We were absolutely horrified to read the blatantly political editorial entitled "Violence in Palestine demands immediate resolution of its settler colonial root causes" in the BMJ Global Health, which according to its website is an "online journal from BMJ dedicated to publishing high-quality peer-reviewed content". The article lacks any scientific value.
The editorial completely ignores the events of October 7, when Hamas terrorists raped, burnt, mutilated, tortured and killed entire families and took women, children and the elderly hostage. In addition, it is full of distortions and obfuscations.
The article refers to alleged "implementation of eliminatory settler colonial strategies by the Israeli occupation that aims to increase morbidity and mortality ". Besides the fact that Gaza has not been occupied by Israel since 2007, and putting aside for a moment the thousands of patients from Gaza (including Hamas terrorists!) that have been treated in Israeli hospitals, and Gazan physicians trained in Israeli hospitals, on the most objective level, the population in Gaza City has grown from 117423 in 1967 to 778187 in 2023. If Israel is trying to increase morbidity and mortality, she is doing a very poor job of it.
Despite this, no one would deny the intolerable living conditions of Gaza residents. Indeed, since Hamas's takeover of the Gaza Strip, they have done everyt...
We were absolutely horrified to read the blatantly political editorial entitled "Violence in Palestine demands immediate resolution of its settler colonial root causes" in the BMJ Global Health, which according to its website is an "online journal from BMJ dedicated to publishing high-quality peer-reviewed content". The article lacks any scientific value.
The editorial completely ignores the events of October 7, when Hamas terrorists raped, burnt, mutilated, tortured and killed entire families and took women, children and the elderly hostage. In addition, it is full of distortions and obfuscations.
The article refers to alleged "implementation of eliminatory settler colonial strategies by the Israeli occupation that aims to increase morbidity and mortality ". Besides the fact that Gaza has not been occupied by Israel since 2007, and putting aside for a moment the thousands of patients from Gaza (including Hamas terrorists!) that have been treated in Israeli hospitals, and Gazan physicians trained in Israeli hospitals, on the most objective level, the population in Gaza City has grown from 117423 in 1967 to 778187 in 2023. If Israel is trying to increase morbidity and mortality, she is doing a very poor job of it.
Despite this, no one would deny the intolerable living conditions of Gaza residents. Indeed, since Hamas's takeover of the Gaza Strip, they have done everything possible, including diverting humanitarian aid for terrorist purposes, to ensure these conditions persist. Recently the terrorists even stole 24,000 litres of fuel meant for Gazan hospitals and schools (https://unwatch.org/unrwa-reports-hamas-stole-humanitarian-aid-hillel-ne...). Israel provides the Gaza Strip water, food, and electricity from its own supplies during times of peace and allows the transport of basic humanitarian aid even during times of war and even now, when its own children, women, frail and sick elderly people are being held hostage there. These shipments are ongoing as I pen this response. The process can be observed in real time on international TV.
We do agree with the authors' call to identify root causes. But the root cause is not the lack of opportunity for Palestinian national determination. It is rather the total and nefarious intolerance of Jewish presence, let alone sovereignty, on even the most minimal swath of land in any part of land that was partitioned by the UN for Palestinian and Jewish national self-determination. This part of land now constitutes sovereign Israel, West Bank and Gaza, with Jews and Arabs in different population proportions in each subregion. The evidence for this is overwhelming in at least five historic missed opportunities all coupled with deadly violent consequences, initially by surrounding Arab nations and subsequently by Palestinian national movements and their supporting terrorist non-Palestinian allies (Hezbollah, Iran, others) in various guises.
It is sad when health professionals weaponize data to try make an invidious political (not health-related) point. And worse when their claims are so untrue.
Zion Hagay MD, President, Israeli Medical Association, Dean of the Faculty of Health Professions, Peres Academic Center
A. Mark Clarfield MD FRCPC
Emeritus Professor of Geriatrics
Chair, National Council on Ageing, Ministry of Health
Rivka Carmi MD, Former president, Ben Gurion University, President of the Israeli National Academy of Science in Medicine
Karl Skorecki MD FRCP(C) FASN
Professor Emeritus and former Dean, Azrieli Faculty of Medicine, Bar-Ilan University, Consultant in Nephrology and Population Genetics, Clinical Research Institute at Rambam Health Care Campus
Malke Borow JD, Director of the Division of Law and Policy, Israeli Medical Association
The International Network for Epidemiology and Policy (NEP) represents 24 epidemiology societies across the globe and works to address policies at the global level that have public health impacts. This includes wars and conflict which cause suffering to large populations and constitute major public health crises (1,2).
As public health experts, the International Network for Epidemiology leadership share the concerns expressed in the editorial by Smith et al (3). The lives of all people should be protected. There is never an ethically defensible justification for murdering civilians or taking them hostage, bombing families, hospitals, schools, universities, Non-Government Organizations, or any residential building. Nor is there justification for depriving people of water, food, electricity, medicine, and shelter.
Calling for a ceasefire based on humanitarian reasons is what every public health expert would do. This is what the authors of the above-mentioned editorial were calling for. We denounce any accusations and threats to authors and editors for expressing such views on the need for preservation of human life, and for ethical standards of conducting wars (2). Such accusations, threats, and lobbying for one political view or another, should not have any place in academic discussions on public health. These activities undermine freedom of speech, the global mission of public health, and the very basic tenets of human rights and dignity to live (2).
