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Lancet Removes Gaza Article, Author Responds

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    Lancet Withdraws Gaza Article, Author Responds March 4, 2009 http://pulsemedia.org/2009/03/04/lancet-withdraws-gaza-article/ email: meca@mecaforpeace.org web:
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      Lancet Withdraws Gaza Article, Author Responds
      March 4, 2009
      http://pulsemedia.org/2009/03/04/lancet-withdraws-gaza-article/
      email: meca@...
      web: http://www.mecaforpeace.org


      On 2 February 2009, The Lancet Medical Journal's Global Health Network online published Dr Swee Ang and Dr Ghassan Abu Sitta's `The Wounds of Gaza', first published here at PULSE. It introduced the article by stating:

      Two Surgeons from the UK, Dr Ghassan Abu Sittah and Dr Swee Ang, managed to get into Gaza during the Israeli invasion. Here they describe their experiences, share their views, and conclude that the people of Gaza are extremely vulnerable and defenseless in the event of another attack.

      On 2 March 09 the Journal removed the article (though The Lancet Student still has it), stating: "We have taken down the blog post The Wounds of Gaza because of factual inaccuracies."

      No specific faults or amendments to the alleged inaccuracies are suggested. The reader comments, overwhelmingly in support, remain posted. A letter penned by four israelis (surprise, surprise!) that objects to the article was published on February 18. Our friend Dr Swee responds to this development and elaborates on the figures.
      Dr Swee Ang on reporting from Palestine and Lebanon
      Many of us are afraid to put numbers down because the pro-Israel Lobby will inundate us with emails and complaints. This has gone to the extent that only figures sanctioned by the Israelis are credible. Everything else is viewed as suspect!

      Over the last twenty-six and a half years, I have taken many blows over this kind of issue. The only question I ask myself when writing is - when is the version according to the victims going to be articulated? The people of Gaza knew that 5,000 were killed in the Khan Younis massacre in 1956; 100,000 gone missing in 1967 of which 35,000 were murdered - just because they cannot go to the Sinai and take pictures, or dig up the mass graves, does not mean we refuse to let them state their case.

      I looked at Northern Gaza - how often have I driven down Sala -Uddin Road in 1988 and 1989. I remember every turn and corner- I know the citrus orchards, the farms and the homes. Often I would stop my ambulance to give a ride to the farm workers and they in return would give me freshly picked lemons and oranges. I now see it completely laid waste by Israeli explosives like the nuclear holocaust of Hiroshima, and yet we were called liars when we put forward the figure of one and a half million tons of explosives. We have seen apartment blocks not only reduced to rubble but incinerated - how many kilotons of explosives are responsible for this kind of damage?
      The Lancet Global Health Network withdrawing `The Wounds of Gaza' is not a problem at all. The wonder is how it even got to be published in the first instance.

      My book From Beirut to Jerusalem, when first published in 1989, was reprinted hard back and then paperback within 2 months, as it was sold out on publication, and again sold out as soon as reprinted. Then Tom Friedman came out with a book with exactly the same title half a year later and by the same publisher. My book was withdrawn from the shelves. It went out of print for many years.

      But the truth has to come out. Most times at great inconvenience to some of us as we well know.

      I just want you to know that I am not afraid to believe the Palestinians. It is a scandal that the extent of the Khan Younis massacre had not come to light for all these years. It is a scandal that what happened in the Six Day War was not published. The intimidation to silence witnesses has to stop. We cannot allow the case to be stated only by the perpetrators of the killings.
      Like the Palestinians in Gaza - I am also not afraid. My witness of Gaza counts. So does your witness. We should not be afraid of saying what the Palestinians told us. They are the ones whose families were killed, who bear the wounds of violence, who are dispossessed and persecuted. Their voices must be heard.

      Dr Swee Ang on the explosives used in Gaza

      The actual tonnage of the explosives dropped on Gaza can only be accurately known to the IDF themselves. So other figures can only be estimates. However some of us have many years of experience looking at bombed out countries.

      Over the 22 days, Gaza was intensely bombed from land, air and sea. The bombs dropped from the air are large, and most of them are more than a ton on average. In the south the bombs used to destroy the tunnels and structures around them are large heavy bombs.

      Of the 21,000 buildings destroyed, 4000 of them are completely demolished. Some believe that these are by small nuclear fission bombs. However there is no proof and it is impossible to tell, though the effect of all structures, especially concrete, being incinerated, would suggest that the size of these bombs are of the order of kilotons—whether they are conventional explosives or otherwise. If you were to look at the effect of the atom bomb on Hiroshima (about 15 - 20 kilotons), you would see the incineration of concrete similar to that of that seen in these 4,000 buildings. These 4,000 buildings would have been destroyed by 4,000 kilotons of explosives. The other 17,000 destroyed buildings are the result of bombs of single figure tonnage judging from the kind of destruction. Apart from bombs being dropped on buildings reducing them to rubble, bombs were also dropped on fields, orchards, farms and roads.

