Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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Which way forward? Try telling the truth
- Alexander Massey (1 June 2003)
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Response to Mr. A. Massey
- Tom P Marshall (2 June 2003)
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'External factor'? Israel, always Israel
- Herschel Zimonas (5 June 2003)
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A correct first step forward
- Wael Al-Delaimy (5 June 2003)
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The way forward
- Abdullatif S Husseini (9 June 2003)
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Alexander Massey, Thames Registry King's College London , Weston Street, London SE1 3QD
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Sir, Samer Jabbour ("Heath and development in the Arab world: which way forward?", BMJ, Vol 326, 24 May, 2003) blames the Arab-Israeli conflict for being 'the main external factor' impeding Arab public health progress and picks 'Palestine, Sudan, and Somalia' as examples of 'catastrophic health and economic situation'. Wisely, Jabbour doesn't back his claim with facts, for they show a rather different picture. According to the World Development Indicators 2002 ("Jerusalem Post", 9 August, 2002), per capita income among Palestinian Arabs in 2000 was $1,660, higher than in Algeria ($1,580) or Egypt ($1,490). Although it has fallen since the eruption of terror two and a half years ago - the World Bank estimated in March 2002 a drop of 19% in Palestinian income in 2001 to about $1,340 - that is still above a country like Morocco ($1,180 in 2000). Further World Bank's estimate was that Palestinian income may fall 20% more in 2002, which would put the per-capita income at $1,070. In other words, Palestinian income today may be some 14% higher than in Syria, where per capita income was $940 in 2000, and nearly three times higher than in Yemen ($370), Sudan ($310), and such Arab League members as Mauritania, Somalia, and Comoros. In 2000, the combined foreign aid that went to all of these 43 million truly poor Arabs, living in five countries, was less than what the three million Palestinians received, though Palestinian income was four times higher. Among other things, this disparity may explain Arafat's respectable no 6 on the latest list of richest 'Kings and Despots'. Meanwhile, even the experts hired by the Medical Aid for Palestinians in May 2002 to assess health needs in and around Jenin, Ramallah, Nablus and Gaza had to conclude that they only noted 'limited impact (of the conflict) on the health status'(Lancet, Vol 360, August 31,2002, p 723). For all Jabber's demagoguery, it is aversion to truth and, in the case of Palestinian Arabs, addiction to terrorism, not 'external factors', which impede public health and other development in the Arab world. Only when Arabs understand that they themselves and their corrupt and despotic rulers, not 'sanctions and occupations', are to blame for their misfortunes, will there be a prospect for progress Competing interests: None declared |
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Tom P Marshall, Lecturer in Public Health Birmingham University B15 2TT
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In his electronic response Alexander Massey characterises an entire people as untruthful and a nation as addicted to terrorism. Perhaps he would like to cite evidence supporting race and nationality as indicators of truthfulness and criminality. I personally find this reasoning distasteful. His letter should remind us that apologists for apartheid used to argue black South Africans were better off than Africans anywhere else on the continent. There was a grain of truth to this. It was easy to point to more impoverished peoples ruled by equally bad regimes. But this did not alter the fundamental truth, apartheid was wrong and its militarism cast a poisonous shadow across Southern Africa. Apartheid’s defenders of course held similar views to Mr Massey on race as an indication of ability to take part in politics. Bad government and corruption plague the Middle East. Whether or not there are more miserably oppressed or impoverished peoples than in the Arab world than Palestinians is beside the point. Only a fool would argue that this conflict has not had more widespread effects than almost any other conflict across the region. There is certainly inequity in the distribution of aid to the Middle East. In 2001, Israel had a per capita GDP of $16,750 and yet received $2.876 billion from the USA: over one third of the USA’s annual aid budget. [1,2] Approximately $60 million dollars of this was for “resettlement of refugees”. Readers will be aware that this often means housing new immigrants to Israel on Palestinian land within the Occupied Territories. New settlements and the resulting dispossession of Palestinians, remain one of the greatest impediments to peace. Competing interests: None declared |
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Herschel Zimonas, retired consultant dermatologist 25 College Crescent, London NW3 5PL
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Tom P Marshall focuses on Alexander Massey's "racism" rather than comment on the issues in the original BMJ article: whether by intent or through ignorance, that is his choice. But whatever Marshall's definition of 'race', Massey didn't suggest that a genetic mutation makes the good citizens of Ramallah burst into dancing or name yet another street after a child murderer when a Tel Aviv school disco is blown to pieces. It is clear, though, that "nurture" is more likely to explain the popularity of terrorism among Palestinian Arabs. Like Germany in the 1930s, a vicious culture of anti-Semitism in the media and education has produced a generation blinded by hatred: opinion polls consistently show that up to 80% of Palestinian Arabs approve of terrorism, and many of those who don't have only tactical objections, contrary to Marshall's melodramatic indignation. Naturally, the battle cry of "Israel is an apartheid state" couldn't be resisted: never mind that the "apartheid state" is airlifting tens of thousands of black Africans away from famine and epidemic, the chanting of "Zionism is Racism" must