Trudy Rubin: Ethnic cleansing in Gaza won't bring peace or security to Israel

While the world's Mideast focus has shifted to Lebanon and Syria, the humanitarian catastrophe in Gaza only gets worse.

In the 14 months since Hamas carried out a brutal surprise attack in Israel, killing 1,200 and taking 250 hostages, Israel has decimated the group's leadership and cadres, blasted its underground tunnel network, and killed at least 45,000 Palestinians — as many as two-thirds of them civilians. It has also destroyed most of the Gaza Strip's housing and civilian infrastructure.

Most of Gaza's civilians have been forced by fighting and by Israeli orders to relocate from their homes into flimsy tent camps or overcrowded schools and mosques that are never safe from bombing. Hunger is rampant, as Israelis block aid trucks or bar security for those who enter. Most hospitals have been destroyed by Israeli bombs or ground fighting, and the few that remain have no supplies to treat the ill or wounded.

Worst of all, Gazans who have remained in the north of the strip, clinging to their damaged homes, are being ordered by Israel to evacuate south, supposedly so that Israeli forces can put down pockets of Hamas resistance. Yet, hard-line Israeli cabinet ministers make clear they want to empty northern Gaza of Palestinians to rebuild Israeli Jewish settlements there — or even drive the Gazans into Egypt.

Some, like National Security Minister Itamar Ben-Gvir, openly call for promoting "the voluntary departure" of Gazans. Translation: Make their life unbearable.

This Israeli behavior is clearly ethnic cleansing, which is a war crime. Sure, Prime Minister Benjamin Netanyahu denies it. Yet, even his tough former defense minister (now a Netanyahu critic), Moshe Ya'alon, responded bluntly when asked if Israel was "on the way" toward ethnic cleansing. "Why on the way?" he retorted. "They're basically cleaning the territory of Arabs."

Unless Israel's allies and moderate Arab partners pressure Netanyahu to surge supplies to Gazan civilians and halt ethnic cleansing, this behavior will boomerang against Israel and its future security, further destabilizing the Middle East.

Western journalists have been almost banned from Gaza, with a few exceptions on official junkets. To get a sense of the worsening conditions in Gaza, I spoke with two American doctors who worked there as volunteers in October for the medical relief agency MedGlobal.

Greg Shay, a retired pediatric pulmonologist from Alameda, Calif., worked at Nasser Hospital in Khan Younis, which has the largest remaining children's ward in Gaza. He has undertaken 35 medical volunteer missions across the globe, including two in Gaza prior to Oct. 7, 2023.

"Working in refugee camps around the world, I have been faced with very difficult situations," he told me. "However, my recent, third trip to Gaza was not only the most devastating and demanding physically, but more overwhelming emotionally. The desolate environment with total destruction of all buildings, homes, roads, electricity, and water, coupled with forced malnutrition and rampant infectious diseases, brings it to an all-new low."

"This was, of course, compounded by the lack of simple medical supplies, medications, soap, and even baby formula," he said. "The suffering, amputations, and children shot in the head by snipers will live with me forever."

Shay described hugely crowded wards where there wasn't room to isolate infectious diseases, and children were so malnourished they couldn't resist infections.

"The hospitals are flooded with diseases we haven't seen in Gaza, which had a 95% vaccination rate before the war. Kids come in starving, with pneumonia, hepatitis, white phosphorus burns, and we don't have 80% of the meds that we need."

The children's cancer ward was bombed, and there is no way to treat cancer cases. The kidney dialysis building was also destroyed by Israeli soldiers, he said, along with ventilators and EKG machines.

Yet, entering Gaza, Shay and other volunteers are not permitted to bring in desperately needed medicine or equipment. "The saddest part was that I had all this cystic fibrosis equipment in Amman, Jordan, and I wasn't allowed to bring it in. Thirty children died."

I heard equally harrowing stories from Nabeel Rana, a vascular surgeon from Charlotte, North Carolina, who served two weeks at Nasser Hospital in Khan Younis and two weeks at Al-Aqsa Hospital in Deir al-Balah, having previously volunteered at Al-Aqsa Hospital from June to July.

"Conditions were definitely worse in October," he told me. "We had no sutures or dressings or gowns. No aid was coming in."

One of his most indelible memories was the children "strewed across the floor" of the emergency room at Al-Aqsa Hospital. "I've never been in a place where I saw so many kid amputees of all ages, from toddlers to 8 or 9 ... with shrapnel wounds and massive gashes in their heads and limbs."

Rana marveled at the courage of the doctors there, some of whom had lost their entire family in Israeli bomb strikes. And the ambulance drivers who went to retrieve bodies, even though they knew "they were at risk of an Israeli double tap," meaning a strike at the rescue workers after the initial bombing.

These scenes are not just the normal carnage of war, but the product of Israeli targeting of hospitals and medical workers — and the blockage of food and medical supplies into Gaza.

Israeli officials say hospital strikes are necessary because Hamas fighters hide within the facilities. But when Hamas is reeling, and its commanders are gone, it is questionable why medical facilities are still targeted.

On Dec. 6, Israeli strikes killed and wounded scores in and around Kamal Radwan Hospital in northern Gaza, which Israel had earlier ordered be evacuated. Residents in the north still desperately need the barely functioning hospital. Is its potential demise part of the move to make northern Gaza unlivable?

Israeli officials also blame the lack of food and medical supplies on international aid agencies not delivering the goods from trucks lined up at the border. That, also, is only part of the story.

Yes, many trucks are waiting to cross, but often because Israel keeps changing the rules. Moreover, aid agencies tell me it is also because Israel has made it impossible to secure the contents, barring Palestinian police from guarding the trucks because they worked for the Gazan government that was run by Hamas before the war.

In fact, international aid agencies say the police were mostly professional. Moreover, private citizen groups who volunteer to guard the trucks have also been targeted by Israel. And Israeli troops often stand by as looters attack unprotected aid.

"There needs to be some international force approved by all to protect the aid convoys," I was told by Sean Carroll, the CEO of the U.S.-based aid agency Anera.

But as of now, there is no visible Israeli effort to improve the humanitarian disaster in Gaza and surge the aid in.

In October, when the entry of food aid virtually stopped, President Joe Biden gave Israel 30 days to improve. He failed to penalize Israel when that period ended, and there was only minimal improvement.

Negotiations have begun once more on a temporary cease-fire in Gaza and the return of some Israeli hostages by Hamas. Yet, Netanyahu has made clear that Israeli troops will remain indefinitely in Gaza, and has offered no political plan for how nearly two million dispossessed Gazan civilians can survive.

Both Netanyahu and President-elect Donald Trump appear to believe that Saudi Arabia and the Gulf emirates will rebuild the Gaza Strip. But the Saudis have made clear that they aren't interested in so doing if Israel reoccupies and resettles Gaza, which guarantees a new generation of resistance fighters will rise. They want Netanyahu to lay out a path to a concrete political future for the Palestinians.

If, instead, this Israeli government insists on ethnically cleansing Gaza (and the West Bank), a long-term Palestinian insurgency will bubble up from the ruins, built from angry young men. That instability will threaten Israel's future and prevent any normalization with Saudi Arabia.

And one day, Israel will no longer be able to prevent foreign journalists from witnessing the wreckage of Gaza that has gone way beyond Israel's right to defend itself. Those scenes are already alienating a generation in the West against Israel's very existence.

Starving Gazan civilians and denying them medical care is not only a war crime but also a losing strategy for Israel. It needs to be stopped. Now.