Palestinian Medical Personnel
Between Fire and their Duty to Remove the Wounded and Sick
The Third Report on Israeli Attacks against Palestinian Medical Personnel
1 September 2002 – 31 December 2004
Consultative Status with the ECOSOC of the United Nations
The Euro-Mediterranean Human Rights Network
E-mail: pchr@pchrgaza.org
web-Page: www.pchrgaza.org
Table of Contents
Israeli Attacks on Medical Personnel
Violation of the Right to Life and Personal Security of Palestinian Medical Personnel
Dozens of Wounded Palestinian Medical Personnel
Cruel, Inhumane and Degrading Treatment of Palestinian Medical Personnel
Arrests and Detentions of Palestinian Medical Personnel by IOF
Attacks on Medical Institutions and Facilities by IOF
Violation of the Right of Medical Units and Transports to Free Movement
Israeli Military Checkpoints Interrupt Activities of Local Hospitals in the Gaza Strip
Disastrous Health Impacts on Palestinian Civilians during Wide Scale Offensives
This report documents grave breaches, including war crimes, of the Geneva Convention Relative to the Protection of Civilian Persons in Time of War of 1949 (the Fourth Geneva Convention) and Additional Protocols of 1977 perpetrated by Israeli Occupation Forces (IOF) against medical personnel operating in the Occupied Palestinian Territory (OPT) between 1 September 2002 and 31 December 2004.[1]
During the reported period, IOF continued to attack Palestinian medical crews and facilities in the OPT, causing disastrous impacts on health conditions of the Palestinian civilian population, who are protected under the Fourth Geneva Convention.[2] These attacks occurred within the wider context of human rights violations perpetrated by IOF against Palestinian civilians in the OPT, including wilful and extra-judicial executions, destruction of civilian property and depriving people of their means of subsistence.
During the reported period, IOF killed 4 Palestinian medical personnel and wounded more than 200 others. Thus, the number of Palestinian medical personnel killed by IOF since the beginning of the al-Aqsa Intifada has mounted to 19 and the number of wounded medical staff has escalated to at least 450.[3]
In addition, 38 Palestinian ambulances have been destroyed and 132 medical vehicles have been severely damaged by IOF. IOF also continue to deny access of Palestinians to medical care, predominantly by restricting the movement of ambulances through checkpoints. Under the current total siege of the OPT, 65 Palestinian civilians have died at Israeli military checkpoints, as IOF prevented their evacuation to hospitals.
Since the beginning of the current Intifada, 3,214 Palestinians, including 618 children, have been killed and at least 40,000 others have been wounded by IOF. Hundreds have been left permanently disabled. Palestinian medical personnel have offered the wounded medical services. The large numbers of casualties clearly indicate that Palestinian medical personnel have carried out work that exceeds the resources available to them.
IOF have escalated their excessive and disproportionate use of force in the OPT. Israeli practices on the ground indicate that the Israeli government has issued orders to its occupation forces to commit illegal acts, including the indiscriminate use of force against Palestinian civilians, which has resulted in many civilian deaths. For example, on 20 October 2003, 7 Palestinian civilians, including a child and an on-duty doctor, were killed in Nusseirat refugee camp in the central Gaza Strip in an attempt by IOF to extra-judicially execute members of the Palestinian resistance. The targeted individuals managed to escape, but 50 Palestinian civilians were wounded in the attack, including 11 children. An 8th civilian died later from his injuries.[4]
IOF have not taken any measures to minimize the numbers of casualties among Palestinian civilians, including medical crews, which indicates that the Israeli political and judiciary establishments agree, or at least do not reject the use of excessive force against Palestinian civilians, in violation of international humanitarian law. The Israeli executive, legislature and judiciary cannot claim that they do not have information regarding each of these attacks against Palestinian medical crews, as they receive regular reports in this regard and media reports detail each incident.
IOF have continued to commit grave breaches of international humanitarian law throughout the OPT. On 28 March 2002, IOF initiated a wide scale offensive on West Bank towns, known as " Operation Defensive Shield", during which they used various types of weapons against Palestinian towns, villages and refugee camps. During this offensive, IOF killed at least 400 Palestinians, wounded more than 2,000 and largely destroyed the civilian infrastructure. In the Gaza Strip, IOF escalated their attacks on the Palestinian civilian population. They launched two wide scale offensives on Rafah and Beit Hanoun.[5]
IOF have continued to attack Palestinian and international medical crews, obstructing their humanitarian mission to provide medical assistance to more than 3 million Palestinians living in the OPT. IOF have killed a number of medical personnel, attacked medical facilities and prevented the entry of medicines and medical supplies.
Continued attacks by IOF on Palestinian medical crews strongly supports PCHR's conclusion that such attacks are instructed by the Israeli political and military establishments. PCHR has already warned of the continuation of such attacks.[6] IOF have also launched a campaign of incitement against Palestinian medical crews and vehicles, accusing them of illegal activities such as the transportation of weapons and members of the Palestinian resistance. Recently, the Israeli Defence Minster claimed that UNRWA ambulances were used in military activities. However, media reports documenting Israeli attacks on Palestinian medical crews proved that these accusations were not true.
IOF have imposed a total siege on the OPT since the beginning of the current Intifada, severely restricting the movement of Palestinian civilians and goods. These measures have not excluded medical and food supplies and the movement of ambulances. IOF positioned at various checkpoints throughout the OPT have obstructed the evacuation of patients to hospital. Subsequently, 68 patients have died due to the obstruction of their evacuation to hospitals by IOF. Dozens of pregnant women have been forced to give birth near military checkpoints, as IOF denied them access to hospitals. According to the Palestinian Ministry of Health, IOF have obstructed the evacuation of patients to hospitals in 1,200 cases.
Since the beginning of the current Intifada, IOF have destroyed 38 ambulances and severely damaged 132 medical vehicles.
All of these attacks have occurred despite the fact that Palestinian medical crews wear clearly marked uniforms, which indicate their status as medical staff, and ambulances, hospitals and medical centres in the OPT are clearly marked as health facilities.
In spite of these difficulties, Palestinian medical personnel have done their best to carry out their humanitarian mission to evacuate the wounded, patients with health problems and pregnant women to hospitals. Since the beginning of the current Intifada, 3,214 Palestinians, including 618 children, have been killed and more than 40,000 others have been wounded by IOF. Most of the wounded have received medical treatment in ambulances and field medical units, as hospitals and medical centres are relatively far from the areas where clashes usually take place. The high number of casualties and injuries in the OPT indicate the heavy burden on Palestinian medical personnel and resources. Presently, the need for health care in the OPT exceeds the capacity of medical units.
During the reported period, IOF continued to attacks medical personnel and violate their rights to protection and safety while carrying out their humanitarian duty of saving the lives of civilians. IOF used excessive force against medical personnel to prevent them from carrying out their duties of offering help to the wounded and patients.
IOF opened fire at ambulances, hospitals, clinics and medical centres. During the reported period, IOF killed 4 medical personnel and wounded dozens of others in the West Bank and the Gaza Strip. The health conditions of hundreds of civilians also deteriorated as IOF checkpoints obstructed their access to hospitals. These attacks require immediate international and local legal action to pressurize IOF to respect the right of each person to receive medical care, and comply to international humanitarian law, especially the provisions relevant to the freedom of movement of medical crews.
