Introduction by Croakey: The Australian Government must increase its efforts for peace in the Middle East, according to the Refugee Council of Australia, noting the devastating impacts of the conflict upon its members, supporters and refugee communities.
The Council’s calls for an urgent, immediate ceasefire and peace-making are echoed in the article below by three GPs who work with refugee communities in Melbourne: Dr Mariam Tokhi, Dr Amireh Fakhouri and Dr Lester Mascarenhas.
“As doctors who are committed to caring for refugees here in Australia, and who witness the long-lasting effects of war, we beseech our medical organisations to speak the truth we know about violence and war,” they write. “We call on all Australian medical colleges and associations to call for a ceasefire.”
Mariam Tokhi, Amireh Fakhouri and Lester Mascarenhas write:
Sara can’t remember why she made the appointment. She is here with her teenage daughter. She reports that she hasn’t felt well in years. The world spins, literally, around her. She has trouble breathing. She cannot concentrate on anything. She often gets lost, and needs to be rescued. I am forgetful, she says, apologising for taking up a doctor’s time.
Then her thirteen year old daughter leans in. She is almost whispering. I made the appointment, she says. Tears are streaming down her face. My mother screams in the night. She thinks they are shooting at her, every night. I don’t know what to do.
At the refugee health clinic where we work as GPs, in Melbourne’s west, we bear witness to the effects of trauma every day. These are physical, psychological and social. Depression. Vertigo. Cancers. Anxiety. Addiction. PTSD. Heart disease. OCD. Domestic violence.
We see the ways in which violence and fear imprint on our patients. Trauma breaks our spirits, and it breaks our bodies. Healing and rebuilding is not easy, and sometimes quite impossible.
As GPs in a refugee clinic, we see patients like Sara every single day. More than half of our patients have a formal diagnosis of PTSD.
As doctors for refugees, we find ourselves again aghast at the extreme violence in the world.
How many times must the world vow “never again”?
Yet again, violence is committed in the Gaza strip by Israeli forces. We are witnessing death and suffering on an unimaginable scale. We mourn the violence perpetrated by Hamas against civilians, after decades of occupation, conflict and Israeli blockade on Gaza.
And, the Israeli military response has had us frozen with fear, watching neighbourhoods flattened from bombs; children and adults trapped alive under rubble, hurt and dying in their thousands. Infant and child deaths are being accepted as collateral damage. We know that this will cause more hurt, harm and ongoing trauma than we can describe.
According to the World Health Organization, there have been at least 108 attacks on healthcare in Gaza and 127 such attacks in the West Bank since 7 October, 2023. Hospitals and primary care clinics in Gaza have been targeted by Israeli bombs.
Israel has blocked the flow of electricity, food, water, fuel and medical items for two million Palestinians, half of whom are children. Many of whom have disabilities or chronic illnesses.
Forty percent of hospitals and seventy percent of primary care services are currently not functioning. Dozens of ambulances have been attacked. It takes years to develop health systems, and only days to destroy them.
Advocacy is critical
The president of the Royal Australian College of General Practitioners, Dr Nicole Higgins, has said to us that the College is “politically neutral in this space, but acknowledging the harm and trauma of war and impact on our members is important”.
But it is impossible to be politically neutral in the face of atrocity.
Doctors can’t just be bystanders: our oaths demand that we advocate for the health of our patients and communities. The individual, community and global health effects of war are immense.
In 2023, we know – science has taught us – that trauma lasts generations. It is passed down, through the way we parent our children, through our narratives of struggle, persecution, support or success, and even through its effects on our DNA. Survivors of war will have higher rates of mental and physical illnesses: so too will their children.
We call to our leaders’ attention the devastation that is being wrought on Palestinian communities, the fear in Jewish and Arab communities across the world; the destruction of health systems and of the environment. It is not only the effects of toxic chemicals, weapons and bombs that we call attention to.
The displacement of refugees has devastating effects on fragile ecosystems. Conflict exacerbates the effects of climate change, but we also know that scarcity drives conflict. Ongoing war in the Middle East will have ripple effects for all of us.
Violence spreads like fire. It is past time for Australia’s leaders, including our Prime Minister Anthony Albanese and Foreign Minister Senator Penny Wong, to help put out these flames. We cannot remain silent.
In the words of the Medical Association for the Prevention of War, “Australia’s abstention – following the total absence of explicit condemnation by Australia of a single crime committed by Israel in the current war – is a matter of profound, and lasting, shame for our nation.”
We have better ways to resolve conflict. Words. Leadership. Committed courage to treat all people respectfully and humanely. A peace process.
At our refugee health clinic, we work with people affected by serious trauma every day. We have worked with Karen refugees, Syrian refugees, Sudanese refugees, Sri Lankan refugees, Iraqi refugees, Afghan refugees and so many more. So many of our patients suffer terribly. It is heavy work. And so we desperately call for peace.
As doctors who are committed to caring for refugees here in Australia, and who witness the long-lasting effects of war, we beseech our medical organisations to speak the truth we know about violence and war. We call on all Australian medical colleges and associations to call for a ceasefire.
We can build an ecosystem of peace. We add our voices to the calls for an end to violence, and to a demand for peace negotiations, and we ask for your voice, too. Ceasefire now. De-escalate now. End occupation now. Peaceful solutions are needed now.
We demand our leaders – our medical leaders, our political leaders – stand up and work for a better, healthier world. A peaceful world. A world that understands the precious fragility of life, health and happiness.
• Dr Mariam Tokhi, Dr Amireh Fakhouri and Dr Lester Mascarenhas are GPs at Utopia Refugee Health in Melbourne’s West.
Previously at Croakey
- “Worse every day”: toll mounts in Gaza, including for children and health workers
- “This cannot go on” – a cry for an end to intolerable suffering
- Medical organisation publishes open letter expressing “extreme concern” at Australia’s failure to support ceasefire in Gaza
- Health sector urged to speak out for ceasefire in Gaza
- Calls for ceasefire amid catastrophe in Gaza – “every child everywhere deserves peace”