We are doctors and scientists, who spend our lives developing means to care and protect health and lives. We are also informed people; we teach the ethics of our professions, together with the knowledge and practice of it. We all have worked in and known the situation of Gaza for years.
On the basis of our ethics and practice, we are denouncing what we witness in the aggression of Gaza by Israel.
We ask our colleagues, old and young professionals, to denounce this Israeli aggression. We challenge the perversity of a propaganda that justifies the creation of an emergency to masquerade a massacre, a so-called “defensive aggression”. In reality it is a ruthless assault of unlimited duration, extent, and intensity. We wish to report the facts as we see them and their implications on the lives of the people.
We are appalled by the military onslaught on civilians in Gaza under the guise of punishing terrorists. This is the third large scale military assault on Gaza since 2008. Each time the death toll is borne mainly by innocent people in Gaza, especially women and children under the unacceptable pretext of Israel eradicating political parties and resistance to the occupation and siege they impose.
This action also terrifies those who are not directly hit, and wounds the soul, mind, and resilience of the young generation. Our condemnation and disgust are further compounded by the denial and prohibition for Gaza to receive external help and supplies to alleviate the dire circumstances.
The blockade on Gaza has tightened further since last year and this has worsened the toll on Gaza's population. In Gaza, people suffer from hunger, thirst, pollution, shortage of medicines, electricity, and any means to get an income, not only by being bombed and shelled. Power crisis, gasoline shortage, water and food scarcity, sewage outflow and ever decreasing resources are disasters caused directly and indirectly by the siege.
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People in Gaza are resisting this aggression because they want a better and normal life and, even while crying in sorrow, pain, and terror, they reject a temporary truce that does not provide a real chance for a better future. A voice under the attacks in Gaza is that of Um Al Ramlawi who speaks for all in Gaza: “They are killing us all anyway—either a slow death by the siege, or a fast one by military attacks. We have nothing left to lose—we must fight for our rights, or die trying.”
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Gaza has been blockaded by sea and land since 2006. Any individual of Gaza, including fishermen venturing beyond 3 nautical miles of the coast of Gaza, face being shot by the Israeli Navy. No one from Gaza can leave from the only two checkpoints, Erez or Rafah, without special permission from the Israelis and the Egyptians, which is hard to come by for many, if not impossible. People in Gaza are unable to go abroad to study, work, visit families, or do business. Wounded and sick people cannot leave easily to get specialised treatment outside Gaza. Entries of food and medicines into Gaza have been restricted and many essential items for survival are prohibited.
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Before the present assault, medical stock items in Gaza were already at an all time low because of the blockade.
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They have run out now. Likewise, Gaza is unable to export its produce. Agriculture has been severely impaired by the imposition of a buffer zone, and agricultural products cannot be exported due to the blockade. 80% of Gaza's population is dependent on food rations from the UN.
Much of Gaza's buildings and infrastructure had been destroyed during Operation Cast Lead, 2008–09, and building materials have been blockaded so that schools, homes, and institutions cannot be properly rebuilt. Factories destroyed by bombardment have rarely been rebuilt adding unemployment to destitution.
Despite the difficult conditions, the people of Gaza and their political leaders have recently moved to resolve their conflicts “without arms and harm” through the process of reconciliation between factions, their leadership renouncing titles and positions, so that a unity government can be formed abolishing the divisive factional politics operating since 2007. This reconciliation, although accepted by many in the international community, was rejected by Israel. The present Israeli attacks stop this chance of political unity between Gaza and the West Bank and single out a part of the Palestinian society by destroying the lives of people of Gaza. Under the pretext of eliminating terrorism, Israel is trying to destroy the growing Palestinian unity. Among other lies, it is stated that civilians in Gaza are hostages of Hamas whereas the truth is that the Gaza Strip is sealed by the Israelis and Egyptians.
Gaza has been bombed continuously for the past 14 days followed now by invasion on land by tanks and thousands of Israeli troops. More than 60 000 civilians from Northern Gaza were ordered to leave their homes. These internally displaced people have nowhere to go since Central and Southern Gaza are also subjected to heavy artillery bombardment. The whole of Gaza is under attack. The only shelters in Gaza are the schools of the UN Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), uncertain shelters already targeted during Cast Lead, killing many.
According to Gaza Ministry of Health and UN Office for the Coordination of Humanitarian Affairs (OCHA),
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as of July 21, 149 of the 558 killed in Gaza and 1100 of the 3504 wounded are children. Those buried under the rubble are not counted yet. As we write, the BBC reports of the bombing of another hospital, hitting the intensive care unit and operating theatres, with deaths of patients and staff. There are now fears for the main hospital Al Shifa. Moreover, most people are psychologically traumatised in Gaza. Anyone older than 6 years has already lived through their third military assault by Israel.
