Dozens of US doctors and nurses who worked in Gaza have written to Joe Biden claiming that the true death toll from Israel’s months-long assault is much higher than previously reported, demanding the US withdraw diplomatic and military support for Israel until there is a ceasefire.
The eight-page letter, delivered on Thursday and addressed to Biden, the first lady, Jill Biden, and the vice-president, Kamala Harris, said the medics saw evidence of widespread violations of laws governing the use of US weapons supplied to Israel, and of international humanitarian law.
Forty-five surgeons, emergency room physicians and nurses who volunteered in several Gaza hospitals over recent months laid out what they described as the “massive human toll from Israel’s attack on Gaza, especially the toll it has taken on women and children”.
“We cannot forget the scenes of unbearable cruelty directed at women and children that we witnessed ourselves,” they wrote.
“Every single signatory to this letter treated children in Gaza who suffered violence that must have been deliberately directed at them. Specifically, every one of us on a daily basis treated pre-teen children who were shot in the head.”
Several of the signatories previously told the Guardian they believed Israeli snipers were targeting children and reported the devastating impact on civilians of weapons designed to spray high levels of shrapnel.
The medics, who volunteered with the World Health Organization and other relief groups, told the president the real death toll is much higher than the Palestinian ministry of health’s casualty figure of more than 39,000 people killed, the majority being women and children.
“It is likely that the death toll from this conflict is already greater than 92,000, an astonishing 4.2% of Gaza’s population,” they wrote.
The medics added almost no one in Gaza has escaped the consequences of the Israeli attack.
“With only marginal exceptions, everyone in Gaza is sick, injured or both. This includes every national aid worker, every international volunteer and probably every Israeli hostage: every man, woman and child,” they said.
The letter warned that “epidemics are raging in Gaza” and described Israel’s repeated displacement of a malnourished and sick civilian population to areas without running water and toilets as “absolutely shocking”.
At the beginning of the letter, the medics preempted accusations of sympathy for the 7 October Hamas assault on Israel in which 1,139 people, mostly Israelis, were killed and 251 abducted. It is unclear how many of the captives are still held by Hamas in Gaza and whether they are alive.
“None of us support the horrors committed on October 7 by Palestinian armed groups and individuals in Israel,” the letter said.
But the signatories said that the subsequent “catastrophe” in Gaza requires the US to withdraw material support for Israel.
“President Biden and Vice-President Harris, any solution to this problem must begin with an immediate and permanent ceasefire. We urge you to withhold military, economic and diplomatic support from the state of Israel and to participate in an international arms embargo of both Israel and all Palestinian armed groups until a permanent ceasefire is established, and until good faith negotiations between Israel and the Palestinians lead to a permanent resolution of the conflict,” the medics wrote.
![Piles of garbage in Gaza among ruined buildings.](https://i.guim.co.uk/img/media/d02a6bdba38c1bdefd50f0d7685d017ba498d748/0_0_6720_4480/master/6720.jpg?width=445&dpr=1&s=none)
The letter details the individual experiences of some of the signatories including surgeons, paediatricians, trauma nurses and anaesthesiologists. Some have worked in Ukraine during the Russian invasion. Others are US military veterans.
Mark Perlmutter, an orthopaedic surgeon, wrote: “Gaza was the first time I held a baby’s brains in my hand. The first of many.”
Feroze Sidhwa, a trauma and critical care surgeon, said he had “never seen such horrific injuries, on such a massive scale, with so few resources”.
Asma Taha, a paediatric nurse practitioner, described the challenges of maternity care.
“Every day I saw babies die. They had been born healthy. Their mothers were so malnourished that they could not breastfeed, and we lacked formula or clean water to feed them, so they starved,” she said in the letter.
The medics said that those who worked with pregnant women regularly saw stillbirths and maternal deaths that were easily preventable in normal circumstances.
“Women underwent C-sections without anesthesia, and were given nothing but Tylenol afterwards because no other pain medications were available,” they wrote.
The letter said that “Israel has directly targeted and deliberately devastated Gaza’s entire healthcare system”.
The medics described their Palestinian colleagues as “among the most traumatized people in Gaza, and perhaps in the entire world” who kept working despite losing family members and their homes. Many were malnourished while working grueling hours without pay.
The letter said that working as as healthcare providers marked Palestinians out.
“Israel has targeted our colleagues in Gaza for death, disappearance and torture. These unconscionable acts are entirely at odds with American law, American values and international humanitarian law,” they wrote.
The medics made a direct appeal to the Bidens.
“President and Dr Biden, we wish you could see the nightmares that plague so many of us since we have returned: dreams of children maimed and mutilated by our weapons, and their inconsolable mothers begging us to save them,” they said.
“We wish you could hear the cries and screams our consciences will not let us forget. We cannot believe that anyone would continue arming the country that is deliberately killing these children after seeing what we have seen.”