9 October 2025
Dr Derek Summerfield is a Consultant Psychiatrist and an authority on the psychological effects of war, torture and forced displacement on civilian populations and especially women and children. His editorial on the impact of Israel’s genocide in Gaza was published in the British Medical Journal (BMJ). Here are his reflections on the current situation.
The study published in the BMJ last week, based on documented injury patterns of 23,000 Gazans speaks for itself. This is the gruesome underbelly of genocidal violence viewed at very close range, inflicted on a people long seen within the Western political order to be in the way, surplus, disposable. Israeli President Herzog has been honest about this : “there are no innocent civilians in Gaza.”
By early 2025 the total tonnage of bombs dropped on Gaza already exceeded the total tonnage dropped on Hamburg, Dresden and London combined during WW2. The well-known famine expert Alex De Waal comments that the level of urban starvation in Gaza had not been seen since the Dutch ‘hunger winter’ 1944-5, or the siege of Leningrad 1941-3.
The fatalities mount: 50,000, then 60,000, it is said. There are said to be 10,000 bodies under the rubble. There is something surreal about these figures, the child deaths climbing to 11,000 yet not a single photo of a dead, maimed Gazan child appearing in UK newspapers. Grotesque snippets emerge: “a child in Gaza watched his mother burn alive and then he died too”; children dead with a single head wound, the sniper’s bullet; hospital patients murdered at close range in their beds, still attached to intravenous drips; a doctor amputates the maimed arm of his daughter to save her life, but without anaesthetic; there is no insulin, no cancer treatment. 1500 healthcare staff murdered, a staggering statistic surely unparalleled in history; doctors abducted and tortured to death; descriptions of Gazans as “starving, alone, and hunted”. 17,000 children unaccompanied, having lost their families. 17,000! Let us dwell on these benighted children for a moment: can we imagine a future for them? What will they say about us all in later years?
30% of the dead are still unidentified. 95% of all buildings are destroyed. 15,000 gravely injured people have been waiting for evacuation and 7,000 have already died. More than 50% of aid columns are delayed or denied entry. The Gazan GDP has fallen by 86%. Unemployment is at 80%. Toxic debris and sewage overflow is everywhere. 95% of aquifers are contaminated.
The epidemiology of recent wars suggests that indirect deaths will come to outnumber direct deaths by a factor of 3 to 15 times. Studies of famine have long suggested that even those who survive starvation and live on carry a life sentence, remaining vulnerable to disease, educational under-achievement, and earlier death.
Throughout all this the Israeli Medical Association (IMA) has remained resolutely silent, and their President publishes a letter in The Lancet justifying bombing hospitals. As my own work has multiply confirmed over the past 30 years, the IMA is a shield and buttress of the Israeli state and serves all state policies. The good news here is that at their Annual Representatives Meeting in June, the BMA voted by a large margin to boycott the IMA, and the South African Medical Association has just joined them.
A person’s views on Gaza furnish a short cut diagnosis of the state of his or her soul. In the decades to come young people will ask us what we were thinking during the Palestinian genocide, what were we doing – the questions German youth in the 1950s and 1960s asked of their parents regarding the Jewish genocide.
And then there is the question of complicity with an ongoing world-shattering mass atrocity. And the role of the UK government, the Labour government. If refusing to admit that a genocide is a genocide and refraining from an intervention that could make a huge difference is not an absolute moral evil, then no moral evil exists.
