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A medical student suspected of shooting dead three people in Rotterdam had a history of psychotic behaviour, according to prosecutors.

Although still investigating Thursday’s deadly attack, the authorities confirmed they had previously warned the Erasmus University Medical Centre (EMC) about his worrying conduct.

And EMC chairman Stefan Sleijfer said this had been taken seriously and the suspect was denied a doctor’s licence unless he underwent psychological evaluation and was declared fit to practice medicine.

Mr Sleijfer, who was dean of the faculty of medicine and health sciences, has said the shootings were probably linked to this examination, which was ongoing.

The 32-year-old has been named as Fouad L, with his surname not publishable under Dutch privacy laws.

He is due to appear before a judge on 3 October, the public prosecutor’s office said.

He is being held on suspicion of killing a 39-year-old woman who lived near his home and her 14-year-old daughter, as well as a 43-year-old doctor who was teaching at the EMC, where the alleged attacker was a student.

The suspect is also believed to have started fires at both locations.

He was arrested a short time later by heavily armed police under the university hospital’s helipad.

Police officers are seen at the scene of a shooting in Rotterdam, Netherlands, Friday, Sept. 29, 2023. Police in the Netherlands said a lone gunman wearing a bulletproof vest opened fire in an apartment and a hospital in the Dutch port city of Rotterdam, Thursday, Sept. 28, 2023, killing three people, including a 14-year-old girl. (AP Photo/Peter Dejong)
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The deadly shooting spree has shocked the Netherlands

A letter has now emerged, previously sent by prosecutors to the EMC, that described the suspect as displaying “psychotic behaviour”.

It also detailed his alcohol problems as well as complaints from neighbours over his treatment of animals for which he has an abuse conviction.

The letter stated: “I presume that the information above will contribute to the decision as to whether the person concerned should be eligible for a general doctor’s diploma.”

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Three killed in Rotterdam shootings

Commenting on the correspondence, Mr Sleijfer said: “What happened was that we had previous signals from the police and they were asking us whether this person was fit and was suitable to become a medical doctor. And that was a signal that we took very seriously.

“Subsequently the student was assessed whether he, from a mental perspective, was fit enough to become a medical doctor. And that was a process that was ongoing.

“So probably there is a relationship with that and the reason why he committed this horrible thing.”

Police chief Fred Westerbeke said: “We see his deed as a targeted action.

“But we need to investigate how and why.”

The rampage, which caused scenes of panic at the hospital with students fleeing and patients wheeled out of the building in beds, has caused shock in the Netherlands where shootings are rare.

Media reported the youngest victim had a twin sister who survived unharmed, while the doctor who died is survived by a wife and child.

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Trump’s USAID cuts could lead to 14 million deaths, report warns

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Trump's USAID cuts could lead to 14 million deaths, report warns

Around 14 million people could die across the world over the next five years because of cuts to the US Agency for International Development (USAID), researchers have warned.

Children under five are expected to make up around a third (4.5 million) of the mortalities, according to a study published in The Lancet medical journal.

Estimates showed that “unless the abrupt funding cuts announced and implemented in the first half of 2025 are reversed, a staggering number of avoidable deaths could occur by 2030”.

“Beyond causing millions of avoidable deaths – particularly among the most vulnerable – these cuts risk reversing decades of progress in health and socioeconomic development in LMICs [low and middle-income countries],” the report said.

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March: ‘We are going to lose children’: Fears over USAID cuts in Kenya

USAID programmes have prevented the deaths of more than 91 million people, around a third of them among children, the study suggests.

The agency’s work has been linked to a 65% fall in deaths from HIV/AIDS, or 25.5 million people.

Eight million deaths from malaria, more than half the total, around 11 million from diarrheal diseases and nearly five million from tuberculosis (TB), have also been prevented.

USAID has been vital in improving global health, “especially in LMICs, particularly African nations,” according to the report.

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Established in 1961, the agency was tasked with providing humanitarian assistance and helping economic growth in developing countries, especially those deemed strategic to Washington.

But the Trump administration has made little secret of its antipathy towards the agency, which became an early victim of cuts carried out by the Department of Government Efficiency (DOGE) – formerly led by Elon Musk – in what the US government said was part of a broader plan to remove wasteful spending.

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USAID ‘a bowl of worms’ – Musk

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What is USAID?