The International Network for Epidemiology and Policy (NEP) represents 24 epidemiology societies across the globe and works to address policies at the global level that have public health impacts. This includes wars and conflict which cause suffering to large populations and constitute major public health crises (1,2).
As public health experts, the International Network for Epidemiology leadership share the concerns expressed in the editorial by Smith et al (3). The lives of all people should be protected. There is never an ethically defensible justification for murdering civilians or taking them hostage, bombing families, hospitals, schools, universities, Non-Government Organizations, or any residential building. Nor is there justification for depriving people of water, food, electricity, medicine, and shelter.
Calling for a ceasefire based on humanitarian reasons is what every public health expert would do. This is what the authors of the above-mentioned editorial were calling for. We denounce any accusations and threats to authors and editors for expressing such views on the need for preservation of human life, and for ethical standards of conducting wars (2). Such accusations, threats, and lobbying for one political view or another, should not have any place in academic discussions on public health. These activities undermine freedom of speech, the global mission of public health, and the very basic tenets of human rights and dignity to live (2).
We recognize all loss of life in the current conflict and denounce the harmful actions of all actors. As public health experts focusing on the health and lives of all people, we can - and must - call out actions resulting in suffering to many, regardless of our political affiliation.
Yours sincerely,
International Network for Epidemiology in Policy (INEP) Executive Committee
Katy Bell (Chair)
Wael Al-Delaimy (Past Chair)
Camille Raynes-Greenow (Past Chair)
Robin Taylor Wilson (Chair Elect)
Jennifer Payne (Secretary)
Abbey Diaz (Communications Officer)
Steve Deppen (Treasurer)
Kathryn Gwiazdon (Expert Advisor)
1. International Network of Epidemiology in Policy. INEP Declaration on human rights and health in war, armed conflict, forced displacement, occupation, and violence: statement of solidarity with the peoples of Ukraine and around the globe, 2022 [Available from: https://www.epidemiologyinpolicy.org/ukraine]
2. International Network of Epidemiology in Policy. A Call for Courage: declaration on international law, health, and freedom of speech – statement of solidarity with the civilians of Israel and Palestine 2023 [Available from: https://www.epidemiologyinpolicy.org/palestine]
3. James S, Edwin Jit Leung K, Layth H, et al. Violence in Palestine demands immediate resolution of its settler colonial root causes. BMJ Global Health 2023;8(10):e014269. doi: 10.1136/bmjgh-2023-014269
The article "Violence in Palestine demands immediate resolution of its settler colonial root causes" presents a highly partial view of history. In the midst of appalling suffering and loss of life in Gaza and Israel, some simple truths need to be reiterated.
Jewish people were indigenous to the region for millennia before the founding of the state of Israel in 1948. In the preceding century, in the face of increasing persecution elsewhere in the world many more Jews concluded that they needed their own national home and made their way to Ottoman-controlled Palestine. This reached a crescendo with the European Holocaust. The fleeing Jews had just as much right to live in Ottoman-controlled and then British mandate controlled Palestine as anyone else. After the establishment of the State of Israel, many hundreds of thousands of Jews were forced to leave the Arab and Iranian world and sought refuge in Israel.[1] The article’s glib description of this complex and traumatic history as ‘settler colonialism’ is incorrect. The nebulous call in the title for ‘the resolution’ of such historical ‘root causes’ is hard to interpret and leaves open the possibility of meaning anything from mass psychological therapy to the end of Israel as a state.
It is informative to note several other ‘root causes’ that are mischaracterised. Contrary to the article's suggestion, and as a further matter of historical record, Israel was invaded by its neighbours in 1948 after...
The article "Violence in Palestine demands immediate resolution of its settler colonial root causes" presents a highly partial view of history. In the midst of appalling suffering and loss of life in Gaza and Israel, some simple truths need to be reiterated.
Jewish people were indigenous to the region for millennia before the founding of the state of Israel in 1948. In the preceding century, in the face of increasing persecution elsewhere in the world many more Jews concluded that they needed their own national home and made their way to Ottoman-controlled Palestine. This reached a crescendo with the European Holocaust. The fleeing Jews had just as much right to live in Ottoman-controlled and then British mandate controlled Palestine as anyone else. After the establishment of the State of Israel, many hundreds of thousands of Jews were forced to leave the Arab and Iranian world and sought refuge in Israel.[1] The article’s glib description of this complex and traumatic history as ‘settler colonialism’ is incorrect. The nebulous call in the title for ‘the resolution’ of such historical ‘root causes’ is hard to interpret and leaves open the possibility of meaning anything from mass psychological therapy to the end of Israel as a state.
It is informative to note several other ‘root causes’ that are mischaracterised. Contrary to the article's suggestion, and as a further matter of historical record, Israel was invaded by its neighbours in 1948 after it accepted the United Nations’ Partition Plan and declared its independence.[2] This invasion, and a widespread regional revanchism that rejects Israel’s right to exist, has had terrible consequences for the Palestinian Arabs and is a root cause of the conflict. Israel cannot be held solely responsible for the consequences of a war started by its enemies.
