The concept of the “war biosphere,” emerges from the recognition that the duration and brutality of wars, along with their associated crimes, create a lasting impact on the affected regions creating a ‘biosphere' that inhabitants are bound to for decades. The ongoing war in Gaza stands as one of the cruelest wars in history, surpassing even the violence witnessed during World War II. Within this war biosphere, tools and methods emerge to both reconfigure the health of the inhabitants and perpetuate harm against them. The Gaza Strip has transformed into the all-encompassing war biosphere, best described by intellectual Achille Mbembe as a ‘death-world.'
If we begin with the methodological destruction of the water and sewage system, we are talking about the destruction of five sewage treatment plants, sixty-five water pump stations, and a staggering 70% of housing. In addition, pre- and post-natal care services have suffered extensive damage and widespread malnutrition compounds the situation.The consequences are far-reaching, affecting not only immediate health but also long-term well-being.
Furthermore, there are 10,000 martyrs under the rubble, their bodies decomposing and contributiong to an environmental contamination crisis. Additionally, there are also 70,000 wounded. For those requiring surgery — some of whom need only one procedure — their wounds necessitate regular dressing at clinics over a six-week period. Imagine the immense demand for medical care arising from these 70,000 wounds. During the Great March of Return, 8,000 young people were wounded by Israeli army snipers. Their rehabilitation journey spanned four years, with an average of nine surgeries per person. Each of these individuals had one injury on their limbs from snipers. Imagine these figures: treating 70,000 wounded Palestinians with reconstructive surgeries and rehabilitating them through physical therapy, and among them, between 5,000 and 6,000 children.
Research conducted by Mads Gilbert following the 2009 war shedslight on the profound consequences faced by children who undergo amputations during wars. These young survivors need between 8 to 12 surgeries until they reach adulthood. Before the war, there were 183 children in Gaza who needed amputations. Imagine how often each of these children, who are still growing, would need to replace their prosthetic limbs. They would need a new prosthetic limb every six months, which is the case for 5,000 children.
The war biosphere also encompasses the continual harm from unexploded bombs, which constitute nearly a third of the bombs dropped on the region during any war. The war's extensive destruction wreaks havoc on Gaza's economy. Poverty, malnutrition, and deteriorating health become entrenched issues. Moreover, the collapse of the medical system for treating chronic noncommunicable diseases (NCDs) — such as diabetes, heart disease, and kidney disease — adds to the region's woes.
We cannot forget the consequence of the deliberate killing of 340 doctors and nurses, such as the martyred Dr. Hammam Alloh, may he rest in peace. It took him 18 years of training until he became a consulting medical doctor; he graduated as a consultant nephrologist from a Jordanian university. We are talking about 340 specialists and consultants taking years and hard work to reach the educational level they were at before they were targeted several years later.
One of the most significant phenomena that significantly alters the war biosphere is the growth of antibiotic-resistant bacteria, which Israeli hospitals are complaining about when treating Israeli soldiers returning from Gaza. One of the causes for the bacteria to transform from antibiotic-susceptible to antibiotic-resistant is the heavy metals present in weapons, like cobalt, selenium, and tungsten. The external coating of artillery shells contains these heavy metals. When these shells explode, they release these metals into the environment which induces genertic changes in bacteria leading them to evolve into antibiotic-resistant strains. Effective antibiotics for common bacterial infections cost around $5 per bottle. However, treating antibiotic-resistant bacteria requires specialized medications, with a single dose coting $300.
This ecosystem needs to be dismantled. If it is not dismantled, it will persist for decades. War biospheres have been evident in regions like Laos, Iraq, and Cambodia. Decades after the wars there have ended, these ecosystems persist as defining factors in the lives and health of their inhabitants. It's not enough to have a Palestinian medical system, a health system is also required. This system must actively dismantle the war biosphere. The war's methodical destruction aims to transform Gaza into an unlivable area. When the gunfire stops, we'll confront an inhospitable biosphere. To prevent Israel from achieving in peace what it couldn't in war, we must establish a robust health system — one capable of dismantling this war-formed biosphere.
In the second part of this lecture, I will delve into a distinctive aspect of the Palestinian liberation movement — one that has persisted from the 1950s to the present day. This element has been illustrated by the establishment of a health system, or a health struggle, which formed an essential part of the Palestinian liberation struggle, in a way we can't see in the African National Congress or Latin America. It began with the People's Clinic in Al-Wehdat Camp in the 1950s, the Red Crescent's experiences in Lebanon, the massacre of Tel al-Zaatar, and the doctors who served during the Siege of Beirut, to the experiences of Medical Aid Committees and Health Work Committees during the First Intifada.
Building a health system within a liberation movement fosters solidarity and camaraderie. This encourages cooperation among the people and uniquely brands the Palestinian struggle in a manner unlike other liberation movements in my opinion. During the Oslo Accords, an attempt to separate the health system from Palestinian society and establish a standalone medical system had adverse consequences. The health system suffered severe deterioration. Initially, the goal was to safeguard the Palestinian health struggle, given the sacrifices made. Accordingly, a strategy needs to be contemplated, so we don't return to square one, and so the Gaza Strip can shift from a besieged area to a liberated area. Recognizing that a liberated area serves as a platform for national liberation, we must address the plight of the besieged area — a victim of colonial war.
The rapid change in the health landscape within the Gaza Strip necessitates a new approach pertaining to priorities and strategies encompassing not only medical treatment but also broader health considerations.
