Interview with Chris Hedges

Outlining Israel's Genocide Enablement Apparatus

I am grateful to Chris Hedges for having me on his show to discuss the report dozens of healthcare workers and lawyers have put together to submit to the United Nations Special Rapporteur for the Right to Health that shows the connections between the killing of doctors in Gaza and the silencing of us in the West. Physicians are morally and professionally obligated to stand against genocide and to protect all life. Our repression by medical institutions is an obstacle to the “avalanche of solidarity” needed to stop Israel’s targeted attacks on healthcare infrastructure and healthcare workers. We continue to call for the immediate release of Dr Hussam Abu Safiya and all the other healthcare workers abducted and detained by Israel and an end to the US-sponsored genocide. Healthcare workers—speak up! We cannot allow this flagrant violation of International Humanitarian Law to become the new normal.

Transcript

Chris Hedges

In September 2024, the University of California, San Francisco (UCSF) medical school placed Dr. Rupa Marya on paid leave. Her clinical privileges were suspended, jeopardizing her medical license. Dr. Marya’s offence was decrying Israeli attacks on ambulances, clinics and hospitals and the targeted assassination and detention of hundreds of health workers, including Dr Hussam Abu Safiya, a pediatrician and the director of the Kamal Adwan Hospital, many of whom have endured torture. She denounced a call by Israeli doctors to bomb all the hospitals in Gaza and criticized The Journal of the American Medical Association for providing moral cover for Israel’s obliteration of health care facilities in Gaza. She asked that the university examine the implications of inviting students with military backgrounds to join academic and health care institutions without accountability or screening. She has called for a medical boycott of Israel and on Jan. 6 helped organize a sick-out by health care providers to protest the genocide.

Dr. Marya’s scholarly work focuses on how capitalism and colonialism have impacted every aspect of our lives including our health. This impact is especially true for the colonized Palestinians. Decolonization, she writes, is not only about liberating the colonized, but also about liberating ourselves, about reorienting our society away from exploitation to one where community and the common good come before profit. Joining me to discuss these issues is Dr. Rupa Marya, a professor of medicine at the University of California, San Francisco, where, until she was suspended, she practiced and taught internal medicine, and who with Raj Patel wrote Inflamed: Deep Medicine and the Anatomy of Injustice.

I have to begin—you've been rooted in this decolonialization, this decolonizing for years and years and years, but the moment you make it applicable to the moment, to the reality around you, they come down on you like a ton of bricks. What happened? Was it that they permitted this kind of research and this kind of truth only when it was theoretical?

Rupa Marya

Yeah, when we think about—thank you, first of all, Chris, for that amazing introduction, and thank you for having me here. So I'm speaking to you today from occupied and unceded Ohlone territory in what's now called the San Francisco Bay Area. And when we were writing about decolonization, people, I think, thought of it as a fait accompli, something in the past, colonialism happened there. We're going to talk about it as a historical process, but that historical process is ongoing, even here in California, with the ongoing erasure of California Native people, with the ongoing genocide of California Native people. So when we realize that those processes of violence are ongoing, that's when it becomes threatening to the powers that benefit off of the colonial structures. And that we saw that around the time of George Floyd, where everyone was reaching to do DEI work and make their land acknowledgements, but no one was willing to give the land back. So we can start talking about these things as liberal trappings, but we can't really talk about them in the essence of what they are, which is the discussion around power. Who has power in their homelands? Who has the power and the ability to live with the right to health? And for those of us who want to build a world of care, we believe everyone has that, everyone should have that. And so when we started talking about Palestine, because that reality is an active settler colonial project with extreme violence. Right now, it's in the most extreme aspect of violence of settler colonialism, which is the genocide, which is the total erasure. From the scholastic side, which we just saw that historic vote from the AHA (American Historical Assocation), to the decimation of the hospitals, the decimation of places of worship, of people's residences, of housing, of the olive groves, everything about Palestinian culture, identity and the possibility of living a healthy life is being structurally attacked, and that is why, and part of how we understand this is a genocidal project. So I think that the very active, real threat that this scholarship poses to US imperial interests, to US Empire is why I'm being targeted and attacked. But these are ideas that have been around for as long as colonialism, has been around for at least 600 years.

