Dear Director General Chan,
Re: Request to Establish a Commission of Inquiry to Investigate Conduct Surrounding Report A69/INF./6 and Resolution A69/B/CONF./1
The International Legal Forum on behalf of the undersigned independent doctors and mental health professionals, and on behalf of Doctors Against Racism And Antisemitism (DARA) and their 700 members, would like to hereby express our deepest concerns regarding the involvement of the World Health Organization (WHO) in the recent politicization of the discussion surrounding the health conditions in the Palestinian Territory, and request that a Commission of Inquiry be established to investigate it.
On May 20, 2016, the Palestinian Authority Ministry of Health submitted Report A69/INF./6 pertaining to health conditions in the Palestinian territory (hereinafter: “The PA Report”) to the 69th World Health Assembly of the WHO. Subsequently, the WHO passed Resolution A69/B/CONF./1 on May 24, 2016 (hereinafter: “the WHO Resolution” or “The Resolution”).
Objective analysis of the above-mentioned report reveals that it is highly politicized and contains many false arguments presented without any references or proof, some of which are no more than a modern day “blood-libel”. Unfortunately, it seems that the PA Report was more of an attempt to demonize, delegitimize, and criticize Israel, rather than an accurate portrayal of the health conditions of Palestinian Arabs, and the causes of those conditions, in the Palestinian territories.
Many of the allegations listed in the Report should have raised serious questions regarding its credible and professional nature. This is particularly evident when compared with the independently prepared WHO reports submitted by the Director General and the Secretariat, which did not mention, or out-rightly contradicted, many of the claims presented in the PA Report .
Despite these facts, the WHO chose not to condemn the PA report, but rather allowed it to be presented in front of the General Assembly. The WHO did not even express reservations from its clearly biased and unfounded nature, thus adding credibility to The PA Report. Moreover, the General Assembly later conducted a full debate that became a forum for condemning Israel based on the questionable PA Report, and passed the Resolution whose premises once again were clearly influenced by same the PA Report.
As representatives of the international medical community, we see ourselves obligated to express serious concerns in every case where the field of medicine and medically-based arguments are exploited for political purposes, especially as it inevitably diverts attention away from real problems and comes at the expense of those in need.
We further wish to express our concerns regarding the dangerous precedent such an incident can create for future exploitation of the WHO, and the damage it can bring to its professionalism, credibility and future funding.
For all those reasons, we urge you to establish a Commission of Inquiry to thoroughly investigate the arguments brought forth in this document, to correct the wrongs created in the process and prevent the reoccurrence of such incidents.
To support our position regarding the clear political nature of the PA Report, we wish to point out a number of examples of false and groundless claims.
Allegations of Environmental Aggressions:
- The Report claims that “no settlement, with the exception of those built within the municipality of Jerusalem, has a sewerage system. Settlements therefore release their wastewater into Palestinian watercourses and land, further exacerbating environmental pollution and degrading Palestinian agricultural supplies“.
A simple examination of publicly available information clearly proves that this allegation is completely false. In fact, virtually all settlements have sewerage systems which are highly regulated. The entities responsible for regulating, reviewing, and approving sewerage plans are the Municipal Environmental Associations of Judea and Samaria and the Civil Administration Environmental Staff Officer.
- The Report claims that factories located in the Israeli settlements and industrial zones produce solid, liquid, and gaseous waste products which pose a threat to the environment and to the general health of the Palestinian population.
However, our examination indicates that these factories are subject to strict environmental regulations which are no different than those which apply to factories located in the pre-67 territories. The factories are supervised by both the Municipal Environmental Associations of Judea and Samaria and the Civil Administration Environmental Staff Officer.
- The Report alleges that Israeli misconduct and aggression are the causes of the large number of Palestinian households which do not have adequate running water and electricity and, consequently, the health concerns that this inevitably causes; however, the Report does not supply any evidence to support this allegation.
On the contrary, numerous studies and academic papers have shown that along with a dramatic improvement in the overall quality of life for Palestinian households, the percentage of Palestinian households connected to water and electricity, dramatically increased after 1967. A report published in 2011 by the Palestinian Central Bureau of Statistics showed that 99.9% of all Palestinian households were connected to electricity, and 91.8% were connected to water networks. The evidence also suggests that Israel works closely with the PA to help improve Palestinian citizens’ quality of life.
In an effort to explain the high levels of mental distress in the Palestinian society the Report claims: “Through its brazen attacks and repeated incursions into Palestinian cities and towns, its use of lethal and horrific force, and its imposition of a suffocating blockade on the Gaza Strip, the Israeli occupation has played a key role in exacerbating mental health problems, particularly among women and children“.
