International Call Childcare Professionals to Protect Children in Gaza

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International Call by Pediatricians and Childhood Professionals for the Protection of Children in Gaza

 

We, pediatricians, childhood professionals, and caregivers from around the world, united by our commitment to the health and well-being of children, issue an urgent call to our respective governments and the global public in light of the humanitarian horror represented by the ongoing genocide (1–6) in Gaza.

 


For months, the children of Gaza, symbols of innocence and injustice, have been paying the highest price for an unending conflict.

 


More than 14,100 children have been killed (7), 23,420 children injured (7), over 17,000 orphaned (8,9), and tens of thousands of others bear irreversible physical and psychological scars (10–13).

 


According to estimates by the renowned scientific journal The Lancet, the death toll in Gaza may be significantly underestimated, potentially reaching 186,000 people (14). In a new article published on January 9, 2025, The Lancet states that deaths caused by traumatic injuries reported by the Gaza Ministry of Health could be underestimated by 41%. For the first 12 months of the genocide, the authors estimate approximately 70,000 Palestinians killed by traumatic injuries (sniper fire, bombings, etc.) (14).

 


London et al., in a highly recommended article titled “A Call from 40 Public Health Scientists for an End to the Continuing Humanitarian and Environmental Catastrophe in Gaza,” emphasize the underreporting of deaths (9).

 


Furthermore, UNICEF officials estimate that about 1,000 children in Gaza have undergone limb amputations since the Israeli army’s invasion of Gaza began (15), most of them without anesthesia (16).

 


Civilians, including children, are the primary victims (14) and are specifically targeted as civilians (17). These are not “collateral damages.”

 


Reports from our colleagues returning from the Gaza Strip are unequivocal: no child is safe; they are even deliberately targeted, as described by 44 surgeons and nurses in a letter published in The New York Times, recounting a series of infants and children found executed with sniper bullets to the head (18).

 


Every day, babies succumb to cold, hunger, and the lack of essential medical care (19).

 


The resurgence of eradicated diseases like polio (11) in Gaza demonstrates the total collapse of the healthcare system and the unbearable living conditions imposed on these populations.

 


This reality underscores the devastating scope of the crisis in Gaza—not only in terms of direct human losses but also through the disastrous living conditions, destruction of healthcare infrastructure, and restrictions on access to basic needs (13).

 


Catherine Russell, UNICEF Executive Director, declared:

 “The Gaza Strip is the most dangerous place in the world for a child.” (15)

 


Dr. Abirami Muthumani (Department of Surgery - Columbia University), in an article titled “Safeguarding Children Through Pediatric Surgical Care in War and Humanitarian Settings: A Call to Action for Pediatric Patients in Gaza” (20), published in World Journal of Pediatric Surgery, reports that many children suffered severe injuries from indiscriminate bombings, leading to polytraumas requiring immediate surgical intervention. He reminds us:

 


 “On average, one child in Gaza is killed every 10 minutes.” (21)

 


Dr. Muthumani also condemns deliberate attacks on healthcare infrastructure and healthcare workers, which we qualify alongside him as flagrant violations of international humanitarian law. He states:

 “Pediatric surgical care cannot be provided when hospital infrastructure is destroyed, and healthcare workers are targeted.”

He concludes by urging the global pediatric surgical community to act collectively. We echo his call:


 “Ongoing support, training programs, and workshops for local healthcare providers in Gaza are essential to strengthen surgical capacities and improve skills in challenging circumstances. Together, through unwavering commitment, collaborative action, and dedication to the ethical principles of our profession, we must respond to this urgent call to protect and care for the innocent victims of conflict—children.”

 


The Palestine Children’s Relief Fund (PCRF), once a vital resource for children, can no longer operate its crucial (and free) programs, including the Gaza Amputee Project, which provided prosthetics and surgeries for amputee children (the very existence of such a program in such a small territory already revealed the crimes committed against children by the occupying power) and the pediatric cardiac surgery program, condemning hundreds of infants with congenital heart defects to a lack of treatment (22).

 


The authors of the article “Gaza, Armed Conflict and Child Health” (Boukari et al.), published in February 2024 in the British Medical Journal (23), available for free online, describe the overall impact of the conflict on children’s health:

 • No Safe Place: The entire child population of Gaza has no safe place to go and lacks adequate access to water, food, toilets, and shelter.

 • Massive Bombings: The article notes that Amnesty International reports the use of massive bombs and white phosphorus (9,24) by Israeli forces, causing severe thermal and chemical injuries with devastating physical, psychological, and social consequences for Gaza’s children.

 • Arbitrary Arrests and Detentions: Since October 7, 2023, 500 to 700 Palestinian children have been arrested without charges, often through administrative detention, a practice with severe and lasting physical and mental consequences.

 • Hospital Crisis: Fuel restrictions (13) and aid blockades have created desperate conditions in hospitals. At Al-Shifa Hospital, 37 premature babies were removed from their incubators due to power outages; six of them died within just two days.

