Palestine: the assault on health and other war crimes
BMJ 2004; 329 doi: https://doi.org/10.1136/bmj.329.7471.924 (Published 14 October 2004) Cite this as: BMJ 2004;329:924
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I write as an academic physician long associated with medical
organizations and medical journals. The recent article written by Dr.
Derek Summerfield does not reflect well on the usual high standards of the
British Medical Journal. His biased work might better be published in a
tabloid. The Journal states its mission: “to publish intellectually sound
material” and,”to publish rigorous accessible information that will help
doctors improve their practice” -- this article does not meet those
standards.
Dr. Summerfield, who I believe is a psychiatrist with an interest is
psychological trauma, is writing about current events and uses weak
scientific evidence, often anecdotes, as the foundation for his
conclusions – not the stuff of good science as promoted by BMJ. Each of
his allegations can be contested and could likely be refuted. Dr.
Summerfied, if so inclined, could study and write in the area of his
expertise. Two highly relevant psychological issues in the Middle East are
these: 1) the psychological impact on children growing up in a culture
that venerates suicide and murder and, 2) the psychological toll paid by
Israeli military personal in evacuating countrymen from their homes of
many years (Israel knew that the people could not have been left in Gaza
unprotected).
Competing interests:
None declared
Competing interests: No competing interests
Mr. Summerfield’s claims to have confirmed the allegations he made in
his earlier correspondence published in the BMJ are not credible and
further demonstrate his strong bias. In this and his others letters and
publications, he focuses entirely on the Palestinian view, ignoring the
complexity of the Arab-Israeli conflict, which has been generating
violence for over 75 years (since the 1920s). The place for this debate
is in political newspapers, and not in respected academic journals.
Indeed, before considering the credibility (or lack of such) in Mr.
Summerfield’s allegations, it is necessary to look at the full picture,
including the Palestinian terror attacks and suicide bombings that have
murdered over 1000 Israelis in the past five years. Universal human
rights norms lose all meaning when they are applied selectively and
exploited for ideological assaults. While the response of Israeli
security forces are properly subject to review, and, where warranted, also
criticism, the obsession with these responses to terror, while erasing the
cause, is immoral and misleading. A medical doctor whose diagnoses are
based on perceived and undocumented effects, without reference to the
source of the disease, would be barred from practising.
In the terms of the substance, Mr. Summerfield’s use of journalistic
accounts as a form of evidence or “proof” would be unacceptable in any
legitimate scientific publication. The reports written by journalists in
The Guardian and the compilations of similar accounts by Amnesty
International and other NGOs do not constitute credible sources, whether
in politics or in medicine. A former official of Amnesty International
has recently reported on the absence of an independent research capability
in this politicised NGO. [1] The claims regarding the number of
Palestinian casualties and their causes are not subject to independent
verification, and there are documented examples where fictitious funerals
have been held (and filmed from an airborne camera, showing the “cadaver”
getting up and running away).[2]
Thus, the credibility of the allegations and quotes in Mr.
Summerfield’s correspondence must be examined in this context, including
the Palestinian terror campaign, and the accompanying political assault
against Israel. In order to avoid contributing to immoral double-
standards and to the continuing conflict in this region, and to help
promote peace and mutual acceptance, such partisan political attacks must
end.
