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Mark Clarfield on Israeli Arab patients in time of war

16 Jan, 09 | by BMJ

Mark ClarfieldSomeone less than familiar with Israel might wonder how during this crisis we handle Israeli Arab patients who walk around the hospital in a bright red kaffieh and use the helicopter pad as a place to pray. After all, we are in the midst of a war just a few miles from the hospital involving an Arab Islamist group bent not only the killing of Jews, but publicly and proudly sworn to the destruction of the Jewish state.

Can one detect any hostility expressed towards our Israeli Arab patients? Do we provide second class service? Is there a problem at all? The simple answer is that both before and during the war, Arab patients were and are treated in our hospital no differently than are their Jewish counterparts. In fact, Soroka Hospital’s staff is made up of both Arabs and Jews, and whatever our politics, in our day to day work we actually get along quite well. In fact, all over the country, Israeli Arab doctors operate on Israeli Jewish patients. For their part, Israeli Jewish paramedics look after Israeli Arabs when the Hamas missiles fall in the south, or Hizbullah rockets in the north. And they can and do strike both Israeli Arabs and Jews. Evidently our enemies believe in equal opportunity.

Oddly enough, relations between the two nations here in Israel reminds me of the charged social/political climate when I lived in Quebec in the fractious 1980s. Then (and now) Anglophones and Francophones, despite sometimes powerful political disagreements, pragmatically worked together. My guess is one can also find an analogy with the relations between Protestants and Catholics in Northern Ireland.

It is true that for the most part, Jewish and Arab folk here in my hospital avoid talking much about politics. But we do talk about our patients and their needs. I will not deny that Israeli society suffers from friction between her nearly 6 million Jews and more than 1 million Arabs as well as displaying both social and economic gaps. But then again other countries are burdened with not dissimilar problems: for example, the United States with whites and blacks; Canada and Australia with their aboriginal populations; or the UK with her Muslim minority. And these countries do not have a war raging on their borders nor missiles lobbed at them from just outside.

That being said, neither within the health service in general nor Israeli hospitals in particular have I ever noticed any problems; furthermore despite the tensions, this war has not produced any in this domain. My wife, also a doctor, who works in a Jerusalem hospital feels the same. Despite the conflict, Israeli hospitals remain bastions of civic and civil sanity.

When this war started the hospital administration decided to close down several wards (including my own geriatrics department) because they were located in buildings relatively insecure against a missile attack. (A direct hit would of course pulverize any building here.) The neonatal intensive care unit also had to be transferred. The scene was an evocative one indeed: a variegated caravan of mothers and fathers – half of whom were Bedouins,the women with their long flowing robes mixed in with Jewish mothers and fathers dressed in more conventional styles, all pushing their babies in incubators to their new home in the hospital. Five of the neonates were attached to ventilators, not an easy lot to transfer in a hurry. Along with parents were staff, both Arab and Jewish helping them along.<

We all hope that one day, despite this recent round of fighting, peace will break out between Israel and her neighbours, including the Palestinian Arabs of the Gaza Strip. Until then, despite all pressures, our hospital as well as all health institutions in Israel remain an excellent model for future coexistence between Arab and Jew.

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  • Caroline Richmond

    Keffiyahs are worn by Arab men, but not women. Those Arabs wandering around the hospital wearing red ones are presumably male and from the east bank of the river Jordan. East banks Arabs — Palestinians — wear black and white keffiyahs, which have recently become a PLO symbol. In Jordan, they wear red keffiyahs.
    I wonder how well Arab men in black and white would be received, and, indeed, of Dr Clarfield has asked them if they are on the butt end of discrimination?

  • Michael Gordon

    I found Dr. Clarfield’s comments very interesting and uplifting. The concurred with my own experiences albeit many years ago of working in a hospital in Jerusalem for two years (1971-73). About a 20-30% of patients were Arab, from either East Jeruslam or the villages and towns around Jersualem or from the West Bank from where many patients came especiallyf or more complext medical care. I dealt with many ill patients and their families whose care I could say without hesitation was provided at the same level of dedication as it was to the Jewish Israeli patients.
    In addition many of the support staff of the hospital were Israeli Arabs whose families had served the hospital which was about 75 years old for generations.
    Lastly I was recruited by the Israel Ministry of Health at the request of the then Palestinian Authority equivalent to help start the first nursing school in the West Bank in Ramallah and spent two years helping to train the first cohort of nurses. I recall the experience with much fondess and through recent Internet searchs have managed to connect to two of my original class who have expressed the same wonderful memories of that special co-existence and mutually respectful and rich experience.
    For those who can only find ways to criticize Israel’s relationship to its Arab population and neighbors, there is a lot to be learned from how they treat those that are ill and in need of help and care.
    Michael Gordon, MD
    Toronto

