Palestinian Resistance as Fuel for Global Health Activism

Interview with Hanne Bosselaers from Médecine pour le Peuple

Malek Mattar (Palestine), When Family Is the Only Shelter, 2021.

Hanne Bosselaers, general practitioner at Médecine pour le Peuple (Doctors for the People), talks about the contribution of health work in Palestine to global movements for solidarity and resistance

By Sophia Assis, Psychologist and Fellow at the Zetkin Forum for Social Research 

Since October 7, 2023, the world has been shocked by the attacks of the Israeli occupation against the territory, lives, and socioeconomic conditions of the Palestinian population. The numbers from Israel’s “response” to Hamas, the Islamic Resistance Movement, leave very little to be added: more than 30.000 Palestinians have been killed,  and around 72.000  people injured. 

Some of the main targets chosen by the Israeli Occupying Forces (IOF) reflect the deliberate cruelty of Israel’s genocidal strategy, which has been systematically attacking the health system in Gaza. Bombs and snipers targeted health centers, hospitals, ambulances, and health workers. These are crimes against humanity, and include preventing injured from accessing urgent care and mass executions targeting refugee camps, schools, and healthcare. One of the first attacks on healthcare happened on October 17, when Israel bombed Al-Ahli Hospital. A few days later, Al-Shifa, Gaza’s biggest hospital, was targeted. On November 11, Israel laid siege to Al-Shifa with 1500 patients and workers inside. On January 22, Israeli snipers shot senior physician Hossam Hamada on the street. Throughout these attacks, the IOF kidnapped and arrested health workers, including Ahmed Muhanna, head of Al-Awda Hospital.

Sophia Assis from the Zetkin Forum for Social Research met with Hanne Bosselaers, a general practitioner of Médecine Pour le People [Doctors for the People, MPLP], who worked at the Al-Awda Hospital in Gaza to discuss the impact of the impact of the attacks on Palestinian healthcare, as well as the spirit of resistance still permeating health activism in Gaza. Dr. Bosselaers is currently in charge of the solidarity actions with Palestine and AWDA Health & Community Association at MPLP, where she is guided by a thoughtful analysis of internationalism, collectivism, and the need for public healthcare.

Sophia Assis (SA): Dr. Bosselaers, could you start by telling me about yourself and your experience as a doctor in Palestine? At what point in your training as a doctor did you realize the need for having this internationalist experience?

Hanne Bosselaers (HB): Today, I am a general practitioner working for Médecine Pour Le Peuple [Medicine for the People, MPLP] in Molenbeek, Brussels. Ten years ago, I went to Palestine, to Gaza, to establish a twinning project between our medical center here, and Al-Quds, a medical and cultural center in Beit Hanoun in the north of Gaza. It is one of the centers of AWDA Health & Community Association, a local Palestinian health and community organization that we have worked with in the West Bank for a long time, but we didn’t have contact with their Gaza branch at the time. I went there to work as a general practitioner (GP). I worked in prenatal consultations in the hospital, and then in general practice, with all kinds of problems, in the medical center in Beit Hanoun.

When did I realize that international experience is important? I had a few experiences abroad during my education as a doctor, including an internship in Ecuador, where I worked in maternity and pediatrics at a public institution in Guayaquil. There I realized to what extent the difference between an unfunded public system and a private health system can go. Three blocks from me was a very bright and fancy hospital, while the public maternity ward was visited by people who had to queue to buy their medicine before coming to deliver. They were already in pain, standing at the pharmacy and waiting to buy their medicine, and only then could they receive the drugs. I understood then that it’s important to have different experiences of medical work to analyze the different health systems. At that time, I didn’t have any political experience. It was more from an interest in how care and health in other countries are organized.

After that I came to MPLP, and after I finished my studies, they proposed that I go to Gaza to establish the twinning program. I realized at that point how important it is to go for real solidarity, helping fellow doctors, but also learning from them, and coming back and advocating based on that experience. In the case of Palestine, it’s really essential to take back your experience of working under occupation, what you lived there on the ground, and bring it back to Belgium to sensibilize people through activism. That’s one of the most important things I learned from my colleagues over there.

SA: From your experience as a doctor and activist, what are the most important lessons you would single out from your experience with health professionals in Palestine?

