“There is a complete destruction of the very infrastructure of this population … that is going to prevent it from repairing ever again. It seems intentional … and I’m seeing this day in and day out. I challenge anyone who can say otherwise based on the observations and data present.”

This is an excerpt from an audio note shared with me by Doctor Mimi Syed, an Emergency Physician from Washington, D.C, who returned from her second medical mission to Al-Aqsa Hospital in Deir al-Balah, Gaza, in January 2025. Her testimony, along with those of other doctors who have volunteered in Gaza hospitals, carries immense legal significance with the potential to hold Israel accountable for carrying out genocide in Gaza.

According to Article 4(2)(c) of the Genocide Convention, 1949, “deliberately inflicting on the group conditions of life calculated to bring about its physical destruction in whole or in part” constitutes an act of genocide. 

This legal provision has been interpreted and analysed by several trial chambers of the International Criminal Tribunal for the former Yugoslavia as the usage of methods of destruction that do not immediately kill all the members of an ethnic group but ultimately seek their physical destruction. Dr. Syed’s comment regarding her observations in Gaza mentioned above affirms that this reality has been set in motion by Israel during the past 23 months in the besieged enclave.

Despite the presence of all of the above staggering evidence of Israel’s ongoing genocide in Gaza, in addition to the courageous and essential documentation by Palestinian journalists and media workers in Gaza, Western mainstream media refuses to use the word ‘genocide’ to describe Israel’s actions in Gaza. There is widespread Genocide denial amongst governments in largely Western democracies, for example, in the U.K. This is despite a landmark UN inquiry that has found Israel’s war on Gaza to be Genocide.

Since her last visit, The Lancet has published a report that concludes life expectancy in Gaza has halved since October 2023. As of September 7th, 2025, 387 people have starved to death in Gaza, including 138 children, as a direct consequence of an Israeli-imposed blockade on the regular and sufficient entry of life-saving humanitarian aid. There is an overwhelming number of testimonies from medical professionals, such as Dr. Syed, who have served in medical missions in Gaza that indicate that Israel is committing “acts of genocide.”

The International Association of Genocide Scholars (IAGS), a 500-member body of academics founded in 1994, recently passed a resolution stating that Israel’s policies and actions in Gaza fulfil the definition of genocide laid out in the 1948 United Nations Convention for the Prevention and Punishment of the Crime of Genocide. 

The current interpretation of the law mentions examples of punishable acts which include, inter alia, failing to provide adequate medical care, subjecting the population to a subsistence diet, systematically expelling members of the group from their homes, and generally creating circumstances that would lead to a slow death, such as the lack of proper food, water, shelter, clothing or sanitation. 

In one of her latest reports, Francesca Albanese, Special Rapporteur on the situation of human rights in the Palestinian territories occupied since 1967, writes about ‘Genocide as colonial erasure’. One of the findings of this document is that “the destruction of infrastructure across the occupied Palestinian territory imperils the long-term survival of the group.”

Dr. Syed, a board-certified emergency medicine physician, is an assistant clinical professor at the University of Washington and Washington State University. A fellow of the American College of Emergency Physicians, Dr. Syed served in Gaza from August 8 to September 5, 2024, and from December 3 to December 31, 2024, at both al-Aqsa Hospital and Nasser Hospital. 

“I went because I am a mother of three small children who happens to be a doctor with the skills needed in Gaza with trauma care,” she told me. “I am also an American citizen whose tax dollars are directly contributing to injuring children in Gaza.” I got in touch with Dr. Syed during her last mission in Gaza while she was serving in Nasser Hospital. During the course of her work, she exchanged numerous voice notes, photographs, and videos to document her observations.

Dr. Syed was denied entry into Gaza on August 2, 2025, by Israeli authorities for what would have been her third medical mission there. She was informed of this decision just a few hours before she was about to enter Gaza, and no official explanation was provided. Dr. Syed has been using her platform to raise awareness about the Genocide in Gaza since her last visit. 

