Article
Comment
Gaza
Middle East
5 min read

The human cost of the Israel-Gaza war

A veteran volunteer surgeon laments a well lived life.

Tim Goodacre is a reconstructive plastic surgeon, and volunteer at a hospital in Gaza.

A young doctor wearing scrubs smiles.
AbdulRahman at work.
Tim Goodacre.

The Israel-Gaza war rages on. Every few days a new tragedy hits our dulled senses. The West Bank and now Lebanon are getting dragged into the conflict. Palestinians and hostages continue to die, and hunger and disease threaten Gaza's displaced people as autumn and winter approach. 

Yet what is often lost is the human face of this conflict. This is the story of one such life. 

AbdulRahman was an intelligent, gentle and diligent young third year medical student in his early twenties, with judgement well beyond his peers. Towards the end of 2023, as the war spread more viciously towards southern Gaza, he was one a group of around 10 students who volunteered to join the team of health care workers at the European Gaza Hospital (EGH). I was volunteering there as a reconstructive plastic surgeon and and met him in the hospital.

Both medical schools in Gaza before the war began were in the north alongside their parent universities. They had been destroyed during the onslaught in the early months of fighting. In the southern town of Khan Younis, the EGH was the sole surviving operational facility to which the wounded could be transferred. It was overwhelmed by the vast numbers of families also taking refuge in what was deemed a safer space than most of the surrounding war zone.  

Many of the senior medical staff and surgeons had retreated to scattered parts of the strip, displaced frequently by the ever-moving conflict and driven by the need to support their families and stay together. ‘Live together-die together’ is an understandable feature in the horror show of war. Students, frequently left with no money or resources, started to volunteer to serve in hospitals in exchange for a little food and a sense of worth in the work they could offer. Any functioning hospital, if briefly ‘deconflicted’ so they could provide relatively safe care, found itself staffed by a disparate crew of local staff, displaced students, and an indeterminate number of more senior surgeons from both Gaza and humanitarian agencies. 

His desire to learn all that could be learnt, and to try to become the best surgeon possible, was palpable.

It was into this chaotic mix that young AbdulRahman walked having fled his family home in the east of Khan Younis in November 2023. A bright young man, with great aspirations to qualify as a surgeon and serve his community, he had spent the first six weeks of the war at home, unable to attend his medical school in Gaza City to the north, but working hard at his studies regardless, using every online and library resource available to him.  

At some point in late November, the battle zone moved south, and his family home was shelled along with many dwellings in the vicinity. Caught in crossfire, he sheltered in his neighbouring relative’s house after his parents and other close family had escaped to Rafah. 

Abdulrahman told me the dramatic story of his escape into the house in which he survived for a week alongside his relative’s family when I spoke to him in late January 2024. This young man not only survived an ordeal of indescribable fear and potential slaughter, but he was then arrested and interrogated in brutal fashion by IDF forces.  

On his release after a harrowing week, he made his way barefoot to the nearest hospital, which happened to be the EGH. In that place of safety, he was given food and water and after recuperation, volunteered to work alongside a reconstructive plastic and burns surgeon who had recently returned to Gaza after training in the UK. 

Although his family were still all alive in Rafah in displaced makeshift shelters, he opted to stay and throw his weight into whatever he could do to support the hospital whilst continuing to learn his profession as a doctor. Travelling occasionally at great personal risk to see and support his family, he devoted all his waking hours to surgical work in EGH operating theatres and wards. His excellent command of English made him immensely valuable to any visiting surgeons who managed to access Gaza during the war months. He was always cheerful, always willing to respond to requests for his time, however stressful the surrounding clamour from desperate patients and relatives might become.  

When his working day was done, in the middle of the night he would arrange for his fellow students to have informal teaching seminars from whoever he could cajole to deliver them, and would absorb knowledge and ideas about best practice like a sponge. His desire to learn all that could be learnt, and to try to become the best surgeon possible, was palpable.  

I had every intention of supporting this fine young man in achieving his professional aspirations by whatever means I could once a ceasefire arose and he could be brought safely to Europe to continue his training. 

In the last week of August, AbdulRahman was sheltering in a relative’s house in Khan Younis. In the small hours of the morning an Israeli attack was launched on the neighbourhood and the house took a direct hit. AbdulRahman was killed instantly. 

He knew, as does every Gazan in these troubled times, that nowhere was safe, and all lives in that tragic zone are at risk. His is a story of a life tragically cut short, of the randomness and destructiveness of war. His death strikes right at the heart of my hopes for the remnant of the fine young population of such a desperately sad nation state. He, and those like him, could have been at the heart of the re-building of Gaza, able to live in what now feels a far-off peace. I cannot translate this into anger, as AbdulRahman himself had a passionate concern for peace and reconciliation, and never once spoke to me in many conversations of support for Hamas, or of hatred for those who had destroyed his country.  

What can be done however, is to honour his life and commitment with similar tenacity in supporting the pursuit of peace, justice for his people, learning and education for the remnant of the nation, and reconstruction of a Palestine that can proudly and honourably reflect the finest values it possesses. AbdulRahman was a great Palestinian, and his all too short life was one which I want to celebrate as one of the finest I have seen in many students of the next generation of doctors. May he rest in peace, and may a lasting peace come quickly to Gaza, to all of Palestine and the whole of the Middle East.

Essay
Comment
Justice
5 min read

Dignity: why people matter

How dignity underlies our ethics and law.

Professor Charles Foster is a Fellow of Exeter College, Oxford, and a member of the Oxford Law Faculty.

A pupil in a classroom looks around and into the camera.
Indus Action

You think that you matter: that you are significant. I agree with you. I think the same about myself.