HB: I was truly impressed by the quality of their education and care of people. They really have a good view of health. There are not many technological facilities: for example, there is only one MRI in Gaza. But while health workers in Palestine may have less technology than European countries, they are better doctors. They are really close to their people. They understand community health and the effects of the occupation and violation of basic rights on health. That is what we discussed a lot at the hospital, we talked about the violations of such rights and the implications for the population’s health. This is something they have really integrated in their work, they are very highly skilled and quality professionals. They also have this real dedication to their people, which is also a form of resistance: staying close to people, protecting their health, making life easier and healthier. It is a real mission for them and they don’t let go of it.

Palestinians have a strong collective organization and vision, they always find new ways to be together and to care for each other, and to preserve health. It is because of their history of 75 years of oppression that they now manage to resist, with a very high resilience. I can’t imagine myself being put in Al-Shifa or any other hospital which has been besieged, bombarded, raided by Israeli soldiers… Imagine Al-Awda hospital: after two weeks of besieging, all their health personnel were locked in the hospital with patients, without electricity, without enough medicine, even without enough water and food. Then they [the IOF] raided the hospital and captured a few of their colleagues. And on the next day they still go on to provide health services to the patients?  They are still standing and receiving patients? I don’t know if Western health workers would be able to handle it.

When I was there, you had huge organizations that organized cultural activities that went into the neighborhoods to see what could be improved. Can we make a little green space? Could we build a sports field? They take a lot of actions that are not directly linked to health, but are aimed at making living easier and, in this sense, healthier. Everybody is in an organization, either a youth, cultural, or health organization; a lot of people have notions of Basic Life Support (BLS) and can give first aid, needed in bombardments. When a catastrophic event happens, so many people are skilled and know what to do. This level of organization and collective thinking I never saw anywhere else in the world. It is one of the most inspiring things about Palestine.

Fatma Shanan (Palestine), Two Girls Holding a Carpet, 2015.

SA: Could you explain how the healthcare system is organized in Palestine? 

HB: Well, of course it is underfunded because the Palestinian Authority doesn’t have a lot of funds to offer quality healthcare services. There are different systems: a public healthcare system, financed by the Ministry of Health of Palestine; a system of public insurance to which not all Palestinians have access to; and another from the United Nations Refugee Agency for Palestine (UNRWA), which takes care of the refugees in Gaza (70% of the population)… They have a lot of primary health care clinics all over Palestine. You have basic pharmacies, first-line care, dentists which are available for the refugees under UNRWA… And then you have international NGOs that provide healthcare services, as well as Palestinian NGOs, like AWDA, which we support. Awda  is a Palestinian NGO funded by international partners and offers some services with the Ministry of Health. Overall, it’s a system that is quite fragmented, underfunded in general, and depends a lot on NGOs and on money coming from external partners.

SA: What is the relationship between the health workers and their people? In this sense, what is the concept of health put into practice in Palestine?

HB: The concept of health in Palestine is that health doesn’t only depend on having a disease and being able to access healthcare but has a global dimension, through its social determinants.  I  had already learned about  the social determinants of health with MPLP, but it became a lot more concrete in Palestine, where you see how people suffer from an economic system that is completely destroyed by occupation. There is no freedom, people don’t have work, they don’t even have clean water… Their social determinants are catastrophic and have a lot of effects on health, and these doctors are really conscious of it. They try not only to cure, but also to prevent and do community actions. 

They have a really holistic view of health. They also care a lot about mental health, which is very difficult to put into practice because there is a lack of availability of psychiatrists and psychologists. There is a very high level of collective trauma because of the bombardments, occupation, and constant fear. A big part of the population is suffering from mental health issues, and they are well-documented. They do their best to treat them and also to find a collective way to deal with the situation. 

For example, they do a lot of activities with children. I feel so proud when I see these Palestinians even now, in Rafah, in the camps, organizing activities for the children. They manage to find circus materials. They manage to find books. And they put tens of children together to make them think of other things and give them the right to be free, to play and be children, which is essential. I don’t know if, in Western societies, which are highly individualistic, we would manage to organize this if we were put in this sort of situation now. I really don’t think so. I think we would hardly  survive.

SA: It is when health, solidarity, and resistance all meet…   

HB: Yes, healthcare workers are a very important part of the resistance. They go, they push their limits further. I don’t know if you saw the video of this female gynecologist in the courtyard of Nasser Hospital. Some snipers shot a man at the other side of the courtyard, he was bleeding on the ground. The snipers were still there, and she took off her coat and ran to the patient to protect him. This is their real spirit; they don’t fear for  their own lives. They are focused on helping as many Palestinians as possible to survive, in a real collective way. 

