We are both doctors: an Israeli doctor writes to a Palestinian colleague
BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g5023 (Published 13 August 2014) Cite this as: BMJ 2014;349:g5023
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Dear Dr Clarfield,
I read with a feeling of hope and admiration, your extraordinarily honest and heartfelt letter to your imagined Palestinian colleague. With such sentiments, combined with the ethos of our profession, room for genuine communication in a safe space becomes possible . It behoves all of us who care about the situation to respond in kind, without the easy partisan clichés.
As a non Jew, I have always been impressed with the Jewish idea of Tikkun Olam ( Repairing the world) . It seems to be to be a perfect motto for physicians also. To live peacefully with each other and take power from the extremists , we must begin by knowing the facts , All the facts and especially to see the narrative of the other, even when we disagree. Anyone who has lived in the Middle East sees the extremists as the writer Clare Hajaj so perfectly described them
“These are two very bunkerized societies and they can’t see each other’s narratives at all,” she says. “The narratives are incredibly similar and they run on these parallel tracks and both of them tell the same stories with the same degree of emotion. The stories have the same themes - and yet they absolutely cannot see it."
... It reminded me more and more powerfully how incredibly hard it is, when people take an arbitrary starting-point for their own story, how hard it is for them to look beyond the narrative they spin themselves."...
“You realize that these are webs that can almost never be untangled because people choose an arbitrary starting-point and they stick to it like glue and refuse to move, because it’s part of what their core identity is built out of."
As physicians who care, we must not make that mistake, but reach out to each other, across whatever divides us, to help and facilitate each others work, irrespective of politics. In my own work in the Third World, I have learnt that providing medical services across conflict situations often provides unique advantages – we are afforded a kind of neutrality . Whatever the politics, people need medical help . The Israel-Palestine situation, especially with the newly announced cessation of violence is a perfect opportunity to make a start.
Thank you for your enlightening article and the generosity of spirit reflected in it. It gives me hope and allows me to dream about what might be possible.
Sincerely
P Joyce
Competing interests: No competing interests
To blame Hamas for the current massacres in Gaza at the hands of the IDF is like blaming the Polish Jewish resistance during the Warsaw Ghetto uprising for the mass murders in Treblinka. I'm no Hamas supporter and I'm no supporter of terror or fighting in any way. Hamas was formed in the late 1980s, yes they are a militant organisation and yes I disagree wholly with large portions of their charter. However, the real terrorising has come from over 60yrs of massacre, land theft and a systematic apartheid by an Israeli agenda that started with a Jewish mandate but now has very little of the great and good Judaic teachings left in it. Is it fair to fight terror with terror? Who is really defending themselves? If I was stuck in a ghetto and thousands of my kin were being starved, dehumanised and slowly exterminated. I know what I would be doing with what little resource I could find. I'd do exactly what Zydowska Organizacja Bojawa did in the Warsaw ghetto all those years ago. I salute those brave individuals and feel pity on them as they must turn in their graves witnessing what their brethren and some of their offspring do in the name of their atrocious torment. Never again should mean never again to anyone by anyone.
Competing interests: No competing interests
As a Muslim Canadian of Pakistani descent who studied medicine at Ben-Gurion University in Israel, I read both an Israeli and Palestinian physician's plea to each other with a unique mixture of both hope and despair. Perhaps most poignant to me was when both doctors mentioned their children. Dr. Abuelaish evoked the gaping void in the world left by the killing of his three daughters, and Dr. Clarfield speaks of his "baby" son, serving in the Israeli military.
Working in Canada as a child and adolescent psychiatrist, I know of the ravages of trauma on the mind and body. I also know of the need to come to terms with the most tragic memories and the importance of gradual exposure and radical acceptance.
We physicians know the importance of valuing human life and fighting against hatred and dehumanization. We physicians know that whether we place our stethoscopes to the chest of an Israeli or a Palestinian we will hear two hearts that sound exactly the same
Living and working in Israel and Palestine helped me to learn that medicine has a unique ability to transcend borders and disciplines and bring people together for the greater good.
I ask my fellow doctors, what will we do so that no Israeli or Palestinian doctor or father needs to fear the impending loss of their child? How can we bring both Dr. Abuelaish and Dr. Clarfield and their fellow people together to embrace each others' existence and walk towards a peaceful future?
Competing interests: No competing interests
Re: We are both doctors: an Israeli doctor writes to a Palestinian colleague
The BMJ is to be commended in inviting an Israeli (1) and a Palestinian(2) doctor to initiate a dialogue on the role of medicine in addressing intractable conflict. Any form of violence is an affront to life, health and wellbeing, and from the WHO definition violence includes threatened or actual use of force against “… another person, or against a group or community, which either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment, or deprivation” (3) thus surely including planned armed conflict.
