June 29, 2024
On June 1,
approximately 50 medical students from Washington University in St. Louis,
Saint Louis University, and others interested in the topic gathered at a public
library in St. Louis’s Central West End near both campuses to hear neonatal
specialist Yassar Arain describe the medical apartheid he experienced while
volunteering in a neonatal intensive care unit in Gaza this spring. Some openly
wept as he recounted tragedies he’d witnessed but was powerless to avert.
Arain is a
Californian of Pakistani descent now practicing medicine in Fort Worth, Texas.
He’s also a father of young children. In mid-April, he joined in a two-week
medical mission under the aegis of the Palestinian American Bridge, a group of
doctors that hosts foreign specialists to help provide care in Gaza in the face
of their own drastically reduced numbers. Per the World Health Organization’s
(WHO) latest monthly tally, since October 7, 2023, Israel has attacked 464
health care facilities, killed 727 health care workers, injured another 933,
and damaged or destroyed 113 ambulances. Among the doctors, 55 specialists were
killed, according to a Reuters report. Hundreds of bodies have been found in
multiple mass graves at three hospitals. At the Neonatal Intensive Care Unit
(NICU) in Gaza, Arain was the sole neonatologist.
One of Arain’s
patients was an infant who’d been shot in the head during a surprise Israeli
attack, while breastfeeding in his mother’s arms. The bullet entered and exited
his skull, making two wounds that baby Mustafa somehow survived, but with an
unknown developmental fate. He’s since had seizures and needs long-term medical
care — and, Arain said, justice. “One of the hardest things that happens for me
internally, in my own mind,” Arain told the gathering, “is how we reconcile
this with what we promote here in America with newborn mothers, which is
skin-to-skin ‘kangaroo’ care. It helps the baby’s temperature stay normal,
develops bonding, delivers healthy bacteria to the gut — all these nurturing
things. But [think about what] we’re putting Palestinian mothers and infants
through.”
Babies in Gaza
are dying needlessly due to supply shortages, babies that would not have died
if hospitals had even 50 percent of the resources they had prior to October,
Arain told the stricken audience. They’ve run out of surefire medications like
surfactant to help prematurely born babies through respiratory ailments, and
don’t have access to certain technologies like a cooling room needed to cool
down babies’ brains when they experience oxygen deprivation. Israel has
destroyed them all. One newborn in need of cooling was delivered at 24 weeks
[(typical gestation is 36) after her mother’s house was bombed, killing her
mother’s family in the blast and sending her into preterm labor as a result of
the shock. But with no place to send babies in need of brain cooling, they are
condemned to a life of neurological impairment. Arain called it “a crime
against humanity.”
In this
exclusive interview for Truthout conducted on June 20, Arain provided updates
on the functioning of the NICU since Israel closed the Rafah crossing in May
and incinerated it on June 17, discussed the accuracy of vital records, his
admiration for his hosts from the Washington University chapter of Medical
Students for Justice in Palestine (MSJP) and the shocking silence of the
American medical establishment on the mass destruction of Palestinian life.
Frances Madeson: How has the
closing of the Rafah border to Egypt impacted the work at the NICU?
Yassar Arain: When the Rafah
border was open, many more doctors and teams were able to cross, and we were
able to bring medical supplies with us. Not only medical supplies, but kids’
clothes and kids’ shoes. More than half the kids I saw didn’t even have shoes
on. So, we were able to bring in a lot of those supplies.
Now they have to
go through two Israeli borders, one at Kerem Shalom and the second with Jordan
through the Allenby Bridge Crossing. We’re only individually allowed to bring
two bags that weigh 23 kilos a piece, and none of it can include medication.
All medications have to go through the WHO shipments, and we know that’s not
that efficient. And we’re not allowed to bring anything more than personal
items.
It has also
impeded getting children out for medical care. There hasn’t been any movement,
to my knowledge, any active movement of children out of Gaza right now.
The other change
is the Israeli authorities are saying that if you’re coming as a doctor or as a
humanitarian worker, you have to come for a minimum of four weeks. Many of us
cannot take four weeks off of work, and Israel knows that. I was supposed to go
back on July 13. I was supposed to fly out to Jordan, but because they refused
to shorten the duration from four to two weeks, I can’t.
We feel there’s
this tightening of the grip on humanitarian aid, and that every week things get
worse.
How has your
reentry been to life in Fort Worth?
Coming back has
been incredibly difficult, because I was surrounded by an abundance of
resources, and I understand the value of those resources in Gaza. You can’t put
a price on it, the things that we throw away in the hospital.
Just the other
day, I did a procedure on a baby, and as part of the supplies, there’s a bottle
of lidocaine that we actually don’t use, but it’s part of this kit so we just
throw it away. That lidocaine could make a huge difference over in Gaza,
because I saw us doing procedures without lidocaine. I saw us pulling chest
tubes out of a 10-year-old kid, and putting stitches in him, and he could have
used that lidocaine instead of us taking the bottle out and literally throwing
it in the trash.
