What can cooperation between Israeli and Palestinian doctors achieve?

Dr Clarfield speaks of the situation for the people of Palestine
(both doctors and patients) as if there is the proverbial 'level playing
field'. It is easy to speak calmy as if all the problems are on the
Palestinian side, in a discussion where Dr Odeh at times exhibits
frustration, when you are a member of an occupying power.

The state of Israel makes life for people on the West Bank almost
intolerable at times and is using collective punishment to keep the people
of Gaza in a state of crushing poverty and lacking the most basic of
health care, clean water and shelter. Dr Clarfield speaks as if Dr Odeh is
being unreasonable in her request for freedom of movement.

I saw for myself the daily humiliation and difficulty faced by
doctors, medical students and other health workers in the West Bank as
they try to work to improve the health of the people. Lack fo access to
drugs was only one facet of it. Dr Clarfield gives one example of
individual cooperation to help a baby from Gaza who needed cardiac
surgery. The vast majority of patients be they women men or children are
not so fortunate. It is a lottery on the scale of which we have no
concept here. Has Dr Clarfield ever stood in a queue for hours at a
checkpoint (where people are treated worse than cattle) only to be turned
back because his paperwork is not quite correct? Or witnessed children
who cannot get treatment because their parents do not have papers?

Sadly his response to Dr Odeh at times come across as patronising;
and the old chestnut of 'the threat of terrorism' rolls out again in his
second response - when there is state terrorism on an unprecedented scale
against the people of Palestine and in particular the Gaza strip. If he
were to visit the West Bank he would see the inhuman effects that the
occupation and economic oppression. He would witness the effect of the
Wall on the physical psychological and social health and wellbeing
Palestinian people. Palestinians have to buy water and collect rainwater
(in rooftop butts which are destroyed by illegal settlers with bullets - I
saw this myself.) while Israel illegally occupies all the land that has
direct access to water and fills swimming pools and waters gardens with
water Palestinians crave to drink or feed their diminishing livestock
with.

Later in the piece Dr Clarfield states '1989 is a long time ago' and
'let us move on' when Dr Odeh mentions the polio outbreak in Al Khedera.
Considering how often the Holocaust is mentioned during Israel / Palestine
discussions and used as a reason to maintain Israel as a military state, a
nuclear power and relentless oppressor of its (rapidly diminishing in
size) neighbour, I would suggest he refrain from using that argument.
Tragedy is tragedy and the Holocaust led to the fourth Geneva Convention,
which is now being constantly and flagrantly flouted by Dr Clarfield's
government.

Sadly until the illegal occupation of Palestinian land is ended,
Palestinians will not see that there is scope for meaningful dialogue when
the dice is so loaded against them. The brave people of Physicans for
Human Rights Israel speak out at the many health issues facing
Palestinians, Bedouin and others both within Israel and in the occupied
territories, and are often vilified for doing so. I would recommend that
Dr Clarfield reads their reporst to acquaint himself with the issues more
clearly. He is doing some fantastic and admirable work, but at times
exhibits extreme naivety about the life for a Palestinian.

Competing interests:
visited Palestine and Israel with Physicians for Human Rights Israel in November 2010. Member of Palestine Solidarity Comapaign and actively involved in campaigns to end the occupation

I see that this Dialogue was first published on 25 June but I have
only just noticed it with the arrival of the current print edition today
(6 Aug). I commend the participants and the BMJ for the initiative and in
particular for the exemplary tone with which most of the exchange was
conducted.

However, although I appreciate Dr Clarfield's manifest commitment to
peace, justice and working across the borders, I was dismayed by some of
his responses to Dr Odeh's factually based statements.

Having spent 10 days with other clinicians on a study tour of West
Bank hospitals and other health facilities (e.g. mobile clinics run by
Physicians for Human Rights, Israel) I recognised everything that Dr Odeh
mentioned.

For example: "For Palestinians, frontiers begin just outside our
homes and are enforced by military checkpoints and other coercive means.
So it is not possible ... to equate between the occupiers and the
occupied. ... The occupation is preventing Palestinians from developing a
proper health system; the country is fragmented, resources are limited,
and people’s movement is restricted. ... Most doctors might be willing to
help, but the Israeli military authorities have a permit system that
places obstacles in the paths of babies and mothers wanting to travel."

I am sure that Dr Clarfield knows all this too, and no doubt much
better than me, but somehow he seems, if not quite to dismiss it, to sound
as if he doesn't accord it the significance it warrants. He responds to
Dr Odeh, "But I appeal to you to try to move on".

