Correspondence

Published Online August 5, 2014 http://dx.doi.org/10.1016/ S0140-6736(14)61301-5

For the list of signatories see appendix

us make sure we inoculate ourselves against the forces that demean these ideals. We declare no competing interests.

*Jeffrey J Goldberger, Richard L Popp, Douglas P Zipes, on behalf of 43 signatories [email protected] Northwestern Memorial Hospital, Northwestern University, Chicago, IL 60611, USA (JJG); Stanford University, Palo Alto, CA, USA (RLP); and Indiana University, Indiana University School of Medicine, Indianapolis, IN, USA (DPZ) 1

Published Online August 5, 2014 http://dx.doi.org/10.1016/ S0140-6736(14)61302-7 For the Gaza Mental Health Foundation see http://www. gazamentalhealth.org

Published Online August 6, 2014 http://dx.doi.org/10.1016/ S0140-6736(14)61304-0

Manduca P, Chalmers I, Summerfield D, Gilbert M, Ang S. An open letter for the people in Gaza. Lancet 2014; 384: 397–98.

As cofounder of the Gaza Mental Health Foundation in the USA, I thank The Lancet for publishing Paola Manduca and colleagues’ letter1 about the terrible effect of the Israeli attacks on the people of Gaza. Our foundation supports mental health work in Gaza. We recently learned that Dr Yasser Abu Jamei, Executive Director of the Gaza Community Mental Health Programme (our partner agency), lost 28 family members when the family home was bombed on July 21. Other staff members have also lost loved ones. It is difficult to see how the agency will be able to treat the traumatised population in view of the extent of its key staff’s trauma. On top of the devastation to homes and lives, hundreds of thousands of people are now being denied access to clean water with potentially lethal consequences. In their 2012 report, Gaza in 2020: a liveable place?,2 the UN warned that the Gaza Strip would soon be unliveable; that day now seems to be at hand. I declare no competing interests.

Nancy Murray [email protected] Gaza Mental Health Foundation, Cambridge, MA 02238, USA 1

2

578

Manduca P, Chalmers I, Summerfield D, Gilbert M, Ang S. An open letter for the people in Gaza. Lancet 2014; 384: 397–98. UNRWA. Gaza in 2020: a liveable place? 2012. http://www.unrwa.org/newsroom/pressreleases/gaza-2020-liveable-place (accessed Aug 4, 2014).

We strongly protest that The Lancet published the sadly prejudiced political diatribe by Paola Manduca and colleagues1 that, among other distortions, accuses 95% of Israeli physicians of being complicit of war crimes. Even during conflicts aimed to defend our existence, Israel and the Israeli Defense Forces (IDF) adhere to the highest moral standards, as one of few, or maybe the only country, that extend a helping hand to its enemies during conflict. The Israeli medical community and the IDF Medical Corps have a major role in this effort. Along the Syrian border, where 1700 innocent civilians were killed only this week, an ongoing and intended massacre of no interest to Manduca and colleagues, a specially dedicated military medical facility continues to treat more than 1000 Syrian victims of civil war. Acutely and chronically ill patients from Gaza and the West Bank are regularly admitted to Israeli hospitals and clinics. In the West Bank, Israeli military medical teams treated 369 Palestinian civilians during the past 18 months, according to the Medical Department of IDF, West Bank Division. Although most patients are evacuated to Palestinian hospitals, we insist on evacuating severe casualties to Israeli level one trauma centres. We are strengthening this effort with the deployment of a field hospital at Gaza border to provide medical care to Palestinian casualties. Dozens of patients treated there are the best answer to Manduca and colleagues. We work closely with our Palestinian colleagues, doing joint professional conferences and courses. In 2013, alone, 182 Palestinian physicians were trained as residents or fellows in Israeli hospitals. There is no border between medical professionals. We have no need for Manduca and colleagues’ perverse ethical code. We prefer to adhere with Moses Maimonides (the Rambam,

12th century): ”Preserve the strength of my body and of my soul that they ever be ready to cheerfully help and support rich and poor, good and bad, enemy as well as friend.”2 We declare no competing interests.

*Adi Leiba, Moshe Pinkert, Yitshak Kreiss [email protected] Central Medical Command, Israeli Medical Corps, Jerusalem, Israel (AL, MP); and Surgeon General Headquarters, Medical Corps, Ramat Gan, Israel (YK) 1

2

Manduca P, Chalmers I, Summerfield D, Gilbert M, Ang S. An open letter for the people in Gaza. Lancet 2014; 384: 397–98. Kaplan KJ, Schwartz MB. Hippocrates, Maimonides and the doctor’s responsibility. Omega (Westport) 1999–2000; 40: 17–26.

The consequences of conflict on health and provision of health-care services have been documented. 1 War and political violence are fundamental public health problems, therefore their prevention should be a central task of health professionals.2 Accordingly, health researchers and providers should, wherever and however possible, aid to alleviate the immediate consequences of political violence and advocate for the prevention of further violence and repression. Because of this mandate, the present situation in Gaza is distressing. As of Aug 1, 11 (of 32) hospitals and 14 clinics have been damaged by the Israeli attacks in Gaza, according to WHO situation report.3 Ten hospitals and 34 (of 75) clinics have closed. 1418 Palestinians have been killed, including 324 children, 166 women (aged 18–60 years), and 60 elderly people. According to Israel’s Ministry of Foreign Affairs, two Israeli civilians and one Thai civilian have been killed, 83 civilians have been wounded, and 64 Israeli Defense Force soldiers and officers have been killed.4 The present situation brings to light the need for international pressure to uphold international laws and codes of ethics that guarantee protection for civilians during war and political conflict. To impede the ability of www.thelancet.com Vol 384 August 16, 2014

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