121 e-Letters

published between 2020 and 2023

  • Getting to the root of root causes

    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...

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  • Supporting the call for a ceasefire

    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).

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  • Addressing 'root causes'

    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...

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  • Response of the Editor-in-Chief regarding the publication of this editorial

    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...

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  • Informing Without Prejudice: Responsible Reporting on the Israeli-Palestinian Conflict

    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...

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  • “The heart of justice is truth telling”

    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...

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  • Unilateral opinion sharing paves the way to further escalation

    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...

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  • Dr

    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

  • Israel/Palestine: BMJ should encourage dialogue, not fuel hatred

    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...

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  • Editor fails basic peer review

    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?