The massacre in Gaza spares no one, and includes the disabled and sick in hospitals, children playing on the beach or on the roof top, with a large majority of non-combatants. Hospitals, clinics, ambulances, mosques, schools, and press buildings have all been attacked, with thousands of private homes bombed, clearly directing fire to target whole families killing them within their homes, depriving families of their homes by chasing them out a few minutes before destruction. An entire area was destroyed on July 20, leaving thousands of displaced people homeless, beside wounding hundreds and killing at least 70—this is way beyond the purpose of finding tunnels. None of these are military objectives. These attacks aim to terrorise, wound the soul and the body of the people, and make their life impossible in the future, as well as also demolishing their homes and prohibiting the means to rebuild.
Weaponry known to cause long-term damages on health of the whole population are used; particularly non fragmentation weaponry and hard-head bombs.
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,
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We witnessed targeted weaponry used indiscriminately and on children and we constantly see that so-called intelligent weapons fail to be precise, unless they are deliberately used to destroy innocent lives.
- Manduca P
- Naim A
- Signoriello S
Specific association of teratogen and toxicant metals in hair of newborns with congenital birth defects or developmentally premature birth in a cohort of couples with documented parental exposure to military attacks: observational study at Al Shifa Hospital, Gaza, Palestine.
Int J Environ Res Public Health. 2014; 11: 5208-5223
We denounce the myth propagated by Israel that the aggression is done caring about saving civilian lives and children's wellbeing.
Israel's behaviour has insulted our humanity, intelligence, and dignity as well as our professional ethics and efforts. Even those of us who want to go and help are unable to reach Gaza due to the blockade.
This “defensive aggression” of unlimited duration, extent, and intensity must be stopped.
Additionally, should the use of gas be further confirmed, this is unequivocally a war crime for which, before anything else, high sanctions will have to be taken immediately on Israel with cessation of any trade and collaborative agreements with Europe.
As we write, other massacres and threats to the medical personnel in emergency services and denial of entry for international humanitarian convoys are reported.
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We as scientists and doctors cannot keep silent while this crime against humanity continues. We urge readers not to be silent too. Gaza trapped under siege, is being killed by one of the world's largest and most sophisticated modern military machines. The land is poisoned by weapon debris, with consequences for future generations. If those of us capable of speaking up fail to do so and take a stand against this war crime, we are also complicit in the destruction of the lives and homes of 1·8 million people in Gaza.
We register with dismay that only 5% of our Israeli academic colleagues signed an appeal to their government to stop the military operation against Gaza. We are tempted to conclude that with the exception of this 5%, the rest of the Israeli academics are complicit in the massacre and destruction of Gaza. We also see the complicity of our countries in Europe and North America in this massacre and the impotence once again of the international institutions and organisations to stop this massacre.
For the Open Letter to Israel Academics see http://haimbresheeth.com/gaza/an-open-letter-to-israel-academics-july-13th-2014
We declare no competing interests.
Supplementary Material
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Supplementary appendix
References
- 1.
Occupied Palestinian Territory: Gaza emergency situation report (as of 21 July 2014, 1500 hrs).(accessed July 22, 2014).
- 2.
Dignity or death—we cannot give up now.(accessed July 22, 2014).
- 3.
Brief report to UNRWA: The Gaza Health Sector as of June 2014.(accessed July 22, 2014).
- 4.
Birth defects in Gaza: prevalence, types, familiarity and correlation with environmental factors.Int J Environ Res Public Health. 2012; 9: 1732-1747
- 5.
Specific association of teratogen and toxicant metals in hair of newborns with congenital birth defects or developmentally premature birth in a cohort of couples with documented parental exposure to military attacks: observational study at Al Shifa Hospital, Gaza, Palestine.Int J Environ Res Public Health. 2014; 11: 5208-5223
- 6.
4 killed, over 50 injured as Israel targets al-Aqsa hospital.(accessed July 22, 2014).
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Published: July 23, 2014
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- Gaza's health and humanitarian crisis
- Israel–Gaza conflict
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The consequences of conflict on health and provision of health-care services have been documented. 1 War and political violence are fundamental public health problems, therefore their prevention should be a central task of health professionals. 2 Accordingly, health researchers and providers should, wherever and however possible, aid to alleviate the immediate consequences of political violence and advocate for the prevention of further violence and repression. Because of this mandate, the present situation in Gaza is distressing.
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- Israel–Gaza conflict
- Israel–Gaza conflict
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We, like you, are doctors and scientists who have devoted our lives to serving others, restoring health, and protecting the vulnerable. We are also informed, and also safeguard ethics in every sphere of our influence. Among us are those who have long collaborated in the advancement of medicine, science, and health with our colleagues, including those in Gaza. Many of us writing today are either members of Israeli academia, or formally or informally engaged with Israeli academia.
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- Israel–Gaza conflict
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The recent open letter for the people in Gaza1 is a political manifesto without any medical connection. It is a reminiscent of another article printed in a respected scientific publication. On April 30, 1938, half a year before Kristallnacht, J Stark wrote in Nature: “I have also directed my efforts against the damaging influence of Jews in German science, because I regard them as the chief exponents and propagandists of the dogmatic spirit.”2
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- Israel–Gaza conflict
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Reality is far from black and white as was depicted in the recent hate-filled Correspondence by Paola Manduca and colleagues.1 The authors of this Correspondence hijacked The Lancet, spewing propaganda that would fail any peer review. Under false claims of “no competing interests”, these authors, deeply involved in pro-Palestinian organisations, cower behind their medical degrees to slander Israel, spread Hamas defamations, and betray our profession. We are baffled by The Lancet's decision to publish such a slanted, evidence-less, open letter.
