To: Dr. Adrian Boyle, President, Royal College of Emergency Medicine

Subject: Joint Petition from UK Emergency Medicine Professionals – Urgent Call to Action on the Gaza Humanitarian Crisis

Dear Dr. Boyle,

We, the undersigned emergency professionals, trainees, nurses, and allied professionals working across emergency services, write to you with deep alarm at the unprecedented humanitarian catastrophe unfolding in Gaza. As frontline healthcare professionals committed to the protection of life, the ethics of medical neutrality, and the dignity of all patients, we feel a moral and professional duty to speak out with urgency and resolve.

As of May 2025, the World Health Organization and United Nations report the near-total collapse of Gaza’s healthcare system. Ninety-four percent of hospitals have been damaged or destroyed, and over 71,000 children under five are projected to suffer acute malnutrition. At least 57 children have already died of starvation since the intensification of the blockade in March. Emergency services have been devastated. Gaza’s only burns unit has been destroyed. The Nasser Medical Complex, a major referral hospital, lost 18 critical care beds following an airstrike.

Across Gaza, healthcare teams are performing emergency surgeries, amputations, and caesarean sections without anaesthesia, electricity, oxygen, or sterile instruments. Trauma systems have collapsed, blood products are unavailable, and the pre-hospital response is overwhelmed. These are not isolated failures, they are the predictable outcome of a deliberate blockade, the obstruction of humanitarian aid, and repeated attacks on healthcare facilities and personnel.

These acts constitute clear violations of international humanitarian law, the Geneva Conventions, and the ethical obligations that underpin our profession. They undermine every principle we uphold, to preserve life, relieve suffering, and provide care impartially and without fear.

We are aware that the Royal College of Emergency Medicine has contributed to international medical education and global health. However, this crisis has not been addressed at a level that aligns with college's principles: it demands explicit, united, and principled leadership from the UK’s most respected medical institutions.

We also recognise that statements may have been issued or are under review. While such responses are welcome, they must not substitute for the clear, urgent, and sustained leadership this moment calls for. Anything short of a public condemnation of siege tactics and the dismantling of emergency care systems risks being perceived as symbolic rather than meaningful.

We therefore respectfully call on the RCEM to:

• Publicly and unequivocally condemn the use of starvation, siege, and the targeting of healthcare infrastructure and workers, and mass killing of civilians
• Publicly support and align with United Nations Security Council Resolution 2728, adopted in March 2024, which calls for an immediate and lasting ceasefire, unimpeded humanitarian access, and the protection of civilians and healthcare personnel.
• Collaborate across colleges and international organisations to advocate for the restoration of emergency care services in Gaza, and the protection of healthcare systems in conflict zones.
• Support legal accountability for those responsible for the obstruction of care, the targeting of ambulances, hospitals, and healthcare workers, and the violation of medical neutrality.
• Provide a platform for RCEM members to advocate, educate, and act, and issue clear ethical guidance for clinicians responding to humanitarian crises of this scale.
• Organise a national conference around health in conflict to highlight the conditions of practicing emergency medicine under these circumstances.

This is a moment that will be remembered — by our patients, our profession, and future generations. As clinicians trained to act in the face of catastrophe, we believe silence is not neutrality — it is abandonment.

We stand ready to support all three Colleges in any action that upholds our shared values and defends the right to care, dignity, and life for all.

Sincerely,

 [The Undersigned] UK Emergency Medicine

 May 2025