Ambulances and the Geneva Convention: what is the evidence base?
For Dr Bradley to dismiss as “political agenda and bias” the mass of independent documentation supporting our charge of systematic and unchallenged violations of medical ethics in the Occupied Palestinian Territories is hardly in the spirit of evidence-based medicine. However, I will restrict my challenge to just one point, which is his claim that Palestinian suicide bombers hide in ambulances. This assertion- whether regarding suicide bombers or, more typically, armaments or explosives- is part of the mantra of arguments regularly made by correspondents at bmj.com in defence of Israeli behaviour towards medical facilities and personnel.
One such group who went to the trouble to examine the evidence was the Jewish American Medical Project. In 2004 Professor Alan Meyers of that group (since re-named) sent me their findings, which were of one documented incident only – in 2002 an explosive belt was found in an ambulance transporting a Palestinian child needing care. They noted that even this was a contested incident (1). They could find no evidence for any other such Geneva Convention transgressions, and indeed cited a broadranging review in the Jerusalem Post (not a newspaper customarily friendly to the Palestinian cause) which concluded similarly. (2)
Ironically, there were a number of reports in 2005 about the use by the Israeli Army of ambulances to move troops and weapons into operations against Palestine, including interviews with several reserve soldiers whose faces were blacked out to protect their identity. In one report Dr Rafi Waldman of Doctors for Human Rights was quoted as expressing his unease at this practice (3). One such account long since in the public domain (and undenied) was of the use of an ambulance to covertly transport Israeli soldiers in the operation that led to the capture of the political leader, Marwan Barghouti.
In a widely publicised event in October 2004, Israeli authorities showed footage of what they alleged were Palestinian militants loading a rocket launcher onto a UN ambulance. The UN responded with robust denials, eventually obliging the authorities to concede that the ambulance had been loading stretchers.
On several occasions I have challenged UK doctors who have made the same claim as Dr Bradley in the BMJ, asking them to cite their references. One or two responded, quoting the website of the Israeli Foreign Ministry – scarcely an independent source! So, BMJ readers can choose: on the one hand we have the Israeli Foreign Ministry, on the other international and regional human rights organisations.
As our collective letter (with UK medical signatories now near 150) makes clear, the Israeli Medical Association (IMA) has maintained a studied silence on the regular attacks on clearly marked Palestinian Red Crescent ambulances (hundreds of cases), and the unwarranted delays at army checkpoints, regardless of the nearness to death of the patients inside or of security conditions in the area (thousands of cases of such delay). Principled protest has been left to others, like the Israeli physicians of Physicians for Human Rights- whose letters to the IMA are not even answered- or the Red Cross (4) (5).
(2) Derfner L. Bad medicine, bad war. Jerusalem Post, 8 Nov 2002, p6
(3) The Australian News, 30 March 2005.
(4) Phr.org.il
(5) International Committee of Red Cross. ICRC deplores increasing number of civilian casualties and lack of respect for medical mission. Press Release 06/93. 12 August 2006.
Competing interests:
None declared
Competing interests:
No competing interests
14 May 2007
derek a summerfield
consultant psychiatrist/honorary senior lecturer
South London & Maudsley NHS Trust/Institute of Psychiatry
Rapid Response:
Ambulances and the Geneva Convention: what is the evidence base?
For Dr Bradley to dismiss as “political agenda and bias” the mass of independent documentation supporting our charge of systematic and unchallenged violations of medical ethics in the Occupied Palestinian Territories is hardly in the spirit of evidence-based medicine. However, I will restrict my challenge to just one point, which is his claim that Palestinian suicide bombers hide in ambulances. This assertion- whether regarding suicide bombers or, more typically, armaments or explosives- is part of the mantra of arguments regularly made by correspondents at bmj.com in defence of Israeli behaviour towards medical facilities and personnel.
One such group who went to the trouble to examine the evidence was the Jewish American Medical Project. In 2004 Professor Alan Meyers of that group (since re-named) sent me their findings, which were of one documented incident only – in 2002 an explosive belt was found in an ambulance transporting a Palestinian child needing care. They noted that even this was a contested incident (1). They could find no evidence for any other such Geneva Convention transgressions, and indeed cited a broadranging review in the Jerusalem Post (not a newspaper customarily friendly to the Palestinian cause) which concluded similarly. (2)
Ironically, there were a number of reports in 2005 about the use by the Israeli Army of ambulances to move troops and weapons into operations against Palestine, including interviews with several reserve soldiers whose faces were blacked out to protect their identity. In one report Dr Rafi Waldman of Doctors for Human Rights was quoted as expressing his unease at this practice (3). One such account long since in the public domain (and undenied) was of the use of an ambulance to covertly transport Israeli soldiers in the operation that led to the capture of the political leader, Marwan Barghouti.
In a widely publicised event in October 2004, Israeli authorities showed footage of what they alleged were Palestinian militants loading a rocket launcher onto a UN ambulance. The UN responded with robust denials, eventually obliging the authorities to concede that the ambulance had been loading stretchers.
On several occasions I have challenged UK doctors who have made the same claim as Dr Bradley in the BMJ, asking them to cite their references. One or two responded, quoting the website of the Israeli Foreign Ministry – scarcely an independent source! So, BMJ readers can choose: on the one hand we have the Israeli Foreign Ministry, on the other international and regional human rights organisations.
As our collective letter (with UK medical signatories now near 150) makes clear, the Israeli Medical Association (IMA) has maintained a studied silence on the regular attacks on clearly marked Palestinian Red Crescent ambulances (hundreds of cases), and the unwarranted delays at army checkpoints, regardless of the nearness to death of the patients inside or of security conditions in the area (thousands of cases of such delay). Principled protest has been left to others, like the Israeli physicians of Physicians for Human Rights- whose letters to the IMA are not even answered- or the Red Cross (4) (5).
(1) JVPHealthand HumanRightsProject@googlegroups.com
(2) Derfner L. Bad medicine, bad war. Jerusalem Post, 8 Nov 2002, p6
(3) The Australian News, 30 March 2005.
(4) Phr.org.il
(5) International Committee of Red Cross. ICRC deplores increasing number of civilian casualties and lack of respect for medical mission. Press Release 06/93. 12 August 2006.
Competing interests:
None declared
Competing interests: No competing interests