The rights to life, freedom and personal security are ensured by international humanitarian and human rights law. Article 3 of the Universal Declaration of Human Rights provides that "everyone has the right to life, liberty and security of person." Article 6 of the International Covenant on Civil and Political Rights provides: "Every human being has the inherent right to life. This right shall be protected by law. No one shall be arbitrarily deprived of his life...".[7] The Fourth Geneva Convention of 1949 prohibits violence to life and person, in particular murder of all kinds, mutilation, cruel treatment and torture against protected persons.
IOF have attacked Palestinian medical personnel and violated their right to carry out their humanitarian mission of offering assistance to the wounded and sick. They also prevented removal of dead bodies, whether civilians or militants, an act that constitutes a war crime under the Fourth Geneva Convention of 1949. IOF have ignored the complaints of the Palestine Red Crescent Society and many international medical organizations. They have even escalated their attacks on Palestinian medical personnel.
IOF have unlawfully attacked Palestinian civilians, without making a distinction between militants and civilians. At the same time, they have attacked medical personnel attempting to give medical attention to civilians wounded by these indiscriminate attacks. This policy seems to be intended to deter medical personnel from providing medical services in areas of conflict. During wide scale offensives on towns in the Gaza Strip, especially Rafah, Beit Hanoun, Jabalya and Khan Yunis, IOF prevented Palestinian medical personnel from providing any medical services in these areas. Nevertheless, Palestinian medical personnel challenged the dangers in order to provide medical help to the wounded and remove the dead.
Despite theses attacks and the shortage of medical equipment, especially following the wide scale Israeli offensive on the West Bank in spring 2002, Palestinian medical personnel still do their best to provide medical services. Attacks by IOF on Palestinian medical personnel have escalated since the beginning of the current Intifada, and these attacks now occur on a regular basis, which indicates that medical personnel are being specifically targeted by IOF.
During the reported period, four Palestinian medical personnel (a physician, two nurses and a civil defence staff member) were killed by IOF in separate incidents. This indicates that IOF have continued to disregard the protection afforded to medical personnel under international humanitarian law. Medical personnel and vehicles are clearly marked and distinguishable, which means that attacks against them by IOF have not been accidental. With these four victims, the number of medical personnel killed by IOF since the beginning of the current Intifada has mounted to 19.
PCHR has investigated cases of fatalities among Palestinian medical personnel cited below:
· IOF Shoot Dead Two Palestinian Medical Personnel in al-Wafaa' Hospital in Gaza City
On Wednesday night, 5 February 2003, IOF killed 2 Palestinian medical personnel who were on duty in al-Wafaa' Hospital in Gaza city. This illegal action was perpetrated by IOF as part of the escalation of Israeli illegal military actions in the OPT. The killing of the two medical personnel came less than 24 hours after Israeli soldiers had violently beaten a French doctor from Medicines sans Frontieres at al-Tuffah checkpoint (which separates the al-Mawasi area from Khan Yunis). The doctor had been attempting, along with his colleagues, to enter the area, which has been completely isolated from the rest of the Gaza Strip, to attempt to provide medical aid for its residents.
According to PCHR's information, at approximately 23:40 on Wednesday, 5 February 2003, IOF moved into al-Sha'af area in the northeast of Gaza City. They surrounded a 4-storey house, in which 4 families, numbering 41 people, live, owned by Mohammed Salah al-Ghoula, approximately 60 metres away from al-Wafaa' Hospital. IOF then destroyed the door, broke into the house and searched it. During the house raid, at approximately 23:55, an Israeli soldier fired a live bullet at a window on the first floor of the hospital, the sign for which is clearly marked in Arabic and English. The bullet hit a nurse in the chest and exited to hit another nurse in the chest as well, thereby killing the two:
1. 'Abdul Karim Hamed Anwar Lubbad, 22, from Jabalya; and
2. 'Omar Sa'ad al-Din Hassan, from the al-Zaytoun neighborhood in Gaza city.
According to a janitor in the hospital, who had accompanied the nurses, they had gone to check on a patient who was crying out in pain. As soon as they entered the room, a shot was heard. The two nurses fell to the ground. They were bleeding. Doctors made efforts to save their lives, but Lubbad died immediately and his colleague died shortly after him.
· A Fireman Killed by IOF in Jabalya
In a major onslaught against the Gaza Strip, on Thursday 6 March 2003, IOF killed 11 Palestinians, mostly civilians, including three children and an old man, when they invaded the northern Gaza Strip town of Jabalya and its refugee camp. Five of the victims, including a fireman, were killed by one tank shell, while they were trying to put out a fire that had broken out in a house. In addition, about 75 Palestinians, including two journalists and four medical personnel, were injured; more than 10 of them seriously. A number of ambulances were also severely damaged.
According to PCHR's investigation and eyewitness reports, at approximately 00:00, IOF, reinforced with dozens of heavy military vehicles and combat helicopters and covered by intense shelling, moved from the Beit Hanoun crossing in the northern Gaza Strip, approximately 4km to the south on Salah al-Din Street, towards the edges of Jabalya. At approximately 05:30, IOF fired several artillery shells at a 450-square-meter, 4-storey house, in which 6 families numbering 21 people live, owned by Ahmed Mohammed Faraj Saleh. The shells hit stores located under the house, burning them. Firemen were not able to reach the house until 06:45. A number of Palestinian civilians gathered to help firemen extinguish the fire. Immediately, an Israeli tank fired a shell at them, although firemen and fire engines were clearly marked. Five Palestinian civilians, including a fireman, Naji Isma'il Abu Jalila, 24, were killed.[8]
· A Doctor Killed by an Aerial Attack
At approximately 21:15 on Monday, 20 October 2003, Israeli helicopter gunships launched a missile at a civilian car travelling approximately 150 meters to the east of Nusseirat refugee camp in the central Gaza Strip. The missile reportedly hit the front of the car, but the passengers managed to flee the vehicle. As Palestinian civilians gathered around the scene of the attack, Israeli helicopter gunships launched another missile towards the car, sending shrapnel into the crowd. Seven Palestinian civilians were killed instantly, including a doctor from Nusseirat Medical Center, Zain al-'Aabdin Mohammed Mahmoud Shahin, who was tending to those wounded by the first missile. 50 civilians were wounded, including 10 seriously, one of whom died from his injuries on Wednesday evening, 22 October 2003.
In his testimony to PCHR, the doctor's father, Mohammed Mahoud Shahin, 78, said:
"My son was on duty that night. At approximately 21:30, my neighbours informed me that he was injured by an Israeli aerial attack on Nusseirat refugee camp, when he was offering medical assistance to the wounded. I informed my other son who has a pharmacy near our house and he in turn phoned Nuseirat. We were informed that he was transferred to Shifa Hospital in Gaza City. My son died from his wound by shrapnel to the head and the chest. My colleagues told me that he was carrying a child who was wounded by shrapnel from a missile fired by Israeli helicopter gunships, when the Israeli helicopter gunships fired another missile. He was wounded by shrapnel from the missile."