Prof. Gerald M. Steinberg
Director, Program on Conflict Management and Negotiation
Political Studies, Bar Ilan University,
Ramat Gan, Israel
References:
[1] Dr. Michael Ehrlich, "Amnesty International -- do your Homework,"
Jerusalem Post, June 2, 2005 (
http://www.jpost.com/servlet/Satellite?pagename=JPost/JP Article/Printer&cid=1117594048704&p=1006953079865
[2] CNN, “IDF: Tape shows Palestinians faked funeral: Erakat denies 'such
stunts' used to win public opinion” May 3, 2002 Posted: 8:15 PM EDT (0015
GMT) http://archives.cnn.com/2002/WORLD/meast/05/03/jenin.tape/
Competing interests:
None declared
Competing interests: No competing interests
Last October I published a review in the BMJ on the appalling human rights situation in the Israeli- occupied Palestinian Territories, providing detailed figures on civilian deaths (over 3000, including over 600 children, in only 4 years) which pointed unambiguously to a culture of impunity for Israeli Defence Force (IDF) soldiers. I also pointed to the rapid rise in poverty and destitution as a direct and foreseen consequence of Israeli policies, with documented rises in child malnutrition, the blocking of food aid distribution, denial of access to medical facilities (including for those critically ill), the killing, wounding and harrassment of Palestinian health professionals on duty, and the destruction to the coherence of the Palestinian health system as a result of the apartheid Wall- all violations of the Fourth Geneva Convention. I was not recording a personal view: I was quoting documentation from the United Nations; Amnesty International; international aid agencies like Medecins Sans Frontieres; Johns Hopkins (USA) and Al Quds (Jerusalem) Universities; the Israeli human rights organisations B’Tselem and Physicians for Human Rights; Health, Development, Information and Policy Institute (Ramallah), and the Palestinian Environmental NGOs Network (though these were not listed after the paper because the BMJ does not include references in this section of the journal). (1)
My paper attracted a mountain of support at bmj.com, with many correspondents adding personal testimony to the case. It also attracted a mountain of criticism, indeed vilification. Here the general tone was one of outrage and of almost unconditional refutation of the substance of the paper. Prominent Jewish organisations and spokespersons made hostile statements about the BMJ and declared the intention to make complaint formally. (2) Israeli mainstream newspapers published articles with titles like “BMJ refuses to apologise”. The BMJ felt obliged to quickly grant publication of a rebutting Personal View and later published a condemnatory letter from Yoram Blachar, longstanding president of the Israeli Medical Association and currently Chair of Council of the international watchdog on medical ethics, the World Medical Association. In his rapid response at bmj.com Dr Blachar wrote that “the lies and hatred in his piece are reminiscent of some of the worst forms of anti-semitic propaganda ever espoused.”
In the first paragraph of my paper I noted that two thirds of all Palestinian child fatalities had been caused by small arms fire (ie. directed fire from relatively close range), and that in fully half of these cases the bullet or bullets had hit the head or upper torso- the sniper’s wound.
I went on to write that “clearly, soldiers are routinely authorised to shoot to kill children in situations of minimal or no threat”. This sentence appeared to cause more offence than any other in the paper, yet this week it has been confirmed in emphatic fashion- the authority being Israeli soldiers who have committed these acts themselves. (3) It is being widely reported that a pressure group of former soldiers calling themselves “Breaking the Silence” want the Israeli public to face the realities of army actions in their name. They expose the cynicism and hollowness of the IDF mantra, which my critics have clearly taken at face value, that everything possible is done to minimise the risk to Palestinian civilians. These soldiers, who include the son of an Israeli general, say that they were ordered in briefings to shoot to kill unarmed civilians, including children, even in periods of calm when there was no threat to themselves or colleagues, and without fear of reprimand from superior officers. In some areas of the Occupied Territories soldiers operated under standing orders to this effect. One soldier Moshe said that even on his sergeant’s training course there was “pressure to get kills”, and ambushes were set up in Jenin in May 2003 to get them.
The ex-soldiers of “Breaking the Silence “ talk about being ordered to “fire at anything that moved”, and “every person you see on the street, kill him…..and we would just do it”. Briefings before operations included express instructions to shoot the first person who climbed on armoured personnel carriers as they lumbered through narrow streets, as children often did, though there was no military threat involved. They described a child of 12, later said to be 8, who climbed on and was shot dead by “one of our sharpshooters”. Moshe told the Guardian that the attitude was: “ so kids got killed. For a soldier it means nothing.” It does not seem he now believes that it means nothing.
