Scienziati e medici Italiani ed Inglesi hanno pubblicato
questa lettera sul British medical Journal
Dal 30 marzo 2018, i civili palestinesi che vivono come profughi ed esiliati a Gaza da quando erano stati cacciati dalla Palestina si sono radunati in manifestazioni disarmate di massa sul loro diritto al ritorno nella patria che hanno perso nel 1948. Affrontati dall'esercito israeliano, inclusi 100 cecchini, il bilancio dei morti e feriti civili palestinesi sta crescendo a un ritmo scioccante mentre scriviamo.
C'è un antefatto. In primo luogo, vi è l'impatto in atto del blocco israeliano di Gaza che dura da 12 anni circa sulla cura e la salute della sua gente e il degrado dei suoi servizi sanitari. La violenza e la distruzione inflitte dall'azione militare israeliana nell’ Operazione Protective Edge nel 2014 e nell’Operazione Cast Lead nel 2008-9 hanno segnato un netto punto di svolta nella pauperizzazione di Gaza, sullo sfondo di un blocco sempre più serrato dal 2006. In quell’attacco nel 2014 furono uccisi oltre 2.200 civili, un quarto dei quali erano bambini, feriti 11.000, distrutto 15 ospedali, 45 cliniche e 80.000 case. (1)
Dal 2014 Israele ha ulteriormente ristretto il passaggio di medicinali e attrezzature essenziali a Gaza e l'ingresso di medici ed esperti stranieri che offrono competenze tecniche non disponibili a livello locale. Gli ospedali di Gaza sono stati impoveriti di antibiotici, agenti anestetici, antidolorifici, altri farmaci essenziali, articoli usa e getta e carburante per gestire le sale chirurgiche. (2) I pazienti muoiono mentre aspettano il permesso di andare in terapia specialistica fuori da Gaza. Tutti gli interventi di chirurgia facoltativa sono stati annullati dallo scorso gennaio 2018 e 3 ospedali sono stati chiusi a causa della scarsità di farmaci, attrezzature e carburante (3). Il personale medico ha lavorato a stipendi ridotti. I professionisti della sanità di Gaza trovano quasi impossibile ottenere il permesso israeliano di recarsi all'estero per migliorare la loro formazione. I regolari episodi di attacco militare a Gaza e l'attuale attacco di manifestanti disarmati fanno parte di un modello di emergenze periodicamente indotte dalla politica israeliana. Gli effetti cumulativi dell'impatto sull'assistenza sanitaria per tutta la popolazione sono stati documentati in più rapporti da ONG, agenzie delle Nazioni Unite e OMS. (4). Questa sembra essere una strategia per la dequalificazione dei servizi sanitari e sociali che colpiscono tutta la popolazione di Gaza.
L'attuale uso sistematico di una forza eccessiva nei confronti di civili disarmati, compresi bambini e giornalisti, sta provocando un'ulteriore crisi per il popolo di Gaza. Dal 30 marzo 2018, i cecchini che sparano munizioni di grado militare hanno causato ferite paralizzanti a dimostranti disarmati. (5) A partire dal 23 aprile 2018,5511 palestinesi, inclusi almeno 454 bambini, sono stati feriti dalle forze israeliane, inclusi 1.739 colpiti da munizioni vere secondo il Ministero della Sanità palestinese a Gaza. A partire dal 27 aprile, il bilancio delle vittime ha raggiunto i 48 e altre centinaia di feriti.
Persino la BBC ha mostrato film sulle deliberate sparatorie su persone che stavano in piedi inoffensive o che stavano scappando, compresi bambini e giornalisti (6). Il fuoco da cecchino è per lo più non alla testa, ma la maggior parte delle ferite sono alla parte inferiore del tronco e alle gambe. Dozzine hanno avuto bisogno dell'amputazione di emergenza di una o di entrambe le gambe, e altre 1.300 hanno richiesto ricostruzioni esterne immediate che comporteranno circa 7.800 ore di chirurgia ricostruttiva complessa successiva se si vogliono salvare gli arti. Questo è calcolato come invalidante. Altre persone potrebbero morire o incorrere in invalidità per tutta la vita a causa del degradato stato di salute del paese, e per il divieto da parte di Israele del trasferimento dei feriti gravi (7). In che modo Gaza sopravvive a questa situazione? E nel frattempo, i molti che hanno perso l'assistenza sanitaria non di emergenza a causa della continua mancanza di medicine ed energia saranno raggiunti da molti altri ora che tutte le scarse risorse sono destinate salvare la vita e gli arti degli arti.