      We do not know enough of the explosive values of DIME to comment and hence have not speculated on it. They have been used in Gaza. But from what is commonly known about them, they are very heavy bombs, more so than conventional.

      As to the person who queried the "million and a half tons of explosives dropped in 22 days" as such an amount would have obliterated Gaza [a question put forward to www.womenforpalestine.org, a site which carried Dr Ang's article]—we can safely answer him that the whole of Northern Gaza has indeed been obliterated - he or she is most welcome to see for themselves! The whole stretch of Northern Gaza has been converted to a complete wasteland. In the South again vast stretches of agricultural areas have also been demolished.

      The figure of one and a half million tons of explosives in our view is a conservative estimate. Those who are sceptical about it need to see it for themselves.

      Dr Swee Ang on the figure of 35,000 political prisoners being executed during the 1967 Six Day war

      The number 35,000 was from the International Co-operation Department (ICD) of Gaza. Within the first 2 hours of the attack on Egypt, 11,000 Egyptian soldiers were killed. But we are not talking about them, as they would be those killed in action.

      After the first 2 hours till the end of the 6-Day War, about 100,000 Egyptian and Palestinian combatants were missing and never found. These included many young men in Gaza who had joined the Egyptians and the early PLA (of Nasser) to fight the Israelis. There are at least 2 mass graves in El-Arish on the edge of the Sinai desert, and the Israelis themselves had admitted to killing those captured, but had not admitted to killing so many. The Gaza information had stated 35,000 executed, but we had not asked them the whereabouts of the remaining 65,000. Many of the missing still have surviving relatives living in Gaza. The names of those executed could be traced from the ICD in Gaza. 1967 is a long time ago, and I do not see what advantage it is to the ICD in Gaza to make up these figures.

      As many of you will be aware, a similar situation occurred with the Sabra and Shatilla massacre, where Palestinian sources believed that 3,000 were killed and IDF only admitted to over 300. Bayan Al-Hout had compiled at least one and a half thousand names to date, and the list is still increasing. We still do not know the whereabouts of the men murdered in the Stadium, now that some soldiers of the Phalange have admitted to executing people there. The bodies buried in Martyr's Square were from within the camp itself, and not those abducted to the Stadium.

      ===

      ORIGINAL ARTICLE, NOW REMOVED


      The Wounds of Gaza
      February 2nd 2009
      http://www.thelancetglobalhealthnetwork.com/archives/608


      Two Surgeons from the UK, Dr Ghassan Abu Sittah and Dr Swee Ang, managed to get into Gaza during the Israeli invasion. Here they describe their experiences, share their views, and conclude that the people of Gaza are extremely vulnerable and defenseless in the event of another attack.

      The wounds of Gaza are deep and multi-layered. Are we talking about the Khan Younis massacre of 5,000 in 1956 or the execution of 35,000 prisoners of war by Israel in 1967? Yet more wounds of the First Intifada, when civil disobedience by an occupied people against the occupiers resulted in massive wounded and hundreds dead? We also cannot discount the 5,420 wounded in southern Gaza alone since 2000. Hence what we are referring to below are only that of the invasion
      as of 27 December 2008,

      Over the period of 27 December 2008 to the ceasefire of 18 Jan 2009, it was estimated that a million and a half tons of explosives were dropped on Gaza Strip. Gaza is 25 miles by 5 miles and home to 1.5 million people. This makes it the most crowded area in the whole world. Prior to this Gaza has been completely blockaded and starved for 50 days. In fact since the Palestinian election Gaza has been under total or partial blockade for several years.

      On the first day of the invasion, 250 persons were killed. Every single police station in Gaza was bombed killing large numbers of police officers. Having wiped out the police force attention was turned to non government targets. Gaza was bombed from the air by F16 and Apache helicopters, shelled from the sea by Israeli gunboats and from the land by tank artillery. Many schools were reduced to rubble, including the American School of Gaza, 40 mosques, hospitals, UN
      buildings, and of course 21,000 homes, 4,000 of which were demolished
      completely. It is estimated that 100,000 people are now homeless.

      Israeli weapons

      The weapons used apart from conventional bombs and high explosives also include unconventional weapons of which at least 4 categories could be identified.

      Phosphorus Shells and bombs

      The bombs dropped were described by eye witnesses as exploding at high altitude scattering a large canopy of phosphorus bomblets which cover a large area.

      During the land invasion, eyewitnesses describe the tanks shelling into homes first with a conventional shell. Once the walls are destroyed, a second shell - a phosphorus shell is then shot into the homes. Used in this manner the phosphorus explodes and burns the families and the homes. Many charred bodies were found among burning phosphorus particles.

      One area of concern is the phosphorus seems to be in a special stabilizing agent. This results in the phosphorus being more stable and not completely burning out. Residues still cover the fields, playground and compounds. They ignite when picked up by curious kids, or produce fumes when farmers return to water their fields. One returning farming family on watering their field met with clouds of fumes producing epistaxis. Thus the phosphorus residues probably
      treated with a stabilizer also act as anti-personnel weapons against children and make the return to normal life difficult without certain hazards.

