His face is haggard yet strangely resilient-like an old, gnarled olive tree which has had its branches hacked off for fuel yet stubbornly survives and puts out tender new shoots. Although he is only in his 40s, apart from his gentle eyes he looks much older. What ages him is the lack of teeth, which shortens his chin and makes his lips sink inward. (He had explained to me, in translation from Arabic, that his teeth were pulled out as torture while he was in jail.)

The ‘old’ man took my hand in his two and looked searchingly into my eyes. He spoke softly but with an intensity of feeling that gripped me as strongly as his bony hands.

“We have nothing against Americans,” he said. “We like Americans. What troubles us is your government. It would sweep us aside like so much dirt for its own selfish ends.

“They tell you that we are the terrorists.” He shook his head sadly. “All we want is peace and a fair share of the land we were born on. But look around you. Look at where and how we are forced to live, and what we are made to endure. Forty-two years in this refugee camp. Strangers in our own land. Is that fair?”

We were standing in sunlight amid the ruins of the man’s house—a house that has been destroyed three times by the soldiers.

The man’s daughter is a community health worker in a neighborhood health center I had been visiting, located in one of the biggest refugee camps in Gaza. She had taken me to visit her family, who live just a block away. on the deeply rutted, sewage-befouled street. (Residents of the camp told me that although the refugees, health workers, UN, and volunteer organizations are prepared to work together to install a much-needed sanitation system, the military government has repeatedly denied permission.)

The health worker had told me that their home was last bulldozed after one of the periodic raids of soldiers during a curfew. Bursting in without a warrant, the soldiers had ransacked the house and found a Palestinian flag. Because her mother had refused to say where she had got the flag, the security police returned a few weeks later and demolished the house as punishment. At the time the health worker’s father was in jail, having been accused of ‘having connections with the PLO’.

Her family has not rebuilt the house because it cannot afford to, having recently scraped together 7,000 shekels to get her father out of jail.

Her father was recently released, but now three of the health worker’s brothers are in prison. Four months ago her fourteen-year-old brother was stopped by the security police for ‘questioning’ while walking down the street with a group of friends. Subjected to a severe beating, the boy admitted to the police that his father was in detention, so they jailed him, too. (In the Occupied Territories anyone can be arrested on any pretext and placed in ‘administrative detention’ for six months without trial. The six-month period—which, I was told, is now being lengthened to one year—can be renewed indefinitely.)

The family is not allowed to visit the brothers in jail. The health worker fears that her brothers are being tortured, as her father was. Her father had shown me a jagged scar on top of his head where he had been blasted with a jet of water so fierce that it had torn open his scalp. The wound itself, he explained, had been an accident, for torture within the jails now usually uses methods that leave no signs.

Even in the case of the agonizing extraction of healthy teeth, it is hard for the victim to prove it was done without anesthetic, as torture. Medical records can be produced to counter this claim.

Still gripping my hand, the health worker’s father paused for a moment and then continued.

“Judge for yourself who are really the terrorists,” he said. “Then go back and talk to your countrymen. Urge them to stand up against the injustices of your government. For it is the American government that stands in the way of a peaceful and fair settlement between Israelis and Palestinians.”

Time and again, as I talked with people in Gaza and the West Bank, I heard similar sentiments. The young doctor in whose home I stayed in East Jerusalem also argued for greater understanding of the Palestinian position. (He himself has been arrested for organizing people concerning their health rights, and the car he drove me around in, despite the large red cross and red crescent it displays, had bullet holes in its hood where soldiers had fired on him during a rescue mission.) These are more or less his words:

For all the abuse we have suffered, we can still sympathize with the Israeli Jews. They, too, have a long history of suffering and expulsion. They have the same need as we do for respect, for understanding, and for land to call their own…

We Palestinians are prepared to live as neighbors with the Israeli people, but with the same rights, and as equals. It is the American government that stands in the way of peace, and the American dollar that is financing the extermination of our people.

In this report on health-related events in the West Bank and Gaza Strip, I do not want to get into a discussion of whether the Israelis or the Palestinians have a greater right to the disputed territories. Both groups clearly have a legitimate need for land they can call their own.

What the Israeli government, with backing from the US government, is doing to the Palestinian people amounts to systematic state terrorism.

My concern is rather with the institutionalized violation of human rights and international law. It is with the ways in which those with disproportionate wealth and power force their will on disadvantaged people. My concern is about questions of social justice, equity, and human decency. For these are the ultimate determinants of the health of peoples, of nations, and of the global environment.

It is important to state things clearly. What the Israeli government, with backing from the US government, is doing to the Palestinian people amounts to systematic state terrorism. Many activists and progressives in the United States more or less know this, but are hesitant to take a strong stand on the issue because they don’t want to be labeled as ‘anti-Semitic’. But to protest the persecution of a vilified people is anything but anti-Semitic! Indeed, millions of Jews—within Israel, the US, and around the world—are deeply upset about what the US and Israeli governments are doing to the Palestinians. One of the groups doing the best jobs of documenting human rights violations in the Occupied Territories, the B’Tselem Israeli Information Center for Human Rights in the Occupied Territories, is composed largely of Israeli Jews.

Progressive Jews everywhere are asking: What has happened to so distort and debase the ideals held by many of Israel’s early settlers? Many reach the conclusion that they and Palestinians alike have become victims of a global power game that would dehumanize and make pawns of us all.

It appears that most Israeli Jews support their government’s condemnation of the Palestinian Liberation Organization (PLO) because they have been led to believe that it is an outlaw terrorist organization determined to butcher all Jews or drive them into the sea. This is no longer true, if it ever was: today the PLO is seeking a peaceful settlement. Certainly, most of the Palestinians I met want peace. But unfortunately the citizenry of Israel is as influenced by the disinformation of the mass media as is the average American.