The article notes that Israel has enforced a 'complete blockade' around Gaza since 2007. This cannot be true since Gaza has a significant border with Egypt; any such blockade, if it existed, would need to be enforced by Egypt as well. Furthermore during these years of apparent complete blockade there has been an enormous urbanisation of Gaza; and import of thousands of rockets and weaponry components as well as concrete for the construction of approximately 500km of underground military facilities [3] by Hamas, the fundamentalist Islamist movement who govern Gaza. Yet the article holds Israel alone responsible for the results of all parties’ actions.
In a similar fashion, the article compares the missile strike on Al-Ahli hospital with the ‘heinous US military bombing’ of the Kunduz Trauma Centre in Afghanistan in 2015. Though the article notes that ‘the origin of the missile strike remains to be determined’, through this comparison the article invites the reader to view this as an Israeli military bombing. This is despite overwhelming evidence that the attack was conducted by Hamas or Islamic Jihad rocket aimed at Israeli civilians - as assessed by Western intelligence agencies [4] and most OSINT sources.[5] The article repeats uncritically the casualty numbers released by the Gaza-based Ministry of Health, without noting these figures are released by a Hamas-run agency – a highly partisan source at a time of conflict. Predictably, other international sources have since estimated much lower figures.[6]
In detailing the suffering inflicted on civilians, the authors omit to mention Hamas’ direct targeting of Israeli civilians (including not just the murder and kidnap of more than 1,400 people, but rape, torture and dismemberment),[5,7] and indirect targeting of Palestinian civilians by using them as human shields for their military infrastructure. Targeting of civilians is unequivocally a war crime under relevant international law; yet the article contains no mention of these actions.
The article ends with a call for the ‘immediate de-escalation of the threat posed by Israel’. No mention is made of the threat posed by Hamas and other designated terrorist organisations to millions of Israelis. The genocidal, racist ideology of Hamas - vividly demonstrated by the events of 7 October and most recently reiterated in remarks made by Hamas representative on television on 24 October, calling for the annihilation of Israel [8] – is another ‘root cause’ that the articles fail to mention.
[1] https://www.jewishvirtuallibrary.org/jewish-refugees-from-arab-countries
[2] https://history.state.gov/milestones/1945-1952/arab-israeli-war
[3] https://www.dw.com/en/what-to-know-about-hamas-tunnels/a-67164646
[4] https://www.bbc.co.uk/news/uk-67198938
[5] https://edition.cnn.com/2023/10/21/middleeast/cnn-investigates-forensic-...
[6] https://www.nytimes.com/2023/10/19/world/middleeast/gaza-hospital-blast-...
[7] https://www.nbcnews.com/news/investigations/videos-hamas-attack-suggest-...
[8] https://www.youtube.com/watch?v=mPWOvwG4_x4
BMJ Global Health has served as a platform for highlighting the global forces that underpin inequities in health and wellbeing everywhere in the world. The journal has published similar articles in relation to wars and conflicts, and in doing so have consistently privileged the voices, needs, experiences, and perspectives those who are marginalised in those wars and conflicts. As with many other manuscripts submitted for consideration as editorials, this article, although unsolicited, was published with only internal peer review. As we have consistently done with papers published in the journal, we welcome rebuttals, contestations, and alternative interpretations. Some of these are being included as online 'rapid response' comments. In time, others will be published in the journal and on our blog.
Those of us who do global health have a responsibility to respect the dignity of people and communities who are marginalised as knowers, and to represent their interpretations of their own reality. The article is in fulfillment of that responsibility. To be socially/politically marginalised is to be interpretively (or hermeneutically) marginalised; or to have interpretations from one's standpoint under-represented in the collective pool of legitimised knowledge. For every complex reality, there may be multiple and even competing interpretations. Our responsibility as a field must include allowing space in our heads and on knowledge platforms for that multip...
BMJ Global Health has served as a platform for highlighting the global forces that underpin inequities in health and wellbeing everywhere in the world. The journal has published similar articles in relation to wars and conflicts, and in doing so have consistently privileged the voices, needs, experiences, and perspectives those who are marginalised in those wars and conflicts. As with many other manuscripts submitted for consideration as editorials, this article, although unsolicited, was published with only internal peer review. As we have consistently done with papers published in the journal, we welcome rebuttals, contestations, and alternative interpretations. Some of these are being included as online 'rapid response' comments. In time, others will be published in the journal and on our blog.
Those of us who do global health have a responsibility to respect the dignity of people and communities who are marginalised as knowers, and to represent their interpretations of their own reality. The article is in fulfillment of that responsibility. To be socially/politically marginalised is to be interpretively (or hermeneutically) marginalised; or to have interpretations from one's standpoint under-represented in the collective pool of legitimised knowledge. For every complex reality, there may be multiple and even competing interpretations. Our responsibility as a field must include allowing space in our heads and on knowledge platforms for that multiplicity, while also striving to privilege interpretations that are marginalised; including how marginalised people and communities see the world and their place in it.
Publication of this editorial is consistent with the nature, mission and rationale of global health and its commitment to equity and justice. This includes hearing voices and perspectives that are otherwise unheard, especially of marginalised people and communities. The content is also consistent with the field’s commitment to the upstream determination of health and wellbeing, including focussing analysis and action on 'root causes' – such as the impacts of colonisation, globalisation, hyper-capitalism, the climate/environment and social/political discrimination on inequities in health and wellbeing.
