I have worked in the world’s most dangerous combat zones. Never have I felt as unsafe as I did in Gaza

Israel poses a palpable, unprecedented risk to medical workers in Gaza with their systemic disregard for international humanitarian law

The Israeli drones hold a particular kind of terror. When they get louder, you know they are close. Are they armed? When there are several, the Palestinians explain they are performing reconnaissance. When they then fly away, you would expect to feel relief. But no, the silence is louder. Palestinian colleagues say the drones have completed their surveillance and will return with munitions.

It is almost two weeks since I left Rafah. For the latter half of April, I lived in West Rafah as part of a team of medics with the German organisation Cadus, providing emergency and generalist medical care at a trauma stabilisation point (TSP) in Khan Younis. The skies were increasingly noisy throughout my time in Gaza. Everyone was waiting for the invasion of Rafah. A week after I left, tanks moved into position in East Rafah and the mass evacuation of civilians, which everyone had spent weeks fearing, started.

A dear friend of mine stayed behind, extending his stay in Gaza. “Is he safe?”, friends and family ask me. I am loathed to buy into a narrative that centres the experience of the white expatriate doctor when the Palestinians have been bearing their more horrific, frank and articulate witness for 75 years and seven months, but at this stage in my long humanitarian medical career I know that the ability to relate to a person of similar lived experience means something. I don’t fight it. “No,” I answer. He is not safe. There is no safe place in Gaza. I am worried about him too.

I have worked in medical humanitarian aid in Sierra Leone, Lebanon, South Sudan, Syria, Iraq, Ukraine, Libya and Jordan throughout the last decade. Some of these jobs have been imbued with serious, tangible risk to life and limb, or of kidnap, but never have I felt as unsafe as I did in Gaza.

Israel poses a palpable, unprecedented risk to humanitarian and medical workers in Gaza. The Israeli state has systematically demonstrated a complete disregard for the imperfect system that has long enabled me to deliver medical care to both civilians and combatants in conflict – that of international humanitarian law, AKA the rules of war. More that 240 aid workers have been killed in Gaza. Hospitals have been destroyed, medical staff murdered, detained without trial, and tortured in prisons. When Dr Al-Bursh was killed recently, the updated numbers reported were of 496 medical workers killed by Israel since Hamas’s attack on 7 October, and 309 arrested.

I was in Khan Younis when the mass grave of Nasser hospital was discovered, and more than 300 bodies uncovered. Families in Khan Younis were also searching for their kin. Most days bodies would be brought to our trauma stabilisation point for transfer to the Palestinian civil defence for burial to be facilitated. Some came in adult-sized bags or wraps. Others in smaller bags, needed only for parts. The smell was extraordinary. When bodies came, Palestinian and international staff would move to help the rescuers. People stopped and watched. Tears streamed down their faces. Colleagues prayed with rescuers. Moments of shared humanity in hell.

It was hard to leave. A week after leaving, I was curled up in my bed at home in southern Tasmania, transposing the sounds of drones to my tranquil environment in my mind. I could not unhear them, and nor did I want to. The most inhumane of conflicts continue in no small part because large swathes of populations who hold power and influence feel too distant to act. Lying in my bed, I hear the movement of wallabies. It’s rhythmic and I can distinguish it from the pademelons. I hear the lone penguin that lives on the track to the beach close to me, calling out in the most contrasting sound to the drones anyone can perhaps imagine. It is confronting. I am reminded of the silence of when the reconnaissance drones fly away.

Two weeks after leaving I am at work as an emergency doctor in Tamworth. Attacks in Rafah are increasing, and I am getting updates from colleagues. Last night I read of new evacuation orders that affect health facilities. I am watching the demise of the remnants of the Palestinian health sector in real time. Many international medical aid workers are trapped by the seizure of the Rafah crossing by Israel and the subsequent uncertainty of any plans to allow them to get out. Even if they want to stay, colleagues describe that without the supply of medical equipment and fuel, there may be no point anyway. Positions they have considered for further trauma stabilisation points turn red on the map as they plan.

I worry for my friend, and I hope fervently that Israel allows international humanitarian workers who are seeking to leave Gaza to do so imminently and safely, but this hope leaves me empty, hollow and nauseated, because what of the Palestinian people? Where is their way of escaping from the violence? Where is the most basic right to safe living – let alone health and freedom – for the civilians of Gaza? It is nowhere. Nowhere at all.

The day I started packing for Gaza, the Australian aid worker Zomi Frankcom was killed. My phone started to go wild. Would I still go? Yes. I believe deeply in the right of all people to have access to medical care. I have followed closely the events in Gaza since 7 October with sorrow and fury. The injustices visited upon the Palestinians by Israel are extreme and it matters to me to stand in solidarity with my Palestinian colleagues amid death, disappearance and the extraordinary restrictions on the delivery of healthcare placed upon them by the Israeli occupying forces. I will continue to do so.

  • Amy Neilson is an Australian rural generalist emergency doctor and academic. She has worked in medical humanitarian aid with Médecins Sans Frontières, the International Committee of the Red Cross and German organisation Cadus.