In March, US Secretary of State Marco Rubio said more than 80% of USAID schemes had been closed following a six-week review, leaving around 1,000 active.

The US is the world’s largest humanitarian aid donor, providing around $61bn (£44bn) in foreign assistance last year, according to government data, or at least 38% of the total, and USAID is the world’s leading donor for humanitarian and development aid, the report said.

Between 2017 and 2020, the agency responded to more than 240 natural disasters and crises worldwide – and in 2016 it sent food assistance to more than 53 million people across 47 countries.

The study assessed all-age and all-cause mortality rates in 133 countries and territories, including all those classified as low and middle-income, supported by USAID from 2001 to 2021.

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Thai PM Paetongtarn Shinawatra suspended amid outrage over leaked phone call

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Thai PM Paetongtarn Shinawatra suspended amid outrage over leaked phone call

Thailand’s prime minister has been suspended after a leaked phone call with a senior Cambodian politician caused outrage.

An ethics investigation into Paetongtarn Shinawatra is under way and she could end up being dismissed.

The country’s constitutional court took up a petition from 36 senators, who claimed dishonesty and a breach of ethical standards, and voted 7 to 2 to suspend her.

Protesters gathered in Bangkok at the weekend. Pic: Reuters
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Protesters gathered in Bangkok at the weekend. Pic: Reuters

The prime minister’s call with Cambodia’s former leader, Hun Sen, sparked public protests after she tried to appease him and criticised a Thai army commander – a taboo move in a country where the military is extremely influential.

Ms Shinawatra was trying to defuse mounting tensions at the border – which in May resulted in the death of one Cambodian soldier.

Thousands of conservative, nationalist protesters held a demo in Bangkok on Saturday to urge her to step down.

Her party is clinging on to power after another group withdrew from their alliance a few weeks ago over the phone call. Calls for a no-confidence vote are likely.

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Deputy prime minister Suriya Juangroongruangkit will take over temporarily while the court looks into the case.

The 38-year-old prime minister – Thailand‘s youngest ever leader – has 15 days to respond to the probe. She has apologised and said her approach in the call was a negotiating tactic.

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The popularity of her government has slumped recently, with an opinion poll showing an approval rating of 9.2%, down from 30.9% in March.

Ms Shinawatra comes from a wealthy dynasty synonymous with Thai politics.

Her father Thaksin Shinawatra – a former Manchester City owner – and aunt Yingluck Shinawatra served as prime minister before her – in the early to mid 2000s – and their time in office also ended ignominiously amid corruption charges and military coups.

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Benjamin Netanyahu to meet Donald Trump next week amid calls for Gaza ceasefire

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Benjamin Netanyahu to meet Donald Trump next week amid calls for Gaza ceasefire

Israeli Prime Minister Benjamin Netanyahu will be meeting Donald Trump next Monday, according to US officials.

The visit on 7 July comes after Mr Trump suggested it was possible a ceasefire in Gaza could be reached within a week.

On Sunday, he wrote on social media: “MAKE THE DEAL IN GAZA. GET THE HOSTAGES BACK!!!”

At least 60 people killed across Gaza on Monday, in what turned out to be some of the heaviest attacks in weeks.

Israeli Prime Minister Benjamin Netanyahu, left, with US President Donald Trump. Pic: Reuters
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Benjamin Netanyahu, left, with Donald Trump during a previous meeting. Pic: Reuters

According to the Hamas-run health ministry, 56,500 people have been killed in the 20-month war.

The visit by Mr Netanyahu to Washington has not been formally announced and the officials who said it would be going ahead spoke on condition of anonymity.

An Israeli official in Washington also confirmed the meeting next Monday.

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White House Press Secretary Karoline Leavitt said the administration was in constant communication with the Israeli government.

She said Mr Trump viewed ending the war in Gaza and returning remaining hostages held by Hamas as a top priority.

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The war in Gaza broke out in retaliation for Hamas’ 7 October 2023 attacks on southern Israel that killed 1,200 people and saw a further 250 taken hostage.

An eight-week ceasefire was reached in the final days of Joe Biden’s US presidency, but Israel resumed the war in March after trying to get Hamas to accept new terms on next steps.

Talks between Israel and Hamas have stalled over whether the war should end as part of any ceasefire.

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