Mentre varie agenzie delle Nazioni Unite e dell'OMS hanno condannato le azioni israeliane, i governi occidentali non hanno emesso un mormorio e quindi rafforzano l'impunità che Israele sembra aver goduto sempre nel trattare la società palestinese. Altri che cercano di documentare e attirare l'attenzione su eventi come questi, anche su riviste mediche, sono spesso soggetti a denigrazioni e ad attacchi personali, così pure gli editori delle riviste (8). Si tratta di questioni di vergogna internazionale.
Derek Summerfield, Institute of Psychiatry, Psychology & Neuroscience, King's College, University of London.
David Halpin, Retired orthopaedic and trauma surgeon. Member - British Orthopaedic Association.
Swee Ang, Consultant Trauma and Orthopaedic Surgeon ,Barts Health, London
Andrea Balduzzi, Researcher, University of Genoa, Italy
Franco Camandona, MD, OspedaliGaliera, Genoa, Italy
Gianni Tognoni, Mario Negri Institute, Milan, Italy,
Ireo Bono, MD, Onncologist, Savon, Italy
Marina Rui, PhD Università di Genoa, Italy
Vittorio Agnoletto, MD, University of Milan, Former MEP, Italy
(1) 50 days of death and ddestruction. Institute for Middle East Understanding. https://imeu.org/article/50-days-of-death-destruction-israels-operation-...
(2)
Emergency Delegation to the Gaza Strip. Physicians for Human Rights Israel.
http://www.phr.org.il/en/phri-emergency-delegation-to-the-gaza-strip-apr...
(3)
-https://www.middleeastmonitor.com/20180213-work-at-main-gaza-hospital-st... February 13, 2018
-http://www.aljazeera.com/news/2018/02/palestinians-die-israel-refuses-me...
(4)
-Unnecessary loss of life http://gisha.org/updates/8742
-Humanitarian Coordinator calls for protection of Palestinian demonstrators in Gaza alongside support for urgent humanitarian needs -https://www.ochaopt.org/content/humanitarian-coordinator-calls-protectio...
-Israel/OPT: Authorities must refrain from using excessive force in response to Palestine Land Day protests https://www.amnesty.org/en/latest/news/2018/03/israelopt-authorities-mus...
5) World Health Organisation Special Situation report- Gaza, Occupied Palestinian Territory.https://israelpalestinenews.org/who-special-situation-report-gaza-occupi...
6)
The Palestinian Day of Return: from a short day of commemoration to a long day of mourning K. Elessi 27 April 2018, Lancet
https://doi.org/10.1016/S0140-6736(18)30940-1
Civilians, health workers, journalists and children killed and wounded march 30-april 27, 2018
-http://www.msf.org/en/article/palestine-msf-teams-gaza-observe-unusually...
-Horrific injuries reported among Gaza protesters https://www.map.org.uk/news/archive/post/828-horrific-injuries-reported-... Palestinians killed and hundreds injured in Gaza during demonstrations along the fence https://www.ochaopt.org/content/four-palestinians-killed-and-hundreds-in...
-New MAP film from Gaza: health workers under attack
https://www.map.org.uk/news/archive/post/827-new-map-film-from-gaza-atta...
-Adalah& Al Mezan petition Israeli Supreme Court: Order Israeli army to stop using snipers, live ammunition to disperse Gaza protests http://www.mezan.org/en/post/22754/Adalah+%26+Al+Mezan+petition+Israeli+...