The Nonviolent Palestinian Quest for Self-Determination

For over two years now, the PLO has made it very clear that it is prepared to accept a peaceful settlement of the Israel-Palestinian conflict. Agreeing to the 1967 ceasefire borders, it seeks recognition of the West Bank and Gaza Strip as an independent state side by side with Israel. Most of the world’s nations now support such a settlement as reasonable and fair. By March 1989, 160 countries recognized the independent state of Palestine. (1) In 1989 the White House went so far as to threaten terminating US funding for the World Health Organization if this UN agency admitted Palestine as a member state. (2)

Contrary to the disinformation spread by the mass media in Israel and the US, the Palestinian intifada, or “uprising” (the word’s literal meaning in Arabic is “shaking off'), is basically neither terroristic nor even violent. The intifada began in December 1987 as a peaceful mass protest against human rights abuses committed by Israeli troops. For the most part it has maintained an essentially nonviolent stance, although recently violence has escalated on both sides. The goal of the intifada has been to mobilize the Palestinians for self-determination, independent of the control structures of the Israeli government, and to resist through ‘grassroots solidarity’ what a Hebrew newspaper has called Israel’s “war of extermination” against the Palestinian population in the Occupied Territories.

The intifada’s strategy of ‘comprehensive civil disobedience’ includes:

  • Organized strikes by the commercial sector. At present all stores except pharmacies are closed every afternoon, and all-day ‘general strikes’ are called in protest (or in memory) of specific human rights violations.

  • Withdrawal of labor from Israel on general strike days and, where possible, on a more permanent basis.

  • Boycotting Israeli products and encouraging the development of a local home-grown economy as an alternative. (For 1988, official Israeli statistics showed a $300 million decline in exports from Israel to the Occupied Territories.)

  • Refusal to pay discriminatory or punitive taxes and fines.

  • Boycotting the official structures of occupation. (Large numbers of Palestinians, including nearly all tax collectors, quit their jobs with the police, soldiers and Israeli civil authorities in the Occupied Territories.)

The activities of the intifada are organized by the Unified National Leadership of the Uprising (UNLU), which comprises the main elements of the PLO. A basic rule of the UNLU prohibits the use of lethal weapons, including guns and knives. Stone throwing at the occupying troops, however, is regarded as a relatively harmless and legitimate form of protest.

The only killings occasionally condoned by the UNLU are those of so-called ‘collaborators’. These are Palestinians who sell information to the Israeli security police or finger leaders of ‘community committees’. Those they inform on are then frequently arrested, tortured, assassinated, or deported. Collaborators are regarded as national traitors and treated as most nations treat traitors during wartime. First they are given a series of warnings to cut their ties with the Israeli authorities, and if they fail to do so they are executed.

The mainstream media in Israel and the US give disproportionate coverage to such killings of collaborators. The media attribute these killings to ‘infighting’ among extremist Arab factions. There clearly is some of this. But by and large there is remarkable unity among Palestinians. Since the beginning of the intifada, about 140 collaborators have been killed.

Under the circumstances, the number of violent acts committed by Palestinians—whether against their fellow Palestinians or against Israeli Jews—appears surprisingly low. This relative restraint seems to stem from a sense of solidarity and discipline, and suggests strong popular support of UNLU’s call for nonviolent resistance. While any violence against innocent civilians is ethically unacceptable, the occasional deadly assaults on Israelis by Palestinians though recently on the rise—have been relatively small in scale compared to the massive, systematic repression and human rights violations carried out by Israeli troops and settlers against the Palestinians. Compare these statistics:

  • According to the Israeli Defense Forces (IDF), from December 1987 to November 1989, eight Israeli soldiers, ten Israeli civilians and 136 collaborators were killed by Palestinians.

  • During the same period, according to the IICHR (Israeli Information Center for Human Rights in the Occupied Territories), 642 Palestinians were killed by Israeli army/settlers, including 131 deaths of children under 16 years due to gunshot wounds, beatings, or tear gas. In addition, according to IICHR, there were 37,439 Palestinian ‘casualties’. (The IDF reported only 8,938 Palestinian casualties for the same period.) The UNRWA categorizes the casualties in the Gaza Strip as follows:

The high number of nonfatal as compared to fatal casualties results in part from the military’s tactic of ‘collective punishment’. So does the high number of beatings. Although the Israeli government reports that many of the serious injuries are the unavoidable consequence of ‘riot control’ in which troops must use violence to protect themselves against assault by the rioters, there is a wealth of evidence indicating that the vast majority of serious injuries are inflicted upon persons who have already been restrained and are helpless.

A fact-finding mission conducted by a delegation of U.S. physicians observed a pattern of

dominant side-forearm and hand mid-shaft fractures. . . which suggested a deliberate policy of systematic beating designed to disable but not to kill, to inflict the maximum damage while reducing the risk of death . . . indeed the word ‘beating’ does not properly convey the literal pounding and mauling with clubs and other instruments required to produce the injuries we saw. (3)

"Everyone who wants the intifada eliminated must understand that there are only three ways to do this: by transfer, starvation, or physical elimination, that is—genocide." —Israeli Chief of General Staff Dan Shomron

Although the Israeli government’s standard reaction to such reports is one of denial, occasionally the truth comes out. A Gaza Strip army commander told a local newspaper, “I only know what orders I gave my soldiers: I ordered them to beat up demonstrators, break their bones, and draw blood.” (4) Another newspaper article explains the strategy:

A detainee sent to Fara’a prison will be freed in 18 days unless the authorities have enough evidence to charge him. He may then resume stoning soldiers. But if troops break his hand, he won’t be able to throw stones for a month and a half. (5)

Since the start of the intifada, the Israeli government has intensified its systematic oppression of the Palestinians. Judging from events, its goal is to make life so unbearable and survival so difficult for the Palestinians that those who remain will abandon their struggle for self-determination and move out. To get rid of the Palestinians, the Israeli government has forsaken its declared humanitarian principles and has resorted to state terrorism, systematic human rights violations, and a wide range of ‘dirty tricks’.

Israel’s Low Intensity Conflict Strategy Against the Intifada

To crush the intifada Israel employs many of the same tactics of ‘low-intensity conflict’ used by the US and South Africa in countries such as Nicaragua and Angola, together with the ploys of ‘total war’ used by the US-supported governments of El Salvadór, Guatemala, and the Philippines to repress their own people. Although the Israeli and US governments consistently deny or minimize the routine violation of human rights, Chief of General Staff Dan Shomron lays the cards on the table when he says:

Everyone who wants the intifada eliminated must understand that there are only three ways to do this: by transfer, starvation, or physical elimination, that is—genocide. (6)

The Israeli government is currently using all three techniques at once. Its ‘war of extermination’ includes frequent raids by soldiers on civilians, unjustified arrests and ‘administrative detention’ without trial, deportations, widespread torture and beatings, plus a wide range of measures designed to undermine the livelihood, economy, and ‘social fabric’ of Palestinians living in the Occupied Territories.