Chris Hedges

Yeah. Well, I went to these schools, and professors are quite happy to be radicals as long as the classroom door is closed, but as soon as they step outside, they become utterly obsequious to the centers of power. That is not your case. That makes you the exception. It's not that it's not taught, it's just that it's not applied.

Rupa Marya

Yeah, and I think that's part of the challenge that UCSF, where I work, has had with me, is that while I've been a physician, and I love my work, serving patients and my community, I've also been an activist. I've also been a world touring musician, where I learned a lot firsthand about the intersections between health and society by taking my band on the road. And when you travel around the world with music, people bring you into their communities. They tell you their stories. And it was very apparent to me, as I toured for 17 years, who was getting sick and how they were getting sick. And that really formed the basis of our understanding that came out in our book, that Raj and I wrote, "Inflamed," where we started to notice that there were dynamics of damage that were being created by social and environmental systems that have been created over the last 600 years to advance very specific agendas of concentrating wealth in very few hands and leaving the rest of the people to serve the interests of those elite. And so right now is a moment where all of that is crumbling, and COVID was an important moment to start to show those things corroding, and the movement for Black lives, and all the movements we've seen, from the Black Panthers party to the AIM (American Indian Movement)movement, and these movements around the world have been critical for raising our consciousness and raising our awareness, and now it's all hitting ahead as we're witnessing this targeted destruction of the Palestinian—well, the health care system in Gaza, specifically, and the ripple effects that's having around the world.

Chris Hedges

Let's talk about it. You've been on it from the beginning. Let's talk about what's happened to the health care system, and let's talk about the plight of medical people, people within the medical profession in Gaza, hundreds of whom have been detained. Many—we have credible instances of torture. And the director of the hospital that I mentioned the introduction has disappeared. We don't actually, I don't think there's any hard information that we even know where he is. We can suppose, we can guess where he is in the Negev [desert], but we don't know.