go on. Never mind that Kuwait ethnically cleansed Palestinian Arabs after the first Gulf war and that Lebanon denies basic human rights to the three generations of residents of refugee camps just a short walk from Samer Jabbour's Beirut office - it is the Jenin "massacre" (quietly downgraded from 5,000 to 52 - mostly armed Palestinians - dead) that fascinates seasoned Israel-bashers. "It's the knee, always the knee" a coach used to say about football injuries: with Jabbour, Marshall, et al, it's Israel, always Israel. I do agree with Marshall that the distribution of aid to the Middle East - and the rest of the world - is scandalous. Whereas hundreds of millions are stolen by Arafat and his henchmen or wasted by the Orwellian Palestinian refugee industry to keep refugees in misery, over three million people have perished in The Congo during the past four years. Of course, our human rights crusaders pay far less attention to the latest Holocaust-scale mass slaughter than to the quality of life of terrorists in Israeli detention. And meanwhile, the Third World is paying a horrific price: how many Ethiopian children could have been saved using the $10 million spent in the UN on the ritual slander of Israel in the past two years? Competing interests: None declared |
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Wael Al-Delaimy, Research Associate School of Public Health, Harvard University
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In his article "Health and development in the Arab world: which way forward? " Sammer Jabbour made a brave attempt at describing the problems facing the health of the Arab world. Rarely have we seen such views or attempts to bring thoughtful solutions or ideas to address the current problems facing the 281 million individuals living in the Arab countries. Furthermore, research, which is the backbone of public health advancement and progress, is a low priority because of the problems described by Dr. Jabbour. Most health systems in the Arab world are very centrally oriented and therefore health policy is organized in a pyramid or "bottle neck" fashion. Adding to these impediments is the political unrest and uncertainty in the region causing internal turmoil that betrays any sincere effort to make a change, and any effort to make that change last. The Israeli- Palestinian conflict is one of the longest and most devastating in the region. Not to mention this conflict as another cause would be not to tell the truth. It is unfortunate that some still deny such causes based on tunnel vision hatred based on race or religion even among supposedly neutral scientists. Such views actually support the claims of Dr. Jabbour that this conflict has had its negative effects even on the health sector of the region. The WHO director in her statement in September 2002 clearly attributed the deterioraiton of the health of Palestinians to occupation and violence (1), a claim supported by an independent assessment by the world health body and much more credible than misleading numbers and claims put by scientists with a hidden political agenda. Iraq is another good example to cite of how once a progressive model of a free advanced health system was turned into ruins by the most strict sanctions in the history of mankind. Numerous reports from our university(2), the WHO (3) and many other respected organizations have documented without doubt the devastating effect of sanctions on the people of Iraq. Dr. Eisenberg accurately described sanctions as "war against public health" (4). The positive thing emerging in recent years is the recognition by the outside world of these negative factors on the health of the Arab world. This recognition is partially a result of the gross political injustice happening to the people of the region by local dictatorships and imported occupiers to Palestine and now Iraq. Yesterday's few powerful voices within the scientific community that indirectly supported these injustices have become the exposed outcasts of today.
1.http://www.who.int/mediacentre/statements/statement04/en/ 2. Ascherio A, Chase R, Cote T, Dehaes G, Hoskins E, Laaouej J, Passey M, Qaderi S, Shuqaidef S, Smith MC, et al. Effect of the Gulf War on infant and child mortality in Iraq. N Engl J Med 1992 Sep 24;327(13):931-6 3. Popal GR. Impact of sanctions on the population of Iraq.East Mediterr Health J 2000 Jul;6(4):791-5 4. Eisenberg L. The sleep of reason produces monsters -- human costs of economic sanctions. N Engl J Med 1997 Apr 24;336(17):1248-50 Competing interests: None declared |
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Abdullatif S Husseini, Asssistant Professor of Public Health Institute of Community and Public Health, Birzeit University, Palestine
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Editor, The author of "Health and development in the Arab world: which way forward?" have identified the basic facts of health and development in the Arab world, and revealed some important limitations of the Arab development report. However, there are two main points that needs further delineation, namely that the historical and cultural context of the Arab- Islamic civilization should be given appropriate consideration in the development report, in addition to the utility of modern far-reaching communication tools such as the Internet. The availability of new tools for communication that may help in bridging the health and knowledge gap between the North and the South should be more emphasized. The "Information superhighway" or the Internet can play a major role by providing a platform for transfer and sharing of knowledge in both directions. In addition to looking outside in its venture to acquire knowledge, skills and expertise, the Arab world should take a deep look into itself. The way forward is to value what we already have on all aspects of development including health promotion and disease prevention from our civilization. At the same time to be opened for the science coming from other parts of the world. And finally to utilize the available state of the art technologies for bridging the gap including the Internet. Abdullatif Husseini, PhD, Coordinator of the Islamic Global health
Network (IGHNet).
Competing interests: None declared |
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