A common theme in these testimonies, entirely in line with the conclusions of human rights observers over many years, is the desire to avenge Israeli casualties and inflict collective punishment on Palestinians as a people. After the deaths of 11 soldiers in operations in Gaza in May 2004, “the commanders said kill as many people as possible”. Rafi, an ex-officer in an elite unit, described Gaza at this time as “a playground for sharpshooters” (what my paper called snipers) licensed to use indiscriminate force. There were standing orders to shoot anyone who appeared to be touching the ground, or seen on a roof or balcony, whoever they were. Rafi alluded to the killing of the Moghayyer children, aged 16 and 13, in Gaza at this time as they collected washing and fed their pigeons on the roof of their home. The IDF initially tried to insist that they had been blown up by a roadside bomb, until journalists were shown the bodies in the morgue, each with a single bullet wound to the head. I mentioned this very case in my BMJ paper (I spelt their name as al-Mughayr), noting that Amnesty had called for an investigation into what the facts suggested was murder. Clearly many correspondents to bmj.com saw this as odious slander. What do they think now?
This is the climate of impunity I and others have been talking about. The Israeli human rights organisation B’Tselem notes that the IDF does not maintain printed rules of engagement and what rules exist are kept secret. The instincts of the IDF are to lie or obfuscate when embarrassing cases arise (which means those that come to foreign attention: Palestinian public opinion is irrelevant). One ex-soldier Avi describes how his company commander confiscated an incriminating video showing a soldier shooting dead out of the blue a Palestinian man unloading his car in the street below. So too now, for the IDF hierarchy is trying to neutralise “Breaking the Silence”. The chief military prosecutor has labelled their testimony as “exaggerated” and “hearsay”.
Nonetheless 17 separate investigations have had to be started.
These ex-soldiers are speaking from the heart; what they have revealed is of course not ‘news’ to those familiar with a situation that has prevailed for many years, not least during the first intifada (1988-93). The lives of Palestinian civilians, including their children, have never been regarded as worth much in relation to IDF imperatives and operations. The human rights history of these times, which includes the state sanctioned use of torture on what Amnesty described as an entirely institutionalised basis, has been exhaustively documented- some of it by myself. The question is why it has made so little difference. Those who posted up outraged responses to my paper last year were doubtless decent, perhaps liberal citizens in relation to any other issue of the day: they provide a telling lesson in the power of selective moral blindness. Will they cling to the ‘explanations’ of the IDF military prosecutor, or regard the ex-soldiers of “Breaking the Silence” as stooges or worse? I do hope not. Further, would any of them admit that they castigated the BMJ and its editorial team unfairly? Will the Jewish organisations and respresentatives who protested last year at what they saw as anti-semitic lies respond at bmj.com to “Breaking the Silence”?
Lastly, are there BMA members who are prepared to lobby for some clear-cut action to be taken as a member organisation of the World Medical Association in relation to the other facet of this dismal picture: the systemic and ongoing violations of the Fourth Geneva Convention? These have been going on under the noses of the Israeli Medical Association, whose silence in Israel has been as telling as the words of their President to the BMJ. This must say something worrying about the judgement and indeed moral probity of IMA and WMA when the case in hand is the Palestinian one, but if the International Committee of the BMA is concerned they are hiding it remarkably well. To date the responses I have elicited from the Committee (from Drs V. Nathanson and E. Borman) have been a case study in evasion. Why is this?
1 Summerfield D. Palestine: the assault on health and other war crimes BMJ 2004; 329: 924
2 BMJ Not Sorry
http://www.totallyjewish.com/news/stories/?disp_type=0&disp_story=noKuuM
by Alex Sholem - Oct 28 Quoted at: http://forum.mpacuk.org/archive/index.php/t-103.html
3 The Guardian. Israeli troops say they were given shoot-to-kill order. Israeli soldiers tell of indiscriminate killings by army and a culture of impunity. 6 Sept 2005.
www.guardian.co.uk/Israel/story/0,2763,1563531,00.html;
www.guardian.co.uk/Israel/story/0,2763,1563273,00.html.
