Dear Colleagues,

As concerned members of the global medical community, we write to collectively speak out against the escalating man-made humanitarian catastrophe unfolding in Gaza. The ongoing conflict has resulted in widespread violations of international law, including documented war crimes, severe violations of children’s rights, and deplorable mistreatment of healthcare workers, compelling us, as members of a profession bound by principles of humanity and justice, to speak out.

While independent journalists have been prohibited from entering Gaza, reports from reputable organizations, including the United Nations (UN), Amnesty International, Médecins Sans Frontières (MSF), the International Court of Justice (ICJ), and the International Criminal Court (ICC), provide undeniable evidence of systemic abuses. The UN has documented deliberate widespread attacks on civilian infrastructure, including hospitals and schools, constituting potential war crimes under international humanitarian law. Amnesty International has detailed the use of unlawful lethal force and the blockade of essential supplies, such as food, water, and medical aid, contributing to the humanitarian disaster. MSF has reported targeted attacks on healthcare facilities and personnel, with over 1000 health workers killed, and many others detained or harassed, severely undermining the right to healthcare.

Recent publications in The Lancet further highlight the magnitude of this crisis: A July 2024 correspondence estimated up to 186,000 deaths, including indirect deaths from disease and malnutrition, while a January 2025 study estimated 64,000 deaths from traumatic injuries alone, with approximately 60% being women, children, and the elderly. The mass displacement and concentration of 1.9 million people has only exacerbated famine and communicable disease outbreaks. First-hand accounts from surgeons, including our Australian colleagues, offer further confirmation of these distressing realities. For the past four months, blockades have severely restricted food aid from entering Gaza, resulting in widespread starvation among patients and medical professionals treating them. This dire situation, compounded by relentless mass casualty incidents at aid distribution sites—where, according to reports from Royal Australasian College of Surgeons (RACS) fellows, civilians have been deliberately targeted—has rendered it nearly impossible for medical personnel to carry out their critical duties effectively.

The ICJ has found that the Israeli government’s actions in Gaza and the occupied territories violate international law, citing policies that risk genocide. The ICC has issued arrest warrants for senior government officials for war crimes and crimes against humanity, reinforcing the need for accountability. The actions of the Israeli government and the Israeli Defense Forces (IDF) violate the Geneva Conventions and betray the rights of children to safety and dignity, as enshrined in the UN Convention on the Rights of the Child. The deliberate targeting of medical personnel and destruction of health infrastructure is an affront to our shared values as surgeons dedicated to preserving life and alleviating suffering.

We, as leaders in surgery across Australia and New Zealand, cannot remain silent in the face of such injustice. Indeed, we have a moral duty to denounce these actions and advocate for accountability. We urge the RACS and relevant surgical subspecialty societies to publicly condemn the ongoing atrocities and demand immediate protection for healthcare workers and civilians in Gaza. Our collective voice can amplify calls from the global community advocating for unfettered access for independent humanitarian organisations and journalists on the ground, the release of all hostages, and a sustained ceasefire.

Thank you for addressing this urgent matter. We trust our profession will respond with the courage and integrity that defines the practice of surgery and its commitment to our shared humanity.

Yours sincerely,

Signatories below, on behalf of concerned surgeons from Australia and New Zealand.