  • A Sabra

    Clarefield language has obviously changed to become more politicized. It seems that it is quiet over there in his hospital that he has plenty of time to write all these blogs. I bet Palestinian doctors are striving for a few hours sleep. He started these blogs to publicize for his suffering and undermine the humanitarian tragedy in Gaza committed by his government. I wonder why he tells about scenes from the start of this war as he claims. If it is so quiet in there, I advise him to write about the horror stories from the 40 Km away Gaza. Or, as suggested by an earlier comment, he could offer himself to the injured people of Gaza, and take much-needed drugs and dressings with him. Despite being geriatrician, it is interesting that he has, in particular, chosen the neonatal unit transfer scene to highlight! I also wonder which war he is talking about, all we see is a hideous genocide.

    Clarfield acknowledges the social and economic gaps among Israeli Jews and Arabs. He then pathetically tries to justify this by the long-winded phrases about the similarity between Israeli minorities and those in Canada, Northern Ireland, USA, etc. Oddly enough, he, then, claims he has not seen any inequalities in the health system in general and in hospital….. Yet, another failed argument to sound factualist. Having Israeli Arab doctors and patients in your hospital does not mean equality and that they are not subject to oppression. I’d like to remind him that South Africa had black doctors working in hospitals during the apartheid regime. Anyone who had the minimal knowledge about the region knows that Israel is far from the moral superiority he is trying to trade. I think Clarfield should be blind not the see the inequalities and discrimination against the disadvantaged minorities in Israel. It is not only the Israeli Arabs but also against Jewish minorities themselves such as Ethiopians, Sephardi, etc. I personally know few professionals from these minorities. Needless to tell about the agonizing journey they have to secure a job in the first instance and the continuous harassment thereafter. Finally, I advise you to go and read the endless reports by Israeli human rights organizations who elaborate on these issues.

    Unless Clarfield as a doctor and human being acknowledges the genocide happening in Gaza by his government and takes action to stop these atrocities, his hope for peace is worthless and misleading.

  • http://www.semeioticabiofisica.it Sergio Stagnaro

    In my opinion, peace could break out between Israel and her neighbours, including the Palestinian Arabs of the Gaza Strip, if mass-media all around the worls would be free of informing each others on their real conditions. Unfortunately, as in west countries, we observe a sport-like participation in the war between Israel and her neighbours, including the Palestinian Arabs of the Gaza Strip. For instance, Santoro’s distressing exhibition during last expensive TV transmission “Anno Zero”, have revealed that such as war may be utilized especially as discussion in a trivial show.

  • Salim

    I am not sure why Mark Clarfield’s vision is so partial and so selfish. He is ignoring the hospitals of Gaza and he does not talk about the health situation of Gazans. I am very disappointed to see that he is a doctor and is so insensitive to the humanitarian catastrophe in Gaza. He should be aware of the deaths caused by the siege alone, about 200 deaths occurred were caused by the siege in last few months when the ambulances were blocked on the borders by Israeli check points. The root cause is occupation and killing of democratically elected members of HAMAS. Gaza is a concentration camp worse than that of the second world war, then at least prisoners were not bombarded from the sky. I can see one thing in common between me and Mark that is the hope of peace. I hope its the same GOD to whom we pray for peace.

  • James Woodcock

    The omission in this article of any discussion of the horror being launched on the population of Gaza by the Israeli state is breathtaking.

    No mention of the 1000 plus dead including so many children, no mention of the use of white phosphorus, no mention of the attack of health workers, no mention of the attacks on aid workers, no mention of the bombing of UN compounds where refugees were told to go, no mention of the lack of running water, no mention of the seige blocking health workers and aid for helping those in desparate need. One could go on.

    Instead we read self congratulaion from a medic that he is willing to treat citizens of his own country.

    He mentions Northern Ireland. In England people were killed by IRA bombs. Yes the UK government launched repression against the Catholics and killed people but it did not lay waste to Derry and other Catholic areas even when they had the audacity to vote for Sinn Fein as the Palestinians have had the audacity to vote for Hamas. If the UK government had launched such a war then I hope that English doctors would have done better than boast about still treating people of Irish descent.