During the reported period, at least 200 medical personnel were wounded by IOF, some by heavy and medium calibre bullets and tanks shells, and others were severely beaten by Israeli soldiers. Thus, the number of Palestinian medical personnel wounded by IOF since the beginning of the current Intifada has mounted to at least 450. Dozens of medical personnel are severely disabled from serious wounds they sustained by IOF. Most of them sustained wounds in the upper part of the body. Almost all of these medical personnel were wounded while on duty. Some of them were transferred to hospitals outside the OPT, due to the lack of necessary medical equipment.[9]
From these figures, it is clear that IOF have not made any effort to ensure the safety and security of Palestinian medical personnel while on duty. Dozens of cases in which IOF deliberately attacked Palestinian medical personnel have been documented. Further, IOF have constantly failed to investigate such attacks and hold those responsible for them accountable.
IOF have carried out attacks on Palestinian medical personnel, while they were wearing clearly marked medical uniforms. IOF have disregarded calls by the ICRC, UNRWA and international human rights organizations to comply with provisions of the Fourth Geneva Convention and allow medical personnel to operate in the OPT without restrictions, and they have even systematically escalated their attacks on medical personnel causing more casualties.
Even though Palestinian medical personnel wear clearly marked uniforms and travel in clearly marked ambulances, IOF have constantly attacked them. Nevertheless, Palestinian medical personnel have continued to carry out their humanitarian duty and provide medical aid to the wounded and sick.
Israeli attacks against Palestinian medical personnel violate international human rights law and humanitarian law. Impacts of such attacks are not limited to medical personnel, but also affect the rights of the wounded and sick. The inability of Palestinian medical personnel to move freely and quickly has resulted in dozens of deaths among sick and wounded civilians. A number of the wounded died as medical personnel were not able to attend them on time due to restrictions imposed by IOF. Attacks by IOF on Palestinian medical personnel peaked during wide scale offensives on towns in the Gaza Strip.
Following are details of some cases, in which Palestinian medical personnel were wounded by IOF:
· At approximately 07:00 on 7 October 2002, IOF positioned in military posts in the vicinity of "Gan Aur" and "Gadid" settlements, southwest of Khan Yunis, and "Neve Dekalim" settlement, west of the town, opened fire at Khan Yunis refugee camp and al-Nimsawi and Baten al-Samin neighborhoods. A Palestinian civilian, 23-year-old Mohammed Farhan Shaloula, was killed by a live bullet to the back. Seven others were wounded. Live bullets and artillery shells also hit Nasser Hospital, approximately 600m east of "Neve Dekalim" settlement. Four Palestinian civilians, including two members of the hospital staff, were wounded. Those wounded inside the hospital were:
1. Nafe' Burhan al-Bura'ei, 22, a maintenance worker at the hospital, critically wounded by a live bullet to the head, while at the hospital. He was evacuated to Shifa' Hospital in Gaza and then to an Israeli hospital.
2. Jibril 'Ateya 'Aabed, 45, a driver of the hospital, wounded by a live bullet to the chest.
3. Munther Radwan al-Masri, 27, wounded by a live bullet to the left thigh while at hospital.
4. 'Aadel Yousef Eslayeh, 36, wounded by shrapnel to the face while at hospital.
In his testimony to PCHR, Jebril Jaber 'Aabed, a driver for Nasser Hospital, said:
"I was called to hospital at approximately 01:30 on Monday, 7 October 2002, after the hospital declared a state of emergency when IOF invaded parts of Khan Yunis. I carried out my duties until Israeli tanks withdrew from those areas. At approximately 08:15, while I was in the facility designed for ambulances in the eastern part of the main building of the hospital, I felt that a live bullet hit me in the chest. I also heard sounds of live bullets hitting walls. Immediately, those who were near me moved me to the reception department, where I received medical treatment."
· On 21 November 2002, IOF that had moved into the villages of Khuza'a and 'Abasan, east of Khan Yunis, opened fire at a number of Palestinian ambulances that came to offer help to the wounded. Three ambulances were damaged and 2 paramedics were wounded:
1. Ahmed 'Ali Jasser, 28, wounded by a live bullet to the left thigh, while he was inside an ambulance of the Palestine Red Crescent Society; and
2. 'Emad al-Din Mohammed Jodei'an Abu Jamous, 25, wounded by shrapnel in the head, while he was inside an ambulance of the Qura'an and Sunna Society.
· On 2 March 2003, IOF that had moved into Khan Yunis opened fire indiscriminately at Palestinian houses in al-Nimsawi neighborhood. A Palestinian civilian, 'Abed Rabbu D'ib 'Abed Rabbu, 52, was injured by shrapnel to the chest and back. He bled to death. According to eyewitnesses, 4 artillery shells hit the bedroom of his house, which is located in al-Nimsawi neighborhood, approximately 100m away from Nasser Hospital. Palestinian medical personnel were not able to reach the area due to the intensive Israeli shelling and because the Israeli soldiers denied them access to the affected house. 'Abed Rabbu bled to death. His body was evacuated to hospital at approximately 07:00, after IOF had withdrawn from the area. Also as a result of Israeli indiscriminate shelling and gunfire, 39 Palestinians, mostly civilians, including 10 children, were wounded. Seven of those were wounded inside Nasser Hospital, including two staff members: Mahmoud Mohammed al-Bardawil, 35, a nurse; and Ahmed Salman al-Faqa'awi, a worker.
· In a major onslaught against the Gaza Strip, on 6 March 2003, IOF killed 11 Palestinians, mostly civilians, when they invaded the northern Gaza Strip town of Jabalya and its refugee camp. In addition, at least 75 Palestinians were injured. This number includes four medical personnel: 'Awad Ahmed Abu Marasa, a paramedic; Yusri 'Aayesh al-Masri, an ambulance driver; Jihad 'Abdul Karim Abu 'Ataya, director of Jabalya ambulance station; and Mohammed Shihda al-Muqayad, a paramedic. Ambulances faced difficulties in reaching the affected areas. Three ambulances, including an UNRWA ambulance, were damaged.
· On 10 October 2003, IOF conducted a large scale incursion into Rafah refugee camp, adjacent to the Egyptian border in the southern Gaza Strip. Under cover of intense shelling and gunfire from tanks and helicopters, IOF invaded the area, one of the most densely populated in the Gaza Strip. During the 2-day incursion, 8 Palestinians were killed, including 3 children, and 53 were wounded; 20 seriously. Women, children and elderly people were among the casualties. An ambulance driver, Rajaa' Salah 'Omar, 30, was seriously wounded by a live bullet to the back. In an unprecedented escalation of the destruction of civilian property, Israeli occupying forces destroyed 170 Palestinian houses, a number of civilian facilities and infrastructure in the area.
· On 28 January 2004, IOF killed 8 Palestinians, including 3 children, and injured four others, including an ambulance driver of the Palestine Red Crescent Society, during a wide scale incursion into al-Zaitoun neighborhood in the south of Gaza City.
· On 21 March 2004, IOF killed 5 Palestinians, including a man and his wife, injured 9 others, and destroyed 5 houses in 'Abasan village, east of Khan Yunis. IOF moved into the village to arrest one of the victims, who was allegedly wanted. During this incursion, IOF used excessive force against civilian residential areas. A Palestinian ambulance driver, Ayman Salman Abu Draz, 38, was among those who were injured. He was hit by shrapnel from a live bullet to the chest.