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- Israel–Gaza conflict
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I commend the Editors of The Lancet for publishing “An open letter for the people in Gaza” by Paola Manduca and colleagues.1 Israel's presentation of its disproportionate and indiscriminate use of force as a form of self-defence is insulting to Palestinian dignity and medical ethics. In Israel and the USA, the repetition of messages dehumanising Palestinians, the misrepresentation of the humanitarian and political situation in the occupied Palestinian territories, and the trivialisation of such violence as a spectator sport represent a further corrosion of our human decency and moral core.
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- Israel–Gaza conflict
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It is totally inappropriate for a peer-reviewed medical journal to publish purely political, inaccurate, and prejudiced pieces such as “An open letter for the people in Gaza”1. If this group of “doctors and scientists” is so concerned about the civilians in Gaza, where is the sympathy for the civilians who are being killed in Syria, the Christians who were murdered by the Islamic State of Iraq and the Levant, or who were forced to flee their homes in Mosul, Iraq, or the victims of Boko Haram in Nigeria? And where is the sympathy for the Israeli citizens who live under constant rocket attacks and invasions through tunnels that extend under kindergartens and people's homes by Hamas, whose charter calls for the destruction of Israel and the murder of Jews? Have any of the signatories to this letter read the Hamas charter? They should.
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- Israel–Gaza conflict
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We too share the pain of Paola Manduca and colleagues1 regarding the horrific loss of innocent civilian lives in Gaza. They, and the readers of The Lancet, should know that Israel, as acknowledged by the European Union and the USA, is making every possible effort to avoid civilian casualties. However, such prevention is extremely difficult, due to the inexcusable fact that Hamas shamefully uses its own fellow civilians as human shields.
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- Israel–Gaza conflict
- Israel–Gaza conflict
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We write as Jewish health professionals in South Africa in response to the debate on the war in Gaza.1 Many of the letters have been critical, sometimes viciously so, of The Lancet for airing this debate, labelling it “inappropriate for a peer-reviewed medical journal to publish purely political, inaccurate, and prejudiced pieces”2 and have gone on to equate the original call by Paola Manduca and colleagues1 as “anti-Jewish bigotry, pure and simple”.2 We disagree and are disturbed at the lack of insight of many of the criticisms that seem to focus on a narrow view of humanitarianism out of touch with current scientific and ethical thinking about the human rights obligations of health professionals.
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- Israel–Gaza conflict
- Israel–Gaza conflict – Authors' reply
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Our Correspondence1 has prompted supportive as well as opposing responses—some of which have been surprisingly personal, perhaps reflecting the violence of recent events in Gaza. We submit this reply in the spirit of participating in an open and respectful discussion. We welcome the opportunity to address some of the main concerns raised by our critics.
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- Israel–Gaza conflict
- Open letter for the people in Gaza—more than a military conflict
- Israel–Gaza conflict
- Letter in support of Richard Horton
- Israel–Gaza conflict
- Israel–Gaza conflict
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We, the members of the Italian Global Health Watch, fully endorse the points so clearly denounced by Paola Manduca and colleagues in their letter1 about Gaza. The renewed tragedy of the ongoing intolerable violation of the right to life and self-determination of Palestinian people by the Israeli troops must be stopped urgently. This urgency must be seen and acted upon, with an aim to increase the capacity of the international medical and non-medical community to associate the massive violation of the human right to life of the Palestinians with the broader issues of the global unchallenged implementation of arbitrarily chosen political, military, and economic priorities—the deepest threat to health and peace.
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- Israel–Gaza conflict
- Israel–Gaza conflict
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I write to join my fellow health professionals in expressing my support for the people of Gaza, 1 and my outrage at Israel's attacks on Gaza's civilians in their homes, hospitals, and UN shelters. As health professionals, our voices matter, since our support for victims in such conflicts tends to be borne out of empathy and compassion for human suffering, rather than political interests. I am Palestinian, and I am equally appalled by civilian death and suffering on both sides. The reality of the present conflict is that it is the Palestinian civilians who overwhelmingly suffered death, injury, and displacement.
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As a humanitarian physician community, we grieve the loss of innocent lives. War is anathema to our moral and medical sensibilities, but nevertheless remains a reality of the present global political landscape, particularly in the Middle East where ongoing internecine struggles exist between different ideologies, killing or displacing thousands of innocent people. Before addressing the inflammatory propaganda promulgated by Paola Manduca and colleagues, 1 we unequivocally state that we hope for the day when “nation shall not lift the sword against nation, neither shall they learn war anymore” (Isaiah 2:4).
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- Israel–Gaza conflict