Latest news with #HippocraticOath
Ya Biladi
2 days ago
- Health
- Ya Biladi
«It's not a war, it's a genocide» : Moroccan doctor returns from Gaza with harrowing testimony
Dr. Abdelkbir Hassini, an anesthesiologist and resuscitation specialist at Hassan II Provincial Hospital in Khouribga (from 1990 to 2016), has devoted nearly thirty-five years to cases requiring his expertise. True to the spirit of the Hippocratic Oath, he took part in an international humanitarian mission in the Gaza Strip from May 29 to June 12, 2025, supporting Palestinian medical staff on the ground. Through the Beverly Hills–based Rahma NGO, and as a member of the Moroccan coordination of Doctors for Palestine, Dr. Hassini spent fifteen days in Khan Younis alongside specialists from Australia, Germany, the UK, and the United States. «With the World Health Organization (WHO), this organization is one of the few currently capable of organizing international humanitarian missions in the Gaza Strip. Despite restrictions on supplies, we were able to bring some medical provisions, equipment, and vital components for our operations. Quantities had to be limited to avoid potential seizures, but we managed to bring in a few batches», Dr. Hassini explains. Having just returned to Morocco, Dr. Hassini, currently working in the private sector, has already resumed his duties, carrying the heavy weight of an intense mission amid the total siege of Gaza. Between anesthesia and resuscitation interventions, he shared with Yabiladi the devastating effects of nearly three years of Israeli military offensives in the region, where «the medical infrastructure is practically out of service». «My assignment reflects a situation words cannot fully capture. Initially, I was supposed to join Nasser Hospital, Gaza's largest remaining referral hospital. But due to the lack of resources on site to carry out medical procedures in our specialties, we were reassigned to Al Amal Hospital. The entire hospital infrastructure in northern Gaza is now unable to accommodate and care for the wounded needing resuscitation, including the European Hospital in Khan Younis», he says. An «exemplary» organization amid a «catastrophic situation» On the ground, «the situation is catastrophic», and even Al Amal Hospital is at risk of being shut down, especially as the ceasefire no longer holds despite numerous UN warnings to Israel. During Dr. Hassini's mission, the WHO also warned that Gaza's health system was collapsing. «There are no longer any operational hospitals in northern Gaza. Nasser and Al Amal are the last two functioning public hospitals in Khan Younis, where most of the population now lives. Without these facilities, essential health services can no longer be provided», the organization cautioned. Speaking to Yabiladi, Dr. Hassini recounted his experience in real time: «Nearly three days into our mission, the director of Al Amal Hospital informed us that the facility was in what the occupation calls an 'evacuation zone,' putting patients and staff at risk. After some hesitation, our NGO reassured us, and we continued operating on site». The permanent medical team and volunteer humanitarians were vital, as the hospital handles all severe injuries that cannot be treated elsewhere. «Severe injuries number in the dozens daily, all received by a single facility with fully mobilized healthcare staff and resuscitation beds at capacity», says Dr. Hassini. «We were able to provide necessary care to patients, especially thanks to the complementary expertise among specialists on site and the diverse mission team I was part of emergency doctors, anesthesiologists, trauma surgeons, and ophthalmologists. We organized a care circuit covering first aid, intensive care, and complex surgeries requiring large quantities of blood. In this regard, I must commend the high skill level of the Palestinian medical staff, who work under these conditions every day in an exemplary way». Describing the conditions, the doctor paints a picture of «inhumane and unimaginable situations, daily killings, and extreme cruelty that even the images from Gaza don't fully show». Among the cases that stayed with him, he recounts one that «illustrates the complex and multifaceted suffering of a single individual and family among the civilian population». «It was a young man who came to Al Amal Hospital carrying his severely injured daughter. The child needed immediate anesthesia and surgery. The father told us that his wife had been maimed in the same attack, and their son had been hit in the face. This reveals that beyond the many patients we see, there's an invisible face of cruelty, transfers impossible outside Gaza, uncounted dead, dismembered bodies, and injured people that families tally every day», he laments. Unjustifiable silence Amid this emergency response, Dr. Hassini praises «the organizational capacity of Palestinian colleagues, who manage to sustain stocks of supplies and medical equipment despite the health system being targeted by the occupation. This allowed us to provide the injured and patients with the necessary blood, pharmaceuticals, and pre-operative care». «When faced with such situations, it is our faith in life that prevails and motivates us as medical professionals. We have no choice but to treat all patients. The Palestinian population's attachment to life constantly reminded us of this, it is one of the greatest lessons from these missions. The citizens of Gaza count their dead and injured every day, yet their hope for a better tomorrow after all this genocide remains intact, and their morale grows stronger». In this context, Dr. Hassini insists, «It must be said: this is no longer a war, it is genocide». «I share the dismay and astonishment of my fellow humanitarian mission members», he adds. He also expresses his «total incomprehension at the unjustifiable silence of the international community, witnessing so much terror and unable to stop the massacre». Under such circumstances, the doctor reflects, «One returns deeply marked by what is happening on the ground, but also strengthened by the mental fortitude that is a tool of resistance for the Palestinian people, a force that makes us question our own everyday challenges and concerns».