The overarching problem with this editorial is not only what is written, but also what is not.
The evidence cited presents a one-sided, revisionist version of events. The article has no reference to Hamas, terrorist attacks, hostages or executions. Nor does it reference the use of human shields, storage of weapons around health facilities, diversion of humanitarian aid for militant use or the prevention of population movement to safer areas. It doesn’t acknowledge the geopolitical landscape, especially the role of neighbouring Arab countries and Iran. The language used is inflammatory; demonising Israel while granting all other actors a 100-year-history of immunity.
The article criticises Israel for warning Palestinian civilians to move away from areas that will come under bombardment. This is the opposite of indiscriminate violence, as accused by the authors, and in accordance with interpretations of international humanitarian law (IHL) [1]. There’s no reference to allegations of Hamas demanding civilians remain in northern Gaza, their alleged attacks on the safe routes out, nor their extensive network of tunnels used for miliary activities and not permitted for civilian shelter [2]. While these conflicting narratives may be unpalatable to the authors it doesn’t excuse their decision to ignore them.
The closing argument reduces this complex historical conflict to right versus wrong, with Israel the only villain. Israel does hold blame, but this is al...
The overarching problem with this editorial is not only what is written, but also what is not.
The evidence cited presents a one-sided, revisionist version of events. The article has no reference to Hamas, terrorist attacks, hostages or executions. Nor does it reference the use of human shields, storage of weapons around health facilities, diversion of humanitarian aid for militant use or the prevention of population movement to safer areas. It doesn’t acknowledge the geopolitical landscape, especially the role of neighbouring Arab countries and Iran. The language used is inflammatory; demonising Israel while granting all other actors a 100-year-history of immunity.
The article criticises Israel for warning Palestinian civilians to move away from areas that will come under bombardment. This is the opposite of indiscriminate violence, as accused by the authors, and in accordance with interpretations of international humanitarian law (IHL) [1]. There’s no reference to allegations of Hamas demanding civilians remain in northern Gaza, their alleged attacks on the safe routes out, nor their extensive network of tunnels used for miliary activities and not permitted for civilian shelter [2]. While these conflicting narratives may be unpalatable to the authors it doesn’t excuse their decision to ignore them.
The closing argument reduces this complex historical conflict to right versus wrong, with Israel the only villain. Israel does hold blame, but this is alongside a multitude of other actors. The lead author stated on X/Twitter he believed the Hamas attack was within “the legal right of Palestinians to resist their occupier” [3], without acknowledging the horror inflicted upon Israeli civilians. Writing an entire article on "the threat posed by Israel to the lives of millions of Palestinians" the authors state their partisan position. This myopia is discriminatory.
In the competing interests one author has written "He therefore has an interest in his people not being subjected to genocide". Unsubstantiated accusations of genocide have been hurled by all sides in this conflict. Publishing this statement implies BMJ agrees an act of genocide being committed by Israel, setting a dangerous precedent for future legitimacy in discussions of crimes against humanity.
Since the release of this editorial there’s been serious concerns raised about its content and the decision to publish it. In response to these complaints there been a counter-campaign to quash criticism. A letter of support, with 1326 signatures [4], implied the article recognised the pain caused to Israelis and condemns the actions of Hamas. As demonstrated, this is untrue. The letter identified the dangers of polarisation but failed to notice this article is a guilty participant of driving division.
Applying a critical eye does not make one unsupportive of the Palestinian cause. It shouldn’t be controversial to expect responsible reporting in a medical journal. Propagating biased articles risks fanning the flames of war and makes peaceful resolutions harder to achieve.
The dire state of the Palestinian people demands attention and calls for a sustained effort to bring peace, dignity and prosperity. Rather than considering the root causes, this article delivers a prejudiced version of a humanitarian and geopolitical crisis. It’s this intelligent form of disinformation which hinders reconciliation and deepens hatred.
The continued presence of this article, in its current form, puts the credibility of BMJ Global Health and BMJ Group into serious doubt.
As of November 10, 2023, more than half of Gaza’s hospitals and nearly three-quarters of Gaza’s primary care clinics are not functioning (as reported by Al Jazeera, CNN, and others). At least 11,000 people have been killed in Gaza as a result of Israel’s ongoing indiscriminate assault and complete blockade. Among those killed, at least 4,500 have been children. Over 27,000 people have been injured, including more than 8,600 children, while another 1,500 children remain missing (see also: https://doi.org/10.1016/S0140-6736(23)02407-8). Many, many more will suffer life-altering physical and mental effects following this conflict. The WHO’s Director General, The United Nations’s Secretary General, the entire country of Bolivia, over 1,000 USAID staff, over 3,000 global health professionals, and millions upon millions of citizens around the world are denouncing this violence as unjustifiable, inhumane, and abhorrent.
The WHO and several UN agencies, among many others, have called attention to the catastrophic health consequences the closure of health facilities, murder of health care providers, and incessant bombardment of all civilian infrastructure is having and will continue to have on Gaza’s population of more than 2 million people, nearly half of whom are younger than 18. Without essentials such as fuel, food, potable water, electricity, and medicines, infectious diseases will spread and malnutrition will worsen; al...
