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James Orbinski is the director of the Dahdaleh Institute for Global Health Research at York University, adjunct professor at the Dalla Lana School of Public Health at the University of Toronto and a former international president of Médecins Sans Frontières (MSF).

The recent seven-day pause in the Israel-Hamas war, and floods of earnest words from world leaders on how Israel must consider the humanitarian needs of Palestinian civilians, have been seen as progress. Yet, as Israeli bombing and ground attacks intensify on Gaza’s second-largest city, the UN is warning of a catastrophic humanitarian situation. Now G7 leaders are calling for more pauses, but these calls are not meaningful signs that the humanitarian situation in Gaza is likely to improve.

Israel has vowed not only to continue its campaign, but to deliver the “mother of all thumpings” and to do so “with intensity” for at least two more months. Does this mean that Israel will continue to inflict a humanitarian horror that openly flouts the laws of war? Apparently so.

Total war has resumed, and its logic has become normalized. Save for the seven-day pause, Israel has bombed relentlessly since Oct. 7, killing more than 16,000 Palestinians and wounding more than 41,000. Israel is using large bombs that maximize destruction and are manifestly unsuited to minimizing civilian death. Israel has repeatedly bombed hospitals and refugee centres. Hundreds of aid workers have been killed. It is a situation I know well. I was MSF’s head of mission in Kigali, Rwanda, during the 1994 Tutsi genocide, where 800,000 Tutsi were massacred. We were actively shelled as we struggled to keep our hospital open, and MSF lost more than 100 aid workers.

Save for a mere trickle of aid, Israel has laid siege to Gaza, cutting off electricity, food, water and medicine. Israel’s denial of adequate aid, which is waiting by the truckload at the borders of Gaza, is immoral by any standard. Palestinian civilians are trapped in a 10-by-40-kilometre strip in inhumane conditions imposed by Israel. They are being treated like cattle, herded and ordered to go from one region of the slaughterhouse to another, as Israel bombs relentlessly and its ground forces invade. Israel is not only inflicting a humanitarian catastrophe on Palestinian civilians, but is also more and more clearly committing war crimes.

In its fury, Israel has conflated the Palestinian people with Hamas, inflicting a collective punishment, and has placed itself outside international law. These laws demand at a minimum proportionality, distinguishing between combatants and non-combatants, and ensuring there is sufficient humanitarian assistance and protection to civilians. Israel is not only failing, but flouting these minimal standards on every front.

The time for earnest handwringing at the sidelines is over. This war must be brought to conform with international law. Canada and all states must be resolute that both Israel and Hamas are bound to the minimum humanitarian standards of the Geneva Conventions and other laws of war.

Hamas’s barbaric attack and slaughter of 1,200 Israelis on Oct. 7 is the single largest attack on Jewish people since the Holocaust. This and Hamas’s ongoing violations of the laws of war – including its ongoing war crime of holding hostages and sending missiles into Israel – do not give Israel license to also violate the laws of war any more than those violations by Israel give Hamas any such licence. Israel must discriminate between civilians and combatants and stop its brutal siege – a form of warfare that was unambiguously outlawed after the Second World War. Hamas must release the hostages and stop using any other illegal methods of war.

The implications of a continuation of this humanitarian hell for Palestinian civilians is grave, and it casts a dark shadow over any future peace process. It also sets an unacceptable precedent for other conflicts such as those in Ukraine, Myanmar and Sudan, as well as for any authoritarian state with aggressive intentions.

The United States is providing unconditional support – including weapons and intelligence – for Israel’s response to Hamas. It is the only state with sufficient military, economic and diplomatic heft to pressure both Israel and Hamas – and their allies – for an immediate and sustained ceasefire. The U.S. must make any aspect of its support of Israel fully conditional on full respect and adherence to the laws of war.

Canada and all nation-states must demand of the U.S., Israel and Hamas that this humanitarian horror be brought to a halt, and that there is full compliance with the laws of war. Only then can calmer heads invoke a shard of wisdom to make a path forward beyond total war – a path that must begin with a minimum respect for human dignity, even in war.

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