 • Direct and Indirect Health Effects: The conflict affects children even before birth: 50,000 pregnant women in Gaza face complications due to stress (13,25), malnutrition (9,26,27) (noting that 90% of preschool-aged children already received only 75% of recommended nutritional needs before the genocide began), and a lack of medical care. Ninety-seven percent of available water is unfit for consumption (13).

 


In January 2024, UN agencies reported that over 15% of children under two suffer from severe malnutrition. Some children admitted to Kamal Adwan Hospital could neither “move nor cry due to the severity of weakness caused by malnutrition and dehydration.” In April 2024, 26 children, most under two years old, died from malnutrition (1).

 


 “The consequences for children, as well as pregnant and breastfeeding women, have been particularly severe, with expected long-term effects on their health and that of their children. Young children, in particular, are predicted to face a ‘diminished future,’ according to a nutrition expert” (1).

 


The conflict has also disrupted vaccination programs, worsened infectious diseases like chickenpox or cholera (13), and destroyed healthcare infrastructure and water supply systems, which were deliberately targeted (13).

 


Finally, we remind the world that at least 493 healthcare professionals have been killed in Gaza (28), such as Dr. Adnan Al-Bursh, head of orthopedics at Al-Shifa Hospital. Several hundred have been kidnapped, like Dr. Hussam Abu Safiya, pediatrician and director of Kamal Adwan Hospital, and many tortured (29,30). 

 

On November 5, 2024, Adèle Khodr, UNICEF Regional Director, raised alarms about the destruction of neonatal intensive care units (NICUs) in the Gaza Strip, highlighting a major crisis for newborns and their families. Kamal Adwan Hospital, the last refuge for neonatal intensive care in northern Gaza, was completely destroyed. The destruction of oxygen and water supplies compromised the care of newborns.

 

4,000 babies have been deprived of vital neonatal care due to the destruction of infrastructure, electricity outages, and insufficient fuel supplies.

 


Before the war, Gaza had 178 incubators distributed across eight neonatal intensive care units. Today, only 54 remain operational—a 70% decrease. In the north, only nine incubators remain, and their functioning is uncertain (19).

 


Every year, at least 6,000 newborns require intensive care, but the war has exacerbated neonatal health complications (prematurity, malnutrition, developmental-related complications), further increasing the need. Limited access to humanitarian aid, especially nutritious food, has led to a rise in premature births and perinatal complications.

 


Adèle Khodr reminds us that healthcare infrastructure and personnel are protected under international humanitarian law. Despite this, newborns are dying in incubators, tents, or the arms of their parents. She laments that this tragedy has yet to provoke sufficient political will to end the war, highlighting a fundamental crisis in our humanity.

 


The World Health Organization (WHO) and Save the Children warn that disease may kill more than the war itself.

 


APPEALS FROM THE PEDIATRIC COMMUNITY

 


In a letter published in July 2024, The Lancet calls for:

 1. An immediate and urgent ceasefire in the Gaza Strip.

 2. Measures to enable the distribution of medical supplies, food, potable water, and other essential resources to meet basic human needs.

 3. Rigorous documentation of the scale and nature of the suffering caused by this conflict to record violations and ensure justice for the victims.

 


In a December 1, 2023, letter, the South African Pediatric Association (SAPA) calls for an immediate ceasefire, secure humanitarian access, and global mobilization to defend children’s rights and protection in conflict zones, including Israel and Palestine (31).

 


In March 2024, the American Academy of Pediatrics (AAP), which had already taken a stand on November 3, 2023 (32) by demanding the protection of children during armed conflicts and the preservation of their basic needs (food, shelter, health), issued a statement emphasizing the devastating impact of armed conflicts on children:

 “The destruction of healthcare infrastructure and the disruption of health systems lead to breaks in vaccination programs, disease surveillance, and access to healthcare and dental care. Traditionally safe spaces for children (e.g., schools, hospitals, and playgrounds) are increasingly affected by armed groups due to indiscriminate crossfire, looting, or direct targeting.”

The statement further explains:

 “Armed conflicts directly and indirectly affect the physical, mental, and behavioral health of children. This can impact every organ system, with effects that may persist throughout life. Furthermore, children are disproportionately affected by the morbidity and mortality associated with armed conflicts” (33).

 


In a letter dated March 1, 2024, the Canadian Paediatric Society supported the call from the WHO, UNICEF, and Médecins Sans Frontières for an immediate and permanent ceasefire. This appeal emphasizes the urgency of ending the violence to protect children and ensure humanitarian access (34).

 


On November 30, 2023, the Asociación Española de Pediatría stated in a public letter:

 “We urgently call on all parties involved for the definitive cessation of these hostilities” (35).

 


Although these appeals are important, they remain timid, avoiding explicit mention of the specific responsibilities of conflict actors or states directly involved.