Rupa Marya

Yeah, so we're, calling health care workers around the world are calling for the immediate release of Dr. Hussam Abu Safiyya, as well as the other more than 400 healthcare workers who are being detained by Israel. So since October 17, with the bombing of the Al-Ahli Hospital in Gaza, Israel has embarked on this campaign to systematically and completely destroy the healthcare infrastructure of Gaza. And this targeting and destruction of the health care system was called on by over 100 Israeli doctors who signed a letter to call for this destruction. This isn't the first time Israel has attacked Gaza's health care systems. So hospitals have been bombed by Israel for years and decades before that, but since October 2023 with the complete siege on Gaza, where the electricity, food, water, medicine was not allowed to come in, and then the targeting attacks on the hospitals, bombing the hospitals and destroying the infrastructure of the hospitals, the combined impact of that is to accelerate the annihilation of the Palestinian people. Now, the pretenses that Israel has been giving that, oh, well, there's Hamas tunnels, there's a Hamas command center, there's a Hamas—you know, even the absurdity of calling Dr. Abu Safiyya a Hamas colonel, there has been no evidence for any of this. All of this has been under false pretenses and multiple independent investigations. AP, even the Associated Press had a piece, the UN has examined, we haven't seen anything like this. Doctors like Dr. [Mark] Perlmutter who went from the United States and came back, said no one saw a gun inside the hospital. No one saw any evidence of any military activity inside the hospital. What they saw were mass casualty events where over 80% of the people who were injured were children. What they saw, as the New York Times editorial piece revealed, was that children were being sniped in the head and in the chest. And I started receiving these reports as early as March of this year, as nurses were returning back from serving medical support in Gaza. So when we understand that this attack, these attacks are to actually specifically destroy the ability of the people who are there to help and heal those who have been harmed in these targeted bombings and attacks on residential units, on residential spaces, on universities, on schools—the people who are tasked with helping those people heal are being eliminated. And so Dr. Nick Maynard gave a talk at Trinity College Dublin, where he described that these Israeli military soldiers were entering hospitals, not only throwing drones, quadcopter drones with the guns, throwing the drones into the hospital so the guns would just gun down patients and staff alike, but also entering the hospital to destroy things like the hemodialysis machines and the CAT scanners and the lab machines. Hamas is not hiding in those machines. This is an attempt to shorten the life of Palestinian people. And so I started receiving communication from Dr. Ghassan Abu-Sittah, who was the doctor who gave his testimony to The Hague back in October of 2023 and at that time, I had been commissioned by the British Medical Journal to write an article about decolonization. They wanted me to talk about decolonization of food. I do work around land return to California native folks and growing food as a human right here in the Bay Area. And so as I was receiving these messages from Dr. Abu-Sittah, I asked the editors at the British Medical Journal if I could instead talk about the decolonization of Palestine. And they agreed, and I said, I'm receiving these reports. So I wrote them up, children and people receiving amputations without enough anesthesia. Surgeons doing surgeries by candlelight because there was no electricity. Physicians using vinegar from the corner store, because there were no medications to treat deadly Pseudomonas infections, just things that caused just horror to my ears as a physician. And so I would type up Abu-Sittah's reports every day and send them in to the British Medical Journal, and they would ask me to rewrite. They asked me to rewrite this essay six or seven times, and then they flat out refused to publish it. They didn't give like, oh, we have other things we're publishing right now. Nothing like that came out in October or November of 2023, and imagine if it had, right. And so this is where we start to look at what is happening in the US and in the Western medical institutions. So people like myself, who were starting to say, stop bombing hospitals were getting death threats and rape threats, were put under investigation for their social media behavior immediately in November of 2023 by my university. We had the American Medical Association silencing even a discussion of a cease fire resolution brought up by medical students and the minority group of physicians who are part of that organization, abandoning their normal democratic processes and silencing even a discussion of a ceasefire resolution. We had residents silenced, nurses suspended, and now a doctor was fired from Emory, who's Palestinian, who spoke up about the right for Palestinians to defend themselves in the face of Israeli aggression. And so when we start to look at what that is about, what we are starting to understand that our repression here in the United States, in the UK and Canada, our repression here, is a part of the genocide there, because by removing our voices, by silencing the medical institutions, by the medical institutions silencing healthcare workers who are speaking up, by firing us, threatening to fire us, disciplining us, suspending us, making us afraid to speak, it has prevented what Dr. Mads Gilbert has described as the avalanche of solidarity that is needed to stop this genocide. And so we are writing this up for a report to the UN that we're submitting as what Dr. Abu-Sittah offered the framework, he called it the Israeli genocide enablement apparatus. That the killing of healthcare workers there is related to the silencing of healthcare workers here, and that by silencing us, the medical institutions we are a part of, which have an obligation, professionally and morally, to uphold all life, are actually abetting genocide, abetting and enabling genocide. And so this is a very serious charge and a very serious thing we need to look at as healthcare workers in the United States, where health equity—we have health disparities where Black mothers are dying at 12 times the rate of white mothers. Well, why is that? So? Even though medical institutions will make pronouncements, yes, we care about health equity. Yes, we want to end health disparities. Just like we were saying before when it comes to actually changing power. Who has the power to make decisions about where the health care resources are going? Who has the power to decide when we'll speak up for life and when we won't? People were quick to denounce the bombing of Ukrainian hospitals by Russia. The AMA put out a statement right away—Russia should not bomb these hospitals. Even Hillary Clinton made a pronouncement. But when it comes to the actual targeting of the entire healthcare infrastructure of Gaza, all of these institutions have been silent and then have been active in repressing and silencing us. This is part of the deeply racist dynamics of the Western medical system and must be taken on by health care workers if we really care about providing the right of health for all.

Chris Hedges

Let's talk about, just briefly, what it's like on the ground for Palestinians in Gaza, they don't have clean water. We're seeing spreads of infectious diseases, malnutrition, hunger. It's very cold in Gaza. People have been dying, I assume, from hypothermia, but from the cold. Let's talk about that, the health crisis that is being orchestrated by Israel on the Palestinians in Gaza, because it's by design. It's by design.

