American doctor calls for action after witnessing war crimes in Gaza

Tammy Abughnaim never considered herself to be an activist. The Chicago-based emergency physician has always just wanted to treat patients and help people in her capacity as a healthcare worker.

But after returning home from two volunteer missions with the World Health Organization in Gaza, she told TRT World she felt she had no choice but to speak up and speak out.

"My job is in the emergency department doing the best I can to save people's lives. But suddenly I have become a witness to war crimes. I've become a witness to violations of international law," she said. "I can't do my job if my country is using my money to kill children and to create a community of amputees and to starve people to death."

Last month, Abughnaim spoke on a panel of physicians at a Democratic National Convention event about the humanitarian crisis in Gaza, exhorting party members to reverse their support for Israel's war. The pleas fell on deaf ears, even as the death toll in Gaza surpasses 41,000 people.

Abughnaim also recently visited Washington, DC to speak to officials about what she witnessed.

In an interview there with TRT World, she describes Israel's uptick in attacks on children, the challenges of treating patients in a warzone and the difficulty of reconciling life in the US with her time in Gaza. Here are the excerpts.

TRT World: When were you in Gaza?

Dr. Tammy Abughnaim: I was in Gaza in March of this year, and I returned in July from July 25th to August 15th. And I was based at Nasser Hospital the second time.

TRT World: And what was your motivation for going?

Dr. Tammy Abughnaim: I felt like I had a duty to stand by my colleagues in Gaza. The health care infrastructure has been attacked by Israel and really decimated and annihilated over 500 health care workers have been killed. And I felt like I could not live with myself unless I stood by them and was able to provide them support during this time.

TRT World: How are you able to get in?

Dr. Tammy Abughnaim: The World Health Organization facilitates everything for emergency medical teams. They assemble teams in conjunction with NGOs, and they go through a rigorous security process in collaboration with the Israelis. Once you're cleared to get in, you're notified by your NGO and then arrangements are made for you to cross over.

It used to be much easier to get into Gaza when the Rafah border was open. It's much, much more complicated now that Israel occupies Rafah. The only way to get in right now is through Israel. You have to go through the Karem Abu Salem (Kerem Shalom) crossing, which means that it's much more restricted in terms of how many people can enter, how often and what they can bring into Jordan.

So you travel through, you land in Amman, you go to the land bridge, the Allenby Bridge in Jordan. You cross over into the Palestinian territories. Obviously, as a medical team, all of your bags are inspected. There are restrictions on what you can and can't bring in. Israel prevents us from bringing in large quantities of medication or medical supplies and equipment.

We were told that we should only really bring in personal supplies and if we were caught with equipment, that the whole convoy would be turned around. So it's very difficult, obviously, as a doctor to do your job without any equipment. Once our bags are searched by the Israelis, we're loaded onto a bus and we have an Israeli police escort all the way to the Kerem Shalom crossing.

This wasn't my first time in the (occupied) West Bank. March was my first time in Gaza ever. I had never been to Gaza before the war.

TRT World: What were your expectations? I know you said previously one of your friends prepared you, but what were you expecting going in and what was your actual experience?

Dr. Tammy Abughnaim: The expectation and the reality were totally different. I was pretty well informed about what was going on just through the news and through social media. But being there physically was very different. I think we underestimate the sensory experience of being in an area where there are Israeli airstrikes and quadcopters and bombings and drones.

The first thing that you notice is the overwhelming number of people. There are just people everywhere, just swarms of people walking around. The smell of metal and rubble and dust and blood, sewage.

The sounds of the drones, it's constant. All the time. The sounds of airstrikes. You never get used to those things. And so the expectation that I had was, okay, I'm going to be able to go and work in the hospital. And the reality was that Israeli restrictions have made it such that really doctors are just practising damage control.

They're not even practising medicine and they're witnessing crimes against humanity.

TRT World: Can you elaborate on some of the things you witnessed?

Dr. Tammy Abughnaim: When I was there in March, the majority of injuries that I saw were airstrikes. But every once in a while we would see things like kids who had been shot by quadcopters - sniper bullets to the head.

The vast majority of patients that I saw at that time were children. I would say probably 60 to 70 percent of my patients were children, and they were all pulled from the rubble of their homes after an Israeli airstrike.

And the majority of them had lost multiple family members. A lot of my patients qualified as a wounded child with no surviving family. So we would have to figure out after we addressed their traumatic injuries what to do with them. Like, where do children go when they have no surviving family? Who takes care of them? And the answer is, we don't know.

