The need to know
Two awful events resulting in the loss of innocent life have shocked and disturbed us all in the last few weeks. Listening to one of the GPs who had to deal with the immediate aftermath of the killings in Cumbria was moving and harrowing. Our hearts went out to the victims' families and friends and to the members of the emergency services who responded. We all share a need to try to understand why it happened and if, and how, it could have been prevented.
When we heard first-hand accounts by people on the ships taking humanitarian aid to Gaza about the violence on board, we, and the international community, were shocked and there was an immediate call to understand what had led to the deaths and injuries. Two stories in Israel's Haaretznewspaper describe responses from within Israel. One headline was that major Israeli supermarket chains were going to boycott Turkish goods: ‘For reasons of ideology and conscience, it would be unacceptable for us to do nothing when the Turkish people behave this way.’1
Another announced what Prime Minister Benjamin Netanyahu said at the start of last week's cabinet meeting, that the main goal of the ‘Gaza flotilla probe’ is to prove to the world that the Israel Navy operation on the Gaza-bound aid ship was appropriate and met international standards.2 Arguably pre-judging the outcome of the enquiry?
The response from the White House was more far-reaching and, hopefully, signalled a shift in policy. According to the statement,3 the US seeks two states that will live side by side in peace and security, ‘a Jewish state of Israel, with true security, acceptance, and rights for all Israelis; and a viable, independent Palestine with contiguous territory that ends the occupation that began in 1967 and realises the potential of the Palestinian people.’
Such a solution would not satisfy those involved who describe it as apartheid but most believe it would represent a huge step forward. Broken Promises, Broken Dreams joins the growing list of books which demonstrate why such progress is essential and why an understanding of the reality of life in the Gaza Strip and the West Bank is necessary. It is written by a Jewish Boston-based physician, Alice Rothchild, who has worked with medical delegations to Israel and the occupied territories with American Jews for a just peace in their health and human rights project.
She explores the complexity of Jewish–Israeli attitudes, the hardships of the Palestinians living in the West Bank and Gaza and the struggles of the brave Israelis who ‘refuse to be enemies’. They often do this despite being exposed to misinformation from an early age. Rothchild describes a study of Israeli textbooks where popular textbooks feature maps of the Greater Land of Israel without evidence of territories under the control of the Palestinian Authority, and where the West Bank is called ‘Judea and Samaria’.
Her description of conditions in Gaza is informative and heart-rending. Of the 1 400 000 people living in an area 26 miles by 5, half are under 15 years of age, according to the World Bank, 75% of Gazans live in poverty and, according to the World Food Programme, 42% face ‘food insecurity’. They also face sanctions and frequent incursions by the Israeli military. Ideal conditions for breeding, among the young men especially, anger and frustration.
Rothchild interviews several doctors trying to provide health care in Gaza. Dr Hussein Shanti is a family physician trained in Italy whose office is about 4 km or 5 minutes from his family home. Because of the Israeli separation wall snaking into the West Bank it now takes him an hour to cover the 30 km journey required. Sixty-five per cent of the arable land of the community he serves is outside the wall and there are serious problems accessing it and harvesting adequate levels of food.
Dr Eyad el Sarraj, who founded the Gaza Community Mental Health Programme in 1990 after the First Intifada, describes the lives of children in the five huge refugee camps, children robbed, not only of their physical and mental health but also ‘of their childhoods’. They suffer epidemic levels of post-traumatic stress symptoms especially bedwetting, while mother-child bonding is often adversely affected by the living conditions. He condemns violence whoever perpetrates it, and a system in which young children aspire to ‘martyrdom’. He describes endless bureaucracy and stupidity from all sides.
Why has he not gone crazy, asks Rothchild:
‘You know, I love this place because I grew up here. I love the sea, I love the people and I love justice and I have something to do. I have to do it. It is so exciting and rewarding and fulfilling. Every time you meet a child and make him smile, that for me is the biggest reward on earth’.
- © British Journal of General Practice, 2010.