Summary:
The International Code of Medical Ethics formulated by the World Medical Association states that in times of war, the ethical obligation to provide optimal medical assistance to the population in a war zone falls under the responsibility of the fighting powers in general and of medical teams in particular. Numerous international treatises assert the obligation to give medical care without discrimination to all victims in a war zone. More specifically, the Israeli army's code of ethics asserts that the soldier will maintain his humanity even in combat; he will acknowledge the utmost importance of human life and will not use his power and his weaponry to harm those who are non combatants. In a later addendum to the code, that relates to the War on Terror the Israeli army's code asserts that soldiers are obliged to provide adequate health services, as conditions allow, equally to themselves and to the enemy.
The purpose of this report is to call attention to occurrences of violations of the international humanitarian law and the Israeli army's ethical code during the course of Israel's attack on Gaza named Operation Cast Lead. These violations included attacks on medical personnel; damage to medical facilities and indiscriminate attacks on civilians not involved in the fighting. Furthermore, Israel placed numerous obstacles in the course of the operation that impeded emergency medical evacuation of the sick and wounded and also caused families to be trapped for days on without food, water, and medications. PHR-Israel believes these violations and the humanitarian crisis that they entailed should take center stage in the moral reckoning that should take place within Israeli society as a whole, and especially within its armed forces.
The report focuses on the medical aspects of the crisis and is based on numerous first hand testimonies that were brought to the attention of PHR-Israel during the attack. These testimonies formed a picture that the state of Israel made a considerable effort to conceal through the sweeping prohibition on the entry of international media into the area and its vague responses given to the High Court.
The report begins by describing the situation of the health system in Gaza on the eve of the attack. Gaza's health system suffered from acute shortage of medical equipment and medication due to the blockade imposed by Israel since June 2007. Its medical staff training too was hindered by prohibitions that made professional connections and training outside Gaza almost impossible. It is this system that was to face the enormous challenge of having to provide treatment to thousands of wounded; a challenge that would have overwhelmed any health system. The healthcare for the chronically ill was severely restricted due to the emergency state and the higher priority given to life threatening injuries of the attack, as well as due to the closure of the crossings through which these patients were previously able to have access to medical treatment outside Gaza.
The report further calls attention to
the problems caused by the obstacles to referrals of the attack victims
outside Gaza. Many of those suffering severe injuries and who were in need
for emergency referrals to more advanced medical centers, suffered from
the bureaucratic impediments imposed by Israel and Egypt during the first
days, and the Palestinians reluctance to cooperate with Israel in the treatment
of the injured later. The prompt televised evacuation of three members
of Dr. Abu Al'Aish's family in Israeli ambulances and helicopter, demonstrated
that when Israel's image was at stake it found the way to overcome all
obstacles.
The report shows how medical staff became
a legitimate target to the attacks of the Israeli forces. According to
a WHO report 16 medical personnel were killed and 25 wounded while being
on duty. PHR-Israel documented 12 such incidents and they are brought in
the report. The attacks on medical staff occurred both before and after
an
appeal to the Israeli High Court by
PHR-Israel and other Israeli human rights organizations. In addition to
attacks on medical personnel and emergency vehicles, many medical facilities
were destroyed as a result of direct attack on them or as a result of attacks
on their vicinities. Israel's accusation that the heads of Hamas were hiding
in hospital basements was strongly denied by directors of hospitals with
whom PHR-Israel kept in contact throughout the Israeli offensive.
Access to the wounded and evacuation
of the dead were held back by these ongoing attacks. Ambulance operators
of MoH, PRCS, Civil Defence and UHWC all reported areas that could not
be reached at all. As a result, the wounded waited for hours and days for
evacuation.
The report uses two examples to demonstrate,
step by step, the resulting tragedy of these impediments to evacuation.
The first case is that of the Al'Aeidi family whose twenty members, some
of them wounded, were trapped for seven days; the second example is that
of Mr. Shurrab and his two sons who were shot by Israeli soldiers on January
16, as they were in their car on their way to Khan Yunis. One of the sons
died
immediately, the other bled to death
for twelve hours. All that time the Israeli soldiers were within a short
distance from the Shurrabs but did not provide any assistance despite the
father's repeated requests.
It is PHR-Israel's belief that in moral
terms Israel's image has been stained by the manner in which it pursued
the attack; by its disproportionate use of force; and by its gross disregard
for requests from local and international human rights organizations in
the face of the humanitarian crisis in the Gaza Strip. The process of demonization
of
Palestinians bears a heavy price for
Israeli society. This process reached its nadir when soldiers in an army
that flaunts its morality declined to help evacuate injured civilians and
trapped families; when soldiers acted in trigger-happy manner as they opened
fire on ambulances, medical installations, and medical personnel; and when
Israel's leaders employed doublespeak in order to deny the existence of
a humanitarian crisis in the Gaza Strip.