The Social Medicine Portal

Out of sight and mind, but the destitution continues: Update on the state of public health in Gaza

Posted by Claudia Chaufan

It may be that the corporate media does not talk about Gaza anymore, in the hope that reality goes away. And because it is not talked about, it feels as if, well, the war is over.  Whether or not this is true is a matter of debate, but the effects of the 22 days of the invasion are not. At least according to an Israeli group Physicians for Human Rights-Israel, which has recently published the results of a fact-finding mission conducted by a team of medical experts. For a summary see below. For an abbreviated, 25-page version of the full report click here.

When reading the report, it is at hard to find the claims of the IDF credible, that they did “everything to avoid civilian casualties”. Indeed, it is hard even to find the words to describe the destruction the invasion left behind.

In the meantime, Gaza’s economy is in shambles. Amy Goodman reports that “unemployment and poverty rates are among the highest in the world” and that “despite international pledges of over $5.2 billion to rebuild Gaza, in the four months since Israel’s assault the siege has not been lifted and only one truck carrying cement and other construction materials has been allowed entry into the Gaza Strip”.

And the Israeli newspaper Haaretz informs that John Ging, head of the UN Relief and Works Agency in Gaza, declared that the amount of goods Israel permits even today into the territory, where some 1.5 million people live, is “wholly and totally inadequate” and that “the United Nations aid official in the Gaza Strip urged Israel on Friday to ease restrictions on the flow of goods into the conflict-torn territory, saying they were “devastating” for the people”. Yet Israeli security forces claim that restrictions cannot be eased because Hamas can use whatever materials it gets to build rockets. Including pasta. Yep, pasta, which accroding to Haaretz and even other mainstream media until last month was not allowed into the Strip, until an international outcry eased its entry.

Finally, writer and film maker Philip Risk points out that while over 1400 were killed during the invasion, “Gaza wears a face of misery” on a regular basis, and “Gazans die because of all sorts of causes that we don’t hear sufficiently about in the media. The sewage system is horrible, water is polluted and diseases are becoming an increasing phenomenon in Gaza. Hospitals can’t cope because they face electricity shortages; a lot of Palestinians are in desperate need of kidney dialysis, the kinds of diseases that are out there are getting worse, it’s simply not a livable space”.

Fact-finding mission into medically-related violations in the Gaza Strip during 27.12.08-18.01.09

In their report, the experts detail 44 testimonies by civilians who came under attack and by medical staff who were prevented from evacuating the wounded. The report provides first-hand evidence regarding the broader effects of the attacks on a civilian population that was already vulnerable on the eve of the offensive.

The experts collected samples of human tissue earth, water, grass and mud suspected to be contaminated by unidentified chemicals. These were sent by the team to laboratories in the UK and South Africa for analysis.

During the military operation in January, Physicians for Human Rights-Israel called for an external independent investigation into the events, for the rehabilitation of the Gaza Strip and for the opening of the Crossings.

Five independent experts in the fields of forensic medicine, burns, medical response to crises and public health, from Germany, Denmark, South Africa and Spain, immediately answered the call and traveled to Gaza between 29 January and 5 February 2009 for their first fact-finding investigation, and then to hospitals in Egypt, where some of the most seriously wounded were being treated.

The medical experts are: Professor Jorgen Thomsen from Denmark, expert in Forensic pathology; Dr. Ralf Syring from Germany, an expert in Public Health in crisis regions; Professor Shabbir Ahmed Wadee from South Africa, an expert in Forensic pathology; Professor Sebastian Van As from South Africa, an expert in Trauma surgery   and Ms. Alicia Vacas Moro from Spain, an expert in International health.