Rupa Marya

It is by design. So cutting off the food, so the amount of aid that's sitting there at the border that Israel is preventing from coming in. Cutting off the food has led to malnourishment. So when folks are malnourished and children are malnourished, they cannot fight infections, and they cannot heal their wounds. So people are dying of preventable diseases, something as simple as diabetic ketoacidosis, something that we can treat with insulin, we can treat with medicine. Children are dying of DKA, diabetic ketoacidosis. Children are dying of preventable causes and getting infections that they should not have, things like polio. And so this is a catastrophic, a manufactured catastrophe, again, to annihilate the Palestinian people. It is utterly dire. Children are freezing to death, as you just mentioned. There's no electricity, there's no fuel, there's no ability to heat themselves. You know, over 80% of the housing has been obliterated. There's no shelter. So these are ways in which to, again, accelerate the death and the annihilation of the Palestinian people. So for physicians and healthcare workers on the ground, I can't even imagine the set of circumstances our colleagues are communicating. So the great work—I encourage everyone to follow Doctors Against Genocide. Every week we meet on Sunday, it's become our church, where we hear reports from our colleagues in Gaza about what's happening. We hear reports from physicians and other healthcare workers who have returned from Gaza to tell us what's happening most immediately on the ground and what's needed. And what's needed is an immediate arms embargo. The United States needs to adhere to its legal obligation to uphold the Geneva Convention and not abet genocide and not provide material support for genocide. We need an arms embargo. We need immediate humanitarian assistance into Gaza, unrestricted, not controlled by Israelis, but there to relieve the suffering of the Palestinian people. We need folks to stop normalizing the presence of genocide endorsers and perpetrators in our spaces of healthcare and in our institutions of learning. If we have IDF reservists on campus, of course, the students are not going to be free to speak. So we need to be able to push for the things that we know are necessary for life, which is the medicine, the food, the electricity, the water. So without these things, life becomes impossible, and that's what Israel is trying to ensure as they seek to depopulate Gaza.

Chris Hedges

I want you to talk about the repression internally within the United States against people such as yourself who have spoken out and the mechanics of it. Is it the [Helen] Diller [Family] Foundation , am I correct? Is that the right name? They are a funder of the Canary Mission, this insidious website that smears and attacks academics and students who speak out for Palestinian rights. They wield—these forces, these institutions, these entities—wield tremendous amounts of money, and they use it. Now, I think that the Diller Foundation is a major contributor to your medical school, is that right? But talk about how, behind the scenes, what is the engine driving this repression? It, of course, has close links with Israel. We saw that over the summer, where universities coordinated with so-called security groups, many with ties to Israel, on ways to essentially turn academic institutions into academic gulags, which they've essentially done, but explain for us how it works, because you've been a kind of target for them now for many, many months.

Rupa Marya

Yeah, and it's been very revealing, and I'm sure there will be lots of fallout from this for the American people to learn about. Especially in California, where I work, at the University of California. So this is a public university. So I was targeted by a California State Senator, Scott Weiner, who is also a recipient of money from the Diller family. So the Diller family makes their money, and this is just—my tale as an example, because it's replicated ad nauseam across the country, but the Diller family makes their money from the Prometheus Real Estate Group. They are the largest corporate landlord of the Bay Area, so their ability to control the rents and set what the market rate is has functionally left thousands of working class people unhoused in the Bay Area, okay? This group then goes and donates money to Scott Weiner, who is a California state senator who helps to green light their real estate development projects. Scott Weiner has ties to Israel, he's been several times during the genocide. Scott Weiner is also involved in a caucus that has gone through California's ethnic studies program and tried to remove any discussion about Palestine. Scott Weiner has personally harassed me and cyber bullied me online. And it was through his cyber bullying that I landed myself on the Canary Mission. So the Dillers fund Scott Wiener, the Dillers fund, the Canary Mission and the Dillers fund UCSF. So the largest funder to the entire UC system is the Diller Foundation. And so the question is, what are these relationships? When I first saw Scott Wiener tag UCSF online, and then UCSF respond with a defamatory post about me, which no one had ever seen before in the history of being at UCSF. Wow, they're attacking a faculty of color for her area of expertise, which is looking at power and health. And so when that happened, some lawyers at the Center for Protest Law and Litigation were like, this is interesting. Are a California State Senator, a donor at a university conspiring to deny this professor her first amendment rights? And that and painting me as a Jew hater, as antisemitic, which has enraged my Jewish community here in the Bay Area, who I've served for years and years, and who wrapped their arms around me as this outrage from the right wing has come. The Diller Foundation also funds an organization, or has funded organizations in the West Bank that empower settlers to evict Palestinians from their homes and to take them over. So these people are literally putting people in tents from San Francisco to Gaza, right? And so understand that these are not theoretical connections, these are a right wing forces masquerading in California as a California Democrat. You know, rainbow-wash Democrat, greenwash Democrat, Scott Weiner is one of the most right-wing forces in California, and we as the people of California—So now California's public schools are overwhelmingly made up of people of color, and here are the people who are trying to insidiously and overtly remove our histories from what we learn, remove our faculty of color, especially, it's women of color who are getting targeted. I think most of the people being targeted across faculties in the California system are women of color. So to silence us, to remove us, to remove our histories, this is part of a right-wing project, a white supremacist project, I should also iterate here. And so that's why we're seeing these strange bedfellows of Christian nationalists in bed with these right-wing Zionists and the American people need to learn about this. Need to learn what is happening to our public school systems, so that we can start to think, wait, where do we want our money to be going? For example, the United States has given over $300 billion to Israel. Meanwhile, people in Israel have universal health care. Here in the United States, my patients are denied health care all the time by these health insurance corporations who are making record profits. During the COVID pandemic, we were told we have to tighten the hatches and everyone buckle up and take a pay cut or take a pay freeze. The doctors got pay freezes. The nurses got increased burden of work on their shoulders. But these health care insurance companies made record profits during COVID. Meanwhile, patients are denied care. People can't find care for their long COVID Now they're denied care, and so we...