· On 21 April 2004, IOF moved into the northern Gaza Strip town of Beit Lahia. They opened fire at Palestinian civilians and property. As a result, 9 Palestinians, including 2 children, were killed and at least 50 others were injured, including 25 children and an ambulance driver and a paramedic of the Palestine Red Crescent Society. IOF also opened fire at an ambulance of the Palestinian Ministry of Health. The ambulance was damaged, but no casualties were reported.
· On 22 April 2004, IOF opened fired at Palestinian children in al-Nada housing project in the northern Gaza Strip. Three children were killed and 30 civilians were wounded. IOF opened fire also at Palestinian ambulances that attempted to evacuate the wounded to hospitals.
According to investigations conducted by PCHR, at approximately 07:30, IOF, located near the al-Nada housing project in the northern Gaza Strip, opened fire at a number of Palestinian children who were throwing stones at them. One of the children, Mohammed Rasem Ahmed al-Malfouh, 17, from Beit Lahia, was killed by a live bullet to the neck.
In the afternoon of 22 April 2004, IOF fired at Palestinian demonstrators and ambulances near the al-Nada housing project in the northern Gaza Strip. At approximately 16:00, 10-year-old Asmaa’ Hamdi Abu Tabaq moved from her house in the al-Nada housing project to purchase goods from a neighbouring grocery shop. On her way back home, she was hit by two live bullets to the abdomen and the left arm. Ambulances were not able to reach her for 5 minutes, as Israeli gunfire continued intensely. Asmaa’ was later evacuated to a hospital in Beit Lahia, but medical efforts to save her life failed and she was pronounced dead 3 hours later.
In his testimony on the incident, Mohammed Salah Nassar, a volunteer paramedic at Kamal ‘Edwan Hospital in Beit Lahia, said:
“At approximately 16:40, I was standing near an ambulance of the Ministry of Health. I was carrying out my job as a volunteer paramedic at Kamal ‘Edwan Hospital in Beit Lahia. Israeli soldiers and about 6 heavy military vehicles, including two bulldozers, were positioned on a hill in the al-Nada area, approximately seven meters away from me. Israeli soldiers were intensely firing at the area, so I went to the ambulance which was hit by several live bullets, but no one was hurt. Then, I saw a little child standing on the stairs of the apartment tower building number 8. She was calling for us to offer her help. She was about 20 meters away from us. We realized that she was wounded by the Israeli gunfire, but we were not able to reach her as the gunfire continued. About five minutes later, the gunfire stopped for a while, so we hurried towards the child. The ambulance driver, Khalil al-Sidawi, and I were able to reach her. She was putting her hand on her abdomen to stop the blood. When the driver carried her, internal parts of the abdomen fell out. Soon after, Israeli soldiers resumed firing at the area, and we sheltered behind a sand barrier. In the meantime, another paramedic called us to help him evacuate two persons who were wounded by live bullets, about five meters away from us, but we were not able to reach them. The Israeli gunfire stopped for a short while, and thus we were able to take the child to the ambulance. As soon as we arrived at the hospital, the child was transferred to the intensive care unit. She underwent surgery, but died three hours later.”
· At approximately 00:30 on 5 May 2004, IOF, reinforced by about 30 heavy military vehicles, moved approximately 700 meters into Palestinian areas located to the northwest of "Kfar Darom" settlement, southeast of Deir al-Balah. They opened fire at Palestinian houses in the area. At approximately 08:00, a member of the Palestinian National Security Force, 'Abdullah 'Ali 'Abdul Fattah al-Jammal, 35, from al-Boreij refugee camp in the central Gaza Strip, was killed and one of his colleagues was injured, when IOF opened fire at their station. At approximately 10:00, at least 12 Palestinian civilians were injured by Israeli gunfire. This number includes an ambulance driver of the Palestine Red Crescent Society, Mohammed Khamis al-Salhi, 35.
· At approximately 19:25 on 15 June 2004, during the funeral procession of al-Lahwani, Israeli troops surrounded 'Abed al-Rahman mosque in Balata refugee camp. A number of children and young men threw stones at these troops, which immediately fired at them. Five Palestinian civilians, including 2 children and an ambulance driver, were wounded. The ambulance driver, Firas al-Bakri, 24, was wounded by a rubber-coated metal bullet to the head.
· On 10 July 2004, Mohammed Salehn Juha, 19, a member of the Palestinian Medical Service, was wounded by a live bullet to the chest during an incursion by IOF into Sheikh 'Ejlin and al-Zaytoun neighborhoods in Gaza City.
· On 10 August 2004, 'Adnan Jasser al-Souso, 47, a paramedic from the Palestine Red Crescent Society, was injured by shrapnel to the chest, when IOF moved into Nablus and opened fire at Palestinian civilians. A Palestinian child was killed and 12 other civilians were wounded.
· At approximately 11.30 on 31 August 2004, IOF positioned at al Matahen checkpoint, north of Khan Yunis, opened fire on Palestinian civilians waiting to pass through. Two medical staff members in an ambulance were injured: Subhi Mamohodd Madi, 50, the driver, injured by shrapnel to the arm; and Rafiq 'Abulah al-'Aabadli, 37, a doctor, injured by shrapnel in his right thigh.
Although IOF is obliged under international law to provide protection for medical personnel while carrying out their humanitarian duties, they have continued to attack medical personnel. No serious investigation has been conducted into any attack by IOF or Israeli settlers against Palestinian medical personnel, which raises doubts that such attacks were launched in accordance with superior instructions. Palestinian medical personnel have been subject to cruel, inhumane and degrading treatment by both IOF and settlers. As a result, many medical personnel have been wounded and have faced difficulties in providing medical aid for patients and the wounded.
· On 5 February 2004, IOF attacked a delegation of Medicins Sans Frontieres, headed by a French citizen, at al-Tuffah military checkpoint at the entrance to the al-Mawasi area in Khan Yunis. The delegation was on a field tour coordinated in advance with IOF, but IOF prevented them from crossing the checkpoint and beat members of the delegation.
· Medicins Sans Frontieres submitted a complaint regarding assaults by IOF against a team from the organization on the settler road that links "Netzarim" settlement with "Karni" crossing point, south of Gaza City. The organization stated that the team was visiting a house belonging to the al-'Aaidi family, in which 28 individuals, including 20 children, live. IOF have seized the roof of this house and have transformed it into a military observation point. They have imposed severe restrictions on the movement of the family. The have lived under severe conditions. The organization stated that IOF fired at its staff members in order to drive them away from the area. The organization submitted applications to the Humanitarian Affairs Coordinator of IOF to be allowed to enter the family's house in April 2004, but it did not receive any official response. On 28 April 2004, a team of the organization went to visit the family's house, but IOF fired at the team seven times. The team was forced to leave the area.
· At approximately 16:00 on 25 January 2004, IOF positioned at the entrance of al-'Arroub refugee camp near Hebron, which was under curfew at the time, stopped an ambulance from the Palestinian Red Crescent Society that was transporting a woman suffering from a kidney condition from Hebron Hospital to the refugee camp. They searched the ambulance and prevented it from moving into the camp or back to the hospital. An Israeli officer threatened the medical crew that he would fire at them, if they did not follow his orders. Then, he forced the crew to move slowly towards the refugee camp in the ambulance. When the ambulance moved into the camp, the medical crew were surprised by the presence of 3 Israeli soldiers on the back of the ambulance. A few minutes later, Israeli soldiers ordered the ambulance driver to stop. The soldiers chased and fired at a number of young men. IOF allowed the ambulance to take the patient to her home and ordered the crew not to use communication sets for 15 minutes. At approximately 17:20, IOF ordered the medical crew to leave the camp. They opened fire as they left, terrifying the medical crew.