(7)
- https://www.ochaopt.org/theme/casualties
-https://mailchi.mp/phr/muwsh5pulz-991741?e=19b7f93641
(8)
Pressure on ‘The Lancet’ for Gaza letter another example of pro-Israel assault on freedom of expression 11 novembre 2014 |Catherine Baker pour Mondoweisshttp://www.aurdip.fr/pressure-on-the-lancet-for-gaza.html?lang=fr
Competing interests: No competing interests
(Traduzione di Diego Siragusa)
english version
The Maiming Fields of Gaza
Since 30 March 2018, Palestinians civilians living as refugees and exiles in Gaza ever since they were driven out from Palestine have been gathering in mass, unarmed demonstration about their right of return to the homeland they lost in 1948. Confronted by the Israeli army, including 100 snipers, the toll of dead and wounded Palestinian civilians is mounting at a shocking rate as we write.
There is a background to this. Firstly, there is the ongoing impact of the 12 year long Israeli blockade of Gaza on the care and health of her people, and the degrading of its health services. The violence and destruction inflicted by Israeli military action in Operation Protective Edge in 2014 and Operation Cast Lead in 2008-9 marked a distinct turning point in the pauperization of Gaza, against a backdrop of an ever tightening blockade since 2006.That assault in 2014 killed over 2,200 civilians, a quarter of whom were children, wounded 11.000, destroyed 15 hospitals, 45 clinics and 80,000 homes.(1)
Since 2014 Israel has further tightened the passage of essential medicines and equipment into Gaza, and of the entry of doctors and experts from abroad who offer technical expertise not available locally. Gazan hospitals have been depleted of antibiotics, anaesthetic agents, painkillers, other essential drugs, disposables, and fuel to run surgical theatres. (2) Patients die while waiting for permission to go for specialist treatment outside Gaza. All elective surgery has been cancelled since last January 2018, and 3 hospitals have closed because of medication, equipment and fuel shortages (3). Medical personnel have been working on reduced salaries. Gazan health professionals find it almost impossible to get Israeli permission to travel abroad to further their training.The regular episodic military assaults on Gaza and the current targeting of unarmed demonstrators are part of a pattern of periodically induced emergencies arising from Israeli policy. The cumulative effects of the impact on healthcare provision for the general population have been documented in multiple reports by NGOs, UN agencies and the WHO. (4).This appears to be a strategy for the de-development of health and social services impinging on all the population of Gaza.
The current systematic use of excessive force towards unarmed civilians, including children and journalists, is provoking a further crisis for the people of Gaza. Since 30 March 2018, snipers firing military grade ammunition have caused crippling wounds to unarmed demonstrators.(5) As of 23 April 2018,5511 Palestinians, including at least 454 children, have been injured by Israeli forces, including 1,739 from live ammunition according to the Palestinian Ministry of Health in Gaza. As of April 27, the death toll has reached 48 and additional hundreds wounded.
Even the BBC has shown films of the deliberate shooting of people who were standing harmlessly or running away, including children and journalists (6). The sniper-fire is mostly not to the head, with most of the wounds to the lower torso and legs. Dozens have needed emergency amputation of either one or both legs, and a further 1,300 required immediate external fixations which will entail an estimated 7,800 hours of subsequent complex reconstructive surgery if the limbs are to be saved. This is calculated maiming. More may die or incur life-long disability because of the degraded state of health service and the prohibition by Israel of the transfer for the seriously wounded (7). How is Gaza to survive this situation? And meanwhile, the many that have lost non-emergency healthcare because of the ongoing lack of medicines and energy will be joined by many more now that all scarce resources are going to life and limb saving efforts.
Whilst various UN and WHO agencies have condemned Israeli actions, Western governments have not uttered a murmur and thus bolster the impunity Israel seems always to have enjoyed in its treatment of Palestinian society. Others who seek to document and to draw attention to events like this, including in medical journals, are often subject to vilifying ad hominem attacks, as have journal editors (8). These are matters of international shame.
Derek Summerfield, Institute of Psychiatry, Psychology & Neuroscience, King's College, University of London.
David Halpin, Retired orthopaedic and trauma surgeon. Member - British Orthopaedic Association.