I asked her about her observations from her time in Gaza in the context of the aforementioned legal provision and findings. What follows is an edited excerpt of our exchanges.

Nilofar Absar: Did you see Palestinians being “deliberately” killed during your medical mission?

Dr. Mimi Syed: Yeah, some children came into our hospital [Al Aqsa Hospital] as a result of airstrikes and sniper shots to the head, chest, and neck. This happened over and over again. These were small children under the age of 12. You can have one child, and crossfire maybe in the head, perhaps even two, but I have numerous documented cases of children who came in with gunshots to the head or to the chest. Additionally, I saw more than that, which I couldn’t record and document because of the life-saving surgeries I had to perform. 

NA: Are there other casualty cases that also seem like deliberate killing?

Dr. S: Yeah, we did see a certain type of shrapnel injury in both my times in Gaza, which is a tungsten-made cube-shaped shrapnel that is usually released from a missile or a drone. These incidents usually took place where there was a congregation. For example, we would have small children who got injured while they were playing soccer, or they were playing with a kite outside. Even during other congregations, for example, evacuation orders would be imposed. People would be together in the streets, maybe even taking shade under a tree, and they would be hit with these devastating shrapnel injuries. 

Tungsten has a very high melting point, so when it is heated and enters the body, it liquifies everything in its path. Consequently, children would be affected more because they have a smaller structure. If these small shrapnels entered an artery, the children would bleed to death, and you couldn’t stop it because this is internal bleeding. So these kids would often come in with small wounds from the outside, but when we would analyse the inside, they would have extreme bleeding. This happened time and again.

NA: Did you see the Israeli Force’s actions causing what you can medically claim as “serious bodily or mental harm” to Palestinians?

Dr. S: Yeah, absolutely. Many people, specifically children, have seen all their family members die. They have been mentally tormented for the last two years. It didn’t start there, of course; [the occupation and] these laws imposed on Gaza’s population have devastating consequences for both mind and body.

Kids haven’t been in school for almost two years now. They’re starting their third year of no school. They’ve witnessed other children die around them and lost their family members. There’s a large population of children who have lost one or both parents in Gaza. 

Gaza has the highest number of child amputees per capita in the world. Losing a limb in adulthood is psychologically so tormenting; I can’t imagine what it does to a child. I’ll give you an example: I came across children who would always say, “We would rather die,” or “I pray that I get killed by a bomb because then I can be with my family,” “I can eat something,” or “I can be in school again because I’ll be in heaven.” These are not normal reactions from children. You should not have children with suicidal thoughts, with thoughts of rather being dead than alive. 

The situation is the same with adults. I recently got a voice note from a medical student with whom I used to work very closely, saying that she and her team are so hungry. They haven’t eaten for days. She also said she would rather pray for death than be alive and be subjected to these horrors of the last two years, because it would be so much easier to die. 

When I think about that, it’s unnerving because she’s not asking for help or food. She’s praying for death, which speaks volumes about the mental health of people there. 

NA: What did you observe that indicates a deliberate “physical destruction” of infrastructure in Gaza?

Dr. S: Every building I saw there had bullet holes and bomb craters. Even the hospital where I slept had bullet holes in the walls by the bed. That’s just the physical parts of the destruction, which will take decades to repair. The roads and agricultural land have also been destroyed, which sets a pattern for the future. You’re not able to grow your own food. You cannot continue the life that you had before. 

Civilian infrastructure has been destroyed, including electricity grids and sewage systems. It’s not just the parts that are superficial, but also the internal physical structures. In the absence of life essentials like clean water, people have to resort to drinking untreated water, extremely high in sodium content. Consumption of this hypersaline water explains why cases of renal failure and dehydration, especially amongst children, are on the rise in Gaza. 

NA: What about a deliberate “physical destruction” of life in Gaza?