While it is indisputable that living in an area of conflict has negative psychological ramifications, there are many additional factors which contribute significantly to mental distress in territories controlled by the PA, and which might be ameliorated with the help of WHO assistance. These additional factors were either mentioned as a side point, or completely ignored, such as the following:
- The Report notes that certain factors within the Palestinian society discourage people from seeking access to mental health, such as the belief that psychiatric medications are addictive, that mental disorders stem from weak moral or religious values, and fear of the social stigma associated with them. The Report also notes that there are only 30 psychologists and one psychiatrist located in the entire West Bank and Gaza. Both these factors make it extremely difficult for people suffering from mental health issues to receive help, exacerbating these issues and placing a large strain on their family members.
- Numerous studies have shown that violence against women is a severe issue in the Palestinian territories, with a recent study by the Center of Women’s Affairs in Gaza claiming that 63% of women in Gaza suffer from marital violence and 73% from verbal abuse. Reports have also shown that women suffering from domestic abuse in areas controlled by the PA are reluctant to seek assistance from authorities, as the legal system and law enforcement authorities do not provide them with adequate assistance (for instance, marital rape is not recognized as a crime). These statistics clearly play a major role in the cases of mental distress, particularly in women and children.
Despite this, the Report does not even mention these studies and statistics, preferring to focus on political issues and the conflict with Israel. By not reporting these statistics, the PA indicates that it does not view these concerns as a serious health issue and prefers to focus on attributing blame for the high levels of mental distress to external factors which serve their political agenda, rather than focusing on raising public awareness and on enforcing the law against domestic abusers. This policy is undoubtedly extremely detrimental to the victims.
Alleged Attacks on Medical Staff and Hospitals and Israeli Misconduct:
- The Report accuses the Israeli army of violating international law by searching, raiding, and, during operation Protective Edge, even bombing hospitals.
However, the report fails to mention that these hospitals allowed militants to seek refuge, in stark violation of international law. The fact that militants sought refuge in hospitals was confirmed by Palestinian security sources after the IDF arrested an armed member of the violent Al Aqsa Martyrs’ Brigades in Rafidiyeh Hospital. Palestinian security forces confirmed that the man arrested was not a patient. During Operation Protective Edge, the Washington Post reported that the Shifa Hospital in Gaza City had become a “de facto headquarters for Hamas leaders”. Hospitals are meant to be a safe haven for the sick and the wounded in times of war. For that reason, exploiting their protected status for military purposes must be unequivocally condemned.
- The Report claims that Israeli Magen David Adom (MDA) medics discriminate between patients and prioritize care for injured Israelis over wounded Palestinians. The Report also alleged that Israeli soldiers deny Palestinian attackers emergency medical assistance.
Having examined the MDA code of conduct and evidence, we have come to the conclusion that these claims are false (we do not reject the possibility that isolated instances of discrimination may have occurred in individual cases against MDA policy; however, as the report fails to introduce any real evidence to back these allegations, we adhere to the general conclusion that the allegations are completely false).
According to the MDA ethical code, a MDA medic is obligated to “meticulously supply the needs of individuals in need of MDA care based on medical criteria alone“, without discriminating between wounded people. This obligation was recently reiterated by MDA director general, Eli Bin, who ordered that paramedics arriving at a terror scene treat the wounded without discrimination, even if it means treating a terrorist before the victims. Bin explained: “When I see my enemy wounded I no longer treat him as a terrorist, but as a human being.”
MDA does instruct medics not to treat a terrorist if he still poses a threat to the medic, in accordance with international Red Cross guidelines. Therefore, in cases where the medics fear that the terrorist still poses a threat (such as a fear that the wounded terrorist may be wearing explosives), the medics will wait for the security forces to tell them that it is safe for them to treat the wounded terrorist.
Similarly, all evidence indicates that IDF soldiers routinely treat sick and wounded Palestinians, without any preconditions, and regardless of the political climate. The IDF also treats wounded Palestinian terrorists, implementing any medical procedures necessary and using cutting edge technology.
Additionally, the IDF recently opened a unit designed solely to provide medical care and humanitarian assistance to the Palestinian population.
- The Report alleges that Israeli authorities blatantly disregard human life and refuse to allow sick Palestinians access to hospitals and medical care. However, when examining the evidence on the ground, it appears that Israeli authorities work in cooperation with the PA to improve the health conditions of Palestinians. Thousands of Palestinian patients are transferred to Israeli hospitals for complicated treatments, regardless of the political and security situations. The Israeli and Palestinian health care sectors also work closely together. There are numerous partnerships between Israeli and Palestinian institutions, including programs which train Palestinian medical professionals at Israeli hospitals.
