Shooting at Ambulances in Israel: a Cardiologist’S Viewpoint
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VIEWPOINT Viewpoint Shooting at ambulances in Israel: a cardiologist’s viewpoint Sami Viskin At the age of 49 years, this cardiologist still volunteers to serve as a field doctor in an infantry troop of the Israel Defense Forces (IDF) reserves. There is nothing unique about this action. Although military service in Israel is compulsory, the ease of evasion of active duty means that those in the front are effectively volunteers. Although some would argue that I am too rusty for this type of activity, being at the front has allowed me to witness first hand what the world press has called “the carnage inflicted by the IDF in the West Bank”1 from a different viewpoint. On March 27, 2002, Israel celebrated Passover, one of the Jewish holidays still observed by all Israelis, secular and religious alike. A Palestinian terrorist carrying a large bomb walked into an observant congregation and detonated his explosives in the midst of the crowd. Because of the many casualties (29 killed and 130 wounded)2 and the escalation in terrorism (118 civilians killed in 4 weeks) it was clear that Israel was heading towards war. We were mobilised Ambulance of the Palestinian Red Crescent Society used for the next morning. smuggling explosives into Israel The first night on duty we were dispatched to the A: The ambulance stopped in the Ramah roadblock near Jerusalem. PRCS Palestinian town of Hares to treat a woman in distress. (Palestinian Red Crescent Society) sign is visible on the open door. The Red Crescent symbol and MICU (Mobile Intensive Care Unit) are visible on There is nothing idyllic about doing midnight house calls the front hood. B: The robot used to handle bombs takes the stretcher in the West Bank nowadays, and the possibility of an out of the ambulance. C: The robot drags the mattress of the stretcher to ambush crossed my mind. What we encountered, in fact, a secure distance. D: The bomb-vest found under the stretcher mattress. was a very scared family and a woman in frank pulmonary Photographed by the IDF in the presence of two representatives of the International Red Cross. oedema. I could not tell if the fear in the children’s eyes was caused by our military attire or by their mother’s condition. Although nitrates are not carried in military IDF to send an official protest to the International Red ambulances, we do carry morphine, furosemide, and Cross on May 2, 2002.4 The communication included oxygen and our patient responded promptly to this reports of terrorists who were disguised as being wounded treatment. Eventually, we transferred the patient (with and transported in ambulances of the Palestinian Red now audible mitral regurgitation) to a Palestinian Crescent Society (the local form of the International Red ambulance that moved her to a hospital in Ramallah. Cross) in attempts to evade the IDF. Also, flagrant abuse In this and in several later encounters with Palestinian of medical accreditation by Palestinian terrorists was ambulance personnel, there were neither smiles nor reported on January 27, 2002, after a terrorist bombing in handshakes. Both sides hurt too much for that now. downtown Jerusalem. Both the female suicide terrorist However, there was professional conduct, collaboration, (Wafa Idris), and the attack coordinators (Mohammed and courtesy as we exchanged information on treated Hababa and Munzar Noor) worked for the Palestinian Red patients. I would later read in disbelief what the press Crescent Society. classified as the indiscriminate firing at Palestinian At the outset of the renewed violence, the IDF had ambulances by Israeli soldiers.1 That is not what I saw. received intelligence reports warning them that some The guidelines of the IDF are straightforward: Palestinian terrorist organisations would use ambulances to smuggle ambulances must be allowed freedom of passage to zones bombs or as car bombs. Based on these reports, on of conflict unless there is evidence that they are being used March 27, 2002, IDF forces in the Ramah roadblock to transport military equipment. These guidelines are signalled an approaching Palestinian ambulance to stop. orders from the General Command of the IDF (as testified When the driver ignored the signals, IDF soldiers fired by the Command Secretary in an official response to an shots in the air and, fortunately, the ambulance stopped. inquiry by the Israel Medical Association).3 In fact, these Inside, the soldiers found a woman and three children, are the same orders I heard when working in the field. aged 4 years, 3 years, and 6 months. A sick child Unfortunately, Palestinian ambulances were repeatedly (reportedly with osteomyelitis) was lying on the stretcher. used to transport combatants and weapons, prompting the However, under the stretcher there was a 10-kg bomb-vest of the same type that suicide terrorists hide under their Published