Anumber of articles relating to the conflict between Israel and the Palestinians have appeared in medical journals recently. They all follow the same pattern, presenting uncorroborated statistics, condemning Israel for supposedly attacking Palestinian health services, and, most disconcerting of all, questioning Israel's basic right to exist.
Derek Summerfield's article (BMJ 2004;329: 924) is a sterling example of this genre. Space prohibits a detailed response to all his claims; I shall therefore limit my response to four specific points.
The first is his use of statistics. Summerfield ignores the fact that Israeli casualties are overwhelmingly civilian (www.ict.org.il/) and that many of the aggressors are on the payroll of the Palestinian Authority, which is heavily financed by the European Union (http://eufunding.org/accountability/NewFPCReport.html). Summerfield's selective application of numbers would not be acceptable in medical research, so why does he present them to BMJ readers?
Secondly, Summerfield states that Israeli “soldiers are routinely authorised to shoot to kill children.” He offers no proof for this. Indeed he cannot, because no such authorisation has been given. Israeli army procedure is in accordance with the Geneva Conventions, to which Israel is a signatory. One may note that Summerfield's Palestinian friends have never signed the Geneva Conventions.
Thirdly, having condemned Israeli troops, Summerfield omits the immorality of Palestinian military tactics. Militant groups regularly encourage children to act as human shields for snipers or Kassam rocket brigades—crimes under international law. The former Palestinian prime minister Abu Mazen was quoted in the Kuwaiti newspaper Alzaman on 20 June 2002 as saying: “At least 40 children in Rafah lost their arms from the throwing of Bangalore torpedoes [pipe bombs]. They received five shekels [about £0.60] in order to throw them.”
Fourthly, as Summerfield denounces Israel's health policies in Palestinian territories, he continues to mislead BMJ readers. The Oslo Accords awarded the Palestinian Authority full responsibility for all health matters in the West Bank and Gaza from 1994. Since then the Palestinians have benefited from approximately $10bn in international aid (http://eufunding.org/accountability/NewFPCReport.html). Yet not even one new hospital can be named. Where has the money gone, Dr Summerfield?
Summerfield hides the context of the conflict. The current stage of the conflict began in September 2000, when the Palestinians launched another intifada against Israel and released all terrorists from prisons, in direct violation of the Oslo Accords.
Summerfield and his ilk never mention that Israel is the sole democratic, pluralistic society in the Middle East. The Israeli government and national healthcare funds provide equal health services for all citizens—regardless of religious or ethnic background.
Figure 1.
Serving a largely Muslim Arab community: Hadassah Hospital in Jerusalem, seen here with New York mayor Michael Bloomberg and his mother at a naming ceremony in her honour
Credit: DAVID BLOOMBERG-POOL/GETTY IMAGES
Hospitals, too, are non-denominational. For example, although the staff at Hadassah Hospital in north Jerusalem are predominantly Jewish, the hospital provides excellent care to a largely Muslim Arab community (Annals of Internal Medicine 2004;140: 307-8).
For the past four years Israel has kept its healthcare system alive in the face of terrorism. And yet not only has Israel maintained the level of standard health care for its citizens, it has also initiated a number of out-reach programmes.
An example is called Saving Children. Started by the Peres Peace Centre, this programme enables hundreds of Palestinian children to receive free medical care, in particular cardiac surgery, from Israeli surgeons. A leading medical officer from the Sheba Hospital in Tel Aviv told me: “On many occasions a significant percentage of the patients in the paediatric intensive care unit are children from the Palestinian territories.”
The Malki Foundation is an example of an Israeli alternative healthcare service. Named after an Israeli teenager killed in a Jerusalem pizzeria by a Palestinian bomber, it provides paramedical services for children with special needs—both Arabs and Jews.
Since the Palestinians launched the current intifada against Israel, social and economic conditions in the region have deteriorated for all. The Jerusalem Post has reported that 18% of the Israeli population is living below the official poverty line; this figure includes Jews, Christians, and Muslims.
Palestinians living in areas controlled by the Palestinian Authority get medical services from the authority. WHO states that despite the conflict “up to 95% of Palestinians were still able to reach a health facility in 2002” (www.who.int/disasters/repo/10543.pdf). If Israel's antiterrorist barrier now hinders these approaches then Summerfield should demand an end to Palestinian terrorism. It is this inhumane terrorism and its apologists that cause social hardship, not Israel's moral duty to protect its citizens.
Unfortunately, the Palestinian Authority has not succeeded in building sufficient medical infrastructure to serve its populace, despite receiving, according to Nigel Roberts of the World Bank, “the highest per capita aid transfer in the history of foreign aid anywhere.” This includes approximately £450m ($830m; €650m) given by the United Kingdom since 1993.
Numerous instances have been documented of Palestinians misusing medical and health supplies. The Red Cross reprimanded the Palestinian Red Crescent Society for using ambulances to transport terrorists and weapons. Peter Hansen, head of the United Nations Relief and Works Agency for Palestine Refugees in the Near East, was quoted by Canada's public service broadcaster CBC as admitting that the agency employs members of Hamas, a recognised terrorist organisation (www.cbc.ca/story/world/national/2004/10/03/unwra041003.html).
Summerfield's misrepresentations are detrimental to the cause of peace. They merely undermine the distinguished reputations of journals such as the BMJ.
It is essential to remember that at Camp David in July 2000 the Palestinians rejected Israel's offer of 97% of the West Bank and Gaza. While this raises the question of how much land will ever satisfy them, this heinous mistake is the direct cause of the death and maiming of thousands of people of all religions. When Palestinian terrorism stops there will be less poverty and fewer inaccurate statistics for the Summerfields of this world to discharge.