Many of these measures involve blatant violations of human rights and international law, not to mention the Israeli constitution. The following are some of the more flagrant violations.

Collective Punishment

International law, as embodied in the 4th Geneva Convention, prohibits collective punishment. Article 33 of the Convention states:

No protected person may be punished for an offence he or she has not personally committed. Collective penalties and likewise all measures of intimidation and terrorism are prohibited. (7)

Nevertheless, collective punishment has been intensified since the beginning of the intifada. A former military governor of the West Bank, Ephraim Sneh, explained the policy in this way:

The most important thing to realize is that the intifada has very broad popular support. Our confrontation is with the entire Palestinian population, and that is why punishment is necessarily collective measures. (8)

MK (member of the Knesset, Israel’s legislature) Geula Cohen puts it even more bluntly:

The Arabs all say they identify with the cause, so let them all suffer for it. (9)

The most common form of collective punishment is the curfew, both local and general. There are round-the-clock curfews which often go on for days or weeks. The intent of the curfews is apparently not simply to discourage rioting and public protests, but also to ‘crush’ the community into submission through a strategy of impoverishment and violence. These ‘crushing curfews’ are associated with a wide range of ‘punishments’ that include house raids, house-by-house beatings, house demolitions, mass arrests, tax raids (i.e., arrests, beatings, confiscations of property, and other harassment directed against shopkeepers and other Palestinians who haven’t paid their taxes), cuts in food, water, and electricity, the denial of access to jobs, education, and health care, and psychological warfare.

Often families go hungry because they are not able to leave their homes to go to the store or to their fields. Frequently such curfews are declared during harvest time, forcing people to go hungry in their homes while their crops rot. (10)

The intent of the curfews is to crush the community into submission through a strategy of impoverishment and violence.

Violators of the curfew are subject to beatings, arrest, detention, and risk being shot with plastic or rubber bullets or even live ammunition.

Such curfews create a major obstacle to health as well as to health care providers. One doctor described to me how he was dragged out of his home, beaten, and arrested for having opened his door to a desperate mother who had braved the curfew to come to his home with a sick child.

Especially in refugee camps and more remote towns, curfews are routine and often repeated, frequently with little or no apparent provocation. Some communities in the West Bank and Gaza have been subjected to ‘crushing curfews’ a full one-third of the time. One of the purposes of the curfews seems to be to engender a sense of terror, abject humiliation, and powerlessness. Children are often beaten in front of their parents. Or parents are battered in front of their children. Children brow up thinking that this condition of terror, brutality, and insecurity is normal.

Demolition and Sealing of Homes and Neighborhoods

As we drove through the streets of the West Bank and Gaza, time and again we saw the ruins of homes that had been bulldozed by soldiers. Occasionally we passed a whole block of houses that had been turned into rubble. I learned that some of these homes had been destroyed because a family member was suspected of belonging to a community committee, or because a child in the neighborhood had thrown a stone at soldiers. Often the demolitions took place without warning, giving occupants no time to remove their belongings.

In other cases homes or whole neighborhoods were ‘sealed’, with entry being blocked by towering walls of cement-filled drums. In the countryside near Jerusalem we saw isolated villages which had had all access roads shut off by mountains of debris piled high by bulldozers, so that neither public transportation nor school buses nor ambulances could come within a mile of the community.

Settlers and Vigilantes

As part of its strategy to disrupt and displace the Palestinians, the Israeli government has been promoting the settlement of immigrant Jews in the West Bank and Gaza Strip. For the ‘settlers’, as they are called, entire new heavily fortified towns are being built, their imposing stone houses and apartments surrounded by high barbed wire fences.

The settlers are granted a wide range of rights, privileges, and assistance denied to the Palestinians. Resentment is inevitable. So arriving Jewish settlers are given machine-guns to protect themselves. They are led to believe that all Arabs are thieves and terrorists. Many settlers, with tacit government approval, assume the role of ‘vigilantes’ or paramilitary ‘loose guns’, organizing their own campaigns of terror, violence, and revenge. When violent ‘incidents’ happen, as they do on an almost daily basis, the Israeli government washes its hands of any accountability or blames the ‘Arabs’ for having provoked them. Although settlers come from many countries, with the most recent big influx originating in the Soviet Union, the settlers with the worst record of human rights violations against Palestinians are those who have migrated from the US—a fact that has outraged Israeli progressives and human rights groups.

The vigilantes are rarely punished, even for the most brutal and unprovoked assaults. And when they are punished, their prisons terms are often cut short. Last December 26 the Israeli government released from jail three settlers who were responsible for an attack on a campus that killed three Palestinian students and left thirty wounded, as well as car bombings in which two Palestinian mayors lost limbs. The men had had their original life sentences reduced on three separate occasions by Israeli President Chaim Herzog, and a fourth time by a parole committee. In the end, they served less than seven years. Although some Israelis celebrated the freed settlers as ‘national heroes’, others protested the early release, declaring that it legitimized and encouraged terrorism against Palestinians. (11)

In Gaza I had a chance to interview a victim of this sort of unprovoked terrorism. While visiting Beach Refugee Camp we saw a young man, obviously disabled, lying on the road embankment. On his leg was a surgical device consisting of a series of thin rods passing through the thighbone. From my work with disabled children in Mexico, I knew the device was designed to gradually lengthen a leg that has been severely shortened and deformed by a fracture.

We asked the young man what had happened. He explained that he had been one of many victims during a rash of ‘Arab bashing’ following an event several months before, when a Palestinian youth in a distant town had commandeered a bus and driven it off a cliff. Several Jewish people had been killed. In response, vigilante settlers all over the Occupied Territories had carried out violent reprisals against Palestinians. At the time the young man—completely unaware of the distant incident with the truck—was driving to Birzeit University, where he was an engineering student. Stopped at a road block, he was dragged from his car by a group of angry settlers who beat him with rocks and clubs, breaking many bones. Then they tied him with a rope to the back of his car and pushed the car off a steep embankment, dragging the young man behind it into a deep ravine. Altogether, he told us, he had suffered 32 fractures.

In Israel's attempt to thwart the Palestinian struggle for self-reliance, deprivation of water has become a key strategy.

