On August 16, we received an email from an SPME member who directed our attention to the August 12 issue of The Lancet, one of the oldest and most widely read British medical journals. Starting on the front cover of that issue, in bold print, was an editorial describing an “escalating humanitarian crisis” in Lebanon, and even-handedly blaming Israel and Hizbollah. The SPME Board decided to submit a letter to the editor of The Lancet. The Lancet editorial and our letter follow:
It is time for urgent action on the Lebanese health crisis. Rarely has a humanitarian crisis been so deliberately and ruthlessly exploited at the expense of civilian populations by warring parties. Forces in Lebanon and Israel are pressing narrow and utterly unrealistic claims, while the international community struggles to act. Israel is never going to defeat by force Hizbollah, a political group now firmly entrenched in Lebanese society. And Hizbollah, even with the support of Iran, will never succeed in destroying Israel. Yet these are the stated aims of both parties. Their mutually cruel and desperate attacks not only harm the lives of unprotected men, women, and children, but also ensure the survival of undiluted enmity for several generations to come.
Jan Egeland, Under-Secretary-General for Humanitarian Affairs, has said of the situation: “Providing aid and saving lives in Lebanon requires these basics: access to those in need, security for those providing it and adequate funding.” Political gridlock means that little has been done to provide these basic life-saving initiatives.
A large section of the southern Lebanese civilian population is currently living in crisis. At least 900000 people out of a population of 4 million have been displaced, their homes already reduced to rubble. The majority have fled north, some finding shelter with family members and friends, but hundreds of thousands of others have sought refuge in public spaces, in schools, and underground car parks. Those remaining are the needy-the old, the sick, the injured, and the poor-without humanitarian assistance.
The ongoing military operation has caused enormous damage to bridges and road networks, severing the humanitarian lifeline between Lebanon and the outside world. This destruction is seriously impeding the health system’s capacity to deliver care. There is particular concern for high-risk groups: pregnant women, the elderly, wounded, or chronically ill. Severe shortages of safe drinking water, food, fuel, and medical supplies are reported all over south Lebanon.
In response, UN agencies and several non-governmental organisations launched a consolidated Flash Appeal for Lebanon on July 24, requesting a total of US$150 million to enable aid groups to supply food, shelter, and protection to civilians caught up in the conflict. The response from the international community to date has been disappointing: only 27% of the total requested has been pledged. In any case, for this humanitarian aid to reach its intended beneficiaries there must be effective access for the providers of that assistance.
Kofi Annan has repeatedly called for an immediate cessation to hostilities to allow urgently needed humanitarian relief to reach the vulnerable populations of Lebanon, while condemning the Security Council for their failure to act firmly and quickly. Despite a draft UN resolution calling for a cessation to hostilities there has been mystifying hesitation among the international community over intervening in this escalating humanitarian crisis. These delays highlight the need for humanitarian issues to be separated from the political and very difficult process of achieving a UN resolution over a ceasefire. What is needed is a twin-track approach.
Sweden’s Prime Minister, Göran Persson, was the first to propose a conference of donors to plan the reconstruction of Lebanon. Persson’s idea could be strengthened by convening a summit of international development and health ministers. They and only they would have the legitimacy to add new diplomatic urgency to the UN Security Council’s effort to achieve an immediate ceasefire. Development and health experts could create a mechanism to coordinate the complex array of international organisations working in Lebanon. They can sharpen legal instruments to protect humanitarian corridors. And they can leverage funding to meet the UN targets.
Most importantly of all, Sweden’s initiative would offer a constructive counterpart to the atrocious failure of the US and UK’s weak, evasive, and ultimately disastrous foreign policy towards the Middle East. Western governments are willing to allow civilians to perish-in the words of WHO, Israel and Hizbollah’s military action “continues to pose an unacceptable threat upon humanitarian access”-in order to protect the political status quo in a region that needs a vigorously renewed effort to achieve long-term stability and security for displaced and threatened peoples on all sides. The humanitarian indifference that typifies American and British policy is a betrayal of democratic principles of peace and reason. It is impossible to express the despair into which their empty leadership has plunged us. The Swedish olive branch, appropriately strengthened, must now be grasped with tenacious resolution.