Dr. S: The population has been physically destroyed, not just by bombs, but also in ways that aren’t easy to appreciate with a video or on social media. For example, this insidious malnourishment that’s been imposed has gotten significantly, exponentially worse since my last visit [there is now a famine in Gaza]. I witnessed mothers who were unable to breastfeed their children because they were so malnourished, and mothers who had folic acid deficiency because they were chronically malnourished. 

Therefore, their children were born with Spina bifida [a condition that occurs when the spine and spinal cord don’t form properly in newborns], an extremely preventable condition. They simply don’t have the fortified foods that they would normally have [in the absence of the Israeli blockade on Humanitarian aid]. These are just examples of physical destruction that go beyond bombs and guns. 

I took photos of dozens of children who had the worst dentition. It’s because they have very little calcium in their diet, and so their bone health is terrible, and that causes necrotic teeth, which are essentially rotting teeth—the worst dentition for the future. I noticed that even adults had poor dentition there, and dentition is an excellent indicator of internal health. This indicates a severe lack of essential nutrients in their bodies, which may have long-term consequences.

Then there’s the issue of “refeeding syndrome”, and infants again are at the highest risk for this. This is a condition where, if you’ve been starved for a prolonged period of time and are then suddenly exposed to food or nutrients, your body has a problem. This can cause severe electrolyte imbalances and derangements, and even lead to cardiac arrhythmias [irregular heartbeats where the heart beats too fast, too slow, or with an erratic rhythm, caused by problems with the heart’s electrical signals], which could be fatal. 

Administering food has to be done under medical supervision. We’ve already had cases of babies dying of refeeding syndrome. Therefore, air-dropping aid must be monitored because it may be risky. Specific types of macronutrients need to be provided to patients under medical supervision, which, of course, is not happening because we know the healthcare system has been destroyed. So we are going to see irreversible effects of the [Israeli-imposed] starvation, which forms a huge part of the deliberate physical destruction of Gaza.

NA: Did you note Israeli policies imposed on Palestinians in Gaza that have resulted in the prevention of births within the population?

Dr. S: The rate of miscarriage in Gaza has increased by up to 300 per cent since October 2023, an incredible figure to understand what that means. It’s not just because of the bombs and guns, but also the insidious nature of this genocide that has imposed this level of malnourishment and lack of access to health care and prenatal care, like prenatal vitamins. 

If a population is being starved, bombed, and shot over and over again, maternal health and prenatal care are not going to be the priority at hospitals. That’s going to be most likely ignored because there are so many more pressing issues. 

When I was working in the pediatric emergency department at Al-Aqsa Hospital, I learnt that pregnant women were feeding their babies sugar water because they didn’t have anything else to give them. That was back in December 2024, and the situation now is much worse. I’m certain that the rate of miscarriages has gone up more than 300 % now, and I think this is all intended to prevent births and affect the future generation. 

When you cripple a society, procreation is not going to happen. Even if it still does, it will be at a rate that’s a fraction of what it normally should be. 

So although we see women who are still giving birth, they’re in terrible conditions. Their babies are severely malnourished. I want to point out that when you are undergoing starvation for a prolonged period, babies, infants, and neonates are the first to die. So, before an adult can even be affected, the babies are going to die because they’re more vulnerable and they need a higher calorie density than adults do. We just can’t provide that for them in Gaza. 

One doesn’t realize the implications of this. You are affecting the future generation. So you are directly preventing births from happening. This is not something that will just go away.

NA: Did you come across instances of children who went missing or are unaccounted for?

Dr. S: I personally witnessed children who escaped from the North of Gaza when there was a checkpoint. They left because they lost both of their parents and were then displaced to Khan Younis. These are children under the age of 12, taking care of each other without any adults, and this was just one instance out of thousands of kids in the same situation. 

I recall a pair of infants that were taken and sent to Egypt. Either the Israeli soldiers had taken them or the Israeli government had allowed the medical evacuation, which is essentially transferring them to Egypt, and they’ve been unaccounted for since then. We don’t know where they are, and I reiterate that’s just one of thousands of kids who have been completely displaced and are not accounted for.