To this day, I don't know where the majority of my patients have ended up. The hospitals function as shelters. At the time, the (Al Aqsa Martyrs' Hospital) was really the only hospital in the area that was considered safe.

And in the emergency department, there were probably 70 to 80 people just living there. They would come in after an Israeli airstrike to their home. Obviously, they have no home to go back to. So they live in the hospital until they can find somewhere to go.

And the majority of the time, they don't find anywhere to go because there's nowhere that is safe.

TRT World: So you went in March more recently in July. What made you go back?

Dr. Tammy Abughnaim: I knew as soon as I left Gaza that I wanted to go back. I felt like there was so much more work to be done and so much more help that was needed. Not just physical help in the sense that as a doctor, I'm helping around in the emergency department, but also psychological help, moral help.

These healthcare workers are exhausted. They've been working for months nonstop. Most of them are not paid. A lot of them are volunteers. And they keep coming to work because they don't know what else to do, because they want to help people. They want to help their people. And they are some of the bravest, most competent, smartest people that I've ever met in my life.

And I could not stand the idea of leaving them behind without support. So I knew that I was going to come back and support them again.

TRT World: And when you came back to Chicago, there was the Democratic National Convention. Can you speak a little bit about your involvement?

Dr. Tammy Abughnaim: I was invited by a friend who works with the Uncommitted Movement. It's a movement within the Democratic Party to attempt to pressure Democratic leadership to change their stance on the war in Gaza and their unconditional support for Israel. Part of the Uncommitted Movement's demands were that they allow a Palestinian-American speaker on the main stage. And that request was denied.

The movement also represents people who are frustrated with the way that the Democratic Party has gone about this crisis, from the lack of humanitarian support to the actual material support of bombs and weapons to Israel. And so the Uncommitted Movement asked me and a few doctors to come speak at a press conference about our experiences in support of them.

We attempted to pressure the Democratic leadership to initiate any kind of arms embargo or restrictions or conditionalising their support to Israel.

And obviously, that request fell on deaf ears. So it does not appear right now that the Democratic Party is particularly interested in changing their stance, which is extremely frustrating for me as a doctor, because I went there, I went to the DNC to share my experiences, and it doesn't seem like the Democratic Party is interested in hearing from American citizens about what American tax dollars are doing over there.

TRT World: And you said you've repeated yourself so many times, Why is it you think it's falling on deaf ears?

Dr. Tammy Abughnaim: I think people have dehumanised Palestinians. I think that over the course of the last 11 months, their suffering has become acceptable, that there are political motivations and political interests behind it. But people don't see Palestinians as people. And because they don't see them as people, it's okay that they continue to suffer and it's okay that we continue to inflict suffering.

As soon as we recognise that Palestinians are people and nobody deserves to go through what they're going through, it stops, right? And there are political interests in continuing the crisis. And so it almost feels like we're just writing this wave of dehumanisation. And I can't really understand why. It baffles me that you can dehumanise anyone.

I'm a doctor, right? I'm trained to see people and to relieve their suffering. And the idea that there's someone out there who could immediately relieve the suffering of the Palestinian people and refuses to do that is unconscionable. It's repulsive to me.

TRT World: And in the medical community, is there a consensus or something that people talk about?

Dr. Tammy Abughnaim: It's something that I talk about with my colleagues on an institutional level.

The medical community in the United States has completely failed on Gaza. The American Medical Association has not issued any kind of condemnation for Israeli attacks on health care, on health care infrastructure, on detention of health care workers, and targeting of health care workers.

We have all sorts of advocacy groups in the United States: the American College of Emergency Physicians, the American Academy of Pediatrics, and all of them have largely failed to exert any kind of pressure on lawmakers or exert any kind of influence on public opinion when it comes to the destruction of healthcare and healthcare infrastructure.

I think it makes sense as doctors and as healthcare workers to be fundamentally against suffering and to be fundamentally against inflicting suffering on people. But our institutions are not really on board.

TRT World: And what do you want to see happen next?

Dr. Tammy Abughnaim: I'm not very optimistic, honestly. I think as a doctor, it's well within my scope to ask that the United States stop arming Israel and to stop providing the weapons that are harming my patients.

At the end of the day, I took an oath to do no harm and to relieve suffering to the extent possible. And I can't uphold that oath and I can't do my job if my country is using my money to kill children and to create a community of amputees and to starve people to death.

TRT World: What would be your message for the world based on your experience in Gaza?

Dr. Tammy Abughnaim: Make it stop. I mean, just make it stop. It's been going on for too long, and it's just too painful. It's too much. We have the power to make it stop.