Perhaps I have misunderstood his position. But why the scare quotes
in the following? "You seem to see the main problems as how to cooperate
with doctors from the 'occupying' [sic] side and being forced to go
through the difficult and sometimes humiliating process of receiving
permission to cross from the territories to Israel."

*Sometimes* humiliating? I don't think 'sometimes' will do here. Dr
Clarfield also writes: "[A] fair reading of the history of this tortured
land will show that not all the blame can be found either with the
Palestinians or the Israelis. We have both missed opportunities for
peace".

Whilst in a basic sort of way, this statement is true enough, it
leaves out the details that would reveal its account as inadequate. As Dr
Odeh says, "To build trust, the initiatives should come from the Israeli
doctors, simply because they are the ones in power and not the
Palestinians". (I realise that Dr Clarfield is one of those -- still far
too few -- who are taking that initiative.)

When Dr Odeh writes, "Israeli doctors should realise that there is no
way that they will be accepted by the international medical community in
general, and the Arab medical community in particular, until the
Palestinian people get their rights to self determination, which starts
with ending the occupation. Israeli doctors will continue to be isolated,
and it’s their choice", Dr Clarfield responds with, "[T]hese are strong
words, and I too from my side could use the same but, in the interests of
our dialogue, I will forgo such a response".

But Dr Odeh's words are unexceptionable, and compared to a good deal
of the overblown polemics we read and hear in relation to this conflict,
they constitute a model of restraint.

(I want to declare here that after a great deal of thought, and
having read vast quantities of the literature pro and con, I do not
support the academic and cultural boycott of Israel, and that includes the
so-called medical boycott. In agreeing with much of what Dr Odeh says, I
don't want to be misunderstood as approving of isolating Israeli doctors.
I'm not sure that Dr Odeh herself does, although I don't know.)

Finally, I am at a loss to understand why Dr Clarfield writes: "I
and many other physicians found that particular Lancet series [
http://bit.ly/9djdc5 ] highly politicised and biased. The editor, Richard
Horton, is clearly one sided in his support for the Palestinian position
and unalloyed hostility to Israeli medicine. This stance is, of course,
his right, but for dialogue to take place, it would be better to find a
more honest broker, one more acceptable to both sides".

I do find this astonishing. We all know that there are productive
ways, and unproductive ways, of writing and speaking about this conflict.
There are, unfortunately, ways that make the charge of antisemitism wholly
appropriate (and not an attempt at closing down dialogue), conversely
there are ways of attempting to defend Israel that are little more than
mendacious apologetics, there is the kind of rhetoric that makes of Israel
some sort of epicentre of evil from which the world can be cleansed only
by its total elimination, and there is sadly a language that can be heard
from some Israelis dripping with anti-Arab racism.

I read those Lancet articles when they came out and I also happen to
know that every possible care was taken to avoid polemics -- they were
pored over again and again to ensure sober, evidential facticity. Dr
Horton is well able to defend himself, but I see nothing 'hostile' or 'one
-sided' about him except that he is one-sidedly hostile to discrimination,
inequality, poverty, racism, ethnic cleansing -- and the medical suffering
resulting from the unjust Israeli occupation.

I would like to close by again thanking the BMJ for this initiative.
The Dialogue might have exposed some of the difficulties, but it -- and
ventures like it -- are the way forward.

Competing interests:
Signatory, Statement, Jews for Justice for Palestinians; Founder member UK branch of Israeli Committee Against House Demolitions; supporter, Physicians for Human Rights, Israel

I read the article with great anticipation as I have seen medicine
act as a humanistic and therapeutic bridge between peoples who have
experienced conflicts and then with great disappointment as Dr. Odeh kept
referring to the political conflict as an impermeable barrier to future
cooperation between doctors on both sides of the divide. There are many
physicians of good will in Israel and abroad who would love to facilitate
medical interactions, exchange and the sharing of knowledge and ideas - as
I am willing to wager exist also within the Palestinian medical community.

Conflict and its associated political ramifications have plagued the
human species from time immemorial - yet somehow with time even long-
standing conflicts usually find a way of resolving. In the meanwhile
physicians can bring about individual and group benefits to suffering
individuals while the slow process of political resolution takes places.
It takes the courage of belief in humanity to make such attempts - the
kind of courage that often exits amongst physicians. I believe Dr.
Clarfield expressed such courage and I would hope that Dr. Odeh can find
it in herself and among her colleagues to seek avenues despite the current
political situation to help those patients that she can and expand
contacts with the many Israeli physicians who would welcome such
iniatives.

Competing interests:
None declared