapse has shown that 4,343 survivors and first responders have died from related illnesses since the attack compared to the 2,974 people who died on September 11 itself. The point is: the deadly effects of asbestos and inhalation of other toxic particles released over the last 15 months will only be evident in the decades to come.
Heavy metal exposure from munitions will have permeated Gaza’s soil and water sources, and, as such, the land used to sustain life in the Strip will have been further poisoned. Previous research conducted after the 2011, 2014 and 2018–2019 Israeli assaults on Gaza linked the high incidents of birth defects and premature births in mothers with evidence of exposure to heavy metals. Furthermore, childhood lead exposure in particular can lead to permanent alterations in the function of the nervous system, with higher incidences of attention deficit disorder and Alzheimer’s and dementia noted later on in life.
And so, whilst this is an important and necessary moment of purported cessation, a time to take stock and contemplate the sheer volume of destruction that has been meted out on a starved and besieged population by a conglomerate of nuclear armed ‘superpowers’, our gaze must be longer.
We must recommit ourselves to the struggle for a justice oriented, full Palestinian liberation. This will require a more fulsome understanding of the long-term impact of Israel’s genocide on the healthcare of the Palestinian population in Gaza, as some the long-term health impacts of surviving the genocide will only become clearer much later on.
In maintaining this longer gaze, it is our duty to stand alongside our sisters and brothers as they rebuild Gaza, yet again. It is critical that we vociferously call for reparations from all who stand accused of aiding and abetting this latest failed attempt at Palestinian erasure.
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