TRT World: Can you elaborate on what you have witnessed there? What struck you?

Dr. Tammy Abughnaim: The biggest difference that I saw from my last time in Gaza, is that this time in Gaza I was seeing a lot more targeting injuries of children.

And by that I mean deliberate gunshots and quadcopter attacks on children. So it was a pretty routine thing that we would see a child with a quadcopter injury. I saw children as young as 19 months old who had been shot by quadcopters while playing outside their tents. I saw a child who was less than 10 years old who had been shot in the butt for walking outside his tent.

I saw a pre-teen who was shot in the left side of the chest and I saw children who had burns over 30 percent of their body, who had their limbs ripped off. At some point you just stand in the emergency department as dozens of children come in after an airstrike or after a mass casualty event.

And you just think somebody has decided that these children need to die. Someone in Israel has decided that these children need to die and someone in America has decided that that's okay. And standing in the middle of a resuscitation room with that thought, it almost incapacitates you. Like how is that an acceptable thought? How has the world decided that Israel is allowed to do this and to get away with it?

I was seeing other types of injuries as well. We had children who were killed by landmines. So Israel entered a hospital in Khan Yunis a few months ago. And when they withdrew their forces, they left behind landmines. And sometimes these landmines are in homes. I took care of two children who found a landmine in a cemetery.

They didn't know what it was. They picked up a large green disk in it and it blew up. And the child who picked up the disc came into the emergency department with half his face blown off, his right arm blown off, and part of his thigh was missing. The other child that was next to him had bleeding throughout his abdomen from the force of the impact.

I feel unfortunately like I could sit here for four days and tell the stories of all of the children who Israel has targeted and all of the children who Israel has killed and not be done with it. And honestly, some days it incapacitates me and I feel like I can't move, I can't breathe.

I can't do anything knowing that this is still going on and knowing that the United States has the power to end it and is not doing that.

TRT World: Were you able to operate with anaesthesia?

Dr. Tammy Abughnaim: There are limited quantities of anaesthesia in the hospital right now. The World Health Organization is attempting to continue to supply it. We did run out of sterile drapes and sterile gowns while I was at the hospital. It's not uncommon at all that we run out of clean supplies. Most of the time we run out of sterile equipment and the equipment needed to sterilise the equipment so that we can reuse them.

We did see patients in the ICU who had to have worms and maggots cleaned out of their mouths every single day because there is no soap. Israel is not allowing soap into Gaza. It's not allowing detergent, it's not allowing bleach. So there's no way to prevent infections. So almost 100 percent of our patients, if they survive Israel's initial bombing, will die because Israel is not allowing in basic hygiene products.

Israel doesn't give a justification (for the ban). This is a pattern of what seems to me to be deliberate obfuscation. Israel does not give reasons for why medical workers can't bring in equipment. It does not give any reasons for why certain equipment is banned, why soap is banned, why ultrasound devices are banned. It does not.

Israel doesn't give reasons for why certain people are not allowed in. My initial team was much larger. We were going to be an eight-person team and Israel refused a few of us, so we ended up as a three-person team.

When you ask Israel for a reason, Israel does not give you a reason. And I think that's a trend that continues in all of our relations with Israel. When the World Health Organization asks, 'Why did you stop our convoy from going into the north with vaccines?'

No reason is ever given because Israel feels like it can get away with it. So it does. It does because the United States provides cover for Israel to be able to do all of this.

The death of American citizens at the hand of Israel is really proof of this. It's extremely hard for me to do my job as an American doctor if I know that at any moment Israel could shoot me, kill me, strike the hospital that I'm in and the United States would do absolutely nothing about it.

TRT World: And there's danger to healthcare workers who have been detained, most mostly Palestinian health care workers, right?

Dr. Tammy Abughnaim: I've had colleagues who have been detained at checkpoints and questioned and intimidated and harassed and assaulted. And of course, the United States is not interested in its humanitarian aid workers and their safety. So really, as an American, you go in and you know that that offers you no protection against Israel.

TRT World: And the WHO tells you that they can't protect you.

Dr. Tammy Abughnaim: There's absolutely no guarantee of safety. Everybody who goes into Gaza knows that Israel can do whatever it wants. And a reason will not be given, an explanation will not be given. And if anything happens to you, if you are injured, if you are attacked, if you are killed, there is nothing that anybody can do about that.

There were days when I would just walk around the hospital complex, knowing that at any moment we could be hit by an airstrike and Israel would suffer no consequences for it. I mean, how do you explain that to your family? Like, 'hey, mom and dad, I'm going into this area where the rule of law, international law, is considered a guideline and not something that needs to be obeyed no matter what.'