We all think we are significant, and that our significance requires us to behave and to be treated in particular ways. One of the main functions of the law (perhaps the function of the law) is to regulate this sense of significance: to protect my sense of my significance and to stop it interfering with the sense of significance that others have.

A common name given to this sense of significance is dignity. It is a defining characteristic of humans. We see it as soon as we see behaviourally modern humans – who came on the scene about 45,000 years ago. We laid our dead tenderly in the earth, clutching flowers and amulets, rather than leaving them out as food for hyenas. We carved our faces into mammoth ivory because we knew that there was something about our faces which should endure. We believed that we had souls and that other things, human and non-human did too. This made eating other ensouled things a real problem. We evolved solemn liturgies of oblation and satisfaction to solve it. Our walk through life and death was elaborately choreographed, because it wasn’t proper to stomp and blunder. Comportment mattered because we mattered.

These were astonishing assertions – so astonishing that no big society has ever taken them completely seriously.

Jumping from pre-history to history, dignity, like other precious resources, was appropriated by the rulers, who said that they and only they had a right to it. The hoi polloi never truly believed this; they knew their own worth and moral weight. But the rulers told an artful story. The gods had dignity, they said, and the gods gave it to their favoured ones – typically the royals and the heroes. The royals were the gods’ embodiments or regents, and so the thrones of Mesopotamia and Egypt were invested and affirmed by divine dignity. The capricious gods of Olympus gave dignity at particular times and for particular purposes to their particular favourites, who therefore became demi-gods for a while.

In the Hebrew world, however, a radically democratic move was afoot. God was indeed dignified, but since every human was made in his image, all humans were dignified too – and in the same way as God. The idea was picked up by St Paul: ‘There is neither Jew nor Greek’, he declared. ‘There is neither bond nor free, there is neither male nor female: for you are all one in Christ Jesus’.

These were astonishing assertions – so astonishing that no big society has ever taken them completely seriously.

The obscenity of Auschwitz relegated the hyper-spiritualised notion of dignity to the cloister, and Kant’s notion to the Academy. For whatever dignity was, it was outraged there, and the outrage extended to bodies and to the non-rationally-autonomous.

Less ambitious, and so more palatable, was Stoicism’s rather anaemic version of the Imago Dei. All humans were potentially dignified, it said, and each human had a duty to strive to realise their dignified potential. It was much less radical than the Judaeo-Christian conception, but still represented a tectonic break with the royal theocracies of Mesopotamia, Egypt and elsewhere.

This Stoical conception of dignity did useful work. It served to save the notion of dignity from two mortal threats - both, embarrassingly, from the Christian world (though Kant’s relationship with Christian orthodoxy was sometimes uneasy).

There is a strand of Platonised Christianity (drawing on the early Augustine)  that spiritualises the idea of dignity. If it prevailed dignity would have nothing to say in hospitals about bowels or bedpans, in bedrooms about sex, in plantations about slavery, in jungles about the fate of trees or toucans, or in newsrooms about anything at all.

Kant located dignity in rational autonomy, so snatching dignity from children, the demented, the unconscious, the depressed, everyone who has drunk a bottle of red wine, and more or less everyone who doesn’t have a PhD in philosophy.

The obscenity of Auschwitz relegated the hyper-spiritualised notion of dignity to the cloister, and Kant’s notion to the Academy. For whatever dignity was, it was outraged there, and the outrage extended to bodies and to the non-rationally-autonomous.

In the immediate aftermath of the Second World War dignity (almost always undefined) appeared in endless national and international laws and declarations. Fairly recently it has started to have a real legal life of its own, being invoked for many purposes, from prisoners’ rights to reproduce to the right to have your name on your tombstone in the language of your choice.

These specific invocations of dignity sometimes disguise its foundational nature – foundational to human nature itself and to the laws that seek to determine how humans should conduct themselves in society

To say that the Judaeo-Christian account of dignity gives rise to all ethics and law in the western world is a big claim. I make it unapologetically.

To see how foundational it is, ask yourself why you think it is wrong to kick a child, but not a rock. Or why it is wrong to play football with a human head, or do an intimate examination, for the purposes of teaching medical students, on a woman in a permanent vegetative state. In describing the wrongness you will certainly find yourself relying on something that looks suspiciously like human dignity.

The law is often said to be protecting interests other than dignity (such as autonomy, freedom, or bodily integrity), or promoting other values (such as beneficence or non-maleficence). Yet on close inspection, those interests and values will all turn out to be parasitic on dignity. Dignity is the first order principle: the others stem from it.

In the last forty or so years there has been a good deal of academic discussion about just what ‘dignity’ means. There is a growing consensus that it has two complementary parts. First: an inalienable element: the intrinsic dignity possessed simply and solely by reason of being human. This cannot be lost or diminished. It just is. And second, a dignity which is a consequence of the first, but denotes how, in the light of your dignified nature, you should comport yourself. If we say of someone ‘She’s let herself down’, we mean that she has failed to behave with the dignity expected of someone who has the high status of being human.

This account of dignity is derived straight from the notion of the Imago Dei, and from Paul’s gloss. The watered-down Stoical version simply gives encouragement to behave well: it has nothing akin to the inalienable element.

To say that the Judaeo-Christian account of dignity gives rise to all ethics and law in the western world is a big claim. I make it unapologetically. Perhaps you think that it is too extravagant. But it is plain enough that this account, or one of its iterations outside the sphere of Judaeo-Christian influence (there are several), accords as does no other with our intuitions about ourselves and about how we should act, and with the most fundamental axioms of the laws in all tolerable jurisdictions. The most enlightened parts of Enlightenment thinking originate in this account, though they are often embarrassed to admit it.

Whatever we mean by the Rule of Law, part of it is that no one is above or outside it: Jews and Greeks, and bond and free, and male and female are to be treated alike. We’re so used to the idea that we have forgotten its revolutionary roots.