[COLUMNIST] Caring about Gaza

A friend recently forwarded me a social media post regarding the state of a local clinic, commenting that ‘We should look after our hospitals first before sending medicine to Gaza’.

Are these sort of comments familiar to you? They are to me, alongside a number of variations that ultimately mean one thing: why bother getting involved in matters involving others? This is supposedly more relevant in healthcare, where resources are finite and we ostensibly need to not spend too much on ‘others’.

It is easy to start with a label, especially a label called ‘others’. When one starts to differentiate between ‘our people’ and ‘others’, it makes it easier to justify to ourselves why we apply different value systems to different people. It makes it easier to compartmentalise in our mind, to choose when we apply rules and when we don’t, to decide when to be merciful and not.

Medical ethics demand that we do not differentiate those in need of care. Despite regular proposals to the contrary, I am very proud of the fact that in Malaysia, the Ministry of Health (MoH) practises a ‘no wrong door’ policy - it does not matter if you are Malaysian, an illegal citizen, a stateless individual or any other such label - anyone who needs treatment will be given treatment.

It is easy to ignore the death of thousands of children if it’s happening halfway across the world. But what if it was happening across the border? What if children of a specific group were being murdered within our borders? Do we still look for excuses based on differences in our skin colour, our religion or the lottery of birth?

When does one begin and end with the inherent values of humanity taught to us by all major religions and all that encompasses medical ethics?

After the initial uproar, many become desensitised and numb to the numbers. As Josef Stalin reportedly said, ‘the death of one person is a tragedy, the death of millions is a statistic’. I am fairly certain that you, dear reader, do not have a clear idea of the scale of the latest events in Gaza - I know I don’t. I had to look up - the number of children and women killed in a place where half the population is under the age of 18, the number of hospitals bombed, the number of schools destroyed - the level of death and destruction visited upon civilians, journalists, doctors and nurses on the pretext that collateral damage is acceptable in the hunt for enemies of war.

There is nothing civilised or justifiable when it comes to the murder of children. Apparently it needs to be pointed out to some that the killing of babies is a bad thing, to the point that the UN Security Council has identified the willful killing and maiming of children as one of six grave violations of its 1999 resolution on children and armed conflict.

Willful ignorance of atrocities committed can be a slippery slope towards tolerance and justification of mistreatment of individuals on the basis of being an ‘other’.

Inasmuch as resources are finite and require careful carving, caring is not a zero sum game and the values of our ethical principles should not be applicable only in circumstances that benefit us.

Most doctors would not just stand by and watch dispassionately if a baby suffocates to death for want of oxygen in front of them. Where possible, we should also extend our support and assistance for those who are dying elsewhere.

The MoH is currently working with the Ministry of Foreign Affairs and civil society organisations to send medical assistance to Gaza. These include consumables like syringe pumps, suture kits, intravenous cannulas, bandages and medication. It will hardly touch the RM41 billion allocation given to MoH for 2024, but will make a world of difference to the child bleeding from a shrapnel wound.

In absolute terms, Malaysia’s contributions to Gazan healthcare is small (but meaningful). Undoubtedly, we face our own challenges at home, from poorly-maintained clinics to the need for healthcare finance reform - all of which I believe can (and are) bring addressed concurrently.

We would certainly do more if we could. In the past, Malaysia has provided peacekeeping forces in Bosnia, South Sudan, Congo and many more. While circumstances and capacity may change, we must be cognisant of our ability to affect change both at home and abroad.

Delivery of care and placing value on all lives, irrespective of race or creed, is a core principle in the delivery of healthcare. Universal values should be applied universally, with compassion and advocacy at the heart of its delivery.

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* Dr Helmy Haja Mydin is a lung specialist & the Special Adviser to the Minister of Health.