Respected AAPA Leadership:

I would like to request for you to draw your attention to an urgent matter. As healthcare professionals, it is undoubtedly our duty to uphold moral standards within society especially when they pertain to patient care, such as unequal access to care and calling out ethical violations. We cannot distance ourselves from matters of social justice and politics because they directly impact the people we care for. Our medical institutions and professional organizations have been vocal in matters such as gun control, reproductive rights, and the unfortunate invasion of Ukraine resulting in the displacement of people from their homes. The concern that I would like to highlight in this email is the mass persecution and intentional targeting of healthcare facilities, patients, civilians and healthcare personnel in Palestine.

I understand that this matter provokes strong emotions. At the end of the day, we must separate ourselves from national and religious identities when egregious crimes are occurring against humanity and hold each other accountable to shared ethical values. An entire population of families and children are being deprived of the basic necessities of living such as food, water, fuel, electricity, sanitation, medications, basic infrastructure all while being bombarded indiscriminately. Women are having babies without any type of anesthesia, insulin is not being allowed in, tube feed dependent children are dying of starvation as well as previously healthy children, oxygen dependent patients die suffocating. There is no sterile field in procedures, basic sanitation supplies are cut off and the casualties are too high for even our institutions to handle. Healthcare personnel and healthcare infrastructure is intentionally being dismantled. This is not a matter of opinion, but documented war crimes noted by independent human rights organizations, including Amnesty International, Human Rights Watch, the International Criminal Court and the International Court of Justice. Independent medical relief organizations, such as MSF and WHO, have closely documented the extent of the destruction and death, particularly in how it disproportionately affects children. 

We must use our knowledge to educate our lawmakers who are actively supporting and arming this genocide about the long-term implications such violations have to a people and their healthcare outcomes. In Gaza, there have been over 50,000 civilian casualties (with numbers estimated to be significantly higher due to inability to identify mutilated bodies or account for those trapped in the rubble), over 30,000 infant/child casualties, and 25,000 children have been orphaned. There are thousands of amputees, some missing multiple limbs. Imagine the generational trauma! Our colleagues in medicine are being intentionally kidnapped and killed in front of their patients. Hospitals are being raided, patients are being killed intentionally. So far three mass graves containing over 500 bodies have been found at these besieged hospitals. Many of the victims were healthcare personnel, still in their scrubs with their hands zip tied behind their backs. Amongst the bodies found were children as young as three years old with their hands bound behind their backs with bullet wounds to the head and patients still attached to their IVs. A group of PICU doctors were forced to abandon 12 incubator bound preterm newborns at gunpoint. They were not allowed to return to these innocent babies, only for them to be found days later decomposing in their incubators. There is a dramatic spike in preterm deliveries due to severe malnutrition and bereavement of pregnant mothers. These babies are sent to NICUs with no fuel or electricity to power incubators, no clean water for formula and limited feeding supplies. As a mother, I am mortified by this manmade catastrophe funded by our American tax dollars and met with silence by our medical institutions. As a healthcare professional, I believe it is imperative for us to openly declare that hospitals, clinics, and healthcare facilities should never be targeted in war. They are safe havens where the basic right of healthcare should be allowed without hindrance from any army. These are only a few of the many crimes being documented in Palestine and I can provide references for them all. 

The Lancet and NEJM have both released statements condemning these grave atrocities. Surely our organization is capable of doing the same. The AAPA has done wonderful things in advancing our profession by educating our lawmakers about a PAs capabilities, resulting in changes to legislation. Surely, with your experience in connecting to our lawmakers, you can convince them to call for a ceasefire in Palestine and to allow unhindered flow of humanitarian aid by opening the borders that have been forcibly shut down by the IDF. This is the only way healing can begin and adequate care can be provided to a population facing a genocide. Imagine trying to care for civilians with the most horrendous injuries ever seen while in the crosshairs of gunfire and bombs (See this account from American doctors returning from a medical mission there).

I also request for you to advocate for particularly vulnerable patient populations to receive care in our American hospitals. There is absolutely no room for the argument that there is nothing that we can do in this matter. It is simply a matter of what you as leaders are willing to do. Will you stay true to the values taught in our training? This is a very dark time in our modern history, we should be at the forefront of calling out healthcare injustice. Using our voices and educating lawmakers of the mistake they are making in funding this war is the bare minimum. I hope that you will consider this. I am happy to provide you with references, resources and a potential template of the statement for your review. We must not allow for a dangerous precedent to be established where targets could be placed on our backs, simply for caring for human beings, regardless of their background and beliefs. Medical care is a human right for all, no exceptions.

Please understand this urgent plea. Our collective society cannot afford our complicity. I hope to hear from you soon. 

Thank you,