The Guardian
13-06-2025
- Health
- The Guardian
Resident doctors have good reason to strike over pay
I write in response to the letter from senior clinicians urging resident doctors to vote against strike action (8 June). During my 22-year career we have seen fundamental changes in medical training, including the introduction of tuition fees for medical school, loss of free accommodation for first-year doctors, the lack of expansion in training numbers, and pay erosion over 15 years. This has left many resident doctors with crippling debt on graduation, spiralling costs of training, deteriorating pay, and the prospect of unemployment. I, and the authors of the letter, were fortunate enough not to face such hardships during training. Hence I urge colleagues not to influence the negotiations between the British Medical Association (BMA) and the government regarding resident doctors' pay. A mandate for strike action is a strong negotiating position, and I for one welcome productive discussions between the government and the BMA to reach a fair settlement. If senior clinicians cannot be supportive of our resident doctors, I suggest that they sit on their hands (with regard to writing letters) and bite their Ajay M VermaKettering, Northamptonshire A group of medical professionals write urging resident doctor colleagues to vote against proposed strike action. They cite the Hippocratic oath. They appear to overlook the daily flouting of the oath by colleagues who are active in the systems of American‑accountable care that have replaced a National Health Service in England. In these, 'first do no harm' appears to have been replaced by 'first protect the bottom line'. The unrest among health workers is not merely about pay; it is about the degradation of an entire public service and its subservience to corporate interests, many of them American. Let's have impassioned letters urging the expulsion of Palantir and co and a return to the principles of Bevan rather than BlackRock. It is untrue to say 'there is no spare money'. The money simply goes into the wrong Donovan Birkenhead, Merseyside The six senior doctors who wrote to you are key among those responsible for allowing the NHS to become such an unpleasant work environment for training doctors. As Wes Streeting so eloquently pointed out, the NHS treats training doctors 'like crap'. A lot could be done to improve the working lives of doctors – simply telling them not to strike is unhelpful and suggests indifference to the challenges they face. Declared interest: parent of two resident EvansMonmouth I am a former NHS GP now living and working in Canada. I read with interest that senior doctors recommend junior doctors don't strike. Would these be senior doctors who had their university education paid for by the state, then had their hospital accommodation paid for by the state, and then enjoyed a fixed benefit pension that kicked in at age 60 (for most of their careers)? Society looked after them well. Could it be possible that today's resident doctors have a different point of view for a reason? I suppose the other thing to say is that fixing morale in the NHS and deciding where society spends its money is outside the remit of the doctor. But fixing the NHS is the government's prerogative. Tom NewthNelson, British Columbia, Canada Have an opinion on anything you've read in the Guardian today? Please email us your letter and it will be considered for publication in our letters section.
The Guardian
08-06-2025
- Health
- The Guardian
Resident doctors should vote against strike action
We write about the call for a strike by resident doctors (Report, 22 May). We do so as fellow experienced professionals and potential patients. There was a genuine case that pay for resident doctors had fallen behind, but a 22% increase last year and an above-inflation offer this year seems to us to go a long way to addressing that. It's certainly far more than many of our colleagues, other professional groups and patients are getting, and it cannot have been easy to persuade the Treasury in such resource-constrained times. There remain significant problems around working conditions and training. They need firm resolution but this will not be achieved through strikes. We have witnessed many governments, NHS restructures and accompanying frustrations for our work. This has never compromised, and should never compromise, the needs and care of people who seek our help. That is why we all go into this profession. A strike now would harm patients and diminish the cause of these doctors. The calls to strike misjudge the mood in the country. There is no spare money – this is a futile gesture, guiding people into a maze without a thread. In our view, the NHS is at a more perilous state than at any time in our careers. A doctors' strike would further diminish the ability of the NHS to deliver, and play into the hands of those who don't believe in an NHS that is publicly funded and based on need not want. We urge resident doctors to keep to the spirit of the Hippocratic oath – vote for the NHS and vote no to strike action. John Oldham Former national clinical lead, quality and productivity, Clare Gerada GP and former chair Royal College of General Practitioners, David Colin-Thome Former GP and national clinical director, Prof James Kingsland University of Central Lancashire, Dr Fiona Cornish GP, Cambridge, Prof John Ashton Former regional director of public health for north-west England and director public health Have an opinion on anything you've read in the Guardian today? Please email us your letter and it will be considered for publication in our letters section.