Competing interests:
None declared
Competing interests: No competing interests
Last night, Friday the 25th of February, my beeper went off at
1120PM, indicating a bomb had exploded in Tel Aviv at a night club. It was
deja vu immediately: June 2001, same time, Friday, 500 meters away, dozens
of dead and scores of injured, and I was in the Emergency Department then.
When I reached my department after a 140 km/hr drive from my home 12 miles
away, I found the usual scene of organized pandemonium, dozens of staff
caring for the first victims. Three youngsters were being pronounced dead
on arrival, another one was being intubated and given bilateral chest
tubes.
At the same time, some 15 more casualties were being brought in, triaged,
assessed, treated. By 0030AM the ED was empty of severe casualties, a
debriefing with Emergency Medical Services scheduled for 0200AM and
surgical operations in progress.
This has been the 25th such mass casualty, terrorism-related event, that I
have had to manage in my own hospital. It is usually young people,
deliberately targeted while they are shopping, drinking in a cafe of
trying to spend a night away from the constant threat, only to run
directly into it.
So, you see, Dr Summerfield's righteous indignation at the checkpoints and
at the (real) hardship Palestinians suffer because of security
precautions, sounds slightly hollow to me and to many of my colleagues,
let alone to the families and friends of the thousands of Israeli victims
of the intifadah. He would have better served the Palestinian cause
(which, by the way I support in its purported aim of a two state solution,
not in the way it is taught in the Palestinian school system: a single
Palestinian state in place of Israel) if he really wanted to understand,
not to judge out of ignorance.
Competing interests:
None declared
Competing interests: No competing interests
Your contributor mentions that he has provided details of other
organisations whose documentation he included: foreign/international
organisations like Medecins Sans Frontieres, the Jewish American Medical
Project;local sources like the highly reputable Israeli human rights group
B'Tselem,and on the Palestinian side the Health, Development ,Information,
and Policy Institute, and the Palestinian Environmental NGOs Network.
Almost without exception each of the above agencies as he well knows
has an anti-Israel bias and agenda. For example Btselem press releases
used the term "Palestinian
civilians" to cover all Palestinian casualties excluding suicide bombers.
Then they changed it so that the word "civilians" was left out of the
description of the
Palestinians. Noam Hoffstater, B'Tselem Spokesperson, explained it is
B'Tselem's interpretation of international law that all Palestinians,
including members of both the illegal militias and the official
Palestinian armed forces, technically have "civilian" status since
there is no Palestinian armed force that qualifies under international law
to be an "army". So much for Summerfield's sources.
It is interesting to note that your contributor fails utterly to
mention even a single source which can be said to be in any way supportive
of Israel. He fails to acknowledge the contribution that Israeli medicine
has made to the Arabs under conditions of War, there being no distinction
or discrimination by Israeli medical staff in the treatment received by
Arab or Jew.
One therefore detects that this tendentious piece of Israel bashing
was no more than political posturing- as an attempt at serioius study it
is an abysmal failure and is unfortunately a blot on the BMJ's ethos.
Competing interests:
I am a Jew and an Israeli and believe my people have an inalienable right to self determination in the land of Israel - something which the contributor would deny.
Competing interests: No competing interests
I welcome Dr Blachar's contribution of 13 December in response to my
paper of 16 October. It gives readers an up to date clarification of the
medical ethical views not just of the longserving President of the Israeli
Medical Association (IMA), but also of the current Chair of Council of no
less than the World Medical Association (WMA). This is the body which
since 1947 has been charged with overseeing medical ethics
internationally, and with taking action against offending parties (as it
once did against the Medical Association of South Africa for their
complicity with excesses during the apartheid era).