I think that's the hardest part for my family. I went for two weeks in March and then three weeks in July.

We stayed in the hospital for three weeks. Moving around in Gaza is extremely difficult. Israel has made it so that if you don't follow a deconfliction protocol, which is where you send your coordinates and send your movements to the Israeli military, informing them of all of that.

And if you don't get the green light, you really shouldn't proceed. Otherwise you're at risk of being bombed. And this deconfliction protocol doesn't work. It fails all the time. Hospitals are technically considered deconflicted. (But) Israel will bomb the complex of the hospital.

It'll bomb a tent next to the hospital. It'll bomb the building across from the hospital. We know with the World Central Kitchen workers that their convoy was bombed three times in a row and their workers were all killed.

So the deconfliction protocol is an illusion. It's the best that the World Health Organization can do in impossible circumstances that Israel has imposed.

TRT World: Did you feel a change in the way your colleagues perceive you?

Dr. Tammy Abughnaim: They definitely think I'm crazy. Thankfully, my direct colleagues in the emergency department have been very supportive.

I can't say the same for hospital-wide administration and I can't say the same for health care institutions in general. There is a lot of repression any time somebody brings up Palestine in a health care setting. So talking about the mental health of Palestinian children, we've had talks about that cancelled by our hospitals.

Talking about occupation in any way or form - You will get you shut down. If there are doctors who are uncomfortable with a Palestinian flag or an identity, their complaints are lodged with hospital administration.

And we've had a lot of people who have been fired from their jobs for expressing horror or grief or any kind of opinion about what's going on from a healthcare perspective.

It's bizarre to me that healthcare institutions in the United States can stand by and watch hospitals being bombed and watch ambulances being bombed and watch people being starved to death and think that they have no skin in the game.

TRT World: Would you like to add anything?

Dr. Tammy Abughnaim: There was a recent Human Rights Watch report that highlighted healthcare workers who have been targeted by Israel.

Israel has a practice of targeting healthcare workers throughout Gaza, specifically detaining them, kidnapping them and then torturing them because they are healthcare workers. I spoke to several colleagues when I was in Gaza, both in March and in July, who had been detained by Israel, abducted after they evacuated from Shifa Hospital.

And these are people who were targeted because of their jobs. So they were pulled out of a line, out of a checkpoint because they were wearing scrubs and they were identified as healthcare workers and they were being tortured because of their status as doctors and nurses. The director of Shifa Hospital, Dr. Mohammed Abu Salmiya, was kidnapped for over 200 days and tortured.

He was recently released. The nurses that I spoke to had been detained for over two months. They had been physically, sexually, psychologically tortured, deprived of food. Their only crime was the fact that they were healing people, that they were trying to help people. Israel is doing this in broad daylight. I mean, there are cameras that are showing them doing it.

And the fact that these camps and detention centres have not been shut down is a slap in the face to every single healthcare worker anywhere in the world who literally just wants to help people and to save lives.

Israel is making it impossible for anybody who wants to save lives to do that.

TRT World: As we speak in DC, the sun is shining and it's blue skies out here. Is it hard to reconcile when you're there and then coming back here?

Dr. Tammy Abughnaim: Once you leave Gaza, it's hard to believe that that world can exist alongside this world.

It's hard to believe that just a few miles away (from the Jordan border), that children are being ripped limb from limb by American-made bombs. It's as soon as you leave Gaza and see what a difference there is in the situation and knowing that there is so much aid that is waiting to be let in, that Israel is not allowing in - it drives you crazy.

It drives me crazy. I think all of the humanitarian aid workers who leave Gaza have a sense of survivor's guilt that we are allowed to come and go and people who need to be evacuated, Palestinians who need health treatment abroad can't get that in some ways. I don't know how to exist in this world. I don't understand how people can accept that reality for the Palestinians.

And I don't know why people aren't shouting at the top of their lungs about it all the time, because it's not socially acceptable for me to shout at the top of my lungs all the time. I kind of have to do this, right? This is not my life. I don't do media, I don't write articles, I don't do TV interviews. I'm a doctor, right?

My job is in the emergency department doing the best I can to save people's lives. But suddenly I have become a witness to war crimes. I've become a witness to violations of international law. And that's not a position that you want your doctors to take. You want them to focus on their jobs. And I can't even do that anymore because I have to do all of these additional things because I feel a responsibility to do it.

Israel isn't letting in journalists and investigators and forensics experts. So I have to gather this data. I have to collect, I have to share. I have to tell people what's going on on the inside. Otherwise, nobody will know.