At this point in Gaza, under genocide, just surviving is an act of resistance. The mission is to save as many people as possible. And health workers do it in a very brave and dedicated way. That’s truly  inspiring.  The concept of health that is practiced is the right to health, the right to live free from occupation, rights that should be universal. This vision is present in all of the health work and that’s how the workers organize themselves, even if there are different political currents. Being Palestinian and defending health for all is something that is really spread among the whole Palestinian society.

SA: What is the importance of healthcare and health workers to the resistance of the Palestinian people?

HB: Healthcare workers are important as they are trained, highly educated, so they have important knowledge, but they are also dedicated to serve their people. This combination is very strong, and makes their health services  resilient, even if they are underfunded and lack everything. Even in the gap between the bombings, they are not able to provide health care as it should be, but they are so creative and so dedicated that they can manage these extreme circumstances. I really admire the people from Al-Awda Hospital; how they continue to go there despite having their director captive for over 50 days now. They don’t have any news about him and 12 other members of their personnel. In all of Gaza, hundreds of health workers are still being held in prison with no news. They might be executed or still alive, we really don’t know. And their colleagues just continue. This dedication to providing health in any circumstance is quite unique and very strong. 

The people support health workers a lot. You can often see the population coming to the hospital and bringing food, even under such difficult circumstances. Health care is seen as something from the community. Especially the primary healthcare centers, like in Beit Hanoun, were like community centers. People walked in and out, would come and chat, bring tea, bring cookies. The Palestinians appreciate their healthcare workers, doctors, nurses, pharmacists… But they also help. If the center needs to be rebuilt or repainted, you will have a lot of people from the community coming and helping. So it is really built by the people.

SA: What do you think of Israel’s attacks on hospitals and health structures in Gaza? Has it been possible to maintain contact with health workers in the hospitals that are still active?

HB: When we talk about the strength of the health system, we are talking about these highly educated and dedicated professionals who are also a sort of resistance. If you need to exterminate a population because you want to take its lands, healthcare workers are the first ones to be attacked. We see that not only in the case of health care, but also in the case of cultural and intellectual figures, journalists, professors, and scientists, who have been murdered. They represent part of people’s needs; if you have a tactic of extermination, they are the first targets. 

That’s what we have seen during all Israel’s attacks on Gaza. It’s not new. Since 2012, they have always targeted health care, and not by hazard or by collateral damage, but directly singling out ambulances, hospitals, and healthcare workers while they are doing their work. Even during the Great Return in 2020, when people marched to the wall around Gaza, healthcare workers were directly targeted by snipers. It is definitely a tactic that is coming back. It’s a strategy. It’s a genocidal strategy to consciously take away the things that people need the most. And they are also conscious of it.  

It has been difficult to keep contact with the healthcare workers in Gaza because of blackouts and I think, also, because of tiredness. In the beginning, I managed to contact some of my friends regularly. One of my doctor friends evacuated to Russia, so I am still in contact with him, although he is not in Gaza anymore. The people from Al-Awda Hospital send many updates, they are active on social media. We can follow what happens in their hospital. 

I also have a lot of contact through Gazan-Palestinians in Belgium, including healthcare workers. For example, Dima, a doctor who worked in Al-Shifa Hospital, is now in Antwerp.  We stay in contact, which is good on the emotional side as well. Talking to other healthcare professionals who know the situation in Gaza is important to share this experience, because it’s quite dramatic. I haven’t been there for ten years, and I can’t even imagine how many of the Palestinians who are abroad are feeling. The Palestinians out of Gaza feel guilty, a lot of them say that they would prefer being there with their family over being the lucky one who is safe. They are not interested in individual safety. There is a very strong collective identity. No one leaves Gaza to be individually saved. If Palestinians leave, they remain with something attached to the Palestinian land. There are very few people who leave permanently and don’t carry their identity and their will for freedom for Palestine within them. It’s very hard for all Palestinians from Gaza who are abroad or who evacuated during this war.

