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Destruction of Conditions of Life (PHR-I)

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"Cast Lead" attack on Gaza humanitarian infrastructure (Jan, 2009)

"Destruction of Conditions of Life: A Health Analysis of the Gaza Genocide" is a July, 2025 position paper by the Physicians for Human Rights–Israel (PHR-I) documents the Israeli assault as "a deliberate, cumulative, and ongoing dismantling of Gaza’s healthcare system - and of the population’s ability to survive. Its meaning: genocide." The paper is dedicated to "Gaza's healthcare providers, medical workers, humanitarian teams, and all those who continue to care for others under fire, while risking their lives and enduring the genocide alongside their loved ones." It was authored by Prof. Itamar Mann, Aseel Aburass, Tirza Leibowitz, Guy Shalev; writing and editing assistance by Keren Shavit and Imran Anati; reading, insights and valuable comments by Prof. Len Rubenstein; and proofread by Daniel Bernstein.

Quotes

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Executive Summary

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: A Health-Centered Analysis of the Gaza Genocide
  • The evidence shows a deliberate and systematic dismantling of Gaza's health and life-sustaining systems—through targeted attacks on hospitals, obstruction of medical aid and evacuations, and the killing and detention of healthcare personnel.
  • ...Israel's actions have destroyed Gaza's healthcare infrastructure in a manner that is both calculated and systematic.
  • Gaza's health system has been systematically dismantled—its hospitals rendered non-functional, medical evacuations blocked, and essential services like trauma care, surgery, dialysis, and maternal health eliminated.
  • [K]illing and detention of over 1,800 healthcare workers... has decimated Gaza's medical capacity and rendered recovery nearly impossible.
  • Humanitarian relief has been deliberately restricted, forcing civilians to approach militarized distribution points that have often become sites of mass killings.
  • As of mid-2025, over 57,000 Palestinians - primarily women and children - have been confirmed killed, with estimates nearing 100,000 when indirect deaths are included.
  • [T]hese acts... part of a deliberate policy targeting Palestinians... fulfill... core acts defined in Article II of the Genocide Convention: (a) killing members of the group; (b) causing serious bodily or mental harm to members of the group; and (c) deliberately inflicting on the group conditions of life calculated to bring about its destruction in whole or in part.
  • Despite international legal rulings, Israel has not complied... and global enforcement remains weak.
  • [D]estruction of Gaza's health system is not only a legal violation but a humanitarian catastrophe demanding urgent global solidarity and response.

I. Context

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  • Understanding... requires following key events at least since the 1948 war—the Palestinian Nakba ("Catastrophe"). Israel forcibly displaced over 80% of the indigenous Palestinian population through mass deportations, internment of civilians, massacres, and the systematic destruction of Palestinian infrastructure. More than 200,000 of the 751,000 Palestinians recorded as refugees fled to the Gaza Strip, tripling its prewar population.
  • Repeated Israeli military escalations between 2008 and 2021 severely damaged healthcare infrastructure and exhausted its emergency response capacity.

2. Key Findings

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  • The dismantling of long-term critical care, as well as preventative and diagnostic medicine, will have lasting consequences for the treatment of infectious, cardiac, oncological, and other diseases...
  • Mass displacement and the destruction of buildings... rendered the education system... inoperable, while also destroying family and community structures...
  • Collapsed water and sanitation systems have led to detrimental environmental effects.

3. The Material Element of the Prohibition on Genocide

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  • [T]he destruction of healthcare infrastructure may constitute both the infliction of conditions of life (Article II(c)) and serious bodily or mental harm (Article II(b)).
  • [A]cts of killing (Article II(a)) may also contribute to broader patterns of deprivation.
  • The deliberate infliction of life-destroying conditions, where undertaken with the intent to eliminate a protected group, constitutes genocide under Article II(c) of the Genocide Convention. The deprivation of basic necessities such as food, water, shelter, and medical care can thus fulfill the material element...
  • Through sustained military attacks, siege policies, and the obstruction of humanitarian access, including medical supplies, Israel has dismantled the institutions and services essential to health and survival.
  • Hospitals, clinics, ambulances, and medical personnel have been systematically targeted, rendered non-functional, or killed. Diagnostic and treatment capacities have been eliminated, resulting in deaths due to acute and chronic life-threatening conditions, including infectious, cardiac, and oncologic diseases.
  • By late December 2023, only nine of the Gaza Strip's 36 hospitals remained partially functional - all located in the south.
  • Repeated direct attacks on hospitals... obstruction of supply flows and aid, and the decimation of medical personnel through killings and detentions made recovery impossible.
  • By early June, the health system had reached a state of near-total collapse. With only 14 out of 36 hospitals only partially functional, and most major facilities in Rafah and central Gaza either shuttered or overwhelmed, medical staff faced impossible conditions.
  • [D]estruction of Kamal Adwan marked dealt a decisive blow to northern Gaza's healthcare system. With no remaining medical facilities, no operational ambulances, and no rescue infrastructure, northern Gaza's health system was erased.
  • [A]ttacks on Gaza's hospitals... blocked medical evacuations, prevented patients from entering or leaving... and killed or detained... patients and medical staff. The raids caused significant damage... while denying... critical resources, including electricity, water, and medical supplies. These... endangered... lives... [and] severely undermined the hospitals' ability to function.

Quotes about "Creating Destruction of Conditions of Life"

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": A Health Analysis of the Gaza Genocide"
  • Taking a health-focused approach to identify genocidal intent and policy, the report documents the systematic dismantling of Gaza’s health system, destruction of medical facilities, blocking of drugs, and killings and arrests of health workers. ...[T]hey implore health and humanitarian communities worldwide to confront the destruction of Gaza’s medical system, attacks on its infrastructure and environment, and deliberate targeting of the conditions needed for human survival in Gaza. ...[T]hird parties, PHRI argues, have a duty to terminate this genocidal campaign and protect the health, lives, and dignity of Palestinians.
  • PHRI... position paper... documents.. a deliberate, cumulative dismantling of Gaza’s health system, and... its people’s ability to survive. This amounts to genocide. Israel’s bombing of hospitals, destruction of medical equipment, and depletion of medications have made medical care... impossible. ...Each day, dozens die of malnutrition. Ninety-two percent of infants aged six months to two years don’t get enough to eat. ...85 children have ...starved to death. Israel has displaced 9 in 10 Gazans, destroyed or damaged 92% of homes, and left... half a million children without schools or stability. It has wiped out essential health services... [A]ctions are critical—and must be taken immediately—to prevent further loss of life.

See also

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Wikipedia
Wikipedia
Wikisource
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