Scoop
01-06-2025
- Health
- Scoop
Gisborne Hospital Senior Doctors Strike Highlights Important Health System Issues
Opinion – Ian Powell Todays dispute is in response to the uncompetitive conditions of employment, particularly salaries (there is a pay gap with Australia of around 65% on base 40-hour salaries). By International Labour Organisation standards, the right of employees through their unions to lawfully strike in Aotearoa New Zealand is limited. In summary, there are only two lawful grounds – in negotiations for a collective employment agreement (whether multi or single employer) and on health and safety grounds. New Zealand's first senior doctors strike The first strike undertaken by senior doctors was during negotiations for a single employer collective agreement between the South Canterbury District Health Board and the Association of Salaried Medical Specialists (ASMS). The dispute centred on inferior remuneration compared with senior doctors in the other DHBs. Health and safety was not a factor. There were four six hour strikes during the normal working week in February-March 2003. As ASMS Executive Director I was the union advocate for South Canterbury's senior doctors. At that time there were no life preserving services agreements required by legislation. However, consistent with the Hippocratic Oath of 'first do no harm,' only scheduled elective (planned) procedures, including surgery, and treatments were affected. Acute treatment that could not be clinically deferred continued. Further, additional notice to than required by law was given. This meant that no elective procedures were cancelled because they had yet to be scheduled in the first place. The strikes were successful in various respects. Subsequently I discussed this in an academic article published later that year in the Journal of Employment Relations titled 'Downing Scalpels and Stethoscopes' (unfortunately it didn't prove possible to locate a link). The almost first national senior doctors strike In 2007-08 ASMS came close to holding the first national strike by senior doctors. This was over a national collective agreement covering all the district health boards (DHBs). The issues were improving remuneration and other conditions and preventing employer attempts to clawback existing consultation rights and weaken a non-clinical time entitlement. However, the protracted dispute was unexpectedly complicated midstream by the increasing loss of specialists to Australia, beginning with Queensland, following mind-bogglingly large salary increases 'across the ditch.' ASMS's strategy was gradual escalation always leaving the employers with the opportunity to reconsider. Highly publicised and massively attended stopwork meetings (similar but technically different from two-hour strikes focussed on non-acute services) were held in each of the DHBs (two in some) over a concentrated period. They were followed by a resounding national postal ballot, with a high response rate, authorising ASMS's National Executive to organise strike action. This proved to be the tipping point. The publicised and membership supported escalations arguably had more effect than had senior doctors gone straight to strike action without this staged escalation. It led to new Labour Health Minister David Cunliffe intervened by directly collaborating with the parties to facilitate a satisfactory resolution without having to proceed with strikes. Owing to the high profile of his intervention it was both brave and risky for Cunliffe. It could have easily gone 'belly-up.' But it didn't; instead, it worked. In addition to the withdrawal of consultation clawbacks and weakening the non-clinical time entitlement employer claims, the settlement included positive improvements to employment entitlements (including salaries) and inclusion of a strong engagement provision. What is notable about both these two disputes, one leading to strikes and the other using the gradual escalation towards a strike to good effect, is that health and safety issues were not at the forefront of the narrative (although it was starting to emerge towards the end with the start of the increasing loss of specialists to Australia). Gisborne Hospital senior doctors strike On 28 May 50 senior doctors employed by Health New Zealand (Te Whatu Ora) at Gisborne Hospital 'walked of the job' at midnight for a 24-hour strike. Similar to their above-mentioned South Canterbury colleagues over 20 years earlier, cover continued to be provided for acute care, including emergencies. One could be forgiven from the media coverage for believing that this was a strike over health and safety concerns. Highlighted was the fact that while all public hospitals suffer from severe senior doctor shortages, Gisborne Hospital had the unwanted record for having the highest rate. The extent of these shortages and the dismissive government response had been previously reported by Marc Daadler in Newsroom (23 April): Gisborne doctors expose Government's inaccurate staffing claims. Radio New Zealand's Morning Report covered the strike that same day in a piece that included interviews with senior doctors: Gisborne Hospital senior doctors strike. In response to a disingenuous criticism from Minister of Health Simeon Brown that the strike was delaying treatment for patients, physician Dr Alex Raines noted that the strike would cause only minor disruption compared to ongoing delays from chronic understaffing. The striking senior doctors also received full support from the Gisborne community including Mayor Rehette Stoltz, again in Morning Report, on the day of the strike: Gisborne Mayor supports striking senior doctors. Senior doctors themselves went the extra mile to connect