I asked the disabled young man if I could photograph him to document his story. He said no, that it might reveal his identity. The security police have warned him not to report how he was injured, saying that if he does, worse is in store for him.

This is not an isolated incident. In a community rehabilitation center I visited in the Gaza Strip, the head physiotherapist told me that 70% of the center’s patients are victims of physical violence. Most are recuperating from fractures. Nearly a third of the victims are children.

Denial of Adequate Water

Israel takes pride in ‘making the desert bloom’. And certainly, as we drove across Israel, I was impressed by the vast stretches of verdant fields and orchards. (Indeed, the so-called ‘Green Line’ separating Israel and the Occupied Territories gets its name from the striking contrast between the ‘green pastures’ of Israel and the red-brown parched ‘wastelands’ of the West Bank.) The difference in land productivity, however, does not result from Israel’s superior ‘green thumb’, but from its power to decide who gets water.

In Israel’s attempt to thwart the Palestinian struggle for self-reliance, deprivation of water has become a key strategy. Thus discriminatory ‘Water Laws’ systematically favor Israelis at the expense of Palestinians.

The water in the West Bank comes primarily from deep aquifers (underground water tables) and requires careful management. Much of this water is robbed from the Palestinians, for use by the Israelis. Of the 807 million cubic meters (m3) of water originating in the West Bank in 1990, 510 million m3 were diverted for use in Israel. Another 160 million m3 were allotted to the Jewish settlers in the West Bank (who number about 100,000), while only 137 million m3 were allowed to the 1,200,000 Palestinians. This means that the settlers get almost twelve times as much water per person as do the Palestinians.

Yet Palestinians must pay twice as much for water as do neighboring settlers. West Bank towns, where the water originates, pay 60% more than households in Tel Aviv.

The discrimination goes even further. To supply the Jewish settlers with abundant good water, the Israeli government bores deep wells into the aquifers. The water pumped up from these aquifers to irrigate the settlers' crops is causing a steady lowering of the water table, so that the shallower but formerly adequate wells of the Palestinians are going dry. The Palestinians, however, are not allowed to dig new or deeper wells without a special permit, and these permits are routinely denied. As a result, the Palestinians are subjected to an acute water shortage, and agricultural production suffers.

The Gaza Strip has even worse water problems than the West Bank. In Gaza the Jewish settlers number a mere 2,500 but possess large plots of land which consume enormous amounts of water. Their deep wells cause sea water to enter the underground reservoirs taped by the Palestinians. As a result, the Palestinians water supply is becoming increasingly saline. Not only does this steadily climbing salinity have a direct harmful effect on people’s health, it has begun to damage agriculture and has potentially disastrous long-term consequences. (12)

Over Fluoridation and Poisoning of Drinking Water

On top of the problem of water shortage and salinity, the Israeli government has reportedly been ‘treating’ the public water supply in Gaza with dangerously high levels of fluoride. (13) This can have devastating long-term effects on health. Fluorosis—or poisoning from excess of fluoride—can cause problems ranging from permanent damage to teeth (especially in children) to spondylitis (severe arthritis of the spine) and progressive nerve damage and paralysis. The results are cumulative. According to dentists I talked to, dental damage due to fluorosis has already been noted in Palestinian children.

Over fluoridation is not the only way in which the public water supply has been poisoned. According to a 1986 World Health Organization report, “the occupation authorities put certain chemicals in the drinking water that have adverse effects on the fertility of the Arab population.” (14)

Prohibition of Adequate Sanitation

Since 1948 hundreds of thousands of refugees have been crowded into huge refugee camps in the Occupied Territories. Especially in Gaza, which has one of the highest population densities in the world, living conditions are deplorable. The refugee camps lack sewage systems, and foul-smelling sewage flows between the crowded huts and across the unleveled dirt streets and alleys. The stench was bad enough in the cool season when I visited. During the hot summer season it is said to be suffocating.

Similarly, there is no adequate system of garbage collection. The desert area surrounding the Gaza refugee camps comprises a big garbage heap, extending for miles. Likewise, the lots where houses have been bulldozed as punishment have been transformed into mountains of garbage.

The unhygienic state of the refugee camps in Gaza persists only because the Israeli government has prohibited measures to provide an adequate sewage and garbage disposal system. The refugee camps are under the administration of the United Nations, which has been repeatedly blocked in its attempt to improve the situation. Similarly, many nongovernmental organizations have made proposals to help put in sewage lines, only to be stymied by red tape. Being forced to live under such grossly unsanitary conditions has a predictably adverse effect on both health and survival, especially that of children.

Excessively High Fees and Punitive Taxes

Palestinians joke wryly that their homeland is the only place in the world where you have to apply for a permit and pay a tax to plant a tomato in your back yard. “They are trying to tax us out of existence,” remarked one elderly Arab. To discourage efforts toward self-reliance, Palestinians are required to obtain a permit and pay extremely high fees for almost anything. Even the poorest families who try to eke out a living collecting refuse with a donkey cart must pay to have the cart licensed. The fee is so high that the many donkey cart drivers must either give up their trade or go about it illegally, in which case they become the targets for harassment, beatings, and detention.

Unfair Economic Conditions and Depressed Wages

Because of the combination of population density, water shortage, and intentional reversal of economic development, hundreds of thousands of Palestinians living in the West Bank and Gaza are forced to seek work elsewhere. Until recently, many sought employment in the oil-rich countries of the Persian Gulf, and sent money home to their needy families. Hundreds of thousands of Palestinians also work in Israel where, like Mexican ‘aliens’ in the US, they suffer discrimination and humiliation. They do the dirtiest, most menial work—the kind the Jews don’t want to do—and at less than half the pay a Jew would receive. Palestinians in the Gaza strip get up at 2 or 3 am, travel three hours by bus to Tel Aviv, work a grueling ten-hour day, and arrive back home late at night. When curfews are declared, workers can leave their homes only at great risk. Apart from income lost through curfews, workers may be fined or fired for their failure to appear on the job.