Palestinian Prisoners in Israeli Prisons:
The Report claims that Palestinians held in Israeli jails are subject to systematic torture, deprived of medical care, and are not provided with sanitary conditions, clean water, or a balanced diet.
Having examined Israeli law and the evidence available, we come to the conclusion that these allegations are false. Israeli law requires that prisoners, including security prisoner (terrorists), receive humane conditions and medical treatment. Furthermore, any prisoner who believes that his or her rights have been violated has a right to appeal to courts, including Israel’s Supreme Court. The International Committee of the Red Cross regularly monitors Israeli prisons insuring that they meet international standards.
- The Report notes that “there is a widespread belief among Palestinians that medical drugs are tested on prisoners, and that Israel has injected prisoners with carcinogenic viruses,” and questions, “Is it true that Israel is injecting prisoners with viruses?” The Report brings no evidence to back up this severe claim. Furthermore, when the Russian newspaper Pravda accused Israel of similar allegations in April 2013, the Palestinian Minister for Prisoners and Former Prisoners in the West Bank admitted that there is no confirmed information to support the allegations.
Falsified Pictures of Israeli Violence:
The Report contains many pictures used to prove and illustrate its allegations. However, media watchdogs have revealed that many of the photos in the Report are photo-shopped, cropped, and/or falsely labeled. A few such examples include:
- A picture on page 40 of the Report captioned “Photograph taken during the Israeli war on Gaza, 2014” was revealed to actually be a fictional computer- generated image posted on The Aviationist Blog on March 8, 2012 to illustrate what a hypothetical Israeli attack on Iranian nuclear reactors would look like (See Attachment A).
- A photo on page 30 of the Report captioned “Settlers attacking a Palestinian child while being observed by Israeli occupation forces” is actually a Getty Images picture showing IDF soldiers evicting Israelis from an illegal outpost. No Palestinians appear in the picture (See Attachment B).
- A photo on page 49 of the Report captioned “Israeli occupation soldiers search the interior of a Palestinian ambulance,” is actually a picture of an IDF soldier inside an Israeli MDA ambulance. The picture was cropped so most of the MDA symbol is cut out of the picture (See Attachment C).
The above examples prove unequivocally that The PA Report is highly politicized, contains false information, and is deliberately misleading. Given the severity of the accusations and the questionable veracity of these accusations, the PA Report must not be recognized by the WHO. The WHO cannot allow itself to become a platform to disseminate and credit baseless allegations, especially those which seem to be no more than modern day “blood libels.”
It is indisputable that there are serious health issues which need to be addressed in the Palestinian society. The PA’s attempt to hijack these issues and cynically exploit them for international political gain, while ignoring some of the major causes of these health issues, does a disservice to and severely harms the Palestinian people.
The WHO, by not condemning The PA Report, essentially endorsed it. Furthermore, by using language in the WHO Resolution which assumed many of the allegations to be factual and requesting that the Director-General report and make practical recommendations for solutions to the alleged problems, the WHO continues to credit The PA Report and allows the objective nature of the WHO to be overshadowed by political agendas.
As representatives of medical and mental health professionals who are committed to maintaining the noble traditions of their profession and to putting the service of humanity and the health of all patients, without discrimination based on nationality or political affiliation, as their first consideration, we condemn the use and exploitation of the health conditions of a society for political gain. We further denounce baseless accusations against their fellow Israeli colleagues who have been defamed and condemned without any valid indication that they have strayed from their commitment to the universal medical values and the protection of all human lives.
Presenting such a political and misleading report to the WHO is unethical and must be reprehended. The PA Report is detrimental to the development and improvement of the health conditions in areas controlled by the PA, and causes future damage because it sets a dangerous precedent of exploiting a medical organization, the WHO in this case, as a political battering tool.
The Field Assessment Report requested by the Sixty-Seventh World Health Assembly, and conducted by an external consultant and three WHO experts, referenced previous resolutions stating that “the role of physicians and other health workers in the preservation and promotion of peace is the most significant factor for the attainment of health for all”. Specifically, with regard to the Palestinian health situation, the report noted that “More efforts to place health considerations above political issues are required”.
Therefore, we call upon the WHO, and to you Mrs. Chan as the Director General of the organization, to condemn the PA for this report and demand that an objective scientific analysis of the health conditions in the Palestinian Authority be conducted, so that legitimate health issues of concern can be properly addressed.
We also wish to offer our assistance in researching and preparing this objective analysis, and would like to take an active role in any future examination of these issues.
