Intended for healthcare professionals

Rapid response to:


Israeli forces are accused of wide ranging human rights violations in Gaza last summer

BMJ 2015; 350 doi: (Published 02 February 2015) Cite this as: BMJ 2015;350:h593

Rapid Response:

Owen Dyer’s news story deals with a report based on interviews by a group of activist physicians. The report accuses Israel of insufficiently protecting Palestinian civilians during the most recent war in Gaza. Here is what the real experts on the topic have had to say.

Colonel (ret.) Richard Kemp was Commander of British Forces in Afghanistan in 2003, and headed the international terrorism team at the Joint Intelligence Committee of the British Prime Minister’s office. He used Al Jazeera’s casualty figures rather than Hamas’ Ministry of Health statistics, which were shown to be biased (1), and found that the majority of casualties were Palestinian combatants and not civilians. He explained that the ratio of non-combatant casualties to civilian casualties was in fact low due to the Israeli army’s “comprehensive and sophisticated measures to minimize civilian casualties during attacks against legitimate military targets” (2). In a later report, he explained that recent NATO actions in Afghanistan and Iraq had significantly higher civilian casualties per combatant casualty (3:1) than the ratio in Gaza (1:1). This means that in recent NATO actions, there were usually 3 civilian casualties for each combatant casualty, whereas in Gaza there was 1 civilian casualty for every 3 combatant casualty, considerably less (3).

A second expert opinion is from General Dempsey, the highest ranking American military officer, who announced that Israel went to “extraordinary lengths” to limit civilian casualties in the recent Gaza war, and the Pentagon had sent a team to learn from the Israeli armed forces (4).

The Israeli armed forces worked hard to protect Palestinian civilians during this military campaign, in spite of the fact that it was launched in response to thousands of missile attacks on all parts of Israel, purposely targeting Israeli civilians. The Israeli army, fighting a terrorist entity that embedded its weapons and combatants in and near homes, hospitals, schools, and mosques, devised new ways to warn civilians to vacate these military targets.

In a July 9th interview on Palestinian television, the Palestinian representative to the UN, Ambassador Ibrahim Khraishi ,made the following remarkably honest comments: “The missiles that are now being launched against Israel, each and every missile constitutes a crime against humanity, whether it hits or misses, because it is directed at civilian targets….Please note that many of our people in Gaza appeared on TV and said that the Israelis warned them to evacuate their homes before the bombardment. In such a case, if someone is killed, the law considers it a mistake rather than an intentional killing because [the Israelis] followed the legal procedures. As for the missiles launched from our side, we never warn anyone about where these missiles are about to fall or about the operations we carry out. Therefore, people should know more before they talk emotionally about appealing to the ICC.” (5).

Sadly, as in the case of Al_Aqsa hospital, an attack on a nearby weapons cache resulted in four casualties (6). This was clearly an error, because no warning had been given. In the case of Wafa hospital, as described in a previous report by Mr. Dyer, the Israeli army held their fire until patients were evacuated, because the hospital staff and activists insisted on keeping the patients inside. Also in that previous report, Mr. Dyer explained that Al-Shifa hospital, where the director complained that Israeli intelligence asked him to warn his family rather than calling them directly, “is a notorious haunt of Hamas leaders” (7).

The physicians’ report mentions the field hospital that Israel erected on the border with Gaza to treat injured Palestinian civilians. They note that some patients refused treatment there, and others were offered referral to other Israeli hospitals. They report a decline in patients treated in Israeli hospitals at that time, however, due to Hamas policy.

From Mr. Dyer’s article, one must deduce the following: Despite all its efforts, the Israeli army cannot save the Palestinian people from its own leadership and the activists who support it.


1. Reuben A. Caution needed with Gaza casualty figures. BBC News Middle East: 11 Aug. 2014 Accessed Dec. 8, 2014 at

2. Kemp R. Gaza's Civilian Casualties: The Truth Is Very Different. The Gatestone Institute 2014: Accessed Dec. 8, 2014 at

3. Kemp R. The Gaza war in 5 minutes: Richard Kemp explains what the media didn’t report. CiF Watch 2014. Accessed Dec. 8, 2014 at

4. Alexander D. Israel tried to limit civilian casualties in Gaza: U.S. military chief. Reuters Nov. 6, 2014: Accessed Dec. 8, 2014 at

5. (2). UN Watch, July 13, 2014. Palestinian UN rep: “Each and every missile launched against Israel constitutes a crime against humanity.”. Retrieved July 30, 2014

6. Aljazeera News, 21 July 2014. Deaths as Israeli tanks shell Gaza hospital. Retrieved February 8, 2015

7. Dyer, O. Israeli forces attack medical facilities in Gaza and destroy brand new hospital. BMJ 2014;349:g4865 doi: 10.1136/bmj.g4865 (Published 28 July 2014). Retrieved February 8, 2015

Competing interests: No competing interests

09 February 2015
Janice Halpern
University of Toronto
Toronto,, ON,M5S 2J7, Canada