  • Nadeem Jilani

    Dr Mark Clarfield
    The day you wrote this piece in bmj, your country and its ‘brave’ soldiers killed three daughters of a Palestinian doctor, Dr. Izze-din al-ayesh, who works to save the lives of Israeli women but lives in Gaza. The irony of this tragedy was that he was being interviewed live on Israeli TV and was regarded as the saner voices among Palestinians as opposed to others whom you describe fanatics “bent on killing Jews”.
    You describe in great detail how Israeli medics do not discriminate against their Arab patients despite being at war with their fellow Palestinians in Gaza, as if it is a gesture of generosity and not an act of duty for these medics towards their fellow citizens. While you are rightly pained by the sight of relocation of babies with incubators in your hospital, you seem completely oblivious of those patients who died and sustained serious injuries when their hospital was bombed by IDF. Any word of condemnation for those children who died while sheltering in a UN run school? Will your ‘humanity’ condone this just because it was done by your country or because those who died were not Israelis? There have been times in history when medics have collaborated with the establishment and done things which brought great disrepute to this noble profession. By supporting their government’s policy towards besieged Palestinians of Gaza and by not speaking up against this mass murder of innocents, I am afraid, Israeli medics also run the same risk.

  • Dr Nasir Ameer

    On Newsnight around a week ago, one reserve Israeli soldier was asked “Do you have any sympathy for the innocent women and children constituting more than half of the total number of people being brought to the hospitals in Gaza?” His response was “No!”
    I told this to one of the staff nurses at our hospital and he said “He must not have meant it”.
    One of the fundamental principles taught to the soldiers is respect for innocent humanity. Where is the respect for humanity in the Israeli soldiers. Their words and their actions negate human rights and war ethics. They should be condemned rather than given the benefit of the doubt.

  • Mark Struthers

    Israel’s medical correspondent in time of war, reports that that the scenes in the ER at Beer-sheva’s hospital are ‘a bit like “M*A*S*H” but without the laughs.

    And Dr Mads Gilbert reports that the Shifa Hospital is ‘truly a scene from Dante’s inferno’.

    http://www.democracynow.org/2009/1/14/white_phosphorous_and_dense_inert_metal

    A Norwegian surgeon, Dr Gilbert tells us that,

    “The condition in Shifa Hospital and in the other hospitals in Gaza is horrifying. I’ve been to Gaza for the last ten years, in and out, teaching and training people in the medical field. I’ve never seen anything like this. I mean, all windows in the Shifa Hospital are out, due to the bombing of the mosque across the street. They have very unstable electricity. They lack supplies, disposables, surgical equipment, trolleys, beds even. They have a fantastic staff, who are working heroically to save their patients, but we have been doing surgery with, almost regularly, two patients in each OR, on the wall, on the floor, in the corridors. The lifts are barely working. The ICU had to triple its capacity with makeshift ICUs. It is really, truly a scene from Dante’s Inferno.”

    The reality of course, is that Professor Clarfield and his geriatric patients, Bedouin or Jew, are not having such a bad old war, after all.

  • Cyril Levitt

    Dr. Clarfield based his remarks on his experiences and those of his wife, and presumably their colleagues, who are working in Israeli hospitals. He offers a modicum of hope that the kind of civility and mutual aid which seem to prevail in Israeli hospitals will offer hope that such good will might be shown in the larger context of confrontation. Many of those who have responded to his rather modest claims and hopes have introduced all manner of “evidence” and “argument” that would seek somehow to invalidate his modest observations and hopes. None of them have refuted or contradicted his observations.

    As a psychoanalyst I am familiar with the use of splitting and projection as primitive psychological forms of defence. All feelings of anger, aggression and guilt are split off from the ego and projected onto an “enemy” who is all bad and thus every evil may be imputed to him or her. This allows the individual to feel good and indeed to wax indignant at the malicious designs of the “enemy.” Collectively this leads to the psychology (and practice) of war. Dr. Clarfield is honestly looking for the road to peace at a time when it seems to becoming harder to find.

    Cyril Levitt, Ph.D.

  • Scientist

    I think this piece exemplifies the duality of Israeli existence. On the one hand, we strive for peace and normality. On the other hand, we are forced to fight ugly battles. And in battle, civilians get hurt. Especially in urban fighting.

    For those comments that try to emphasize the suffering in Gaza as compared to the ideal scene in Soroka I would answer: its a pity that a war hungry organization is in control in Gaza. Hamas openly declares it craves war with Israel (read their web site). It declares its objective is the elimination of Israel, and the means it has chosen is the targeting of civilians, and fighting under a human shield. So it’s a pity that Gaza has opted for war, and an urban one at that, with or without the wishes of the people in the street. But it’s was not Israel’s choice.