· On 11 April 2004, a paramedic from the Palestine Red Crescent Society in Nablus was violently beaten by IOF. According to the paramedic, on Sunday morning, 11 April 2004, while he and one of his colleagues were transporting two patients in an ambulance from Nablus to Ramallah, IOF positioned at a checkpoint on al-Sawia road stopped them. They searched the ambulance and took the identity cards of the two paramedics. They also forced the two patients to get out of the ambulance. Soon after, IOF ordered the medical crew to travel back. The crew made a phone call to coordinate their passage through the ICRC. Then, they were allowed to cross the checkpoint. Another Israeli military checkpoint stopped the ambulance as it was travelling on Road 90, near 'Ein Yabroud village. An Israeli soldier checked the identity cards of the paramedics. The soldiers ordered the paramedic in charge of the mission to get out of the ambulance, in order for them to search it. The soldier pushed the paramedic for no apparent reason. When the paramedic asked the soldier why he was pushing him, he hit him on the head and the neck and pushed him towards the ambulance. Soon after, the soldier raised his hand to hit the paramedic on the head, but the paramedic held the soldier's hand. Immediately, 4 other soldiers intervened and violently beat the paramedic. When his colleague attempted to intervene, Israeli soldiers beat and threatened him. Israeli soldiers continued to beat the first paramedic sporadically for nearly half an hour. Then, they took him blindfolded and handcuffed in a military jeep towards "Oufar" military post, claiming that he had attempted to beat a soldier. There, he was violently beaten. Nearly an hour later, IOF released the paramedic after threatening to shoot him, if he attacked any other soldier in the future, as they claimed he had done on this occasion.
· At approximately 15:00 on Monday, 26 July 2004, an ambulance driver of the Palestinian Union of Medical Relief Committees, Muntasser Hanthawi, 24, was travelling from Nablus to Jenin. When he crossed an Israeli military checkpoint at al-Naqoura crossroads, he saw a Palestinian taxi stopping in the area. He learnt that there was a patient in the taxi, so he offered help. Soon, an Israeli military jeep arrived in the area. Three Israeli soldiers got out and violently beat Hathnawi, even though he was in uniform. Israeli soldiers handcuffed Hathnawi and took him towards the nearby checkpoint. There, he was held for an hour until the ICRC intervened to release him. Hathnawi sustained bruises throughout his body.
· At approximately 10:00 on Tuesday, 24 August 2004, Hassan Mohammed 'Awad, 27, from Ethna village south of Hebron, was transporting a number of patients in an ambulance towards Beit Jala Hospital. When he arrived at an Israeli military checkpoint erected near "Kfar Etzion" settlement, north of Hebron, Israeli soldiers stopped him. They forced him and the patients to get out of the ambulance and checked them. When 'Awad protested at the way the Israeli soldiers were dealing with the patients, the soldiers violently beat and handcuffed him. They held him for nearly an hour. 'Awad sustained injuries throughout his body.
· On Saturday afternoon, 11 September 2004, IOF positioned at Beit Eiba checkpoint, west of Nablus, held Leena Budair, 24, a paramedic from Far'oun village south of Tulkarm, for several hours. According to eyewitnesses, IOF forced her to get out of an ambulance from them Palestine Red Crescent Society, while she was on her way to Nablus, and held her for several hours.
During the reported period, IOF arrested and detained a number of Palestinian medical personnel and raided hospitals and medical facilities, in an attempt to prevent medical personnel from carrying out their humanitarian mission. IOF escalated their attacks on Palestinian medical personnel and facilities during incursions into Palestinian communities.
The following are cases of arrests and detentions of Palestinian medical personnel during the reported period:
· On 1 April 2004, IOF raided the Mental Health Hospital in Bethlehem after opening fire at it. IOF arrested 13 Palestinians, including 8 staff members of the hospital and the Palestinian Military Health Service, and damaged the building and equipment of the hospital.
According to investigations conducted by PCHR, at approximately 02:30, Israeli occupying forces, reinforced by heavy military vehicles and 2 helicopters, moved into Bethlehem. At approximately 02:50, they surrounded the Mental Health Hospital. A number of Israeli soldiers took positions on the roofs of neighbouring houses. They opened fire at the hospital and called through megaphones to those who were inside the hospital to get out, without mentioning names. At approximately 03:00, IOF raided the houses of Dr. ‘Essam Bannoura, director of the hospital, in Beit Sahour, east of Bethlehem and ‘Aadel ‘Eissa al-Lahham, the administrative director of the hospital, in al-Souha village, southwest of Bethlehem. They handcuffed the two and detained them, while they were still in their nightwear, approximately 30 meters away from the hospital. At approximately 03:10, IOF resumed firing at the hospital. The Israeli gunfire continued for one hour, after which IOF broke into the hospital. They opened fire inside the hospital and damaged equipment. They arrested 13 Palestinians, including 4 hospital staff members and 4 staff members of the Palestinian Military Medical Service.
According to Dr. ‘Essam Bannoura, the losses incurred by the hospital during this Israeli military attack is estimated at US$500,000. The building and equipment of the hospital were severely damaged.
· At approximately 13:15 on Thursday, 17 June 2004, IOF positioned at a military checkpoint at Jeet crossroads, east of Qalqilya, arrested 'Alaa' 'Omar Samman, 26, an ambulance driver from the Palestine Red Crescent Society, when he was transporting a sick child to Rafidya Hospital in Nablus. IOF took him to the "Shavi Shomron" settlement, where they detained him for 4 hours. Then, they moved him to Hawara detention centre, south of Nablus, where they detained him for two days.
· On 2 November 2004, following an extra-judicial execution of 3 Palestinians in Nablus, on the evening of 1 November 2004, shortly after midnight, IOF raided and searched the emergency centre of the Palestine Red Crescent Society in the city. They also searched a number of ambulances and interrogated medical crews.
Since the beginning of the current Intifada, Palestinian medical institutions and facilities, including hospitals and clinics, have been attacked by Israeli occupying forces. These facilities have not been immune to the shelling that has targeted Palestinian residential areas. During the reported period, IOF escalated their attacks on Palestinian medical institutions and facilities. These institutions and facilities were severely damaged. The following are the most significant attacks by IOF on Palestinian medical institutions and facilities during the reported period:
· On 7 October 2002, Israeli tanks and helicopter gunships opened fire at the Palestine Red Crescent Society Hospital in Khan Yunis, during an incursion into the town. The building was severely damaged and medical crews were unable to carry out their humanitarian mission. No casualties were reported.
· At approximately 10:30, on 5 December 2002, IOF in a military post in the Tal Zo’rob area, southwest of Rafah, fired two artillery shells to the east. The two shells fell on the Egyptian border near Zo’rob square. As a result, shrapnel hit a building of the Palestine Red Crescent Society in the area, damaging its doors and windows, but no casualties were reported.
