A full-scale Israeli invasion of Rafah will worsen humanitarian 'apocalypse'

Ismael Abu Dayyah/AP

The horrors I saw haunt me still. A mother on the floor wiping the face of her dead teenage son with her hijab. Patients lying next to their blown-off limbs. The screams of children with no analgesics to treat their excruciating pain. A pediatric division filled with infants with respiratory infections and their mothers begging for formula watching their babies not gain weight or grow.

Samantha Power, the administrator of the U.S. Agency for International Development, confirmed famine is underway in northern Gaza, bolstering the urgency to address the humanitarian crisis. Any suggestion that the famine has been adequately addressed, and that malnutrition has been treated in less than a month is absurd.

For the Biden administration to suggest there’s been significant "improvement" in the humanitarian situation is dangerously misleading. Delays, restrictions and attacks still constrain aid — 41% of aid requests to northern Gaza were denied. A permanent cease-fire is necessary for proper humanitarian improvement.

Allowing any ground operation in Rafah to expand undermines the urgent humanitarian needs and risks countless civilian lives. There can be no meaningful improvement under continued bombardment, destruction and displacement to the north toward famine. The single remaining pedestrian crossing in Gaza was recently closed as Israeli tanks descended.

If what I saw in Khan Younis in January as an American doctor from Chicago is any indication of what's to come, an Israeli invasion of Rafah will be a bloodbath in the midst of a historic medical, humanitarian and infrastructure apocalypse. The invasion in Khan Younis displaced thousands daily, worsened aid access and drove scores of families into the hospital carrying lifeless and limp children, still begging for help.

After soldiers left Khan Younis, Palestinians returning to ruins that were once their homes said it reeked of death. Israel's supposed "precise and limited" raid of Nasser Hospital, where I volunteered, left it inoperative — its floors overflowing with sewage and its grounds the site of mass graves.

Rafah has 1.5 million Palestinian civilians, including children, living in tents. Is Israel’s plan to herd traumatized Palestinians — displaced multiple times — from Rafah like cattle to live among the dead and sewage, to risk disease?

Reality on the ground is different from what policymakers understand in war rooms, far from the constant sound of bombs and drones. Far from the pools and smell of blood I stood in. As a father of two daughters, my worst night was pronouncing three girls from the same building dead. The reality is, no evacuation can truly mitigate civilian harm.

Israeli Defense Minister Yoav Gallant promised an attack on Rafah as “successful” as Shifa Hospital. Yet Shifa is a graveyard of bodies. — some flattened by tanks or shredded, others buried somewhere in one of the medical complex’s mass graves. Raiding hospitals and decimating the health system will lead to more ominous effects of a ground offensive on civilians than the Biden administration understands. Coupled with the U.S. defunding UNRWA — the United Nations Relief and Works Agency for Palestinian refugees — Palestinian suffering is intensified with no sanctuary for relief or recovery.

Demolished roads, buildings, sanitation systems and critical infrastructure ensure no humane or safe way to move and house 1.5 million people. Leaflets asking displaced people in Rafah to move to safer areas are death sentences dropping from the sky.

Existing poor health indicators, standards of care and malnutrition will be exacerbated. Families will resist moving to avoid such degradation and dehumanization.

President Joe Biden must leverage policy tools to stop the invasion and end the war — it’s a moral and strategic responsibility. Rafah must be a definitive red line. In a phone call with Benjamin Netanyahu, Biden warned against a Rafah offensive, but the president needs to prevent a full-scale Rafah invasion with concrete policy actions: ending unconditional U.S. weapons and military aid assistance. A cease-fire deal crafted by Egypt, Qatar, and the U.S. had Palestinians in Gaza celebrating outside of their tents in hopes that it would bring an end to the suffering. An incursion in Rafah by the Israelis will deepen the humanitarian crisis and ensure a protracted war.

When I met with the president, I shared a letter from orphaned 8-year-old Hadeel. She lost everything and begged him to stop the invasion. Hadeel is one of a million children in Gaza desperate for this war to end.

Dr. Thaer Ahmad is an emergency response doctor from Chicago who has served on multiple medical missions in Gaza, most recently for three weeks in Khan Younis. 

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