My paper was substantially concerned to document the health
consequences for Palestinian society of current Israeli policies in re-
occupied Gaza and the West Bank,including systemic violations of the
Fourth Geneva Convention and other codes guaranteeing protection for
medical facilities, patients and medical professionals. In the text I
quoted international sources like the UN Committee for Human Rights,
Amnesty International, Johns Hopkins University USA. Regarding local
sources, I included a reference to the (unflattering) conclusions drawn by
Physicians for Human Rights Israel about the attitude of the IMA towards
medical ethical issues in the Occupied Palestinian Territories. The BMJ
does not print numbered listed references in this section of the journal
but in my rapid responses I have provided details of other organisations
whose documentation I included: foreign/international organisations like
Medecins Sans Frontieres, the Jewish American Medical Project;local
sources like the highly reputable Israeli human rights group B'Tselem,and
on the Palestinian side the Health, Development ,Information, and Policy
Institute, and the Palestinian Environmental NGOs Network. It should be
noted that Palestinian and Israeli sources are virtually the same in their
running accounts of the numbers of Palestinians killed, the numbers of
children etc.
Dr Blachar cannot but be familiar with the publications of such
bodies, and with local and global concern about the events I describe. His
response is nothing if not emphatic: it is to unconditionally dismiss the
data in my paper, which he refers to as "outright lies". We are to
understand that there are no substantive legitimate concerns regarding
health and medical ethics arising out of Israeli Government and Defence
Force policy and practice. We are to understand further that the Chair of
the WMA Council regards the publication of human rights material of this
kind in an international medical journal as "irresponsible and
professional".
And further still, he writes that this material is "reminiscent of
some of the worst forms of anti-Semitic propaganda ever espoused." The
worst forms of anti-Semitic propaganda ever espoused?? By this Dr Blachar
can only be pointing to the Nazi period. So what we have here is the Chair
of the WMA Council, no less,asserting that only someone with an anti-
Semitic and indeed Nazi mindset could document rocketed Palestinian
hospitals and clinics, medical staff fired on and killed or gravely
wounded on duty,patients dying because their ambulance is refused passage
to hospital past a military checkpoint, the distribution of food aid
impeded, the rise of malnutrition because of the Israeli assault on the
Palestinian economy and appropriation of land, large numbers of children
shot dead on their way to school, at school,in their homes, and much
besides.
I'm afraid that Dr Blachar condemns himself out of his own mouth. I
can see why Professor Noam Chomsky could tell me last year, whilst
deploring Dr Blachar's election to his WMA role,that the ethical track
record of the IMA demonstrated "utter moral degeneration".
Perhaps some readers are surprised at Dr Blachar's position but,
sadly, I am not.I and others- many of whom are Israeli- who have
campaigned for many years against torture as an instrument of state policy
in Israel, know that the IMA never once seriously challenged or denounced
the Israeli goverment over its use- despite a huge amount of authoritative
documentation in the public realm. To give just one reference, in 1996
Amnesty concluded that Israeli doctors working with the Security Services
"form part of a system in which detainees are tortured, ill-treated and
humiliated in ways that place prison medical practice in conflict with
medical ethics"(1). Indeed, in answer to a paper of mine in the Lancet, Dr
Blachar once justified the use of "moderate physical pressure", which was
the Israeli euphemism for torture and condemned as such by the UN
Committee on Torture (2). As I noted at the time,it is not often that the
president of a national medical association uses the pages of an
international medical journal to condone such practices. He also defended
the then IMA Head of Ethics (yes, Ethics!) Prof Eran Dolev when I reported
in the Journal of the Royal Society of Medicine in 2001 that Prof Dolev
had told a visiting human rights delegation that "a couple of broken
fingers" was a price worth paying for information during the interrogation
of Palestinian men.He accused me of slandering Prof Dolev and, as he does
now,of having an "agenda of hate" (3). The delegation, which was from the
London-based Medical Foundation for the Care of Torture,wrote in to the
Journal to confirm that this was indeed what Prof Dolev had said (4).