Furthermore, we call upon the PA to put its citizens’ well-being, rather than political concerns, at the top of its agenda. We urge the Palestinian leadership to put aside persisting disagreements between the authorities in the Gaza Strip and the West Bank, and reintegrate the over 2000 gravely needed health workers who, at the request of the PA, stopped working in 2007, but continue to receive full pay, further draining the Palestinian health budget. We call upon the WHO and the donor countries to oversee this reintegration and ensure that the resources allocated for the development of the Palestinian health system and human resources are properly utilized.
Additionally, we call upon the PA to raise awareness among its citizens to issues related to mental health and domestic abuse, especially as they affect women and children. We further call upon the WHO to help implement programs to train Palestinian doctors in the field of mental health and to create programs designed to empower Palestinian women, whose problems have been largely neglected.
Yifa Segal, Esq.
 A69/44 Add.1 Health conditions in the occupied Palestinian territory, including east Jerusalem, and in the occupied Syrian Golan: http://apps.who.int/gb/ebwha/pdf_files/WHA69/A69_44Add1-en.pdf
 A69/44 Health conditions in the occupied Palestinian territory, including east Jerusalem, and in the occupied Syrian Golan: http://apps.who.int/gb/ebwha/pdf_files/WHA69/A69_44-en.pdf
 PA Health Report page 33
Municipal Environmental Associations of Judea and Samaria Website: http://www.enviosh.org.il/english
 Israeli Ministry of Environmental Protection Website: http://www.sviva.gov.il/YourEnv/KamatYosh/Pages/KamatRoles.aspx
 PA Health Report page 32
 Meir, Yitzchak. “Management of Industry Hazards and Business Licenses.” State of the Environment in Judea & Samaria (2012):37-45
 See supra, note 6
 See supra, note 7
  PA Health Report page 43, 33
 See for example: Stone, David “An Evidence-Based Analysis of the Nature and Impact of Israeli Public Health Policies Practices in the West Bank and Gaza.” Fathom Autumn (2014): available at http://fathomjournal.org/wp-content/uploads/2014/12/Has-Israel-damaged-Palestinian-health.pdf
 PCBS report available at: http://www.pcbs.gov.ps/Portals/_pcbs/PressRelease/int_Pop_2012e.pdf
Israeli Ministry of Foreign Affairs (MFA): http://mfa.gov.il/MFA/ForeignPolicy/Peace/Humanitarian/Pages/Reclaimed-water-workshop-for-Palestinian-farmers-4-Dec-2014.aspx;http://mfa.gov.il/MFA/ForeignPolicy/Peace/Humanitarian/Pages/Workshop-on-recycled-water-for-agriculture-in-the-PA-10-Nov-2013.aspx; http://mfa.gov.il/MFA/ForeignPolicy/Peace/Humanitarian/Documents/DecemberStorm.pdf
 PA Health Report page 17
 Id, page 16
 The New York Times: http://www.nytimes.com/2006/11/07/world/middleeast/07palestinians.html?_r=2
 UNICEF Report on the affect of marital violence on children: http://www.unicef.org/media/files/BehindClosedDoors.pdf
 PA Health Report page 49
 PA Health Report page 49
 International first aid and resuscitation guidelines, 2016: http://www.ifrc.org/Global/Publications/Health/First-Aid-2016-Guidelines_EN.pdf
Ynet: IDF doctor saves life of Palestinian baby: http://www.ynetnews.com/articles/0,7340,L-4513440,00.html ;
Ynet: IDF, settlers save Arab baby: http://www.ynetnews.com/articles/0,7340,L-4043536,00.html
 PA Health Report page 22
 See supra, note 14
 PA Health Report page 22
 Knesset report on prisoners’ conditions: https://www.knesset.gov.il/mmm/data/pdf/m03603.pdf
 Country Reports on Human Rights Practices for 2015: http://www.state.gov/j/drl/rls/hrrpt/humanrightsreport/index.htm?year=2015&dlid=252927#wrapper
 Israellycool Blog: http://www.israellycool.com/2014/07/16/stop-using-this-obvious-fake-image/
 Committee for Accuracy in Middle East Reporting in America (CAMERA) Blog: http://blog.camera.org/archives/2016/05/post_161.html
 World Medical Association Declaration of Geneva: http://www.wma.net/en/30publications/10policies/g1/index.html
 World Health Assembly, Resolution 34.38, 1981
 WHO-EM/OPT/006/E Report of a Field Assessment of Health Conditions in the Occupied Palestinian Territory, 2015: http://applications.emro.who.int/docs/Cons_Rep_2015_EN_16311.pdf
 WHO Report of a Field Assessment of Health Conditions in the Occupied Palestinian Territory, 2016: http://apps.who.int/gb/Statements/Report_Palestinian_territory/Report_Palestinian_territory-en.pdf