As of November 10, 2023, more than half of Gaza’s hospitals and nearly three-quarters of Gaza’s primary care clinics are not functioning (as reported by Al Jazeera, CNN, and others). At least 11,000 people have been killed in Gaza as a result of Israel’s ongoing indiscriminate assault and complete blockade. Among those killed, at least 4,500 have been children. Over 27,000 people have been injured, including more than 8,600 children, while another 1,500 children remain missing (see also: https://doi.org/10.1016/S0140-6736(23)02407-8). Many, many more will suffer life-altering physical and mental effects following this conflict. The WHO’s Director General, The United Nations’s Secretary General, the entire country of Bolivia, over 1,000 USAID staff, over 3,000 global health professionals, and millions upon millions of citizens around the world are denouncing this violence as unjustifiable, inhumane, and abhorrent.
The WHO and several UN agencies, among many others, have called attention to the catastrophic health consequences the closure of health facilities, murder of health care providers, and incessant bombardment of all civilian infrastructure is having and will continue to have on Gaza’s population of more than 2 million people, nearly half of whom are younger than 18. Without essentials such as fuel, food, potable water, electricity, and medicines, infectious diseases will spread and malnutrition will worsen; already, thousands of cases of diarrhea and upper respiratory infections have been reported, which will cause the greatest harm to children (https://www.emro.who.int/media/news/risk-of-disease-spread-soars-in-gaza...). These harms are in addition to the harm caused by disruptions to cancer and other noncommunicable disease care, obstetric care, and routine health services.
This editorial lays out some of these dire facts, while situating recent events within the longer history of Israeli occupation of Palestine and in particular the occupation’s deleterious effects on health and the health system in occupied Palestine. This contextualization helpfully positions Israel’s ongoing assault on Gaza (not to mention ongoing persecution and dispossession happening concurrently in the West Bank) within an extensively documented, ongoing campaign of dispossession and dehumanization of the Palestinian people, dating back, at minimum, to the 1948 Nakba.
There is absolutely no justification for this level of human suffering. There is no defense for murdering over 4,500 children (and counting). There is no defense for condemning to death thousands of sick, injured, elderly, and young people who cannot leave hospitals or other protected structures. What is the point of our international institutions if we cannot abide by this most basic principle? What is the point of global health if we cannot collectively condemn and stop this kind of violence?
Violence begets more violence; dehumanization begets more dehumanization. We cannot possibly ignore the decades-long history of the Israeli government’s treatment of Palestinians and the extraordinarily, incontrovertibly excessive use of force in Gaza. And, at the same time, by acknowledging that history, we are not justifying or calling for violence against Israeli civilians. All people everywhere deserve to be free.
We read with increasing surprise and disgust the editorial by Smith J et al regarding the war in Israel.1 It represents an extremely one-sided opinion, without taking into account the facts that happened, nor past history. We are medical doctors, in our case oncologists, sworn not to harm, fighting for human lives, and dedicating ourselves to accompany our patients - in some cases for months and even longer - striving for cure, and if not possible to relieve pain and maintain quality of life. In this, we do not distinguish between gender, age, culture, religion, skin colour, sexual preference, geography and we definitely should not be dealing with politics. Therefore, we were extremely shocked that a medical journal like BMJ publishes such an inappropriate letter.
On 7 October 2023, the terrorist group Hamas carried out a surprise attack on Israel, brutally murdering 1,400 people and kidnapping more than 200, beheading babies, murdering children and elderly, without distinction as to age, gender or nationality. This was acknowledged formally by the UK Prime Minister, as well as by other world leaders, based on cruel but validated evidence. Only a small part of the gruesome information was released, out of respect for the victims and the relatives, and only after this was deemed unavoidable in order to react to unbalanced and even fake information. Many Israeli citizens from the ruthless Hamas attack are still missing and many bodies or body parts cannot be identified...
We read with increasing surprise and disgust the editorial by Smith J et al regarding the war in Israel.1 It represents an extremely one-sided opinion, without taking into account the facts that happened, nor past history. We are medical doctors, in our case oncologists, sworn not to harm, fighting for human lives, and dedicating ourselves to accompany our patients - in some cases for months and even longer - striving for cure, and if not possible to relieve pain and maintain quality of life. In this, we do not distinguish between gender, age, culture, religion, skin colour, sexual preference, geography and we definitely should not be dealing with politics. Therefore, we were extremely shocked that a medical journal like BMJ publishes such an inappropriate letter.
On 7 October 2023, the terrorist group Hamas carried out a surprise attack on Israel, brutally murdering 1,400 people and kidnapping more than 200, beheading babies, murdering children and elderly, without distinction as to age, gender or nationality. This was acknowledged formally by the UK Prime Minister, as well as by other world leaders, based on cruel but validated evidence. Only a small part of the gruesome information was released, out of respect for the victims and the relatives, and only after this was deemed unavoidable in order to react to unbalanced and even fake information. Many Israeli citizens from the ruthless Hamas attack are still missing and many bodies or body parts cannot be identified due to the brutality of the Hamas slaughter.
Regardless of religion, culture, political view and anything else, we should as a medical community condemn these acts, without looking for excuses to justify them. We should support bringing all hostages home safety, which maybe will end this terrible war, and allow for negotiations for peace to take place, after which the lengthy process of rehabilitation of the civilians on both sides of the border can start.
Our world is heading towards a human-made apocalypse, with wars and conflict like in Israel, Ukraine and more than 100 other places around the world. Humanity stands by and watches at the side-line – we cannot allow this!
