Physicians for Human Rights-Israel: Report on Medical Ethics during the War on Gaza

Physicians for Human Rights-Israel

"The Military repeatedly violated Codes of Medical Ethics during the Gaza Offensive"

Prevention of medical assistance from the trapped and the wounded, severe difficulties to emergency medical evacuation, attacks on medical personnel and medical facilities, and de facto prevention from the chronically ill and gravely wounded referral to medical care outside Gaza. "We call for an outside independent body to investigate the events" say representatives of Physicians for Human Rights-Israel.

To download the full report from PHR web site press here

The new report, published today by Physicians for Human Rights-Israel, gives room for concern that during the operation in Gaza, Israeli soldiers repeatedly acted in violation of the army's code of ethics, the medical code of ethics, and basic human values. These actions suggest repeated violations of the International Law regarding the treatment of the ill and the wounded and the protection of medical personnel.

The report examines six topics: the situation of the Gaza health system on the eve of the military operation, the difficulties in evacuating the wounded to medical centers outside Gaza, attacks on medical personnel, difficulties in internal evacuation of the wounded, attacks on medical facilities and injury to chronic and acute patients.

Based on numerous first hand testimonies that were brought to the attention of PHR-Israel during the attack, the report depicts a grave picture of the realities in Gaza during those 22 days. In some of the cases revealed to PHR-Israel, the army did not allow for the evacuation of wounded and trapped civilians for days on, leaving them in isolated pockets with no access to food, water and medical treatment. The army did not assist these civilians but even more, it prevented the Palestinian emergency vehicles and staff from reaching these civilians. In other cases, the soldiers did not give medical assistance to wounded human beings that were within several feet from the soldiers. This, in serious violation of the army's Ethical Code for the War on Terror of 2004 that states that "soldiers are obliged to provide adequate health services, as conditions allow, equally to themselves and to the enemy."

PHR-Israel received reports of 16 medical personnel that were killed and 25 that were wounded from the Israeli army's fire, all of them while performing their medical duties. Furthermore, 34 medical facilities were hit by the army, eight hospitals and 26 primary care clinics; this in severe violation of directives of international law that forbid attacks on medical personnel and medical facilities in times of fighting.

Prevention of evacuation and assistance for the wounded

On January 3 the house of the al'Aiedi family, situated in the south east of Gaza City, sustained missile fire from which 6 of the twenty members of the family were wounded. Attempts to leave the house were repeatedly met by artillery fire. Upon receiving notification of the event, on the morning of January 4, PHR-Israel contacted the army and tried to coordinate the evacuation of the family but to no avail. For six days, the army prevented the evacuation of the family, prevented ambulances from approaching the area, and did not provide food and water to the family or medical assistance to the wounded. On January 6, two of the wounded were able to leave their house, holding a white flag, and were compelled to walk for 2 kilometers until reaching an emergency vehicle. The other wounded were too weak to follow them. Only on January 10 were the family members able to leave their house walking and carrying their wounded.

On January 16 at approximately 2 in the afternoon three members of the Shurrarb family, the father and two sons were hit by automatic fire on their car as they were trying to gather supplies during the humanitarian ceasefire. One son was almost immediately killed, the second son was wounded in the leg and the father of was lightly injured by shrapnel. Soldiers besieged the area around the car. PHR-Israel's requests to the army to assist or evacuate the wounded were not addressed and the injured son, with no medical assistance, was losing considerable amounts of blood. At midnight the father informed PHR-Israel that his second son had bled to death. Mahmud, the father, told PHR-Israel's representative that his son cried and asked him to call an ambulance and that the soldiers at the location cursed him and threatened that if he did not put down his cell phone, they would shoot him. Mahmud and the bodies of his two children were evacuated on January 17 at 12:00 in the afternoon, 24 hours after the shooting incident

Attacks on Medical Personnel
The report details 12 incidents, including occurrences in which helicopters and tanks fired on ambulances and medical personnel. In other instances medical teams were turned away by soldiers from areas that they reached to treat the wounded
On December 31 a helicopter hit a medical team that had set out to offer help to a bleeding injured person in the northeast Gaza Strip. The doctor, the paramedic, and the wounded person they had gone to help were killed.

On January 10th five Red Crescent ambulances and a Red Cross car entered the Al-Atatra neighborhood and tank fire erupted in their direction. An ambulance driver and paramedic were injured and the medical team left without evacuating the wounded.

The report further shows that though the Israeli health system was prepared and able to receive the wounded from the Gaza Strip only few were actually referred to Israel for treatment. The closing of the crossings, bureaucratic obstacles put forward by Israel, the collapse of the coordination system, and later, the refusal of the Palestinian Authority and the Hamas to refer the wounded to Israel resulted in the fact that during the 22 days of the offensive, 6 out of 5380 wounded people received medical treatment in Israel.

The report calls the army to reiterate to its soldiers the protection granted under international law to medical personnel performing their duties and must prosecute those who violate these provisions.

Furthermore, because the testimonies indicated that the violations were neither individual nor isolated incidents, PHR-Israel convened an independent committee of international experts on forensic medicine and public health, who worked in the Gaza Strip collecting additional testimonies, examining the extent of the incidents and investigating suspicions of violations of medical ethics, the army's ethical code and international law. This report is expected to be published by the committee on April 6. 2009.

Physicians for Human Rights – Israel argues that the attack on Gaza revealed a stark decline in IDF morals concerning the Palestinian population of Gaza, which in reality amounts to a contempt for Palestinian lives The army's repeated promises to the High Court to look into attacks on medical teams and medical centers have gone unfulfilled, and there are suspicions concerning its seriousness and readiness to carry out the matter. . PHR-Israel therefore believes it is critical that the investigation of the attack on Gaza is completed by a neutral, external investigator without ties to the Israeli army.

In the absence of a proper Israeli investigation, PHR-Israel demands that a neutral, independent international body carry out a thorough investigation. Should this investigation find Israel had violated the International Law, the Customary Law and the Israeli Law, those responsible for these violations should be brought to justice and Israel should be held responsible for the rehabilitation of the victims of these violations.
For additional details contact Ran Yaron,: 972547577696 .