SPME’s Response to Lancet:
To the Editor:
One trouble with editorials written in the heat of the moment for a weekly is that they get overtaken by events. Contrary to the expectations of your front-page editorialist (August 12), a cease-fire
is, at least for the time being, in place in Israel and Lebanon.
The editorialist made a point of not blaming Israel alone for all the suffering caused by the war in Lebanon. But even-handedly faulting Israel and Hizbollah is not the same thing as seeking the truth.
Hizbollah did everything it could to maximize civilian casualties. Israel did everything it could to minimize casualties among civilians used by Hizbollah as human shields. We wonder what crystal ball the editorialist used as a basis for the claim that Israel is never going to defeat by force Hizbollah and Hizbollah will never destroy Israel. That proposition is not based on any evidence we have seen, and despite its superficial symmetry, it implicitly acknowledges the lack of symmetry in Hizbollah’s and Israel’s aims.
A Lancet editorialist should be able to distinguish explicitly between an organization that tries, albeit with imperfect instruments, to kill civilians and a state that tries, albeit with imperfect instruments, to
minimize such casualties while protecting its own people. Surely readers of this journal can understand that there is no such thing as a perfect surgical strike.
The quotation from Jan Egeland’s account of the situation is accurate but leaves out the passage where he lays full blame for the devastation on Hizbollah. Access and security are certainly necessary for the provision of humanitarian aid, but according to Shimon Peres, Israel allowed aid supplied by Arab countries to reach Lebanon even during active hostilities. Moreover, it is in the interests of both Israel and the United States to make sure that aid from the international community reaches its intended beneficiaries, if only to counterbalance the aid that will come from Iran via Hizbullah.
Unfortunately, some international organizations may be too bureaucratic to react as quickly as Hizbullah, and according to some reports, neither the West nor the Arab governments have made overly generous offers of support to the Lebanese government. Human Rights Watch asserts that one of the major obstacle to the provision of aid in some areas is unexploded missiles and bombs, which have cost some civilians their lives since the cease-fire began. But it is probably too early to know exactly what is happening on the ground, and things may change a lot in the next few weeks.
Meanwhile, we share the editorialist’s concern for the suffering human beings in the areas affected by the fighting. But they will not benefit from sensationalizing and the blame game. In the future, we hope that the Lancet will take a more constructive and fact-based approach to addressing their humanitarian and medical needs. Such an approach would be in keeping with the journal’s expertise, mission, and history, and would be less likely to be result in editorials that are obsolete by the time of publication.
Judith S. Jacobson, DrPH, MBA
Associate Professor of Clinical Epidemiology
Columbia University, New York, New York, USA
On behalf of Scholars for Peace in the Middle East
Edward S. Beck, Ed..D., CCMHC, NCC, LPC, Alvernia College and
Susquehanna Institute, President
Board of Directors
Jonathan Adelman, Ph.D., University of Denver
Steven Albert, Ph.D., MPH, University of Pittsburgh
Leila Beckwith MD, Professor of Pediatrics Emerita at UCLA
Phyllis Chesler, Ph.D., City U. of New York
John R. Cohn, MD, Thomas Jefferson College of Medicine
Donna Robinson Divine, Ph.D., Smith College
Stanley Dubinsky, Ph.D., U. of South Carolina
Rev. India E. Garnett, M.Div. Treasurer, Harrisburg PA Chapter, United
Church of Christ
Rabbi Peter Haas, Ph.D. Case Western Reserve U.
Efraim Karsh, Kings College U. of London
Richard Landes,Ph.D. Boston U.
Ruth Lichtenberg-Contreras, Ph.D., Secretary, U. of Vienna and Natural
History Museum of Vienna
Allan Lipton, MD, Penn State College of Medicine, Milton S. Hershey
Medical Center
Robert S. Mirin, Esq., Harrisburg, PA
G.S. Don Morris, Ph.D.,California Polytechnic U./Wingate Institute IL
Philip Carl Salzman,Ph.D. McGill U.
Gerald Steinberg, Ph.D., Bar Ilan U.