1. Smith J, Kwong EJL, Hanbali L, et al. Violence in Palestine demands immediate resolution of its settler colonial root causes. BMJ Glob Health 2023;8:e014269. doi:10.1136/bmjgh-2023-014269
Re: Violence in Palestine demands immediate resolution of its settler colonial root causes.
I came across the above article today in the BMJ which I have really appreciated as it brings to light the ongoing burden on human life and health from colonialism in current times.
My thoughts are with all striving healthcare colleagues on the ground and with those that have lost their lives in Palestine and Israel trying to serve those most at need. I am very saddened by the ongoing loss of lives to the extent of healthcare workers not being spared by the occupying IDF regime. It is truly a dark time for humanity but this article being published gives added hope in human resilience and unity when standing for human suffering and adversity regardless of faith, culture or race.
Thank you once again to all those who have spoken out about the atrocities in Palestine and demanding immediate resolution of its settler colonial root causes.
Re your editorial, Smith et al.Violence in Palestine
My late father had a life subscription to the BMJ, so I read your journal every week for over 40 years. In all these years I have never read an article so one-sided as Smith et al's.
I am an Israeli who does not approve of her government's bombing of Gaza. Even though the Israeli army has notified people in Gaza of its plans to bomb their cities beforehand, many innocent people have been killed, which is appalling. The survivors, like the authors of the paper, will now hate us even more.
But this must be put in context. Just as the 1948 Nakba, which involved the displacement of thousands of Palestinians, was preceded by attacks on the new state of Israel (whose foundation was approved by the United Nations) by the armies of Lebanon, Syria, Iraq and Egypt, so the bombing of Gaza was preceded by an attack by Hamas terrorists, who did not warn their potential victims, but deliberately burned families alive, maimed and killed children in front of their parents and parents in front of their children and took hundreds of hostages. I myself was present on Kibbutz Sa’ad on the Gaza border on 7th October when all this happened, although thank God I did not witness these barbarities. But I did spend the day under repeated Hamas rocket attacks, and one rocket landed on a house less than 50 yards from me. We too were not warned beforehand of these attacks.
The paper was also biased in that it repo...
Re your editorial, Smith et al.Violence in Palestine
My late father had a life subscription to the BMJ, so I read your journal every week for over 40 years. In all these years I have never read an article so one-sided as Smith et al's.
I am an Israeli who does not approve of her government's bombing of Gaza. Even though the Israeli army has notified people in Gaza of its plans to bomb their cities beforehand, many innocent people have been killed, which is appalling. The survivors, like the authors of the paper, will now hate us even more.
But this must be put in context. Just as the 1948 Nakba, which involved the displacement of thousands of Palestinians, was preceded by attacks on the new state of Israel (whose foundation was approved by the United Nations) by the armies of Lebanon, Syria, Iraq and Egypt, so the bombing of Gaza was preceded by an attack by Hamas terrorists, who did not warn their potential victims, but deliberately burned families alive, maimed and killed children in front of their parents and parents in front of their children and took hundreds of hostages. I myself was present on Kibbutz Sa’ad on the Gaza border on 7th October when all this happened, although thank God I did not witness these barbarities. But I did spend the day under repeated Hamas rocket attacks, and one rocket landed on a house less than 50 yards from me. We too were not warned beforehand of these attacks.
The paper was also biased in that it reported the Israelis’ ‘deliberate targeting of limbs leading to traumatic limb loss and disability.’ Yes, Israeli soldiers dealing with suspected terrorists in the Occupied Territories are instructed not to shoot to kill, but to target limbs instead. Compare this with the evidence of the US Secretary of State Blinken presented to the American Senate, on deliberate injuries to limbs inflicted on just one of the Israeli families attacked by Hamas [warning: traumatic content]: the father’s eye gouged out, the mother’s breast cut off, the girl’s foot amputated, the boy’s fingers cut off, and then their executioners sat down and had a meal.
Publishing biased and partial information will not help solve the conflict, even if you publish something from the other side next week. It may, however, turn world opinion even more against Israel - and against Jews elsewhere. I understand that several Jewish schools in London have been closed since the beginning of this war because of anti-Semitic attacks on pupils.
I would have expected the BMJ to be more aware of what it was doing, and to give us a fair and nuanced account of what is a complex situation. I do not agree with what my government has been doing and have been demonstrating peacefully against them for the last 40 weeks. But many of my fellow demonstrators have been so horrified by this massacre that they are prepared to countenance even the government's excessive reaction to it in Gaza. You are doing the same as they are - you are prepared to publish a horrifically one-sided view, rather than something which might lead to dialogue, not just more hatred and violence.
In hope for better times
I am concerned about an article that doesn't happen to have the peer review process one associates with the BMJ journals. The article 'Violence in Palestine demands an immediate resolution of its settler-colonial root causes' by James Smith et. al., http://dx.doi.org/10.1136/bmjgh-2023-014269, is cited as having had internal rather than external peer review.
Given the significant potential for hidden and overt bias in this type of emotion-seeking article, particularly as stated in the competing interests of the authors, how is the BMJ group able to ensure that the internal peer review provided a balanced and unbiased review? Why was the accepted practice of obtaining external peer review by experts in the field not undertaken?
