As a physician, I remember the first time I saw a child dying.
She was in the pediatric intensive care unit, flown in from a remote First Nations community with her family on the way. Intubated and sedated to cope with the blisters covering her little body, she’d had three of her four limbs amputated — the result of a horrific meningococcal infection.
I remember standing rooted to the ground, unable to walk away from her bedside, wanting more than anything to undo her suffering. This was long before I became involved in academic medicine as Indigenous Health Faculty lead for the Department of Family and Community Medicine at the University of Toronto, yet it profoundly shaped my understanding of suffering and the fragility of life.
I was a medical student without a magic cure, but I needed to stay close to her simply so she wouldn’t be alone. I remember everything about those moments, from the rhythm of her breath to the stillness of her body.
Around the world, health-care workers are trained to be observers and meticulously examine those before us, monitoring life and death with intense attention. We witness with a required objectivity, documenting and responding with specificity. We encounter incredibly difficult moments, but the ones involving children are particularly engraved in our minds.
The horrific situation in Gaza
I have been considering what health-care workers are experiencing in Gaza, “the world’s most dangerous place to be a child,” according to UNICEF.
Every single day, they bear witness to a reality that the New York Times has deemed “too horrific for publication” as it declines to print images of dozens of children with gunshot wounds to the head, neck and chest.
These images came from health-care providers, documenting the time they spent in Gaza to provide desperately needed medical care in a place where nearly half the population is children.
They’re fighting daily to stem the tsunami of death that has often been referred to as the world’s first live-streamed genocide. With unimaginable determination and exhaustion, they are treating tens of thousands of children, some who have been mortally wounded and maimed due to indiscriminate bombing and sniping. These young people have been starved and terrorized by what the United Nations has called a war on children.
This crisis also constitutes a war on health care as hospitals in Gaza have been attacked, besieged, burned or decimated. Hundreds of Palestinian health-care workers in Gaza and the Occupied West Bank have been killed and countless more have been injured or abducted. Human Rights Watch says some have been subjected to torture.
(AP Photo/Abdel Kareem Hana)
Burning alive
A UN inquiry recently accused Israel of systematically destroying Gaza’s health-care system, amounting to a “crime of extermination.”
A distressing video captured the agonizing moment as a patient, still tethered to his IV, was seen burning alive in his hospital bed, sparking global outrage.
Hours after it went viral, Israel banned several Canadian and American medical aid organizations from entering Gaza to provide critical emergency support — crippling the ability of health-care workers to not only support their Palestinian colleagues in providing life-saving care, but also to document what is happening in Gaza.
Because foreign journalists are barred from entering Gaza and Palestinian journalists have been targeted and killed at an unprecedented rate, much of what the public knows about Gaza is coming from health-care teams.
Over the past year, health-care professionals have had to learn new terminology to describe what is happening in Palestine: scholasticide, sophicide, domicide and ecocide.
(AP Photo/Abdel Kareem Hana)
Parallels in Turtle Island
The plight in Gaza resonates with the historical experiences of the Indigenous Peoples of Turtle Island. As an intergenerational survivor of the Indian Residential School System, I am acutely aware of the power dynamics inherent in silence and the systemic erasure that often accompanies genocide.
Canada recently observed the fourth National Day for Truth and Reconciliation, a time when the nation grapples with the ongoing impact of atrocities committed against Indigenous peoples.
My work focuses on examining and understanding health practices and structures to better understand how to create anti-racist and anti-oppressive spaces for colleagues, learners and patients within our health-care systems, including how to engage Indigenous communities to propose and shape strategies.
Polish jurist Raphael Lemkin coined the term “genocide,” identifying the techniques employed during genocide in eight areas: political, social, cultural, economic, biological, physical, religious and moral. Such systemic and immense violence is foundational to settler colonialism, and children bear the harshest brunt of the requisite dehumanization.
Many of the atrocities against Indigenous people in Canada were carried out against Indigenous children, legitimized and legalized under the Indian Act — the blueprint for racial oppression within a democracy — and further enabled and enforced through secrecy, segregation and silence.
Notable among the historical witnesses to these atrocities was Dr. Peter Bryce, a physician who documented the shocking mortality rates and abuses experienced by Indigenous children within the residential school system.
As chief medical officer for the Department of Interior and Indian Affairs, Bryce went public with his findings.
He was subsequently ostracized from the government and medical community and forced to retire. Defiantly, he went on to publish his findings in a report titled “The Story of A National Crime” in 1922.
One hundred years later, his report remains a critical document for understanding the acts of genocide inflicted upon Indigenous Peoples.
Read more:
Residential school system recognized as genocide in Canada’s House of Commons: A harbinger of change
Listening to health-care workers
Bryce’s outspokenness shows that the voices of health-care workers are vital because we possess unique insights into the humanitarian crisis that unfolds in regions of conflict.
They have a direct impact in areas of conflict due to their ability to provide care — and bear witness. What health-care workers are experiencing in Gaza is becoming incompatible with human life.
Meaningful change will only emerge through an end to military aid, arms transfers and diplomatic cover for Israel, especially given it faces serious allegations from two international courts of genocide, war crimes and crimes against humanity.
An immediate ceasefire and the lifting of the illegal blockade of Gaza are essential to enable health-care teams to provide critical life-saving care and to bear witness to the ongoing suffering.
For me, personally, I carry the legacy of my ancestors as they watch down on me. Their survival of the horrors of the residential school system compel me — as a health-care professional — to break the silence around those suffering in Gaza.