Swee Ang, Consultant Trauma and Orthopaedic Surgeon ,Barts Health, London
Andrea Balduzzi, Researcher, University of Genoa, Italy
Franco Camandona, MD, OspedaliGaliera, Genoa, Italy
Gianni Tognoni, Mario Negri Institute, Milan, Italy,
Ireo Bono, MD, Onncologist, Savon, Italy
Marina Rui, PhD Università di Genoa, Italy
Vittorio Agnoletto, MD, University of Milan, Former MEP, Italy
David Halpin, Retired orthopaedic and trauma surgeon. Member - British Orthopaedic Association.
Swee Ang, Consultant Trauma and Orthopaedic Surgeon ,Barts Health, London
Andrea Balduzzi, Researcher, University of Genoa, Italy
Franco Camandona, MD, OspedaliGaliera, Genoa, Italy
Gianni Tognoni, Mario Negri Institute, Milan, Italy,
Ireo Bono, MD, Onncologist, Savon, Italy
Marina Rui, PhD Università di Genoa, Italy
Vittorio Agnoletto, MD, University of Milan, Former MEP, Italy
(1) 50 days of death and ddestruction. Institute for Middle East Understanding. https://imeu.
(2)
Emergency Delegation to the Gaza Strip. Physicians for Human Rights Israel.
http://www.phr.org.il/en/phri-
Emergency Delegation to the Gaza Strip. Physicians for Human Rights Israel.
http://www.phr.org.il/en/phri-
(3)
-https://www.
-http://www.aljazeera.com/
-https://www.
-http://www.aljazeera.com/
(4)
-Unnecessary loss of life http://gisha.org/updates/
-Humanitarian Coordinator calls for protection of Palestinian demonstrators in Gaza alongside support for urgent humanitarian needs -https://www.ochaopt.org/
-Israel/OPT: Authorities must refrain from using excessive force in response to Palestine Land Day protests https://www.amnesty.
-Unnecessary loss of life http://gisha.org/updates/
-Humanitarian Coordinator calls for protection of Palestinian demonstrators in Gaza alongside support for urgent humanitarian needs -https://www.ochaopt.org/
-Israel/OPT: Authorities must refrain from using excessive force in response to Palestine Land Day protests https://www.amnesty.
5) World Health Organisation Special Situation report- Gaza, Occupied Palestinian Territory.https://
6)
The Palestinian Day of Return: from a short day of commemoration to a long day of mourning K. Elessi 27 April 2018, Lancet
https://doi.org/10.1016/S0140-
Civilians, health workers, journalists and children killed and wounded march 30-april 27, 2018
-http://www.msf.org/en/
-Horrific injuries reported among Gaza protesters https://www.map.
-New MAP film from Gaza: health workers under attack
https://www.map.org.uk/news/
-Adalah& Al Mezan petition Israeli Supreme Court: Order Israeli army to stop using snipers, live ammunition to disperse Gaza protests http://www.mezan.org/
(7)
- https://www.ochaopt.org/
-https://mailchi.mp/phr/
The Palestinian Day of Return: from a short day of commemoration to a long day of mourning K. Elessi 27 April 2018, Lancet
https://doi.org/10.1016/S0140-
Civilians, health workers, journalists and children killed and wounded march 30-april 27, 2018
-http://www.msf.org/en/
-Horrific injuries reported among Gaza protesters https://www.map.
-New MAP film from Gaza: health workers under attack
https://www.map.org.uk/news/
-Adalah& Al Mezan petition Israeli Supreme Court: Order Israeli army to stop using snipers, live ammunition to disperse Gaza protests http://www.mezan.org/
(7)
- https://www.ochaopt.org/
-https://mailchi.mp/phr/
(8)
Pressure on ‘The Lancet’ for Gaza letter another example of pro-Israel assault on freedom of expression 11 novembre 2014 |Catherine Baker pour Mondoweisshttp://www.aurdip.
Pressure on ‘The Lancet’ for Gaza letter another example of pro-Israel assault on freedom of expression 11 novembre 2014 |Catherine Baker pour Mondoweisshttp://www.aurdip.
Competing interests: No competing interests
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