It sounds like
your experience was life-changing.
Very much so,
because of the people. You don’t hear them really speak ill of their situation.
They may complain to the extent of: why is this still happening? But they don’t
engage in self-pity to the point of becoming immobile or incapable of carrying
on. They continue to carry on their tasks and their responsibilities day after
day, for themselves, their families and their greater society at large. They
bear the pain knowing from their perspective, they are very much on the right
side of history. It’s pretty incredible to see.
When you talk to
the people of Gaza, they know they were born into this very tense situation
from a geopolitical standpoint. But they also know their history, regardless of
how the history of Palestine has been attempted to be manipulated. They’re
under no pretense of the Nakba not happening.
I wish everyone
here in the U.S. could have shared at least a few minutes of what I experienced
there, of what Palestinians, especially Palestinians of Gaza, are actually
like. Because their love for humanity and their love for peace and the pursuit
of justice is inspiring, especially when you have this physical environment
that is just devastated.
What would
happen when a patient of yours would perish? How did deaths get reported?
The most
impressive thing was they still kept paper documents; medical documentation
still happened and it happened diligently. So within the hospital, things do
get documented, and they do go up the chain, so that deaths and births are
reported if they happen in the medical facility.
But the
challenge is the vast majority of medical facilities have been either literally
destroyed by the IDF, or there’s nobody to staff them. If a family member dies,
and this family member is in the middle of a refugee camp that’s kilometers
away from the nearest medical facility, they might just bury the person right
there, and it won’t get reported.
The first night
I got to Gaza, I met one of the doctors, and he was telling me he was a surgeon
and he lives at the hospital now because his home was destroyed. He was saying
how when his house was destroyed, his parents perished in the building, and at one
point he just went back and dug through the rubble, found their bodies, and
there and then, buried them. Did they get reported? Probably not, and how many
bodies are still under the rubble? I’ve heard 100 to 200,000. And once you see
the destruction with your own eyes, it becomes very clear, yeah, that’s easily
fathomable.
You were invited
to St. Louis by Washington University student organizers with MSJP, and your
program was their first public event. In fact, they recorded it and have made
it available online [Part One and Part Two]. Why did you think it important to
come? And, knowing the dangers, why in your talk did you encourage medical
workers and students to go to Gaza?
They thanked me,
but it’s me who thanks them. It gives me hope and keeps me going. Especially as
first year medical students, a majority of them, and their ability to be
cognizant of these injustices and to care enough to do something. I think the
youth and their youthful exuberance towards seeking justice for Palestinians
nationally is enlightening — it feels like a Vietnam War [resistance] moment.
There’s so many
of us that are dying for an opportunity to do something more than just speak up
in the U.S. We’ve been aching and yearning for an ability to do more than just
chant during a protest, not that that’s not important. But to actually put our hands
and our minds to work to help them to alleviate their pain.
You’ve
criticized the American medical establishment for its silence. Why are you so
adamant that they should speak up on behalf of Palestinian life?
Gaza is exposing
a lot of hypocrisy that maybe wasn’t exposed before, or maybe people hadn’t
confronted within themselves and within their profession, or society at large.
From a medical perspective, as a physician, I see the hypocrisy being exposed
within physicians as well as our practice.
The overarching
job of a physician is to save lives, and saving lives does not come with
restrictions — geographically, ethnically, religiously — it comes with no
restrictions.
For physicians
to see the atrocities, to know of the atrocities occurring in Gaza and to not
feel the need to advocate for their lives to be preserved, is hypocrisy
manifesting itself.
When you see
children dying, dead, limbless or incapacitated from the war, does that not tug
at a physician’s standard of morality? If they’re still not able to advocate
for a ceasefire or to preserve the lives of children, then I really question
their ability to provide care in the U.S. to any patient that walks in.
If a Palestinian
child somehow escapes Gaza and shows up in the U.S., now all of a sudden, they
can treat that child and their family with justice. But if asked to sign a
petition or to speak up about not having that child killed in Gaza, they’re
silent. How do you reconcile those two things? How do you reconcile the silence
of the American Medical Association in not adopting a ceasefire resolution?
If we put aside
any sense of empathy and compassion, and we take the most coldhearted approach
towards the genocide in Gaza, then we should ask: How does it make sense for us
to continue to support Israel? What shared values are we preserving?
Because what is
happening is truly a genocide. It is a destruction of a people, not only from a
life perspective, but it is destruction of their ability to educate themselves,
to grow and cultivate the land. It is a destruction of the American sense of morality.
It’s the self-destruction of our own country’s reputation on an international
scale.
This interview has been lightly
edited for clarity.
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