Dr Blachar's position at WMA enables him to snuff out any potentially
embarrassing questions about the assault on health in the Occupied
Territories; arguably that is why he is there. It is not the IMA but
Physicians for Human Rights Israel who represent the true principles of
humanitarian and ethically sound medical practice in that country.Some
respondents have mistakenly assumed that I was against Dr Blachar's
position at the WMA because he was an Israeli.That is ridiculous:I would
be proud to have someone from Physicians for Human Rights Israel (whom Dr
Blachar dismisses as "political"!) as Council Chair at the WMA.
Thus I asserted in the Lancet and BMJ last year that Dr Blachar was
grotesquely unfit to assume WMA Council Chairmanship, and why I questioned
the judgement of WMA Secretary General Delon for his unstinting support
for Blachar.(5)(6)In turn this raises questions about the public stance
and private calculations of the ethical arm of the British Medical
Association (BMA), a WMA member with clout,in refusing to recognise such
mockery and farce at the WMA. It is up to BMA members to make the BMA face
up to their responsibilities,and to exert the kind of pressure at the WMA
that could translate into greater protection for Palestinian medical staff
and facilities, and for their patients.This is what the WMA is for!
I would ask Dr Blachar to please give bmj.com his official view on
whether there have been breaches of the Fourth Geneva Convention on the
part of the Israeli Defence Force, and if so what he did about it.
Lastly,in several places in his rapid response Dr Blachar claims that I am
telling "lies". I challenge him,then,to provide evidence here that any
piece of data I included is indeed wrong,is a lie. Will you meet these
challenges, Dr Blachar?
1 Amnesty International. "Under constant medical supervision",
torture, ill-treatment and the health professions in Israel and the
Occupied territories. AI Index MDE 15/37/96. London 1996.
2 Blachar Y. The truth about Israeli medical ethics. Lancet 1997;
350:1247.
3 Blachar Y. Attitudes to torture.J Royal Soc Med 2001;94:658
4 Bamber H, Gordon E, Heilbronn R, Forrest D.Attitudes to Torture. J
Royal Soc Med 2002;95: 271
5 Summerfield D.What is the WMA for? The case of the Israeli Medical
Association. Lancet 2003;361: 424
6 Summerfield D. Medical ethics, the Israeli medical Association, and
the state of the World Medical Association. BMJ 2003;327: 561.
Competing interests:
None declared
Competing interests: No competing interests
Summerfield is spot on the mark when he anticipates that I will not
accept his further response to my request for a specific reference to his
specific allegation of conspiracy by the IDF. The best he can now offer
is the uncorroborated statement of an Israeli soldier accused of shooting
a civilian that he was acting on orders, dished up with Summerfield's
familiar diet of yet more unsubstantiated allegations.
Does Summerfield ever wonder what his vituperative diatribes against
Israel have contributed to the welfare of the Palestinians? His
contribution to the demonisation of Israel merely reinvigorates the cult
of victimisation and martyrdom that the Arab leaders have used for their
own political ends in denying their peoples democracy and a normal life.
At present Egypt is due to return her ambassador to Israel and
stronger trade ties between the two countries are planned. The handing
back of Gaza to Palestinan control is on course, the presumptive next
Palestinian president has admitted that the armed uprising since 2000 was
a mistake and support for Hamas among the Palestinians is falling.
Perhaps Summerfield would consider using his undoubted energy and verbal
skills for conciliation and assisting those who want peace and a fair
solution to this 56 year long problem. If he did he would certainly help
the Palestinians a good deal more than, in my opinion, he has done to
date.