At the time of my visit to Gaza, approximately 100,000 residents from the area traveled daily to and from their jobs in Israel. (They are not allowed to stay in Israel overnight.) At a time when the crisis in the Persian Gulf has made poor families even more dependent on employment in Israel, the Israeli government has just passed a law to cut back the number of itinerant workers from Gaza to 50,000. (Officials grudgingly admit that Israel depends on the Palestinian labor force, just as the US depends on the low-income labor of Mexicans. (15) )

Although Israel today is a relatively wealthy and highly developed country, most Palestinians employed in Israel have a hard time making ends meet. They are grievously mistreated, underpaid, and overtaxed. Although they pay a sizable percentage of their paltry income for health insurance, they are entitled to very marginal benefits. When a worker from Gaza is injured in Tel Aviv, he usually receives only provisional emergency care, then is sent back to Gaza. In Gaza City the government hospitals are crowded, dirty, understaffed, and ill-equipped compared to the facilities in Israel proper. The situation reminds me of South Africa with its stark contrast between the elegant hospitals for whites and the sorry hospitals for blacks. In truth, the brutal and pervasive discrimination against Palestinians in Israel is nothing less than apartheid.

Violations Against Health Workers and Facilities

In the aftermath of confrontations with the troops, in which large numbers of demonstrators and bystanders are often seriously injured, Israeli soldiers routinely block attempts by emergency medical teams to enter the conflict areas. Several doctors and ambulance drivers told me how they had repeatedly been stopped and turned back by Israeli troops, or had been forced to take back alleys and side roads to avoid roadblocks. Even though military regulations require that soldiers help persons injured in ‘confrontations’ to reach medical facilities, they rarely do so. Sometimes they have pulled injured persons out of rescue vehicles and beaten or detained them, occasionally with fatal results. (16)

Many injured persons are afraid to seek medical help because on a number of occasions soldiers have burst into hospitals or clinics and dragged injured patients from their beds. Some doctors and nurses who have tried to protect their patients have been beaten or arrested. (17)

Also, soldiers have sometimes commandeered Palestinian ambulances in order to infiltrate without being detected into neighborhoods which residents have barricaded. Then they suddenly jump out of the ambulance to beat, shoot, and arrest people attending a community gathering.

All of these actions are clear violations of medical immunity under international law. But the worst violations are the attacks on hospitals themselves, such as the one that took place this last October. The DF had opened fire on a Palestinian demonstration at the Temple Mount in Jerusalem. At least seventeen Palestinians were killed and many more were injured. Many of the injured were taken to Maqassed Hospital. The soldiers then raided the hospital, throwing tear gas indiscriminately into the wards, including the maternity ward. Newborn babies and their mothers had to be quickly evacuated. Such raids on hospitals and clinics, I was told, are not uncommon.

Lethal Misuse of ‘Riot-Control’ Weapons

Throwing tear gas canisters into enclosed areas can be deadly, especially for infants, old people, and persons with respiratory conditions. International law and also instructions on the canisters warn against such abuse. Yet the Israeli troops routinely throw the canisters into homes, meeting halls, and even hospitals.

According to a study conducted by Anne Nixon for Rädda Barnen (the Swedish Save the Children organization) and the Ford Foundation, nearly one quarter of the 159 child deaths recorded in the first two years of the intifada were a result of tear gas, mostly canisters thrown into private homes. Of these 37 tear gas deaths, over three quarters were infants. During this same period an estimated 10,600 to 13,000 children required medical treatment for tear gas-related injuries. (18)

Medical workers showed me remains of tear gas canisters they had collected, including one (shown in the photo below) which exploded in a closed room, causing severe lung damage to two infants. Printed clearly on the canister was “Made in Philadelphia”. Shipment of tear gas from the US continues. However, at least one of the US companies supplying Israel, Transtechnology, has suspended shipments of tear gas there because of the repeated reports of deadly misuse. (19)

The Palestinians are also used as guinea pigs to test new weapons. According to UN representatives I talked with, it appears that the US and Israeli militaries are experimenting both with new gases in tear gas canisters and with suffer-sized canisters. While the ordinary tear gas canister is the size of a Coke can, these huge new tear gas ‘bombs’ are the size of a wastebasket, and are dropped from helicopters into crowds, homes, and public buildings.

So-called ‘plastic bullets’ and ‘rubber bullets’, also designed for ‘crowd control’, are routinely misused. Although they are intended to be fired at the ground in front of rioters and to strike them on the ricochet, troops routinely fire them pointblank into the body, face, or back of the head of often fleeing victims. Scores of deaths, and hundreds of skull fractures, blinded eyes, and other serious disabilities have been the result. Again, many of the casualties are children.

Perhaps the most serious human rights violation is the use of live ammunition, especially high-velocity bullets. These bullets—which disintegrate upon contact and cause such extensive damage that if they hit an arm or leg it must often be amputated—have no place in domestic riot control.

Closures of Schools, Colleges, and Universities

Shortly after the start of the intifada, the Israeli government closed down all schools, colleges, and universities in the West Bank. In effect, education was condemned as subversive. Primary and secondary schools were allowed to reopen after one and a half years, but classes are still suspended intermittently during curfews. Several months ago most of the colleges were allowed to resume functioning, but the universities (except for Bethlehem University) remain closed. Any student or professor caught on the campus of a closed university is subject to beating, arrest, or deportation. (20)

In some ways learning has suffered from this repression. But in other ways it has become intensified and more pragmatic. Most professors have continued to give classes outside the university premises, in mosques, churches, and private homes, although this is regal. At first the IDF made great efforts to identify and raid these clandestine centers of learning, but at present such informal classes are for the most part tolerated.

Deportation of Community Leaders

One of the aims of Israeli government policy is the disintegration of community organization and structure. Yet the more the intifada has been suppressed, the more it has spread. In the struggle to survive the terror and repression, Palestinians have pulled together and developed new strategies for production, communication, survival, and mutual assistance. One outcome of this process has been the formation of ‘popular committees’ to help people help each other. These community committees were quickly declared illegal, and many of their members were subjected to beatings and ‘administrative detention’. (21)

Members of the popular committees, along with suspected members of the PLO, are now frequently being deported by force to refugee camps in Jordan and Lebanon.

Deportations are carried out on two grounds: for alleged security (i.e., political) reasons, and for lack of a valid residence permit. (Residence permits are often taken away from people for little or no reason, subjecting them to the risk of subsequent deportation.) The deportations on political grounds can be appealed to the Israeli High Court; to date, however, no order has ever been overturned. (22) Deportation of persons from their homeland is yet another violation of international law. But, despite protests by human rights groups, increasingly large numbers of Palestinians are being deported, with diminishing possibilities for appeal.