Chris Hedges

I just want to interrupt, because, from your book, you write about how this impacted disproportionately poor people of color. That it's not just all of us, but the people who really took the brunt of it were poor people of color.

Rupa Marya

Absolutely and the biggest block that's trying to prevent Medicare for all, or universal government health care, single payer health care in the United States are white folks who don't want to see Black people get healthcare. And there was a great New York Times article written about that. And so I think that when we understand that these are right-wing white supremacist forces that are trying to hold on to a structure of power, that needs to come down, that needs to be composted, that needs to be re-imagined. The University of California belongs to the people of California. I, as a physician, serve the people of California, all of them. And so I also serve people of the world. When I look at my scholarship around colonialism and health, these are global phenomenon that have their reach right here into the heart of where we live, in the Bay Area. And so as we start to make these connections and start to see instead of sending the money there, let's get universal health care here. Instead of muzzling our students and creating, as you said, gulags on campus, let's invite them to participate in imagining the world that we need as we are confronting these intersecting crises of pandemic, of climate collapse and now genocide. So we need the students engaged. We need them excited about building a better world, not demoralized, like I've seen across campuses. We need to get them activated again.

Chris Hedges

What about the medical associations? You've also run into conflict with the AMA and these big, large medical organizations. Why are they so tied to the Zionist project?

Rupa Marya

Because it's a part of US empire. So as we understand the AMA, these medical associations are mouthpieces for US Empire. They're not mouthpieces for the health of the people of the United States. And that's where we start to have to look at how we dissect away empire from the work of being a doctor, from the work of being a physician, the work of being a health care worker. We want to serve our communities. We want to see everyone get health care, have housing, have education, without going into debt. Medical debt in the United States is the number one cause of personal bankruptcy. We know that debt itself is a driver, an independent driver, of chronic inflammation. Raj and I wrote about that in our book. And so when we look at these systems, it's a clear indication that it's time to start inverting them. We don't need to shoot CEOs in broad daylight, that doesn't solve anything. What does, though, is people organizing their labor, organizing themselves, and refusing to participate in a system that will take our money and send it to destroy a health care system in one country while we are not getting health care here, and it's a critical time to do that.

Chris Hedges

Let's talk about your report, which you're about to submit to the UN. Tell us what it is you are writing about and what you're proposing.

Rupa Marya

So this report is being written, probably about by 20 different healthcare workers now and lawyers, some who are in Gaza, some who've been to Gaza and come back and reported. Some of us who have been here and just advocated to stop the genocide. This is a project that we're doing with Doctors Against Genocide, which has been a wonderful group to advocate for ending this and all genocides. But in that report, we are describing fully what we're calling the genocide enablement apparatus of Israel as it pertains to the destruction of healthcare in Gaza and the silencing of healthcare workers across the West. We understand that these things are related and they need to be treated as such. So in addition to that framework and analysis, we're also at advocating for doctors, for physicians to be involved in the international legal framework around when we define and call something a genocide. It does not take months to see that this was a genocide. So for those of us who were in touch with the physicians on the ground and the health care workers on the ground in October, it was clear that this was a genocide. How people were being targeted, the kinds of wounds we were seeing, the kinds of structural targeting we were seeing of those things that were necessary for life—so water, food, medicine, energy and then shelter. So when we saw those things go down, for physicians, it was very clear that this was a way to accelerate the annihilation of the Palestinian people. And so our report makes an argument for why doctors need to be involved from an international framework to prevent future genocide. So we're not waiting for the legal back and forth the way that we have

Chris Hedges

And talk about the sick out. So this is—what is it? A one day work stoppage? These kinds of activities to begin to push back against the genocide.