Competing interests:
None declared
Competing interests: No competing interests
I have already responded in detail to Hoffbrand but fear that it will
not be possible to satisfy him. However it might be instructive to look at
the current Israeli army investigation into the widely reported killing of
British peace volunteer Tom Hurndall last year in Gaza, apparently while
trying to shelter some Palestinian children under fire. Firstly,an initial
army investigation cleared the soldier who fired the shots that killed
Hurndall,Idier Taysir,and the case was only re-opened under pressure from
the British Foreign Office. As I have recorded before, it is only when
there are public relational issues at stake that the Israeli army goes
through any form of investigation likely to do more than find a soldier
innocent of any wrongdoing. This is part of the climate of impunity I have
been recording.This is point number one.
Idier Tayser has now reportedly admitted that he lied when he
originally claimed that Hurndall was carrying a weapon, but said he was
under orders to open fire on even unarmed people. This is point number
two, which has been made in the past by such as the Israeli human rights
organisation B'Tselem, that soldiers and indeed the army hierachy
regularly resort to lies and obfuscation in justifying their actions.
Tayser said he had followed a general understanding, frequently
reiterated by more senior officers, that anyone entering a firing zone
must be shot, even if that person was unarmed.This connects with the more
recent case of the shooting of a 13 year old girl in Rafah (I have
discussed this case in previous rapid responses), reflecting an unwritten
policy of shooting unarmed civilians who enter whatever the Israeli army
deems a closed security zone (which very typically is in a densely
populated Palestinian residential area). This is point number three, that
the Israeli army (like many armies- look at the US army in Iraq) operates
not just to written codes of engagement but to unwritten ones too,
sanctioned and disseminated by senior officers. Will Hoffbrand please note
this.
Tayser went on to say "They tell us all the time to fire; there is
approval.All the troops (in Rafah) fire without approval at anyone who
crosses a red line". Here we have point number four,the official
legitimation and indeed encouragement of soldiers to use their firepower
in an indiscriminate way, with the inevitable harvest of civilian deaths-
not least children-to be regarded as irrelevant.
Competing interests:
None declared
Competing interests: No competing interests
Although Dr. Summerfield’s article in this month’s BMJ is entitled
“Palestine: the assault on health and other war crimes”, it appears that
the health issues he cites are merely an excuse for him to lambaste Israel
for assorted other “war crimes” as he perceives it, making one wonder why
and how such an article made its way to the BMJ. We were surprised to see
an article of this sort appear in a respected medical journal such as
this, and feel that this decision to publish it was irresponsible and
unprofessional.
Summerfield can try to excuse his repugnant behavior by claiming that
the “pro-Israel lobby uses the term “anti-Semitic” in a morally corrupt
way”’, but this does not alter the fact that the lies and hatred he spews
in his piece are reminiscent of some of the worst forms of anti-Semitic
propaganda ever espoused.
Issues such as the security fence are clear political issues, and
although I do not wish to enter a political discourse, suffice it to say
that what Dr. Summerfield terms a “grotesque barrier”, whose real purpose,
he asserts with complete confidence is to “permanently lock more than 50
illegal Israeli settlements into Israel proper” has proven its value
regarding its real purpose, which is to block the entry of terrorists and
reduce the number of terrorist attacks. I have no doubt that if one of Dr.
Summerfield’s loved ones would blow up into pieces as a result of a
suicide bomber who managed to infiltrate from an area in which the
“grotesque” barrier was not yet complete, he would understand and feel the
need for such a barrier.
In addition, many of the things that Dr. Summerfield cites are
presented in a complete vacuum, disconnected from reality. Israel is
required to defend its citizens daily from terrorist activity, an
obligation which in no way contradicts the reality in which Israel, on a
daily basis, provides medical care to Palestinian men, women and children.
Some statistics to consider:
According to a report of the Health Coordinator of the Civil
Administration for the West Bank (the full report is attached), in the
first half of 2004 alone, 19 Palestinian children with congenital defects
(cardiac or orthopedic), cancer or other ailments, received operations
overseas, and 206 (as opposed to 118 total last year) received treatment,
including operations, in Israeli hospitals such as Wolfson Hospital in
Holon, Sheba Hospital in Tel Aviv, Hadassah and Shaarei Zedek Hospitals in
Jerusalem, Rambam Hospital in Haifa, and Masqad and St. John’s Hospitals
in Jerusalem.