From the conclusion of the report:

“…Besides the large-scale, largely impersonal destruction that the team witnessed and heard of, it was especially distressing to hear of individual cases in which soldiers had been within seeing, hearing and speaking distance of their victims for significant stretches of time, but despite the opportunity for ‘humanisation’, had denied wounded people access to lifesaving medical care, or even shot at civilians at short range…”
One of the testimonies in the report describes the aftermath of an attack. Muhammad Saad Abu Halima had lost two brothers and a young sister; his wife and daughter were wounded. He told the delegation his experience of evacuation:

“…We were going down the street Kamal Adwan, and we had almost reached the school when the soldiers halted us. A tank appeared on the street and stopped close to the school. The soldiers were occupying the second floor of a building which was only 20 meters away from the street. They could see that we were all wounded and dirty from the explosions, because the tractor was open at the back. They shot at us, killing my cousins Matar Saad Abu Halima and Muhammad Hikma Abu Halima, who were driving us to the hospital. The soldiers ordered us to get out of the tractor, and they asked me to take off my clothes. I did it and they checked all my body. I think they were looking for explosives, but we were all injured and in pitiful conditions. How could we think of carrying explosives when my younger siblings and my own children were dying? Then, when I was almost expecting death, they shouted at me: “you can get dressed and go”. They did not allow us to use the tractor.
I held my sister Shahed in my arms … but the soldiers said that the baby was already dead, so they forced me to leave her in the car. I tried to help my wife Ghada, who was completely burned, and they forced us to walk to the hospital. For about 300 meters the soldiers were shooting at our feet as we walked, raising so much dust that the wounds of my wife became full of dirt. After a while we saw a lorry on the road. It was overcrowded with people going to the hospital after the heavy attacks, but they made us room and we arrived at Shifa’ Hospital….”

Another testimony in the report tells the story of the Abed Rabbo family. Souad Abed Rabbo, 54, told the team that the soldiers called to the family to exit their house. She, her daughter-in-law and her three granddaughters exited the house holding white flags:

“Outside the house there was an Israeli tank. It had come from the west towards the house that was facing north. It was 11.30 – 12.00. The tank was in the garden about ten meters from her, when she stopped to receive permission to leave unharmed. On her right side were the three girls; behind her was the daughter in law close to the door of the house. The soldier on the tank never replied. They were looking into each others´ eyes for 7-10 minutes, when suddenly a soldier opened fire and shot the granddaughter of the witness, Souad, in the neck and chest. She died immediately. They also shot Amal. She was hit in the chest and abdomen, and the interviewee saw her intestines come out. Amal died a little later. The daughter in law ran immediately into the house and was not hurt. The witness Souad Abed Rabbo was hit twice, as she turned around in a clockwise movement. She was hit in the left arm and in the left buttock. She did not see who shot. She assumed that the shots were fired from gun(s) not from the tank, but she was not certain. She saw three soldiers on top of the tanks holding weapons…Samar was hit in the chest with the bullet coming out of the back…at the time of the interview she was in a hospital in Belgium suffering paralysis.”

In their concluding remarks, the experts say:

“The underlying meaning of the attack on the Gaza Strip, or at least its final consequence, appears to be one of creating terror without mercy to anyone.  Nearly all the people we spoke to slept cuddled together with the other members of their family in a central room of the house during the three weeks of attack.  No one knew where or when the next bomb or explosion would occur. It appears that the wide range of attacks with sophisticated weaponry was predominantly focussed on terrorising the population. …”
Hadas Ziv, Executive Director of Physicians for Human Rights-Israel:

The military was well aware that such an attack on a densely populated area would exert a terrible toll on the civilian population. It was the Israeli Army’s responsibility to secure a way for the civilian population to flee the zone of combat.
At the moment, three things need to be done:
- A rigorous, transparent, and independent investigation should be conducted, one in which the victims’ voices will be heard. The newly appointed investigative committee of the Human Rights Council is an important step in this direction. We hope Israel will fully cooperate with it.
- There is also an urgent need to open the Crossings and to allow the rehabilitation of Gaza.
- Israeli society needs to understand and assert its responsibility to end the culture of impunity so that such severe violations of international law and medical ethics will not occur in the future.