Rupa Marya

So Sick From Genocide, is the name of the campaign. Some of us have taken longer leave. So people are experiencing severe moral injury. The health care workers around the world have been shocked not only by the violence that they're seeing—patients burned alive in their beds, physicians tortured to death, like Dr. Adnan al-Bursh by Israeli military, by Israeli doctors, that was an article in the British Medical Journal. So physicians, healthcare workers, nurses, we are experiencing high degrees of moral injury in just witnessing this genocide. Not only that, the silencing that's happening in our medical institutions further dehumanizes us because we are not able to enter our places of work with our grief. We are not able to say out loud, oh, my God, they killed 18,000 children. I just saw a picture of a child burned alive. We're not able to talk about that and that repression is causing another level of moral injury to health care workers. And so what people have asked for is just a time to grieve, a mental health break. And when we look at that too, with the dehumanization that's required of us every day as health care workers in a capitalist system where we are witnessing people denied the care that they deserve from the health care insurance companies. There's just a toll that happens. Physician burnout is one of the leading causes of suicide. Our profession has a very high rate of suicide, and burnout is an inappropriate term. We're not burning out. We're being morally injured. We're being morally injured by these structures. And so this is a time for us to grieve, for us to gather, for us to take care of ourselves, as well as a time for us to start thinking about how to organize our labor so that we can start building the health care system we need, because medical students don't want to be part of of that violence. They're asking for something different.

Chris Hedges

Where do you if you draw, if you can draw a historical parallel. I mean, I was in Sarajevo during the war, and it's not that the hospitals wouldn't get hit. They did, everything got hit, but they weren't targeted. They weren't destroyed. They weren't obliterated. I'm having a hard time remembering, I mean a kind of scorched earth campaign where, I mean, we have Israeli tanks surrounding hospitals, firing into these hospitals. There was a massacre at Al Shifa Hospital. Is there a historical analogy to what's happening?

Rupa Marya

I don't think there is one historically, but we do know that the Geneva Conventions came out of the fall of Nazi Germany. That we decided collectively in the world that we did not want to see the targeting of healthcare facilities, because we understand that it's critical for people who are sick to get care, and it's critical for healthcare workers to work without this kind of threat. So again, the false pretenses that they're all Hamas, like everything's Hamas. What are these children Hamas? Like everyone's potential Hamas? So you can say that and murder everybody, just like doctors who were standing on the front line in Standing Rock. So I was called by California native folks out to assist the grandmothers in the Dakotas during the Standing Rock encampment as they were fighting to get a pipeline stopped—the Dakota Access Pipeline—from going through their drinking water, from going through their sacred water. The military contractor TigerSwan, which was probably cut its teeth in Israel as well, framed all of us there at the encampment as terrorists. Had the fervor of jihadi terrorists, we were told, because we were there making sure that grandmothers, who were getting shot in the face and in the groin and chest by rubber bullets, were not injured. That, to me, was preposterous. So if you can label anyone who is against the interests of US empire and the fossil fuel industry and the oligarchs that are controlling what we're all living under, you can describe us all as terrorists, and that's what they're doing in Gaza. And there hasn't been something like this. And what's atrocious is that the West has been silent, that Western medical institutions that were part of the doctors trials, the Nuremberg trials, looking at what happened in Nazi Germany and deciding to create something different, that those medical institutions have been silent, and so it's a time for us to push back. It's a time for us to speak up. I've been hammered. I have been hammered for 15 months, and I'm still here speaking. And if all of us do that, they can't fire us all. They can't suspend us all. We are how this system works, and we need to recognize that and start speaking up.

Chris Hedges

Great. Thanks, Rupa. I want to thank Diego [Ramos], Max [Jones], Thomas [Hedges] and Sofia [Menemenlis], who produced the show. You can find me ChrisHedges.Substack.com.