A number of leading medical professionals and a US lawyer have written an open letter pointing out that the Israeli occupation authorities continue to block the passage of vital medical supplies to the besieged Gaza Strip. It is, they say, “collective punishment” of the Palestinians in the coastal enclave. The letter was sent originally to a medical journal, which had published similar letters and did not respond to the signatories. This, they say, is a “worrying sign of neglect” of the issue.
The Gaza Strip has been under a blockade imposed by Israel and its allies for seventeen years. The territory was described by the then British Prime Minister David Cameron as a “prison camp”. That was in 2010, and the situation has deteriorated for the 2.4 million Palestinians in Gaza ever since.
The full text of the letter is as follows:
The Ministry of Health (MoH) in the Gaza Strip wrestles with the cumulatively deleterious effects of Israel’s siege of Gaza imposed since 2006. In 2022, delivery of essential medical supplies to hard-pressed public and private hospitals was denied or delayed. This has affected, for example, the import of x-ray machines, calibration tools for mammograms, interventional catheters, digital video monitors, and mobile imaging units for general surgery and orthopaedics. All of these require Israeli permission to be released from suppliers in the West Bank and delivery to the Gaza Strip through the Israeli-controlled border. The MoH estimates that about 50 per cent of patients in the Gaza Strip have been affected by the lack of medical equipment.
Historically, Israel has maintained a “controlled below needs” scarcity of medicines and laboratory supplies in Gaza, even when these have been donated charitably. The MoH’s recent press release noted that the tightening of the Israeli blockade compounds the ongoing problems of chronic scarcity and uncertainty facing the MoH and jeopardises service planning and provision.
This situation leads to patients seeking diagnosis and special care outside the Gaza Strip. According to the 2022 UN report, 2,067 patients applied for treatment outside Gaza in specialist hospitals in the West Bank and Jerusalem, and 868 applications (42 per cent) were delayed or rejected. Patients with cancer, heart disease, stroke and complex fractures face a harsh fate as a result of delays in obtaining diagnostic tests and starting treatment, including surgery. Ten patients, including a baby, were denied urgent exit for potentially lifesaving care and have died since the start of 2022.
As an occupying power controlling Palestinian life, Israel continues to flout its obligations in international humanitarian law to ensure the basic rights to health care of Gazan society.
This has occurred “normally and is a political practice also in time of peace” for almost 17 years. The continuity of afflictive collective measures, the length and the intentionality of the “system”, in point of law enshrines the crime of collective punishment — a war crime1 — and implies States’ responsibilities in its prevention.
The criminal system of the blockade of Gaza must be lifted in all fields.
Recently and noticeably, some political parties and individual Parliamentarians in the new Israeli Knesset are, indeed, ready to go further, even spelling out genocidal intentions, including threatening to raze Gaza soon.
Meanwhile, collective punishment measures have been escalated in all other Palestinian territories, including evictions, demolition of housing, displacements, arbitrary detention, punishment of prisoners, destruction of crops and agricultural lands, and impediments to medics and ambulances to assist the wounded. All of these based on ethnicity and all fitting the definition of collective punishment.
Israeli impunity continues to be bolstered by the shameful inaction of the international community in this situation. This pattern has not and will not be changed by condemnatory words, but requires concrete action to remove the blockade of Gaza and to protect Palestinian lives. In cases of collective punishment, there is indeed a mandate for all States to act by all means available.
Meanwhile, as professionals in health and law, our duty is to present the facts we witness and the paradigm in which the suffering of Gaza’s people is inscribed.
The content of this article was presented to a Medical Journal, but not accepted for publication, a worrying sign of neglect.
1- Collective punishment is a punishment or sanction imposed on a group for acts allegedly perpetrated by a member of that group, which could be an ethnic or political group, or just the family, friends and neighbours of the perpetrator. Collective punishment is prohibited by treaty in both international and non-international armed conflicts, more specifically Common Article 3 of the Geneva Conventions and Additional Protocol II. .The current blockade of Gaza has been criticised by the International Committee of the Red Cross, in a United Nations report, and by various other organisations as collective punishment aimed at the Palestinians. UN condemns ‘war crimes’ in Gaza” BBC News. 16 September, 2009.
Paola Manduca, PhD, Retired Geneticist, University of Genoa, Italy
Vittorio Agnoletto, MD, University of Milan, Italy
Swee Ang, MD, Consultant orthopaedic surgeon, former UN and WHO consultant to Gaza and the OPT(1988 and 1989)
Andrea Balduzzi, Retired Researcher, University of Genoa, Italy
Ireo Bono, MD, Retired Oncologist, Savona, Italy
Francis Boyle, Lawyer, USA
Franco Camandona, MD, Gynaecology and Obstetrics, E.O. Ospedali Galliera, Genova, Italy
Iain Chalmers, Department of Primary Care, University of Oxford, UK
Carla Ciccone, MD, Gynaecologist, retired AOSG Moscati, Avellino, Italy
Valerio Gennaro, MD, PhD, Oncologist, environmental epidemiologist, past director Liguria Mesothelioma Registry, Genoa, Italy
Colin Green, Professor of Surgical Science, University College London and Academician of the Ukraine National Academy of Science
Brigitte Herremans, PhD, research fellow at Justice Visions, Human Rights Centre, Faculty of Law and Criminology, Ghent University
Jon Jureidini, PhD MBBS FRANZCP, Child Psychiatrist, Robinson Research Institute, The University of Adelaide, Australia
Lucio Nitsch, MD, Professor Emeritus of Applied Biology, University of Napoli Federico II, Italy
Alice Rothchild, MD, retired, Harvard Medical School, USA
Derek Summerfield, MD, King’s College London, UK
Nozomi Takahashi, Department of Biomedical Molecular Biology, Ghent University, Belgium
Gianni Tognoni, MD, Milan University, Italy and Permanent People’s Tribunal
Guido Veronese PhD, Associate Professor in Clinical Psychology, Dept. of Human Sciences “R. Massa”, University of Milano-Bicocca