Coming back to your question, yes, the contact has been fragmented, but we have information about what is happening, especially in Al-Awda, because we have close contacts. There is a lot of good journalism on social media as well. People keep on making videos and going into the hospitals, showing the world what is happening. We won’t be able to tell afterwards that we didn’t know what was happening. Everything is very well-documented. 

I hope that the International Court of Justice will rule on the documentation about the repeated attacks on health care. There are hundreds and hundreds of cases. They will have to go through all of it and hold Israel accountable because we cannot let it go with allthis  impunity. This is also something that the global solidarity movement of health workers is seeing: the attacks are so repeated, so strategic, so cruel, that more and more health workers say that we have to stand up against them. 

SA: Speaking of solidarity, in Belgium and Europe, we have seen so many solidarity actions with Palestine. Could you tell us about the actions that have been developed in the MPLP medical centers?

HB: We are organizing together with Viva Salud, our sister organization, which has a lot of international partners. We made a big emergency appeal for Al-Awda Hospital. We already collected more than €200,000. It is one of the largest emergency funds that we ever raised. And we see that people are really generous and trust us because I went there and know this organization. So when we go to the market here in Molenbeek, it is easy to convince people to donate because it goes straight to an organization we know and that does good work. 

This solidarity appeal is very important because it is not only helping to rebuild a part of the Gazan health system but a way to sensibilize, make people see what is happening on the ground, and give them the possibility to act. 

We have other solidarity initiatives going on, and of course we take part in all the demonstrations in solidarity with Palestine. On the last demonstration in January, we went with a banner saying “Make health, not war” with a lot of health workers from Médecine Pour le Peuple, but also other health professionals. We try to build this movement further. 

We also have “Boycott Teva”, a campaign focusing on an Israeli company that produces generic drugs, which is very, very complicit with the Israeli government. There are many alternatives to the non-essential drugs that Teva produces in the Belgian market, so it is easy for healthcare workers not to prescribe Teva. We also sensibilize our pharmacists. This is a campaign that we have been doing since 2014. We keep it going and do some sensibilization about not prescribing Teva medicines. 

SA: What is the importance of internationalism for MPLP? 

HB: It is important to stand up against injustice everywhere in the world because if an occupation and apartheid, a genocide, as cruel as we see it in Palestine, exists, it is through the powers that rule the whole world. It’s the capitalist economic system that produces these kinds of cruelty. And when it happens, it’s essential to stand with the people, to choose your side. And that is something we do in Belgium as MPLP. But we want to do it globally, and we want to seek other organizations internationally to support each other. That’s why we send people to Palestine. That’s why we talk a lot about it, and not only Palestine – we also have solidarity projects in Congo, in the Philippines, in Cuba. This internationalism is essential if we want to liberate the world from our current system that is causing oppression and inequality. We will have to be strong, and we will have to have international solidarity and international ties. It’s part of our DNA and for me, it was a decisive factor in my engagement. 

If I hadn’t been to Gaza, I don’t know if I would be such an engaged doctor in MPLP today. They really inspired me. We have so much to learn from the Palestinian way of organizing, from the way they have their identity rooted really profoundly in them. All the children, for example, know the great Palestinian poets, they know how to dance the traditional dance Dabke, and how to make the Palestinian food. There is a very large cultural identity that they preserve. And the collective resistance is one of the most inspiring things I have seen in my life. It gives me a lot of fuel for activism.

SA: In your opinion, what do you think health professionals should do to demonstrate solidarity with Palestine?

HB: Go to demonstrations and identify as a health care worker. You can speak out with the other healthcare workers against all the attacks we see on Palestinian healthcare. Of course, support the case of South Africa at the International Court of Justice. I think it’s really important to help document attacks on healthcare and support healthcare workers because even here, we have a voice and are listened to… So we must try to speak up. These are specific examples. Of course, we are part of the broad solidarity movement with Palestine, which is a civil movement with a lot of different currents. Identifying as a healthcare worker within this movement and speaking up against the attacks on health is an important aspect of international solidarity. And that’s why we see in different countries new organizations of healthcare workers for Palestine appearing. And I think this emerging movement should reinforce the global movement, where we defend health everywhere at all times, accessible to all.

Dr. Hanne Bosselaers, Peter Martens, Vijay Prashad, and a COMAC activist at a COMAC event on February 16, 2024 at Université Catholique de Louvain in Belgium. Photo: COMAC

This interview has been published in two parts on People’s Dispatch.