In addition, 800 ambulances passed over the Allenby bridge, 9900
patients got permits to receive medical care in Israel and an additional
9500 received permits for medical care in East Jerusalem. Total permits
for patients, visitors and accompanying persons to Israeli hospitals,
including those in East Jerusalem, totaled 19,679. One thousand special
permits were granted to the medical sector during a closure. 400 requests
by Palestinian companies for the import of raw materials, drugs, food etc.
were granted as were 400 approvals for passage of medical equipment,
medicines or oxygen to the West Bank.
Not only was the care offered, NIS 14,072,751 (approximately
3,127,278 USD) worth of debts of the Palestinian Authority to Israeli
hospitals were offset.
As regards the work of the Civil Administration:1000 delays of
patients and medical personnel at roadblocks during closures were
clarified, 300 inquiries of external bodies such as PHR, ICRC etc. were
responded to, 400 professional opinions were submitted to the Israeli GSS
(who based their security decisions in part on medical recommendations),
136 professional opinions were submitted in legal matters or on the matter
of visitor permits.
The conclusion that can be drawn is that Summerfield’s article is a
collection of outright lies, half-truths and certainly a one-sided view of
the situation and total disregard for the context and history of the
conflict.
With regard to Dr. Summerfield’s obsessive and repeated attacks on
the IMA and the WMA: I again state that the IMA has been far from silent
in the face of alleged health violations, but rather has consistently
forwarded such allegations to the army or the government for their
investigation and addressing of the issue. In more than one case, the
allegations have proved untrue, in some cases, remedial action was taken
and in several the army defended their actions. We have met, and continue
to meet with various Israeli, Palestinian and international
representatives to see how the situation might be improved. We have also
trained medical officers in the ethical complexities of such a volatile
situation, where their kindness and ethical stand might be abused.
However, neither the IMA nor the WMA is willing to take a political stand
on an issue, nor to give credence to the half truths and untruths spouted
by Dr. Summerfield, and unfortunately, published in an otherwise
respectable medical journal despite the clear political agenda and the
total lack of corroboration of any claim made.
Dr. Yoram Blachar
President, Israel Medical Association
Competing interests:
None declared
Competing interests: No competing interests
Author's further response
Professors Steinberg and Katz have written in response to my letter
in this week's BMJ (24 Sept), though have attached it to my 2004 paper
here. As I have written before, those who seek unconditionally to defend
the policies of the Israeli government and military are obliged to
maintain a highly selective moral blindness in the face of a mass of
documentation, scarcely rivalled anywhere,by both international and local
organisations(from which I draw), and which include the Israeli human
rights organisations Physicians for Human Rights and B'Tselem. This is
what Katz refers to as "weak scientific evidence." Steinberg regards as
"not credible" the world's most famous and authoritative human rights
organisation, Amnesty International, whose multiple publications bearing
out what I have documented over the years in the BMJ and The Lancet are
accessible at amnesty.org.
What would they and others say to the more than 300 Israeli ex-soldiers of "Breaking the Silence" whose testimony I pointed to. These men
have been compelled to speak out because, in their words,they "feel
corrupted" by what they have seen or been required to do whilst serving in
the Occupied Territories. Indeed they see it as a "patriotic duty" to do
this. They wish to open the eyes of fellow Israelis, and of supporters in
the Jewish diaspora. What would Katz and Steinberg say to them, and to the
BMJ, once they have read their
verbatim testimony? This can be found at
http://www.breakingthesilence.org.il/files_eng/rulesofengagementbooklet.doc
I await their response.
Competing interests:
None declared
Competing interests: No competing interests