· On 6 March 2003, IOF opened fire at a building in the northern Gaza Strip town of Beit Hanoun. A pharmacy belonging to Mohammed 'Abdul Hadi Shihab, which is located on the first floor of the building, was severely damaged.
· On 22 May 2003, a medicine factory belonging to Marwan Ahmed al-Astal in the northern Gaza Strip town of Beit Hanoun, was severely damaged when IOF moved into the town and opened fire indiscriminately. Losses were estimated at US$30,000.
· On 4 March 2004, an ambulance from the Palestine Red Crescent Society was hit by several live bullets when it was near the office of the society in Rafah, during an Israeli military incursion into the town. Ambulances faced extreme difficulties in providing help to the wounded, due to the intense Israeli gunfire.
· At approximately 01:30 on 15 May 2004, an Israeli helicopter gunship launched 3 missiles at the first floor of a 3-storey building owned by Akram Sabri al-Hatu in the densely populated al-Rimal neighborhood in Gaza City. Two missiles struck the offices of the Union of Nurses located on the first floor of the building, causing extensive destruction. The third missile struck an uninhabited residential apartment located near the office of the Union of Nurses, also causing extensive destruction. A number of neighbouring houses and shops were also damaged. 10 Palestinian civilians, including a paramedic, were injured in the attack, and a number of other civilians were treated for shock.
· At approximately 12:00, on 23 July 2004, IOF positioned in military posts in the vicinity of "Neve Dekalim" settlement, west of Khan Yunis, opened fire at Palestinian houses located to the east and north. A number of live bullets hit rooms in the Nasser Hospital, nearly 700 meters away from the source of fire. A patient, 'Abdullah Ibrahim Abu Mustafa, 35, was injured by shrapnel to the left hand, and a number of rooms were damaged.
· At approximately 17:00, on 28 July 2004, IOF positioned in military posts in the vicinity of "Neve Dekalim" settlement, west of Khan Yunis, opened fire at houses in the al-Nimsawi neighbourhood and Khan Yunis refugee camp. A number of live bullets hit the Nasser Hospital, nearly 700 meters away from the settlement, injuring a member of its staff, Ra'fat 'Abdullah 'Eissa, 39, with shrapnel to the neck.
· At approximately 11:45, on 1 August 2004, IOF positioned in military posts in the vicinity of "Neve Dekalim" settlement, west of Khan Yunis, opened fire at residential areas and civilian facilities in the town. Live bullets hit the Nasser Hospital. A member of its staff, Ibrahim Jalal Wadi, 46, was wounded by a live bullet to the left shoulder, and the patients and staff were terrified.
· At approximately 09.00, on 24 August 2004, IOF moved into Bethlehem. They surrounded the al-A'ela al Mukadasa (The French) Hospital and closed all entrances to the area. They entered the main square and detonated sound bombs. Dozens of soldiers entered the hospital and began to raid offices and beds. They searched the whole building and after three hours they withdrew and arrested two Palestinian civilians 'Adnan and Ratib 'Ebayat, 32 and 29 respectively. They claimed that 'Adnan was the leader of the al Aqsa Martyrs Brigade in Bethlehem and had been wanted by IOF for four years.
· At approximately 10:15, on 14 September 2004, an ambulance from the Palestine Red Crescent Society was stopped by IOF near the Western Wall in Jerusalem. The ambulance was on it way back from "Gilo" checkpoint, after delivering a patient to another ambulance from Bethlehem at the checkpoint. IOF checked the identity cards of the medical crew for nearly half an hour. Then, an Israeli policeman ordered the medical crew to get out of the ambulance and sit away from it. IOF searched the ambulance and damaged its contents. Soon after, the policeman moved towards the medical crew and ordered them to sign two documents, one was a fine and the other was a statement saying that the ambulance had been untouched. The medical crew refused to sign the two documents.
· At approximately 10:00 on the same day, IOF positioned in military checkpoints along the Egyptian border, south of Rafah, opened fire at Palestinian residential areas in the town. A number of live bullets hit the Abu Yousef al-Najjar Hospital, 800 meters away from the border, and damaged it.
· At approximately 10:30, Israeli troops positioned in military posts in the vicinity of "Neve Dekalim" settlement, west of Khan Yunis, shelled Palestinian residential areas and civilian facilities to the east and north. Two Palestinian civilians were wounded. An artillery shell also hit the physiotherapy department at Nasser Hospital, causing severe damage. Patients and medical crews were terrified during the attack.
· At approximately 12:15, IOF positioned in military posts in the vicinity of "Neve Dekalim" settlement, west of Khan Yunis, opened fire at a number of Palestinian children who gathered near the settlement and threw stones at the troops. Two children were wounded. A number of live bullets and some shrapnel hit Nasser medical compound, damaging a number of its departments and an ambulance.
· At approximately 22:30, IOF positioned in military posts in the vicinity of "Neve Dekalim" settlement, west of Khan Yunis, shelled Palestinian houses in Khan Yunis refugee camp and al-Nimsawi neighborhood. A number of houses were damaged and an artillery shell fell near the administration building in Nasser medical compound, and damaged the building.
· At approximately 20:00, IOF positioned in military posts in the vicinity of "Neve Dekalim" settlement, west of Khan Yunis, opened fire at Palestinian houses in al-Nimsawi neighborhood and Khan Yunis refugee camp. A number of live bullets hit the building of Nasser Hospital, located nearly 700 meters away from the settlement. A Palestinian civilian, Munther Ma'moun al-Batash, 26, who was receiving medical treatment following a car accident, was injured by a live bullet to the head.
IOF have imposed a total siege on the OPT since the beginning of the current Intifada in September 2000, severely restricting the freedom of movement of persons and goods. Palestinian medical crews have faced extreme difficulties in attending the wounded and patients. They have also been subject to severe restrictions in access to hospitals, clinics and medical centres, due to Israeli military checkpoints erected throughout the OPT. The Israeli closure measures have left serious impacts on the health conditions of the Palestinian civilian population. According to PCHR's documentation, 68 Palestinian civilians died, as a result of IOF positioned at various checkpoints obstructing their access to medical care. Many pregnant women have also been forced to give childbirth at Israeli military checkpoints.
Israeli military checkpoints, located on the main roads in the Gaza Strip, have obstructed activities of local hospitals and the freedom of movement of medical vehicles. For instance, al-Matahen and Abu Houli checkpoints, north of Khan Yunis, separate the southern and central Gaza Strip, and al-Shuhada checkpoint, south of Gaza City, separates the central and northern Gaza Strip. There are 15 hospitals in the Gaza Strip, the largest of which are Shifa Hospital in Gaza City, Gaza European Hospital and Nasser Hospital in Khan Yunis. The other hospitals are relatively small and largely dependent on the three main hospitals, making them vulnerable when Israeli military checkpoints are closed. During the Israeli wide-scale offensive on Rafah in May 2004, IOF isolated the town from its surroundings, which threatened the health of Palestinian civilians living in the town.
