Steinberg/Rosen letter on diarrhea disease in Gaza

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Letter to the Editors

Comments on `Palestinian refugee conditions associated with intestinal
parasites and diarrhoea: Nuseirat refugee camp as a case study’ by T.A. Abu
Mourad (Public Health 2004; 118:131-42)

Laura Rosen
School of Public Health, Hebrew University, Jerusalem, Israel

and Gerald M. Steinberg
Director, Program on Conflict Management, Bar Ilan University, Ramat Gan,

Available online 23 April 2004.


As researchers involved in prevention of communicable diseases in both Jewish and Arab children, and in analysis of conflict management, respectively, we are extremely disturbed by the decision to publish the article, “Palestinian refugee conditions associated with intestinal parasites and diarrhoea”, by T.A. Abu Mourad (Public Health 118(2), 131-142). The first paragraph as well as the body of the text includes a number of false and misleading accusations, which reflect a highly partisan
Palestinian political narrative. We do not understand how and why the reviewers and editor allowed the publication of such one-sided political claims in a scientific journal.

While the history of this protracted ethno-national conflict is far too complex to summarize in a few sentences, the author’s claim that “The Palestinian refugee problem came into being in 1948 as a result of the disturbances before and after the occupation of Palestine and the creation of the State of Israel…” is false, and confuses this symptom of the conflict with its cause. The refugees resulted from the campaign of terror and the accompanying invasion by the armies Egypt, Syria, Jordan, and Iraq
in 1948, with the declared goal of destroying the State of Israel. This war in turn, followed the Arab rejection of UN Resolution 181 (November 29, 1947), which called for the establishment of two states to reflect the ancient claims of the Jewish population and the claims of the Palestinian Arabs.[1.] Since then, the Arab refusal to agree to any compromise plans that would have resettled the refugees, and provided them with citizenship, employment, education and health care, has led to their current condition. In contrast, the similar number of Jewish refugees who fled from Arab countries at the same time were resettled and integrated into Israeli society. The political exploitation of Palestinian refugees as political pawns is a major factor in the conditions described by T.A. Abu Mourad, and
the absence of any acknowledgement of this is particularly misleading.

The author also asserts that “infectious diseases, including intestinal parasites, exist among the refugees…and will continue to exist unless they return back to their cities and villages.” This sentence is a clear attempt to mix political and medical issues. In terms of public health, there are many examples of refugees from other conflicts around the world who have been resettled and enjoy a high standard of medical care. At the same time, there are many areas of the world where infectious diseases are common, and where the local populations do not claim refugee status.[2.]

Furthermore, in discussing the impact of unemployment, the author asserts that it “indicates how Israeli siege and closure has had a devastating impact on the economic situation”. This is a further attempt to shift the blame to Israel, as the cause of the closures-the Palestinian-initiated violence, and the consequent attempt by the Israeli government to prevent murder of its civilians by suicide bombers-is entirely ignored. Further, the author ignores the evidence of corruption in the
Palestinian government, and the systematic abuse of aid money, including the purchase
of explosives and weapons, rather than funding medical care. These activities are documented by the International Monetary Fund, the World Bank and other sources.[3.] Substantial funds donated by the European Union, the Government of Japan, and many other funders to Palestinian
Authority during the Oslo process were squandered and used to kill Israelis, rather than building the intended infrastructure for a hygienic environment and prosperous society. Such a system could surely have prevented the unsanitary conditions and high morbidity levels. This core factor is not mentioned by the author of this article, clearly demonstrating a reporting bias, that, while commonplace in political advocacy, is unacceptable in scientific publications.

In summary, the publication of a scientific article with a clear political agenda expressed through selective and misleading presentation of background facts has seriously damaged the credibility of this journal. We call upon the publisher and the Royal Institute of Public Health to undertake an independent investigation into the review process and to take all necessary steps to prevent a repetition.

1. H. Sacher. A history of Israel: from the rise of Zionism to our time (2nd ed.), Knopf, NY (1996) There are numerous respected academic references that present the detailed history of this conflict, including.
M.B. Oren. Six Days of War: June 1967 and the Making of the Modern Middle
East, Presidio Press (2003).
W. Laqueur and B. Rubin, Editors, The Israel-Arab reader: a documentary
history of the Middle East conflict (6th ed.), Penguin (2001).

2. World Health Organization, The World Health Report 2003: Shaping the Future.

3. International Monetary Fund West Bank And Gaza: Economic Performance and Reform under Conflict Conditions A. Bennett, K. Nashashibi, S. Beidas, S. Reichold, and J. Toujas-Bernat, Middle Eastern Department, September 15, 2003; World Bank Country Brief, Middle East and North Africa Region West Bank and Gaza, Washington DC, August 2003; Statement of Dr Rachel Ehrendfeld, Director of the Center for the Study of Corruption and the Rule of Law (CSC) before the House Armed Services Committee Special Oversight Panel on Terrorism, House Armed Services Committee, Rayburn House Office Building, Washington, D.C. 20515, 6 June 2002. In addition, the Parliament
of the European Union has recently initiated a special investigation of corruption in EU funding for the Palestinian Authority.

Public Health
Volume 118, Issue 4, June 2004, Page 307

Steinberg/Rosen letter on diarrhea disease in Gaza

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