Impact on Health

The mufti-faceted ‘war of extermination’ against the Palestinians has taken a heavy toll on life and health, especially among children. The infant mortality rate (IMR) in the Occupied Territories varies from 40 to 80 (deaths per 1,000 live births) depending on the area, as compared to fourteen in Israel proper. The Israeli government officially claims an IMR of 30 for Palestinians. However, both the UN and UNICEF confirm the higher figures. Even the Israeli Central Bureau of Statistics reported an IMR of 70/1000 for the West Bank in 1985. (23)

Child mortality is especially high in the refugee cams during the hot summer season, primarily due to diarrhea) disease. The death of so many children from diarrhea is linked to the rampant spread of disease through rotting debris and open sewers. As we have discussed, this sanitation nightmare is perpetuated by the refusal of the Israeli government to permit adequate systems of sewage and refuse disposal.

Also contributing to the high mortality from diarrhea is widespread malnutrition, which lowers children’s resistance to infection. (It is a well-known medical maxim that “the child who dies from diarrhea dies from malnutrition.") Malnutrition rates among Palestinian children vary from 34% in rural areas near Jerusalem to 40% in the Hebron District and 55% among girls in the Ain al-Dyouk area of the Jordan Valley. Mothers' nutritional status during pregnancy also affects the health and survival of children. In some areas of the Occupied Territories more than 60% of mothers have been found to be anemic. (24)

Again, there is little question that Israeli punitive measures-including embargoes, deprivation of food and water, stifling taxes, and barriers to agricultural and other productivity—contribute significantly to the present levels of child and maternal malnutrition. (25)

Before the intifada, government expenditures on health—and therefore the quality of government medical services—were much lower in the Occupied Territories than in Israel. In response to the intifada, spending on health and other services in the Territories was slashed even further. Hundreds of Palestinian doctors and health personnel lost their jobs. One of the newest hospitals in East Jerusalem was converted into a huge police station.

The charts below show how the infant mortality rates in the West Bank and Gaza, on the one hand, and Israel, on the other, correlate conversely with the relative spending on health.

Source: The Union of Palestinian Medical Relief Committees, West Bank and Gaza Strip (UPMRC)


Out of the Ashes

“Under conditions of military rule, the challenge that faces Palestinians lies precisely in their ability to develop creative modes of coordination and cooperation from the bottom upwards—as this seems to be a matter of survival.” (26)

  • The Union of Palestinian Medical Relief Committees, West Bank and Gaza Strip

In spite of the Israeli government’s massive assault on the human rights of the Palestinian people, I came away from the West Bank and Gaza with an odd sense of exhilaration, even hope. There is something uplifting about the human bond, the courageous unity, the accelerated pulse of trust and understanding and mutual assistance, the unrelenting sense of urgency that draws people together when they face severe repression and daunting odds.

The uphill struggle for basic rights often brings out the best in people. It shatters their previous self-centered outlook and somehow makes them more resourceful, more giving, and more fully alive-more fully human. Men and women, adults and children, teachers and students, priests and parishioners, healers and patients all begin to relate to each other and work together more as equals and friends, sharing a common vision.

The more the intifada is suppressed, the more it spreads.

I have witnessed this same kind of vital human synergy in the struggle for self-determination in just a few other circumstances: once when I visited Nicaragua at the time of the overthrow of Somoza; once when I was hosted by progressive groups struggling against apartheid in South Africa; and once when I was in Mozambique.

When power structures become too repressive, they sow the seeds of their own undoing. Latin Americans say half-jokingly, “Paulo Freire was a great ‘consciousness raiser’, but Anastasio Somoza was more effective.” And so it is in the Occupied Territories.

Even some Israeli leaders have come to admit the counterproductive results of violent repression. For example, MKs Yossi Sarid and Dedi Zucker made the following observation:

The past year has shown that the more the intifada is suppressed, the more it spreads. It is possible to contain a particular outbreak of rebellion by concentrated effort, but it is impossible to put down the rebellion itself which is constantly changing in accordance with its needs and possibilities. Most of the means of suppression employed were not only ineffective but actually boomeranged and inflamed the intifada. The punishments m general, but specifically the collective punishments, drew more and more Palestinians into the cycle of resistance, broadened it and deepened its roots. (27)

The sense of solidarity that has arisen out of the Palestinian struggle is truly impressive. For example, when I visited the community blood bank in Gaza, the director told me with pride that in spite of the enormous need for transfusions due to the brutality of the soldiers, the bank was never short of blood. Hundreds of youths, many of them teenagers, enthusiastically donate blood. The bank has a sophisticated record system of the blood types of virtually the whole community, so that those in need can be quickly matched with donors in times of crisis. The bank’s director told me that during the Armenian earthquake disaster, when large amounts of blood were desperately needed, the young Arabs in the refugee camps rallied to make donations.

The Palestinian Revolution in Health Care

In East Jerusalem and the West Bank I met many people who are committing their lives, often at considerable risk, to helping their people work together and endure. Because of my experience in primary health care, I was warmly welcomed by the Union of Palestinian Medical Relief Committees (UPMRC), a network spread throughout the Occupied Territories. Amazingly, its membership includes nearly a third of all Palestinian doctors. These daringly progressive doctors have taken a highly effective community based approach to primary health care, and are actively training and providing back-up for community and village health workers.

I visited UPMRC health posts in both the West Bank and Gaza, and was impressed by the clean, orderly facilities as well as the competence, comprehensiveness, and friendliness of care. There is strong emphasis on preventive measures, especially in maternal and child health.

With cooperation from Birzeit University (which officially remains closed), the UPMRC has developed some excellent posters and teaching materials. One of the group’s innovative ideas is to print health messages illustrated with colorful drawings on plastic shopping bags. Themes include oral rehydration therapy, breastfeeding, and appropriate weaning foods.

Despite repeated IDF raids on the community health posts, health workers continue to provide badly needed health promotion and services. Many injured and beaten persons who are afraid to go to the government medical facilities come to these community health posts, confident that they are among friends.

The UPMRC health team also runs an ambulance service and braves abuse by soldiers in order to provide emergency services in conflict situations. Several doctors and health workers have been killed while attempting to help the injured. Over 30 have been beaten and/or arrested—some of them several times.