with the public with the organisation of donations to a local food bank, including a free sausage sizzle, as reported by the Gisborne Herald (30 May): Striking senior doctors support Gisborne foodbank. Recognising the level of community support for the doctors, Dr Raines observed that 'There's a warmth and solidarity in the community that's very special.' In turn, the head of the food bank said they '…supported the doctors in their kaupapa of supporting the unwell and vulnerable of the community.' Important health system issues The strike action by Gisborne Hospital's senior doctors raises important issues for our health system. First, and foremost, this strike was the first of a series of local hospital-based strikes in pursuit of a new national collective agreement. They are not on the grounds of health and safety. These local strikes follow last month's national strike. However, in contrast to the South Canterbury strikes of 2003 and the staged escalations of the national dispute in 2007-08, health and safety is directly linked to this dispute. Today's dispute is in response to the uncompetitive conditions of employment, particularly salaries (there is a pay gap with Australia of around 65% on base 40-hour salaries). This sits behind the severe widespread senior doctor shortages which, in turn, sits behind high levels of fatigue and burnout. It means that Health New Zealand is required by the Government to continue to underpay its senior doctors who are left having to make up the deficit by paying for the health system with their health. Patients also pay for the deficit by being put at greater risk of harm, even death. Another health system issue is that senior doctor strikes receive strong community support (the same can be seen for nurses). While the Government does not value the health system's senior doctors (and nurses), the public does. In South Canterbury on 2003 Grey Power were actively and publicly supporting the striking senior doctors. Strong public is occurring right now for striking senior doctors in Gisborne as articulated by the city's mayor and foodbank. Finally, providing they don't completely flop, strikes are empowering for those undertaking the action. This was certainly the case in South Canterbury. In fact, the strikes contributed to improving the relationship between senior doctors and senior management (without any change in personnel). There is every reason to believe that the strike actions being undertaken and planned by Health New Zealand's senior doctors won't be similarly empowered. In this context it is timely to recall the observation of British working class historian EP Thompson that from struggles comes increased consciousness.
Scoop
01-06-2025
- Health
- Scoop
Gisborne Hospital Senior Doctors Strike Highlights Important Health System Issues
By International Labour Organisation standards, the right of employees through their unions to lawfully strike in Aotearoa New Zealand is limited. In summary, there are only two lawful grounds – in negotiations for a collective employment agreement (whether multi or single employer) and on health and safety grounds. New Zealand's first senior doctors strike The first strike undertaken by senior doctors was during negotiations for a single employer collective agreement between the South Canterbury District Health Board and the Association of Salaried Medical Specialists (ASMS). The dispute centred on inferior remuneration compared with senior doctors in the other DHBs. Health and safety was not a factor. There were four six hour strikes during the normal working week in February-March 2003. As ASMS Executive Director I was the union advocate for South Canterbury's senior doctors. At that time there were no life preserving services agreements required by legislation. However, consistent with the Hippocratic Oath of 'first do no harm,' only scheduled elective (planned) procedures, including surgery, and treatments were affected. Acute treatment that could not be clinically deferred continued. Further, additional notice to than required by law was given. This meant that no elective procedures were cancelled because they had yet to be scheduled in the first place. The strikes were successful in various respects. Subsequently I discussed this in an academic article published later that year in the Journal of Employment Relations titled 'Downing Scalpels and Stethoscopes' (unfortunately it didn't prove possible to locate a link). The almost first national senior doctors strike In 2007-08 ASMS came close to holding the first national strike by senior doctors. This was over a national collective agreement covering all the district health boards (DHBs). The issues were improving remuneration and other conditions and preventing employer attempts to clawback existing consultation rights and weaken a non-clinical time entitlement. However, the protracted dispute was unexpectedly complicated midstream by the increasing loss of specialists to Australia, beginning with Queensland, following mind-bogglingly large salary increases 'across the ditch.' ASMS's strategy was gradual escalation always leaving the employers with the opportunity to reconsider. Highly publicised and massively attended stopwork meetings (similar but technically different from two-hour strikes focussed on non-acute services) were held in each of the DHBs (two in some) over a concentrated period. They were followed by a resounding national postal ballot, with a high response rate, authorising ASMS's National Executive to organise strike action. This proved to be the tipping point. The publicised and membership supported escalations arguably had more effect than had senior doctors gone straight to strike action