On 16 May 2004, Dr. Mohammed Abu Shahla, Director of Gaza European Hospital, stated:
"The closure of the main roads that link between the south and north of the Gaza Strip impacted the activities of Gaza European Hospital in Khan Yunis, which serves thousands of Palestinians in Khan Yunis and Rafah. Many staff members of the hospital were not able to reach the hospital. We were also not able to bring certain medicines and equipment that we receive from Gaza on a daily basis. Transfer of patients who are in serious condition to Shifa Hospital in Gaza City was also impacted. Many of our staff members were not able to have holidays, as staff members of the hospital living in the north were not able to reach the hospital. A number of doctors were forced to treat patients, whose conditions were outside their areas of expertise. For instance, on Friday, 14 May 2004, we were forced to make a doctor perform heart surgery on a man who was wounded by IOF, even though such cases are usually transferred to Shifa Hospital in Gaza City. In the past days, there was a need to transfer 7 cases to Shifa Hospital, but we were not able to transfer them due to the closure of roads and so we were forced to treat them."
On 12 May 2005, Dr. Ali Mousa, Director of Abu Yousef al-Najjar Hospital in Rafah, stated:
"As IOF closed al-Matahen and Abu Houli checkpoints on Salah al-Din Street, which links between the north and south of the Gaza Strip, ambulances of our hospital were not able to travel to Shifa Hospital in Gaza City to transfer serious cases. Medical crews are subject to humiliation by IOF at military checkpoints. They are held for several hours and are sometimes checked by IOF. With regard to medical supplies, the Palestinian Ministry of Health provides us with medical supplies that suffice for three months, but that does mean that a shortage does not emerge due to the high numbers of the wounded treated at the hospital. When IOF close Salah al-Din Street, the health conditions of the wounded are seriously impacted."
IOF have continued to violate the right of Palestinian medical personnel to freedom of movement. They have obstructed the passage of many ambulances that have attempted to evacuate the wounded. IOF have escalated restrictions on movement of Palestinian medical personnel, threatening the lives of many Palestinian civilians, including the wounded, sick, pregnant women and children.
IOF have maintained a strict siege on the OPT, violating both economic, social and cultural rights, and civil and political rights of the Palestinian civilian population. They have isolated Jerusalem from the rest of the OPT, and separated the West Bank and Gaza Strip, transforming the two areas into two large detention centres. This has had disastrous impacts on the living conditions of Palestinians and the basic services provided to them.
Under the Israeli full-scale offensive on the West Bank in spring 2002, the health situation further deteriorated, as Palestinian medical personnel faced extreme difficulties in evacuating the wounded and patients to hospitals. The health conditions of patients suffering from chronic diseases, such as diabetes, cancer and heart diseases, deteriorated, due to the lack of medicines and appropriate medical care, as IOF tightened the siege imposed on Palestinian communities, in violation of Palestinian economic, social and cultural rights. Palestinian medical personnel were not able to provide medical services to Palestinian civilians or the wounded. The international community has failed to force Israel to abide by the principles of international humanitarian law. Due to the Israeli comprehensive siege, dozens of Palestinian hospitals and medical centres lost more than 60% of their treatment capacity.
PCHR has documented a number of cases, in which IOF restricted the movement of Palestinian medical crews:
· On 30 October 2003, 3 ambulances from the Palestinian Union of Medical Relief Committees were thoroughly searched by Israeli soldiers at Hawara and Za'tara checkpoints, south of Nablus. Two of the ambulances were transporting medicines and medical equipment, while the third was evacuating a pregnant woman to a hospital in Nablus.
According to investigations conducted by PCHR, at approximately 09:00, two of the ambulances moved from Ramallah towards Nablus and Jenin. They were transporting medicines and medical equipment to two medical centres. At approximately 10:00, the ambulances arrived at Za'tara checkpoint, south of Nablus and were stopped and thoroughly searched by Israeli soldiers, during which time medicines and medical equipment were damaged. Approximately half an hour later, Israeli soldiers at Hawara checkpoint, south of Nablus, stopped another ambulance of the Palestinian Union of Medical Relief Committees, which was transporting a pregnant woman, Hanan Khalil Malek, 30, from Beeta village to Rafidya Hospital in Nablus, as she was suffering from acute haemorrhaging. Israeli soldiers searched the ambulance and made it wait for more than two hours, during which time the patient’s condition deteriorated.
· At approximately 08:10 on 2 November 2003, Israeli soldiers at Hawara checkpoint, south of Nablus, stopped and searched an ambulance from the Palestinian Union of Medical Relief Committees that was travelling from Nablus to 'Assira village, south of the city. Approximately two hours later, they forced the ambulance to travel back, informing the medical personnel that the checkpoint was closed.
· Also on 2 November 2003, Israeli soldiers at Beit 'Eiba checkpoint, west of Nablus, stopped and searched an ambulance of the Palestinian Union of Medical Relief Committees that was travelling from Nablus to 'Azzoun and Habla villages in Qalqilya. Approximately 2 hours later, they forced the ambulance to travel back, informing the medical personnel that the checkpoint was closed.
· In the evening of 26 November 2003, IOF shot a Palestinian child in Yatta village, south of Hebron. They also obstructed his evacuation to the hospital, where he died the following morning. Another Palestinian was wounded and a third was arrested.
According to investigations conducted by PCHR, at approximately 19:50, an armoured personnel carrier and 12 military jeeps, accompanied by 2 civilian cars carrying several Israeli undercover units, moved into al-Musalla area in the centre of Yatta village, south of Hebron. IOF then began to open fire at houses in the area. As a result, two Palestinian civilians, including a child, were wounded:
1. Rashad Tawfiq ‘Abdul Rahman Mur, 16, seriously wounded by a live bullet to the abdomen, died the following morning; and
2. Mousa Ahmed Mahmoud Abu ‘Ali, 28, wounded by two live bullets to the pelvis and the left hand.
According to eyewitnesses, Israeli soldiers got out of a military jeep, and began to open fire at Mur from a distance of approximately 30 meters. Ambulances were not able to attend to the wounded due to the intense Israeli gunfire. Mur was evacuated in a civilian car to a clinic in the village, where he received first aid treatment. An ambulance then transferred him to al-Ahli Hospital in Hebron. He arrived at the hospital in a critical condition. His evacuation to the hospital took more than two hours due to the intense gunfire from Israeli occupying forces. A few hours later, Mur was transferred to Ramallah Hospital. However, he was pronounced dead at approximately 07:00 the following day. According to medical sources, the child had been hit by an exploding bullet and died of an acute haemorrhage.
· On 4 and 5 December 2003, IOF positioned at Beit Eiba checkpoint, west of Nablus, denied passage for Palestinian medical personnel and ambulances to nearby villages, claiming that according to the law, an ambulance can move with a patient, one physician and one medic only. The villages near Nablus lack medical personnel. As a result, medical personnel have to be sent into the villages from Nablus. According to these medical personnel, Israeli soldiers want them to exit the ambulances and then cross the military checkpoints on foot before re-entering the ambulances on the other sides of checkpoints. Considering the long delays imposed on civilians that cross the checkpoints on foot and the large amount of checkpoints that exist, this policy causes the ambulances to be delayed for several hours. As a result, such a policy seriously endangers the lives of all patients in the villages who may potentially need emergency medical attention.
· On Monday morning, 22 December 2003, Israeli soldiers at Deir Ballout military checkpoint, east of Qalqilya, and at al-Lubban checkpoint, northwest of Ramallah, denied passage of a Palestinian woman, who was 7 months pregnant and was in labour, claiming that she could not pass because she was travelling in a private car and not in an ambulance. The woman gave birth to twins, who died at the checkpoints.