The doctor who was my host in East Jerusalem, one of the founders of the UPMRC, told me that he has been arrested three times. One night the security police arrived at his home and marched him away. “For questioning,” they said.

“At least they didn’t torture me,” the doctor said. Then he told me how they made him stand for 24 hours with his hands against a wall and a black cloth bag placed over his head so that he could not see and had difficulty breathing. To me that sounded like torture, but the Palestinians reserve the term for much worse brutalities.

In spite of all he has gone through, the doctor is still ready to stand up to the Israeli army in defense of his people. He has two young daughters, ages one and three. One Sunday when the family was in church, a small boy who had just thrown a stone at passing soldiers dashed into the church followed by a band of soldiers brandishing weapons. While the congregation cowered in terror, the doctor calmly stepped forward and asked the soldiers to please not intervene in a place of worship. The soldiers, taken aback, pointed their weapons at the doctor, then grumbled some threats and retreated—this time without either arresting the doctor or pursuing the boy.

“You have a lot of courage,” I commented.

The doctor shook his head sadly. “We try to keep our children away from all the violence,” he said. “But this time our little girls were right there watching the whole thing: the enraged soldiers, the terrified people, the pointing of guns. They, too, were terrified. My three-year-old wept all night. She still wakes up screaming . . . What does all this conflict and cruelty do to children growing up?”

The Role of the US Government in Perpetuating Middle East Conflicts

It all seems so unnecessary. I found myself asking how all this Israeli-Arab conflict has come about. And why hasn’t it been resolved?

In a swank, very plastic, US-style fast food cafeteria we stopped at on the Israeli side of the Green Line after leaving the Gaza Strip, we watched a group of Israeli soldiers laughing and joking as they ate their hamburgers and sipped their Cokes. Many of them looked so fresh and young and innocent, like schoolboys. I came away with the feeling that both the Palestinian people and the Israeli soldiers are being used, like expendable pawns, in a global power game. Most Palestinians and many of the Jewish people long for peace. If the US government also truly wanted peace and was willing to withhold some of its vast military and economic aid to Israel until an equitable settlement was reached, a peaceful resolution would be around the corner.

But the US government has another agenda. It has purchased the allegiance of Israel with billions of dollars and used the Israeli government as a hired gun to do some of the dirtiest work in its global power game. It has conscripted Israel’s leaders as accomplices in US covert operations, illegal supply of arms, and dirty wars ranging from Latin America to Africa. It has transformed this tiny, idealistic nation of kibbutzim into a repressive police state and US proxy—a heavily armed outpost of Washington’s foreign policy bolstering US economic and military dominance over the oil-producing countries of the Persian Gulf.

Peace and negotiated settlement are at present clearly not top priority for the US government, either in the Israel-Arab conflict or in the Iraq-Kuwait conflict. The US government is more concerned about the profits of American oil companies and the military industrial complex than about the lives and well-being of the world’s people.

But whatever the immediate effects of the current war, some big changes are in the air. The US government and the wealthy interests it represents have gone too far too often. They have wrought violence and brought hunger to too many of the world’s people. Too many of the so-called democracies they helped to create and militarized have defended only the freedom of the strong to exploit the weak. But gradually the oppressed peoples of the world are awakening, rallying, and preparing to struggle for their rights. Major political changes are brewing in the Middle East and in the world as a whole. The disaster of growth-oriented development at the expense of equity and ecological balance cannot continue much longer.

The time has come for the US government to draw back from its attempt to dominate the world economy. Washington needs to start allowing struggling peoples everywhere to determine their own course. We need to drastically reduce military spending and invest the resulting ‘peace dividend’ in energy—and environment-conserving measures so that we no longer have to depend on oil imports from the Middle East.

It is time for Americans to awaken to the plight of our world and its people, to join in solidarity with humanity, and to demand a radical change in our government, and in our foreign and domestic policy.

There may still be time to limit far-reaching global disaster if we act now. Oppose US abuse of power! And as a start, oppose the Gulf war. Support a peaceful, negotiated settlement of both the Israeli Palestinian and Iraqi-Kuwaiti conflicts. We need to take just as vigorous action to end Israeli violations of human rights and international law in the Occupied Territories as to oppose similar Iraqi violations in Kuwait—not because Saddam Hussein says so, but because moral consistency demands it. If we do otherwise we are hypocrites; we forfeit all moral authority. As US citizens, we bear a special responsibility to take action, since our government has contributed significantly to creating both these tragic and dangerous confrontations. HW

Things We Can Each Do Right Now

  • Protest the US policy of violence in the Middle East. Call, write, and send telegrams to President Bush and Congress demanding a halt to the war against Iraq, whose prim victims are sure to be innocent civilians. Call for a return to the quest for a peaceful settlement and an end to all the acts of buying and violence plaguing the Middle East, including Iraq’s invasion o Kuwait, Syria’s and Israel’s occupation of Lebanon, Israel’s violations of Palestinians' rights (including the blanket curfew that the Israeli military has been enforcing in the Occupied Territories ever since the war began), and the massive US attack on Iraq. Urge that such an all-inclusive settlement be a first step toward a new era of respect for the rights and self-determination of all peoples.

  • Petition and vote for laws to prohibit PAC (political action committees) donations to the election campaigns of presidential and congressional candidates. As it stands, the bribery power of these PACs over high-level decisions allows powerful economic interests—such as the arms industry, oil industry, and pro-Israel lobby to dictate national and international policies, including those in the Middle East. This is reflected in Washington’s massive backing for Israel and refusal to support the UN in negotiating a fair settlement between Israel and Palestine. Not until Congressional policy decisions become genuinely democratic cyan we hope that the US government will give more weight to the needs of distressed peoples and less weight to the selfish demands of powerful economic interests. (See article beginning on p. I7.)

  • Become better informed, and help others become informed, about the complex dynamics of health, wealth, and power in the Middle East and throughout the world. Don’t trust the mainstream media; the lens through which it transmits reality is distorted by its vested interest in the status quo and its allegiance to dominant economic forces. Instead, read the alternative press, human rights and independent studies by those whose allegiance is to humanity and the disadvantaged, and reach your own conclusions. (See the suggested reading list that follows.)