    I think the scene at Soroka – and I know it well – shows that Israelis have no wishes to kill Arabs, as long as they are willing to co-exist with us. In fact, we are willing to co-exists even if they are not willing to co-exist, but are not using violence to try and change reality. Most Israeli-Arab students and I spoke admit they wish Israel would vanish. The Israeli-Arab leaders openly side with countries that are still at war with Israel. And yet they are getting fair treatment at Hospitals (with the gaps other minorities in Israel also suffer), get education – and some professorship positions – in our universities, etc.

  • James Woodcock

    Scientist in the response above seems to forget that Israel has consistently used violence to change reality from driving out the Palestinians in 1948 to create the state of Israel in 1948, through the settlers in the West Bank, to the carnage we see in 2009.

    Do the slogans on the house in Palestine occupied by Israeli soldiers match up to a desire to co-exist?
    “Arabs need 2 die”, “no Arabs in the State of Israel” and “One down and 999,999 to go” A drawing of a gravestone bore the inscription “Arabs 1948 to 2009″.http://www.independent.co.uk/news/world/middle-east/gazans-return-to-mourn-their-dead-and-salvage-their-lives-1451409.html

    However, Mark Clarfield says that Jews and Arabs can live together and I believe he is right. The question must be on what basis people can live together when two groups both claim the same piece of land that is Palestine/Israel as their own? The two state solution seems to have little going for it. Israel has overwhelming power compared to the Palestinians and has sadly shown it will not allow a viable Palestinian state. The only solution I can see is one state that includes both groups and treats everyone equally. That is a state in which all the people living in that land are full citizens and have a democratic vote replacing a state founded on religion and exclusivity. This would no longer be an overwhelmingly Jewish state but it could provide the way for peaceful co-existence.

  • From Canada

    I am shocked by James Woodcock’s comments. He has successfully distorted the entire history OF the 20th century. He has chosen to blame Israel for all the ill that has befallen the Arabs living in Gaza. The Arabs care more about sending rockets into Israel, for the past 8 YEARS than in building their own land and helping their own people! What people sends their own children to be suicide bombers! What people uses their own children as human shields to increase the number of injuries and fatalities incurred!

    Israel has through great effort and a genuine desire to live and prosper, succeeded in building an oasis in a sea of hate! What Israel has contributed to the world since 1948 is far greater than all of the entire Arab world has ever contributed! If not for Israel’s inventions, you would not even be able to read this blog, never mind all the medical discoveries and innovations over the past 61 years!

    THERE WILL PEACE IN THE MIDDLE EAST, ONLY WHEN THE ARABS LOVE THEIR CHILDREN MORE THAN THEY HATE THE JEW!

    Kudos to Dr. Clarfield!

  • Aileen Flavin

    Some comments on both blogs from Mark Clarfield.
    I don’t feel any doctor should congratulate themself for treating all patients with dignity. It is simply our professional duty to do so at all times.
    A reference is made to Northern Ireland. A comparison could perhaps be made between “Bloody Sunday” where the British army shot dead 14 civilians and recent events in Gaza. This was a very painful episode in our Island’s history but it pales into insignificance when compared with the suffering and death inflicted by the Israeli army on the civilian population of Gaza in the past few weeks. The lesson however to be learnt from “Bloody Sunday” was that it lead to a huge increase in recruitment to the IRA and delayed peace by decades.
    We as doctors cannot justify violence on any basis. First and foremost our role is to relieve human pain and suffering and we must reject anything that causes it. On a rational basis the evidence is that violence simply does not work. History tells us it never leads to a lasting peace.

  • Richard S. Levy

    Aileen Flavin misconstrues Mark Clarfield’s motives and makes statements about the ABSOLUTE inefficacy of violence which do not withstand a modicum of thought.
    In his last paragraph, Dr. Clarfield explains his reason for writing his article: when people are killing each other it is crucial to focus on reasons to remain hopeful,and reasons to believe in the realistic possibility of co-existence. He gives us those reasons in his description of the civility which reigns in his hospital.
    Second, it simply does not coincide with fact to say that violence never works. The Allied forces used violence to defeat Hitlerism, fascism and Imperial Japan. NATO did not use cap guns and rubber tipped arrows to put an end to brutal “ethnic cleansing” in the Balkans.
    In the early 40’s Gandhi advised the Jews in Europe rounded up by the Nazis to emulate Indian non-violent resistance against England. A few years later, even that great practicing of non-violence had to admit he was very wrong.
    Self-defence was a hard-wired evolutionary instinct before it became a “human right.” I am sure that if Aileen Flavin’s long line of ancestors had indeed suppressed this urge, as she would have the Israelis do, she would not now exist to write her comment.
    Of course (it needs to be said to avoid facile accusation)violence, in self-defence, should be a last resort… after warnings, consideration of dialogue, proportionate to the danger (long term as well as short term)designed to minimize non-combatant casualties, and so on.