October 24, 2023
To the Editor:
We were absolutely horrified to read the blatantly political editorial entitled "Violence in Palestine demands immediate resolution of its settler colonial root causes" in the BMJ Global Health, which according to its website is an "online journal from BMJ dedicated to publishing high-quality peer-reviewed content". The article lacks any scientific value.
The editorial completely ignores the events of October 7, when Hamas terrorists raped, burnt, mutilated, tortured and killed entire families and took women, children and the elderly hostage. In addition, it is full of distortions and obfuscations.
The article refers to alleged "implementation of eliminatory settler colonial strategies by the Israeli occupation that aims to increase morbidity and mortality ". Besides the fact that Gaza has not been occupied by Israel since 2007, and putting aside for a moment the thousands of patients from Gaza (including Hamas terrorists!) that have been treated in Israeli hospitals, and Gazan physicians trained in Israeli hospitals, on the most objective level, the population in Gaza City has grown from 117423 in 1967 to 778187 in 2023. If Israel is trying to increase morbidity and mortality, she is doing a very poor job of it.
Despite this, no one would deny the intolerable living conditions of Gaza residents. Indeed, since Hamas's takeover of the Gaza Strip, they have done everyt...
Show MoreThe International Network for Epidemiology and Policy (NEP) represents 24 epidemiology societies across the globe and works to address policies at the global level that have public health impacts. This includes wars and conflict which cause suffering to large populations and constitute major public health crises (1,2).
As public health experts, the International Network for Epidemiology leadership share the concerns expressed in the editorial by Smith et al (3). The lives of all people should be protected. There is never an ethically defensible justification for murdering civilians or taking them hostage, bombing families, hospitals, schools, universities, Non-Government Organizations, or any residential building. Nor is there justification for depriving people of water, food, electricity, medicine, and shelter.
Calling for a ceasefire based on humanitarian reasons is what every public health expert would do. This is what the authors of the above-mentioned editorial were calling for. We denounce any accusations and threats to authors and editors for expressing such views on the need for preservation of human life, and for ethical standards of conducting wars (2). Such accusations, threats, and lobbying for one political view or another, should not have any place in academic discussions on public health. These activities undermine freedom of speech, the global mission of public health, and the very basic tenets of human rights and dignity to live (2).
...Show MoreThe article "Violence in Palestine demands immediate resolution of its settler colonial root causes" presents a highly partial view of history. In the midst of appalling suffering and loss of life in Gaza and Israel, some simple truths need to be reiterated.
Show MoreJewish people were indigenous to the region for millennia before the founding of the state of Israel in 1948. In the preceding century, in the face of increasing persecution elsewhere in the world many more Jews concluded that they needed their own national home and made their way to Ottoman-controlled Palestine. This reached a crescendo with the European Holocaust. The fleeing Jews had just as much right to live in Ottoman-controlled and then British mandate controlled Palestine as anyone else. After the establishment of the State of Israel, many hundreds of thousands of Jews were forced to leave the Arab and Iranian world and sought refuge in Israel.[1] The article’s glib description of this complex and traumatic history as ‘settler colonialism’ is incorrect. The nebulous call in the title for ‘the resolution’ of such historical ‘root causes’ is hard to interpret and leaves open the possibility of meaning anything from mass psychological therapy to the end of Israel as a state.
It is informative to note several other ‘root causes’ that are mischaracterised. Contrary to the article's suggestion, and as a further matter of historical record, Israel was invaded by its neighbours in 1948 after...
BMJ Global Health has served as a platform for highlighting the global forces that underpin inequities in health and wellbeing everywhere in the world. The journal has published similar articles in relation to wars and conflicts, and in doing so have consistently privileged the voices, needs, experiences, and perspectives those who are marginalised in those wars and conflicts. As with many other manuscripts submitted for consideration as editorials, this article, although unsolicited, was published with only internal peer review. As we have consistently done with papers published in the journal, we welcome rebuttals, contestations, and alternative interpretations. Some of these are being included as online 'rapid response' comments. In time, others will be published in the journal and on our blog.
Those of us who do global health have a responsibility to respect the dignity of people and communities who are marginalised as knowers, and to represent their interpretations of their own reality. The article is in fulfillment of that responsibility. To be socially/politically marginalised is to be interpretively (or hermeneutically) marginalised; or to have interpretations from one's standpoint under-represented in the collective pool of legitimised knowledge. For every complex reality, there may be multiple and even competing interpretations. Our responsibility as a field must include allowing space in our heads and on knowledge platforms for that multip...
Show MoreThe overarching problem with this editorial is not only what is written, but also what is not.
The evidence cited presents a one-sided, revisionist version of events. The article has no reference to Hamas, terrorist attacks, hostages or executions. Nor does it reference the use of human shields, storage of weapons around health facilities, diversion of humanitarian aid for militant use or the prevention of population movement to safer areas. It doesn’t acknowledge the geopolitical landscape, especially the role of neighbouring Arab countries and Iran. The language used is inflammatory; demonising Israel while granting all other actors a 100-year-history of immunity.
The article criticises Israel for warning Palestinian civilians to move away from areas that will come under bombardment. This is the opposite of indiscriminate violence, as accused by the authors, and in accordance with interpretations of international humanitarian law (IHL) [1]. There’s no reference to allegations of Hamas demanding civilians remain in northern Gaza, their alleged attacks on the safe routes out, nor their extensive network of tunnels used for miliary activities and not permitted for civilian shelter [2]. While these conflicting narratives may be unpalatable to the authors it doesn’t excuse their decision to ignore them.