online March 11, 2003 clothes (figure). The ambulance driver (Isalam Jibril, age http://image.thelancet.com/extras/02art8008web.pdf 31 years) testified that he was moving the bomb to Department of Cardiology, Sourasky Tel-Aviv Medical Center, Ramallah, a 15-min drive from Jerusalem. Sackler-School of Medicine, Tel Aviv University, Tel Aviv 64239, The same intelligence reports on the potential use of Israel (Dr S Viskin MD) ambulances as car bombs led to tragic consequences on (e-mail: [email protected]) March 4, 2002. An IDF infantry unit in Jenin spotted a THE LANCET • Published online March 11, 2003 • http://image.thelancet.com/extras/02art8008web.pdf 1 For personal use. Only reproduce with permission from The Lancet Publishing Group. VIEWPOINT Palestinian ambulance approaching rapidly and opened young men were thrown out the window of the police fire, killing two men, including Saliman Halil, director of station top floor. The picture of an assassin proudly the Red Crescent Society in Jenin. The IDF conducted an showing off his hands covered with the victims’ blood to official inquiry. The inquiry discovered that the traffic of the applauding crowd was incomprehensible to all civilised Palestinian ambulances in Jenin on that day had been people watching the televised news.7 Incidentally, Riccardo coordinated through the District Coordination Office Cristiano, the representative of the Italian state television, (DCO). This particular ambulance, however, entered an later apologised to the Palestinian Authority for filming area of active battle without informing the DCO and the this event.8 soldiers that saw it approaching at speed were convinced it Finally, one incident will be remembered for its irony. was a car bomb attack. This was a close encounter and the When Jonathan Jesner, a young student from Glasgow, response came within seconds. Seven shots were fired, Scotland, was fatally wounded in a bus that was blown up with fatal consequences. The IDF prosecutor found the in midtown Tel Aviv, his family agreed to donate all organs soldiers’ explanations credible. Knowing the people for transplantation; one of his kidneys was successfully involved, I personally found the explanations credible— transplanted to a 7-year-old Palestinian girl. Thus, the nonetheless tragic—but it is clear that different readers tragedy inflicted by the Israel-Palestine conflict on a Jewish will interpret the same facts in different ways, depending family became the salvation of a Palestinian family. on their preconceptions. To understand the effect of terrorism on Israel, it must Civilians are being killed on both sides. There is, be set in the context of the country’s size. Israel’s however, a fundamental difference between the civilian population is smaller than that of New York City, USA; losses suffered by Israel and Palestine. I do not pretend to 70% of Israel’s inhabitants live in the Tel Aviv area, where have the absolute truth and I will not pretend to be the width of the country (from the Mediterranean Sea to unbiased. I can only give you the truth as I know it. This the West Bank) is only 15 km at its narrowest point. Jenin, truth is so simple that it may be difficult for some to the capital of fundamentalist Palestinian terror, is less than accept. Deaths among Palestinian unarmed civilians, 50 min from Tel Aviv and only 20 min from Jerusalem by caught in the crossfire between fighting forces, were car. Consequently, being mobilised to the army does not unintentional.5 This is a tragic, yet unavoidable mean flying thousands of miles, but rather driving your consequence of war, of all wars. Genuine, continuous own car practically to the battle site. Of note, downtown efforts are being made by the IDF to keep Palestinian Jerusalem alone has been attacked 13 times within the past civilian losses to a minimum, at times at the cost of Israeli 2 years and selected streets have been repeatedly bombed. soldiers’ lives. By contrast, civilian losses in Israel are At the same time, more than 20 buses or bus stops have nothing short of deliberate. been attacked, with large numbers of casualties. Palestinian terrorists have the most accurate system for We do not claim to have a monopoly on tragedy and we delivering bombs. The suicidal terrorists simply walk with regret the suffering inflicted on Palestinian civilians. their bomb-vests under their clothes and detonate the Especially, we regret the losses sustained by Palestinian weapon at the exact point they target. They choose to medical personnel in the course of attending their explode bombs next to large crowds and often target wounded. However, ascribing these tragic events to groups of young people and children. For example, on revenge or to a disregard for medical neutrality only March 12, 2002, a terrorist opted to explode a bomb next reflects unawareness of the fact that our best men are at to a group of women waiting with their baby carriages the front of the line.