  • Join local groups working for human rights, social justice, and self-determination in the Middle East and elsewhere. (See insert.)

  • Get to know, befriend, and form a personal bond with persons or groups who are looked down upon, feared, distrusted, or are in other ways ‘different’. Ultimately, everyone is human. By building on one another’s strengths rather than condemning or attacking others for their weaknesses, we can go beyond the fear and misunderstanding that our own isolation creates.


  1. The Jerusalem Media and Communication Centre (JMCC), The Intifada: An Overview—The First Two Years (1989), p. 32.

  2. “Baker Urges Cutting Off of Funds if UN Agencies Upgrade PLO,” New York Times, May 2, 1989, p. A6.

  3. Amnesty International, Excessive Force: Beatings to Maintain Law and Order, 1988.

  4. Ma’ariv, January 28, 1988.

  5. Jerusalem Post, January 20, 1988.

  6. Jerusalem Post, June 16, 1989.

  7. Jean S. Pictet, ed., Commentary: IV Geneva Convention Relative to the Protection of Civilian Persons in Time of War (Geneva: International Committee of the Red Cross, 1958), pp. 224-225.

  8. International Herald Tribune, October 13, 1988.

  9. DataBase Project on Palestinian Human Rights, Uprising in Palestine: The First Year (Chicago and Jerusalem, 1989), p. 109.

  10. Anne Elizabeth Nixon, The Status of Palestinian Children during the Uprising in the Occupied Territories (a study conducted by the Ford Foundation and Rädda Barren, January 1990), Part II, p. 45.

  11. “Three Israeli Terrorists Are Released in Fourth Reduction of their Terms,” New York Times, December 27, 1990, p. A3.

  12. Most of the information in this section comes from the following article: Paulo de Rooij and Luis Vazquez, “Making the Desert Bloom?,” Links Health and Development Report, Vol. 7, Nos. 3/4 (Fall/W inter 1990), p. 16.

  13. Ibid., p. 16.

  14. Ibid., p. 16.

  15. See for example an article on this topic in the October 7, 1988 edition of the Jerusalem Post, and an editorial in the June 1, 1989 edition of Attalia.

  16. Physicians for Human Rights, The Casualties of Conflict: Medical Care and Human Rights in the West Bank and Gaza Strip (March 30, 1988); Nixon, The Status of Palestinian Children during the Uprising in the Occupied Territories, Part II, p. 46.

  17. Physicians for Human Rights, The Casualties of Conflict: Medical Care and Human Rights in the West Bank and Gaza Strip, pp. 26-27; Nixon, The Status of Palestinian Children during the Uprising in the Occupied Territories, Part II, P. 47.

  18. Nixon, The Status of Palestinian Children during the Uprising in the Occupied Territories, Part I, pp. 5-6.

  19. In May 1988 Transtechnology suspended tear gas shipments to Israel “until such a time as Israel demonstrates that it is prepared to use the product in a proper and non-lethal manner.” Al-Fajr English, May 22, 1989.

  20. JMCC, The Intifada: An Overview -The First Two Years (1989), pp. 1011; JMCC, Lessons of Occupation: Palestinian Higher Education during the Uprising (1990), pp. 18-31.

  21. Nixon, The Status of Palestinian Children during the Uprising in the Occupied Territories, Part II, p. 46; JMCC, The Intifada: An Overview—The First Two Years, p. 27.

  22. JMCC, The Intifada: An Overview -The First Two Years, p. 1.

  23. The Union of Palestinian Medical Relief Committees, West Bank and Gaza Strip (UPMRC), An Overview of Health Conditions and Services in the Occupied Territories (Jerusalem, August 1987), pp. 8-10.

  24. UPMRC, An Overview of Health Conditions and Services in the Occupied Territories, pp. 10-1 1.

  25. Nixon, The Status of Palestinian Children during the Uprising in the Occupied Territories, Part Il, p. 47, p. 60.

  26. UPMRC, An Overview of Health Conditions and Services in the Israeli Occupied Territories, p. 26.

  27. Jerusalem Post, December 9, 1988.

Suggested Reading

Al-Haq: Law in Service of Man. Punishing a Nation: Human Rights Violations during the Palestinian Uprising. West Bank: Ramallah, 1988.

Aruri, Naseer. Occupation: Israel over Palestine. Association of Arab American University Graduates, 1983.

Benvenisti, Meron. 1987 Report: Demographic, Economic, Legal, Social and Political Developments in the West Bank. Jerusalem: West Bank Data Project, 1987.

Bookbinder, Hyman, and Abourezk, James. Through Different Eyes. Bethesda, Maryland: Adler and Adler, 1987.

Chomsky, Noam. The Fateful Triangle: The United States, Israel, and the Palestinians. Boston: South End Press, 1984.

Cobban, Helena. The Palestine Liberation Organization. Cambridge: Cambridge University Press, 1985.

Flapan, Simha. The Birth of Israel: Myths and Realities. Pantheon, 1988.

Lilienthal, Alfred. The Zionist Connection: What Price Israel? New York: Dodd, Mead, and Company, 1978.

Lustick, Ian. Arabs in the Jewish State: Israel’s Control of a National Minority. University of Texas Press, 1980.

Nixon Anne Elizabeth. The Status of Palestinian Children during the Uprising in the Occupied Territories. Rädda Barren, January 1990.

Peretz, Don. Intifada: The Palestinian Uprising. Boulder, Colorado: Westview, 1990.

Said, Edward. Covering Islam: How the Media and the Experts Determine How We Seethe Rest of the World. New York: Pantheon Books, 1981.

Said, Edward, and Hitchens, Christopher (eds.). Blaming the Victims: Spurious Scholarship and the Palestinian Question. Routledge Chapman and Hall, 1988.

Shehadeh, Raja. Occupier’s Law: Israel and the West Bank. Washington, D.C.: Institute for Palestine Studies, 1985.

Stockwell, John. The Praetorian Guard: The US in the New International Security State. Boston: South End Press, 1990.

Timmerman, Jacobo. The Longest War: Israel in Lebanon. New York: Alfred A. Knopf, 1982.

Turki, Fawaz. The Disinherited: Journal of a Palestinian Exile. New York: Monthly Review Press, 1972.

US Department of State. Country Reports on Human Rights Practices for 1988 and 1989 (Section on Israel and Occupied Territories).