The closing argument reduces this complex historical conflict to right versus wrong, with Israel the only villain. Israel does hold blame, but this is al...
Show MoreAs of November 10, 2023, more than half of Gaza’s hospitals and nearly three-quarters of Gaza’s primary care clinics are not functioning (as reported by Al Jazeera, CNN, and others). At least 11,000 people have been killed in Gaza as a result of Israel’s ongoing indiscriminate assault and complete blockade. Among those killed, at least 4,500 have been children. Over 27,000 people have been injured, including more than 8,600 children, while another 1,500 children remain missing (see also: https://doi.org/10.1016/S0140-6736(23)02407-8). Many, many more will suffer life-altering physical and mental effects following this conflict. The WHO’s Director General, The United Nations’s Secretary General, the entire country of Bolivia, over 1,000 USAID staff, over 3,000 global health professionals, and millions upon millions of citizens around the world are denouncing this violence as unjustifiable, inhumane, and abhorrent.
The WHO and several UN agencies, among many others, have called attention to the catastrophic health consequences the closure of health facilities, murder of health care providers, and incessant bombardment of all civilian infrastructure is having and will continue to have on Gaza’s population of more than 2 million people, nearly half of whom are younger than 18. Without essentials such as fuel, food, potable water, electricity, and medicines, infectious diseases will spread and malnutrition will worsen; al...
Show MoreWe read with increasing surprise and disgust the editorial by Smith J et al regarding the war in Israel.1 It represents an extremely one-sided opinion, without taking into account the facts that happened, nor past history. We are medical doctors, in our case oncologists, sworn not to harm, fighting for human lives, and dedicating ourselves to accompany our patients - in some cases for months and even longer - striving for cure, and if not possible to relieve pain and maintain quality of life. In this, we do not distinguish between gender, age, culture, religion, skin colour, sexual preference, geography and we definitely should not be dealing with politics. Therefore, we were extremely shocked that a medical journal like BMJ publishes such an inappropriate letter.
Show MoreOn 7 October 2023, the terrorist group Hamas carried out a surprise attack on Israel, brutally murdering 1,400 people and kidnapping more than 200, beheading babies, murdering children and elderly, without distinction as to age, gender or nationality. This was acknowledged formally by the UK Prime Minister, as well as by other world leaders, based on cruel but validated evidence. Only a small part of the gruesome information was released, out of respect for the victims and the relatives, and only after this was deemed unavoidable in order to react to unbalanced and even fake information. Many Israeli citizens from the ruthless Hamas attack are still missing and many bodies or body parts cannot be identified...
Dear team at BMJ Global Health
Re: Violence in Palestine demands immediate resolution of its settler colonial root causes.
I came across the above article today in the BMJ which I have really appreciated as it brings to light the ongoing burden on human life and health from colonialism in current times.
My thoughts are with all striving healthcare colleagues on the ground and with those that have lost their lives in Palestine and Israel trying to serve those most at need. I am very saddened by the ongoing loss of lives to the extent of healthcare workers not being spared by the occupying IDF regime. It is truly a dark time for humanity but this article being published gives added hope in human resilience and unity when standing for human suffering and adversity regardless of faith, culture or race.
Thank you once again to all those who have spoken out about the atrocities in Palestine and demanding immediate resolution of its settler colonial root causes.
Kind regards
Re your editorial, Smith et al.Violence in Palestine
My late father had a life subscription to the BMJ, so I read your journal every week for over 40 years. In all these years I have never read an article so one-sided as Smith et al's.
Show MoreI am an Israeli who does not approve of her government's bombing of Gaza. Even though the Israeli army has notified people in Gaza of its plans to bomb their cities beforehand, many innocent people have been killed, which is appalling. The survivors, like the authors of the paper, will now hate us even more.
But this must be put in context. Just as the 1948 Nakba, which involved the displacement of thousands of Palestinians, was preceded by attacks on the new state of Israel (whose foundation was approved by the United Nations) by the armies of Lebanon, Syria, Iraq and Egypt, so the bombing of Gaza was preceded by an attack by Hamas terrorists, who did not warn their potential victims, but deliberately burned families alive, maimed and killed children in front of their parents and parents in front of their children and took hundreds of hostages. I myself was present on Kibbutz Sa’ad on the Gaza border on 7th October when all this happened, although thank God I did not witness these barbarities. But I did spend the day under repeated Hamas rocket attacks, and one rocket landed on a house less than 50 yards from me. We too were not warned beforehand of these attacks.
The paper was also biased in that it repo...
Hello Editors
I am concerned about an article that doesn't happen to have the peer review process one associates with the BMJ journals. The article 'Violence in Palestine demands an immediate resolution of its settler-colonial root causes' by James Smith et. al.,
http://dx.doi.org/10.1136/bmjgh-2023-014269, is cited as having had internal rather than external peer review.
Given the significant potential for hidden and overt bias in this type of emotion-seeking article, particularly as stated in the competing interests of the authors, how is the BMJ group able to ensure that the internal peer review provided a balanced and unbiased review? Why was the accepted practice of obtaining external peer review by experts in the field not undertaken?
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