  • Ilan Benjamin

    James Woodcock believes that Jews and Arabs can co-exist within the same country in the Middle East. Would he be so kind as to name one such country (apart from Israel, of course)? Would he also be so kind as to comment on the whereabouts of the Jewsih population of Lebanon, Syria, Egypt, Iraq, Iran, Tunisia and Yemen? It seems that their centuries-old Jewsih communities have evaporated in what can only be called ethnic cleansing. These countries are now in fact “Judenrein”. I am afraid this is the fate that awaits Jews who try to co-exist with Arab majorities. Does Mr. Woodcock for one minute doubt that Israel is fighting for its very survival, surrounded as it is by a tsunami of hostility? Does he think that Israel would stand in the way of a viable Palestinian state that would not have as its fundamental mandate the extermination of the state of Israel? Does he think that Ahmadinejad is just kidding?

  • Adam D C

    I agree with the comments of James Woodcock, where is Dr Clarfield’s compassion?

    He talks of treating Arabs in Israel, they are Israeli, hopefully he would treat any person of any race or religion wherever he may be. He is meant to be a Doctor. He may even lower himself and treat me, a fiercely anti-zionist ex-catholic! Or would he need to know my views or background before he did so?

    He wonders why other countries with multicultural populations and minorities:

    “…do not have a war raging on their borders nor missiles lobbed at them from just outside”

    Maybe it is because other countries don’t expel thousands of people(as Israel did in 1947-8)from their homes and lands, then steal it, then round up the rest of the population into poverty stricken ghettos, like the West Bank and particularly Gaza, determine that to have full rights a as citizen of ‘Your’ country you need to be of a specific religion, ban Political parties of these ‘Arab’ groups from running in elections in ‘Your’ democracy! Periodically terrorize the populations with wars, demolitions assassinations, blockades, sieges and imprisonments, and allow heavily armed ‘Settlers’ (Militants) to sit atop hills overlooking every Palestinian Town and Village, who’s water is fouled by the untreated sewage, from those very same hilltop settlements. Then steal more land building a huge wall to protect the ‘Settlers’ from the people in the valley, cutting them off from multiple resources, including the right to free movement!

    And just as an aside – The rockets that strike ‘Israel’ are actually striking the ‘Occupied Territories” so its not “outside” Israel that they are coming from, the Militants are bombing there own land.(according to The UN Resolution 242)

    So the only reason for his blogg must be to deflect attention away from the Israeli assault on Gaza, which has killed over 1,300 people, left thousands injured, some critically,left many more thousands homeless, and continues to lay siege to the ‘Strip’ because it democratically voted for a government Israel does not like? And which it attempted to overthrow with the aid of the former ‘baddies’ Fatah.

    When will it end?
    When Israeli eliminates its own racist and xenophobic policies, stops playing the Palestinian factions off against each over, and looks for a genuin peaceful solution, it needs to discuss allowing refugees to return, and Jews and Palestinians can learn to live together in peace. Nobody says it will be easy but killing innocents is usually a good way of allowing the hatred to intensify and continue, it no way to achieve peace.

  • http://bmj David L. Benkoff M.D.

    Dear Adam,
    wonderful sentiments indeed. Are you aware that the PLO came into existence BEFORE Israel “occupied” Gaza and West Bank? At least 2 years before. So who do you think they needed liberation from? Egypt and Jordan. Fellow Arabs. Israel is not the problem sir. This thumbprint of land is not important to Arabs. If it were, the “refugees” would not have left their homes. We never hear any comments of outrage regarding the shelling of civilians in Israel. Why is that? Where is the defense in those unprovoked bombs? And why is this conflict, and not the carnage in the Congo (>5 MILLION deaths, rape, torture, illegal detainment) so important that a medical journal turns from its mission statement to sponsor this dialogue, rife with willful distortion of history and facts? And don’t we ALL know the obvious, deep rooted and ugly answer to these questions?

  • http://bmj David L. Benkoff M.D.

    OK people, I have some homework for you. That is, IF there is any real interest in what is going on inside Palestine.
    Go to the website of the Palestinian Media Watch (www.pmw.il/)
    browse for a while. See what is being force fed to their children via all forms of media. Ask yourselves if any meaningful discussions toward peace are furthered by this reprehensible behavior.
    Show me ANY other country or society that shamelessly exploits their children like this.
    I suggest prophylactic anti-emetics before watching. It should make you ill.
    There will never be peace until this type of behavior stops. Belief dictates behavior. What chance do these kids have? This is child abuse.

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