 


In contrast, a group of English pediatricians, in a letter signed by 750 medical professionals and addressed to their Prime Minister, took a much clearer stance, demanding immediate action to halt arms exports to Israel. They warned:

 “The continued provision of military equipment contributes to the destruction of innocent lives.

These pediatricians also call for the immediate imposition of sanctions against Israel to hold the country accountable for the ongoing violence. In this letter, they stress the severity of the situation and declare:

 “The United Kingdom can no longer remain a passive observer. The UK’s complicity in the deaths of numerous children, many of whom are innocent victims of the conflict, must end” (36).

 


Similarly, a group of Australian doctors took a strong position in a letter published in The Lancet, stating:

 “Our colleagues in Gaza are simply heroic. At a time when solidarity is crucial, they feel utterly abandoned” (37).

 


As for the French Pediatric Society (SFP), it declared on October 17, 2023:

 “The French Pediatric Society laments that children are the primary victims of the Israeli-Palestinian conflict. The SFP wishes to express its full support and solidarity with all children, adolescents, and their families experiencing traumatic episodes with alarming consequences, as well as with the doctors and pediatric colleagues on the ground” (38).

 

Since this date, no further public messages or positions have been issued by the SFP. While expressing compassion, this response remains largely insufficient in the face of the scale of atrocities and suffering experienced by children.

 


OUR ETHICAL RESPONSIBILITY

 


As pediatricians, childhood care professionals, and advocates for children, we have an ethical responsibility to denounce grave violations of children’s rights and call for urgent international mobilization. Inaction or ambiguity in positions weakens our mission to defend the most vulnerable children.

 


The current genocide by the State of Israel against the Palestinian population of Gaza constitutes grave violations of children’s rights as outlined in the United Nations Convention on the Rights of the Child (CRC) (39).

 


These violations include six key areas:

 1. Recruitment and use of children.

 2. Killing or maiming of children.

 3. Sexual violence against children.

 4. Attacks on schools or hospitals.

 5. Abduction of children.

 6. Denial of humanitarian access.

 


In Gaza, four of these violations are flagrantly observed:

 1. Killing and maiming of children.

 2. Arbitrary abductions and detentions.

 3. Attacks on schools and hospitals.

 4. Denial of humanitarian access.

 


The CRC also states that every child has fundamental rights, including:

 • The right to life.

 • The right not to be separated from their parents.

 • The right to health and appropriate medical care.

 • The right to living conditions conducive to optimal physical, mental, emotional, and social development.

 • The right to an identity, including a name, surname, and nationality.

 • The right to express themselves freely and be heard on matters concerning them.

 • The right to age-appropriate information.

 • For children with disabilities, the right to fully enjoy life and actively participate in society.

 


In Gaza, these rights are systematically violated.

 


We remind the world that the Geneva Conventions (40) stipulate that governments and non-governmental entities have an obligation to maintain the neutrality of medical and educational spaces, as well as the safety of living environments for children:

 


 “Civilian homes, schools, playgrounds, and healthcare infrastructure must be safe places to allow children to live, learn, and receive medical care. Childhood health professionals also have a responsibility to uphold human rights standards, such as non-discrimination, in these safe spaces.”

 


CONCLUSION

 


The atrocities in Gaza are a blatant affront to children’s fundamental rights and to the very principles of humanity. As caregivers and childhood professionals, we cannot remain silent. We denounce this genocide—this planned and organized suffering that is destroying an entire generation of Palestinian children. These crimes must no longer be ignored or tolerated.

 


We call on international bodies, governments, humanitarian organizations, and our colleagues worldwide to mobilize to demand:

 • A permanent ceasefire.

 • The opening of humanitarian corridors and access to medical care for all children in Gaza.

 • The release of all Palestinian children arbitrarily imprisoned by Israel.

 • An end to arms deliveries to Israel, which directly fuel the attacks and massive destruction of human lives, including children.

 • International mobilization for the reconstruction of medical and educational infrastructure, as well as urgent implementation of vaccination programs and access to education for Gaza’s children.

 • A strengthened global pediatric surgical community through training, workshops, and collaboration with local providers to meet Gaza’s surgical and pediatric needs.

 • Amplification of evidence on the war’s impact on children via scientific publications, media, and social networks.

 • Independent investigations into these crimes to ensure justice and to protect children worldwide from such horrors in the future.

 • Integration of data on the conflict’s effects on children’s health into policy recommendations and international legal procedures.

 


The international community must end this impunity and act to protect children.

 


Finally, we welcome with relief the implementation of the ceasefire on Sunday, January 19, 2025, and reiterate the demand for it to be permanent.

 


As pediatricians and childhood professionals, we have an ethical responsibility to defend children’s rights and protect the most vulnerable. The international community must act immediately to end the suffering inflicted on Gaza’s children and guarantee their right to a safe and dignified future.

 


Child protection is a universal responsibility. Let us unite our voices to defend children’s rights and save those who can still be saved.

 


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Pétition lancée le 19 janvier 2025