What is disappointing overall is the limited and partially negative response. Negative forensic analysis of peace-promoting hopes or plans is known to be a negative and entrenching process, setting back rather than promoting the desired peace. What is needed, as demonstrated from South Africa to Ireland, is for leaders and key stakeholders to concentrate on vision and forward progress, not blame-seeking analysis of the past.
Sadly, the health sector is almost always reluctant to engage innovatively and authoritatively in addressing clear non-clinical threats to public health, including life-reducing hazards of unduly processed food, irresponsible driving, and alcohol abuse. Surely in the pursuit of health there should be no hesitation in contributing actively to finding solutions to health threats, extending far beyond immediate casualties, and instead including large-scale public health interventions (4,5,6).
The particular scientific approach that the health sector can bring is identifying evidence and turning this into evidence-based campaigns, including promoting evidence-based policy. This applies no less in looking at inter-state and inter-population conflict. As with all population health campaigns, action needs to span from leaders to individual behaviour, in this case to reject violence rather than out-fight the other party, and to include values and knowledge as precursors to action. Ironically, most conflicts claim a faith base, and all faiths genuinely adopted eschew violence.
There are a number of potential lines of enquiry suitable for an investigative public health approach into engrained violence. For instance, the constitution of the Irish Republic from foundation in 1937 until a referendum in 1998 following the Good Friday agreement, laid claim to be the true government of the whole island of Ireland and thus indicated that the UK presence as the government of Northern Ireland’s six counties was illegitimate colonialism, yet this did not lead to all out confrontation between the two countries. The Irish Republican Army (IRA) undertook random bombings in England which killed and injured innocent civilians but there was not mass recrimination – indeed, the father of one murdered child became a peace campaigner so as to understand and address the cause of such hatred (7). The IRA targeted and nearly killed not only the British Prime Minister Margaret Thatcher but many of her Cabinet through the Brighton bombing (8), but there was no reprisal by destroying residential areas where the organisers might have lived, or annexing territory as a punishment. In South Africa, parts of the Balkans, Malaysia and elsewhere previously conflicting groups have learned to promote mutual understanding and peace.
So what are the attitudinal and behavioural factors that enable a response though peaceful camping in one location while elsewhere violence and destruction ensue? This indeed should be the subject of behavioural research to enable promotion of public health. South Africa and Bishop Desmond Tutu have shown the power for human wellbeing of Truth and Reconciliation (9). Civil society in Northern Ireland triggered several peace initiatives and led to two quite separate Nobel Peace Prizes.
This comes back to the important role of the BMJ in opening up the issues. There are advocates of peace and mutual understanding in both Israel and Palestine, but they are far less reported than official and adversarial views. Ironically, Abuelaish’s daughters were active in a joint Israeli-Palestinian youth movement for peace and the eldest one visited the USA to campaign for peace (10) before her death by shelling of their home – the video the group made is still on line (11).
Surely it is beholden on the health community to advocate for peace-promoting actions and behaviour in conflict areas such as Palestine and Israel, based on evidence produced by research, as much as it should be to advocate addressing industry-induced avoidable mortality and morbidity caused by sugar enriched foods or tobacco use. Each addresses avoidable deaths, and in each area society, including the health sector, is complicit by its inaction.
Would it be possible to hope that this BMJ initiative could bring the strength of modern public health to consider violence of any kind as a public health threat to which its powers could be applied, scientifically and impartially, in the cause of saving lives? Surely medicine cannot discriminate in the types of death and injury it seeks to prevent. And the BMJ could be the impartial channel of reporting facts, and encouraging otherwise hidden initiatives.
1. Clarfield M. We are both doctors: an Israeli doctor writes to a Palestinian colleague; BMJ 2014;349:g5023
2. Abuelaish I. We are both doctors: a Palestinian doctor writes to an Israeli colleague; BMJ 2014;349:g5106
3. http://www.who.int/topics/violence/en/ (accessed 5 September 2014).
4. Roberts H. Intervening in communities: challenges for public health; J Epidemiol Community Health. Sep 2004; 58(9): 729–730.
5. Lyons RA, Ford DV, Moore L, Rodgers SE. Use of data linkage to measure the population health effect of non-health-care interventions; Lancet, 383, 9927,1517 – 1519.
6. Institute of Medicine. For the Public's Health: Investing in a Healthier Future, IOM, Washington, 2012.
7. http://www.foundation4peace.org/who-we-are/ (accessed 5 September 2014)
8. http://en.wikipedia.org/wiki/Brighton_hotel_bombing (accessed 5 September 2014)
9. http://www.justice.gov.za/trc/ (accessed 5 September 2014)
10. http://web.archive.org/web/20110124122410/http://www.daughtersforlife.co... (click "Bessan") (accessed 5 September 2014)
11. https://www.youtube.com/watch?v=8bgQ5uqubxk (accessed 5 September 2014).
Competing interests: No competing interests