On October 11th, cardiopulmonary resuscitation was performed on the lifeless body of paramedic Hatem Awad as he was rushed through an ambulance bay in Gaza. Awad and his colleagues from the Palestinian Red Crescent had just been given the green light to head into eastern Gaza to assist victims of airstrikes, not knowing they would become victims themselves.

On October 17th, surgeon Dr. Ghassan Abu Sittah stood in the ruins of Al Ahli Baptist Hospital in Gaza, surrounded by corpses, shock visible in his eyes as he said, “We could see the bodies of children piled up … there were body parts everywhere … the impunity that Israel believes it has from its allies has led to this massacre … more hospitals will be targeted.”

As U.S. health care workers, we dread mass casualty events above all else, and one coupled with no water, electricity, or fuel is a death sentence for the victims and responders.

No entity has the right to deny humans access to health care. It is horrifying to watch our Palestinian colleagues forced to operate without anesthesia, by the light of their phones.

Medicine has historically been viewed as an “apolitical” field and practice; a detrimental designation that has continually allowed the House of Medicine to remain silent, indifferent, or complicit during humanity’s greatest tragedies.

Health care access and delivery do not exist in a vacuum; medical apartheid has plagued Gaza since the Nakba of 1948. Gazans must obtain permission from Israel to leave Gaza for medical treatment for conditions their under-resourced hospitals are not equipped to handle. In 2022, more than 20,000 permits were denied. The 17-year siege has made Gaza dependent on external aid and crippled its infrastructure. From 2019 to 2021, only 55 percent of the necessary medical supplies were found in Ministry supply stores. These stores are now nonexistent, and as of this week, vinegar is being used to treat bacterial infections while ice cream trucks are holding corpses before burial.

At the time of writing, more than 100 health care workers have been killed as a result of airstrikes on Gaza, and nearly every hospital has been threatened with bombing if they do not succeed in the impossible task of evacuating patients and the refugees who have sought sanctuary on hospital grounds.

We know what happens next. More than 50,000 people are seeking shelter in and around Shifa Hospital, whose shutdown is imminent. If Palestinians manage to survive the shellings, they will face new horrors. Infectious diseases will become rampant. Wounds will fester. Mass graves will become health hazards.

All people have the right to self-determination and freedom from apartheid, medical apartheid included. Our health care institutions, unions, professional organizations, schools, and politicians must call for a ceasefire and allow for the immediate and unconditional aid to be sent to Gaza.

Tammy Abughnaim is an emergency physician. Emily Hacker is a health policy analyst.