An open letter to Prime Minister Mark Carney: The right to health and the protection of civilians and health-care workers in Gaza
Dear Prime Minister Carney,
Re: The right to health and the protection of civilians and health-care workers in Gaza
The Registered Nurses’ Association of Ontario (RNAO), a leading professional nursing association representing more than 54,400 registered nurses, nurse practitioners and nursing students, writes to you with grave concern regarding the ongoing humanitarian crisis in Gaza. We urge the government to take concrete steps to protect the right to health, ensuring the safety of civilians and health-care workers, and upholding international humanitarian law.
As health-care professionals, we are compelled to speak out whenever core humanitarian principles are in jeopardy. In our recent statement on The Right to Health and the Protection of Civilians and Health-care Workers in Conflict Zones (1), RNAO affirmed the core principles of protecting life, respecting law and affirming the dignity of every human being – grounded in professional ethics and international law.1
What we are witnessing in Gaza is the widespread breakdown of these principles. Numerous reports and international agencies have documented conditions that raise urgent concerns:
- Sustained bombardment and siege tactics have rendered most health-care facilities non-functional, while those that remain struggle to operate due to critical shortages of electricity, fuel, medicine, and supplies (5,6).
- Hundreds of health workers have been killed, injured, or detained, while many more work under life-threatening conditions including starvation (7).
- Access to care for civilians has collapsed, with women giving birth without anesthesia, surgeries performed without sterilized equipment, and patients dying from treatable conditions (8).
- Essential supplies such as water, food, electricity and humanitarian aid have been severely restricted, while the destruction of basic infrastructure – water systems, power supply, and food distribution networks – has created catastrophic humanitarian conditions (9,10).
- The repeated forced displacement of the population – estimated to affect more than 95 percent of Gaza’s residents – has left people with no safe refuge, and declared "safe zones" have been repeatedly targeted (9,11).
- Statements by Israeli officials have indicated plans to concentrate the population in a small portion of Gaza’s territory, prompting warnings about forced displacement and long-term humanitarian consequences (12).
- The expulsion or sidelining of recognized humanitarian agencies and the reported use of aid distribution as a method of control and coercion have deepened the crisis (13,14).
These events are not isolated incidents. They reflect patterns that international humanitarian law is designed to prevent – particularly in relation to the targeting of civilians, the destruction of essential infrastructure, and the obstruction of humanitarian aid. These patterns demand urgent international response (14,15).
Prime Minister, RNAO is heartened that Canada has recognized the need to move beyond statements – such as several you have made recently, both independently and in concert with international partners (16, 17, 18) – toward concrete action. We hope that your July 30 announcement that Canada “intends to recognize the State of Palestine… in September 2025,” subject to certain conditions (19), marks the beginning of such meaningful steps.
We recognize that Israel has invoked its right to self-defence following the horrific attacks of October 7, 2023 – during which Hamas-led armed groups committed numerous war crimes, including mass killings, hostage-taking, sexual and gender-based violence, and indiscriminate rocket fire against civilians (20,21). These acts, and the continued holding of hostages, are heinous and must be unequivocally condemned.
At the same time, one set of war crimes can never justify another. The principle of proportionality under international humanitarian law must guide all responses. Civilians and health workers must never be targets. The ongoing destruction of Gaza’s health infrastructure, the denial of aid, the use of starvation as a weapon, and the forced displacement of its population raise grave concerns and demand the same level of scrutiny and accountability as all violations of humanitarian law.
Canada bears both a moral and legal responsibility to act. Prior to your July 30 statement (19), Canada’s response had been limited to statements of concern and condemnation, while the devastation in Gaza continues with impunity. Strong action is needed – words, which can risk being perceived as rhetorical cover, are no longer enough. Nurses call on the federal government to:
- Demand an immediate and sustained ceasefire to protect civilian life and allow for humanitarian operations to resume safely.
- Support urgent interventions to prevent starvation and address the collapse of essential health and nutrition systems in Gaza.
- Ensure full and unimpeded humanitarian access, including fuel, food, medical supplies, and evacuation of the wounded, through recognized international agencies.
- Demand the return of all hostages taken during the Oct. 7 attacks and the release of all civilians unlawfully detained, including Palestinians imprisoned without charge or trial.
- Condemn the targeting of health-care workers, facilities, and patients in clear and unequivocal terms.
- Support independent investigations into violations of international humanitarian law and ensure accountability for all parties responsible.
- Cease the transfer of arms, dual-use materials, and military technologies to any party credibly accused of serious violations of international law.
- Affirm Canada’s commitment to the right to health and the protection of civilians and health-care personnel as core principles of global human rights.
- Stand firmly against rising Antisemitism and Islamophobia in Canada, and ensure a climate of respect, safety, and solidarity for all communities.
Prime Minister, Canada must demonstrate through action – not only words – that it will not stand by in the face of mass suffering, grave violations of international law, and the systematic destruction of an entire population’s access to life-sustaining essentials. The time for condemnation alone has passed. Canada must act decisively to restore human dignity, uphold international law, and protect civilians, health-care workers, and the right to health in Gaza.
Respectfully, signing on behalf of the RNAO Board of Directors,
Dr. Doris Grinspun RN, BScN, MSN, PhD, LLD(hon), Dr(hc) DHC DHC, FAAN, FCAN, O.ONT RNAO CEO
NP Lhamo Dolkar RN(EC), CCN, MSc, NP- PHC RNAO President
Copy
The Hon. Anita Anand, Minister of Foreign Affairs
The Hon. Marjorie Michel, Minister of Health
The Hon. Bob Rae, Ambassador and Permanent Representative of Canada to the United Nations in New York