without this staged escalation. It led to new Labour Health Minister David Cunliffe intervened by directly collaborating with the parties to facilitate a satisfactory resolution without having to proceed with strikes. Owing to the high profile of his intervention it was both brave and risky for Cunliffe. It could have easily gone 'belly-up.' But it didn't; instead, it worked. In addition to the withdrawal of consultation clawbacks and weakening the non-clinical time entitlement employer claims, the settlement included positive improvements to employment entitlements (including salaries) and inclusion of a strong engagement provision. What is notable about both these two disputes, one leading to strikes and the other using the gradual escalation towards a strike to good effect, is that health and safety issues were not at the forefront of the narrative (although it was starting to emerge towards the end with the start of the increasing loss of specialists to Australia). Gisborne Hospital senior doctors strike On 28 May 50 senior doctors employed by Health New Zealand (Te Whatu Ora) at Gisborne Hospital 'walked of the job' at midnight for a 24-hour strike. Similar to their above-mentioned South Canterbury colleagues over 20 years earlier, cover continued to be provided for acute care, including emergencies. One could be forgiven from the media coverage for believing that this was a strike over health and safety concerns. Highlighted was the fact that while all public hospitals suffer from severe senior doctor shortages, Gisborne Hospital had the unwanted record for having the highest rate. The extent of these shortages and the dismissive government response had been previously reported by Marc Daadler in Newsroom (23 April): Gisborne doctors expose Government's inaccurate staffing claims. Radio New Zealand's Morning Report covered the strike that same day in a piece that included interviews with senior doctors: Gisborne Hospital senior doctors strike. In response to a disingenuous criticism from Minister of Health Simeon Brown that the strike was delaying treatment for patients, physician Dr Alex Raines noted that the strike would cause only minor disruption compared to ongoing delays from chronic understaffing. The striking senior doctors also received full support from the Gisborne community including Mayor Rehette Stoltz, again in Morning Report, on the day of the strike: Gisborne Mayor supports striking senior doctors. Senior doctors themselves went the extra mile to connect with the public with the organisation of donations to a local food bank, including a free sausage sizzle, as reported by the Gisborne Herald (30 May): Striking senior doctors support Gisborne foodbank. Recognising the level of community support for the doctors, Dr Raines observed that 'There's a warmth and solidarity in the community that's very special.' In turn, the head of the food bank said they '…supported the doctors in their kaupapa of supporting the unwell and vulnerable of the community.' Important health system issues The strike action by Gisborne Hospital's senior doctors raises important issues for our health system. First, and foremost, this strike was the first of a series of local hospital-based strikes in pursuit of a new national collective agreement. They are not on the grounds of health and safety. These local strikes follow last month's national strike. However, in contrast to the South Canterbury strikes of 2003 and the staged escalations of the national dispute in 2007-08, health and safety is directly linked to this dispute. Today's dispute is in response to the uncompetitive conditions of employment, particularly salaries (there is a pay gap with Australia of around 65% on base 40-hour salaries). This sits behind the severe widespread senior doctor shortages which, in turn, sits behind high levels of fatigue and burnout. It means that Health New Zealand is required by the Government to continue to underpay its senior doctors who are left having to make up the deficit by paying for the health system with their health. Patients also pay for the deficit by being put at greater risk of harm, even death. Another health system issue is that senior doctor strikes receive strong community support (the same can be seen for nurses). While the Government does not value the health system's senior doctors (and nurses), the public does. In South Canterbury on 2003 Grey Power were actively and publicly supporting the striking senior doctors. Strong public is occurring right now for striking senior doctors in Gisborne as articulated by the city's mayor and foodbank. Finally, providing they don't completely flop, strikes are empowering for those undertaking the action. This was certainly the case in South Canterbury. In fact, the strikes contributed to improving the relationship between senior doctors and senior management (without any change in personnel). There is every reason to believe that the strike actions being undertaken and planned by Health New Zealand's senior doctors won't be similarly empowered. In this context it is timely to recall the observation of British working class historian EP Thompson that from struggles comes increased consciousness. Ian Powell Otaihanga Second Opinion is a regular health systems blog in New Zealand. Ian Powell is the editor of the health systems blog 'Otaihanga Second Opinion.' He is also a columnist for New Zealand Doctor, occasional columnist for the Sunday Star Times, and contributor to the Victoria University hosted Democracy Project. For over 30 years , until December 2019, he was the Executive Director of Association of Salaried Medical Specialists, the union representing senior doctors and dentists in New Zealand.