According to PCHR's investigations, and an affidavit by Lamis Tayseer Ibrahim Qassem, 26, from Deir Ballout village, at approximately 01:30, she felt labour pains. Immediately, her husband called for an ambulance from Beit Rima village. He asked medical personnel to meet him and his wife near Deir Ballout checkpoint in order to save time. Then, he took his wife in his private car towards the checkpoint. At approximately 02:00, they arrived at the checkpoint and an ambulance was waiting at the other side of the checkpoint. However, Israeli soldiers denied passage for the medical personnel to take the woman to the ambulance. At approximately 03:30, Israeli soldiers finally agreed to allow the medical personnel to go to the woman. Soon, the woman gave birth to a dead baby. Then, Israeli soldiers allowed the ambulance to take the woman and travel towards Ramallah. On the way to Ramallah, Israeli soldiers at al-Lubban military checkpoint stopped and searched the ambulance. There, the woman gave birth to another dead baby.
· At approximately 17:00, on 20 August 2004, IOF stopped an ambulance from the Palestine Red Crescent Society at the entrance of al-'Eizariya village near Jerusalem. The ambulance was travelling from Ramallah to al-'Eizariya village. IOF searched the ambulance, confiscated all communication sets and damaged its contents. Nearly an hour later, they allowed the ambulance to move.
During wide-scale offensives on Palestinian communities, IOF used various means of aggression against Palestinian medical crews in the field, to prevent them from evacuating patients and the wounded to hospitals and removing dead bodies. As a result, the health conditions of many of those in need of urgent medical attention deteriorated and a number of people died.
Rafah
On 13 May 2004, IOF initiated a wide scale offensive on the southern Gaza Strip town and refugee camp of Rafah, during which they committed a series of serious violations of human rights. During this offensive, IOF launched a series of attacks on Palestinian ambulances and medical crews, in an attempt to prevent them from evacuating the wounded to hospital and removing the bodies of those who had been killed on the street. A number of the wounded remained bleeding for several hours without ambulances being able to attend them and they died as a result. Television screens around the world showed an UNRWA paramedic being shot at by IOF, while he was trying to evacuate a Palestinian gunman, who was seriously wounded by IOF in the Tal al-Sultan neighbourhood on Tuesday morning, 18 May 2004. The paramedic survived, but the UNRWA ambulance was damaged.[10]
IOF also held a number of ambulances for several hours and imposed severe restrictions on the movement of others, in violation of international humanitarian law, which ensures freedom of movement of medical crews and vehicles. A number of ambulances were damaged.
Palestinian and international medical organizations expressed grave concerns regarding the health conditions in Rafah during this wide scale offensive, as IOF launched a series of attacks on ambulances and medical crews. There were also serious concerns about the lives of patients, children and pregnant women in the affected areas, as IOF attacked and imposed severe restrictions on the movement of ambulances and medical crews.
During this offensive, IOF perpetrated a series of serious violations of international humanitarian law. They used excessive and disproportionate force. Apparently, Israeli soldiers were instructed to attack ambulances and medical crews. This fact can be proved by the Israeli Defence Minster's accusations that a number of ambulances had been participating in military operations.[11]
No investigation was conducted into any single attacks against Palestinian ambulances or medical crews, even though they were clear violations of international humanitarian law and some of them were shown on television screens around the world.
The following are a number of the most significant attacks by IOF against Palestinian ambulances and medical crews during the wide scale offensive on Rafah:
· An UNRWA nurse, who accompanied an UNRWA ambulance into the Tal al-Sultan neighbourhood, described to PCHR's field worker in Rafah how he survived Israeli gunfire, while he was attempting to evacuate a wounded man:
"At approximately 04:00 on Tuesday, 18 May 2004, a physician and I travelled in an UNRWA ambulance to Tal al-Sultan neighbourhood after we had received information that a number of people were wounded as a result of an Israeli air strike. We were able to evacuate four of the wounded to Abu Yousef al-Najjar Hospital. At approximately 04:45, we were informed that two people were wounded in Bader camp in the Tal al-Sultan neighbourhood, one of them was inside a house whilst the other was on the street. Immediately, we went to the area. We asked a resident of the area and he told us that he had been hearing the cries of a person in severe pain for several hours. He walked near the ambulance to guide us. We moved a few meters and we could see a young man lying on the ground. The ambulance was fired at, but we were not hurt. The driver moved forward until we were about five meters away from the young man. In the meantime, shooting at us intensified, so the driver was forced to travel back and take shelter. We called the director of the UNRWA clinic in Rafah and he asked us to protect ourselves. We also called the director of UNRWA radio operations and he asked us to protect ourselves as much as possible. Then, we called the Palestine Red Crescent Society to help us. Actually, they sent four ambulances to the area. The ambulances were accompanied by a Reuters vehicle. We all moved in a convoy with lights turned on. However, we were fired at, so we were forced to retreat. We got out of the vehicles and took shelter behind walls. We were able to enter a house belonging to the Barhoum family, where we succeeded in evacuating a young man who had already been wounded in the abdomen. Israeli soldiers continued to fire at us from a neighbouring house. It was 05:00, and we moved the young man to an ambulance from the Palestine Red Crescent Society. The other young man was still on the ground and we were only five meters away from him. I took position between two ambulances and moved towards the young men. I came to about two meters away from him, but Israeli soldiers fired at me intensively, so I retreated. The young man was holding a gun and was wearing a green shirt and blue trousers. He was motionless. Soon, I decided to attempt again to pull him. I was able to catch his leg and pull him, but Israeli soldiers fired at us. He was hit by at least 10 bullets. One of the bullet hit him in the leg that I caught. I felt a live bullet passing near my face, so I retreated. I noticed that Israeli soldiers were attempting to hit the young man's gun to hurt me and my colleagues. I attempted again to pull him and I was able to bring him between two ambulances. His gun remained in the place. We carried him into one of the ambulances. We checked him and we discovered that he was dead. We transported his body to Abu Yousef al-Najjar Hospital. There, he was identified by people as Ziad Shabana. Our ambulance was hit by a number of live bullets."[12]
· IOF attacked an ambulance of the Palestinian Ministry of Health in al-Brazil neighbourhood. Israeli bulldozers covered the ambulance with ruins of destroyed houses and tanks hit it. In his testimony to PCHR on this attack, a member of the medical crew said:[13]
"At approximately 12:00, on Thursday, 20 May 2004, we went to al-Brazil neighbourhood to evacuate a woman and her three children who were injured and were inside a house. When we arrived at the area, I saw a number of Israeli military vehicles positioned in the area. We stopped approximately 50 meters away from the house where the woman and the three children were present. The driver pressed the horn to call residents of the house to bring the wounded out, as we were not able to move closer to the house due to the presence of Israeli military vehicles. No one got out of the house. The driver was talking on the phone with the coordination official of the Ministry of Health informing him about the situation. The official asked us to wait until IOF allow us to move forward. However, five minutes later, the Israeli tanks fired at us. The ambulance was not damaged, but we were forced to moved 20 meters back. A few minutes later, I saw a bulldozer and a tank coming towards us. I also saw another tank and bulldozer behind us. We were then surrounded by tanks and bulldozers. One of the bulld