      Surgeons from hospitals are also reporting cases where after primary laparotomy for relatively small wounds with minimal contamination find on second look laparotomy increasing areas of tissue necrosis at about 3 days. Patients then become gravely ill and by about 10 days those patients needing a third relook encounter massive liver necrosis. This may or may not be accompanied by generalized bleeding, kidney failure and heart failure and death. Although acidosis, liver necrosis and sudden cardiac arrest due to hypocalcemia are known
      to be a complication of white phosphorus it is not possible to attribute these complications as being due to phosphorus alone.

      There is real urgency to analyze and identify the real nature of this modified phosphorus as to its long term effect on the people of Gaza. There is also urgency in collecting and disposing of the phosphorus residues littering the entire Gaza Strip. As they give off toxic fumes when coming into contact with water, once the rain falls the whole area would be polluted with acid phosphorus fumes. Children should be warned not to handle and play with these phosphorus
      residues.

      Heavy Bombs

      The use of DIME (dense inert material explosives) were evident, though it is unsure whether depleted uranium were used in the south. In the civilian areas, surviving patients were found to have limbs truncated by DIME, since the stumps apart from being characteristically cut off in guillotine fashion also fail to
      bleed. Bomb casing and shrapnel are extremely heavy.

      Fuel Air Explosives

      Bunker busters and implosion bombs have been used . There are buildings especially the 8 storey Science and Technology Building of the Islamic University of Gaza which had been reduced to a pile of rubble no higher than 5-6 feet.

      Silent Bombs

      People in Gaza described a silent bomb which is extremely destructive. The bomb arrives as a silent projectile at most with a whistling sound and creates a large area where all objects and living things are vaporized with minimal trace. We are unable to fit this into conventional weapons but the possibility of new particle weapons being tested should be suspected.

      Executions

      Survivors describe Israeli tanks arriving in front of homes asking residents to come out. Children, old people and women would come forward and as they were lined up they were just fired on and killed. Families have lost tens of their members through such executions. The deliberate targeting of unarmed children and women is well documented by human right groups in the Gaza Strip over the past month.

      Targeting of ambulances

      Thirteen ambulances had been fired upon killing drivers and first aid personnel in the process of rescue and evacuation of the wounded.

      Cluster bombs

      The first patients wounded by cluster were brought into Abu Yusef Najjar Hospital. Since more than 50% of the tunnels have been destroyed, Gaza has lost part of her lifeline. These tunnels contrary to popular belief are not for weapons, though small light weapons could have been smuggled through them. However they are the main stay of food and fuel for Gaza. Palestinians are beginning to tunnel again. However it became clear that cluster bombs were dropped on to the Rafah border and the first was accidentally set of by tunneling. Five burns patients were brought in after setting off a booby trap
      kind of device.

      Death toll

      As of 25 January 2009, the death toll was estimated at 1,350 with the numbers increasing daily. This is due to the severely wounded continuing to die in hospitals. 60% of those killed were children.

      Severe injuries

      The severely injured numbered 5,450, with 40% being children. These are mainly large burns and polytrauma patients. Single limb fractures and walking wounded are not included in these figures.

      Through our conversations with doctors and nurses the word holocaust and catastrophe were repeatedly used. The medical staff all bear the psychological trauma of the past month living though the situation and dealing with mass casualties which swamped their casualties and operating rooms. Many patients died in the Accident and Emergency Department while awaiting treatment. In a district hospital, the orthopaedic surgeon carried out 13 external fixations in less than a day.

      It is estimated that of the severely injured, 1,600 will suffer permanently disabilities. These include amputations, spinal cord injuries, head injuries, large burns with crippling contractures.

      Special factors

      The death and injury toll is especially high in this recent assault due to several factors:

      No escape: As Gaza is sealed by Israeli troops, no one can escape the
      bombardment and the land invasion. There is simply no escape. Even within the Gaza Strip itself, movement from north to south is impossible as Israeli tanks had cut the northern half of Gaza from the south. Compare this with the situation in Lebanon 1982 and 2006, when it was possible for people to escape from an area of heavy bombardment to an area of relative calm - there was no such is option for Gaza.

      Gaza is very densely populated. It is eerie to see that the bombs used by Israel have been precision bombs. They have a hundred percent hit rate on buildings which are crowded with people. Examples are the central market, police stations. Schools, the UN compounds used as a safety shelter from bombardment, mosques (40 of them destroyed), and the homes of families who thought they were safe as there were no combatants in them and high rise flats where a single implosion
      bomb would destroy multiple families. This pattern of consistent targeting of civilians makes one suspect that the military targets are but collateral damage, while civilians are the primary targets.

      The quantity and quality of the ammunition being used as described above.

      Gaza’s lack of defense against the modern weapons of Israel. She has no tanks, no planes, no anti-aircraft missiles against the invading army. We experienced that first hand in a minor clash of Israeli tank shells versus Palestinian AK47 return fire. The forces were simply unmatched.

      Absence of well constructed bomb shelters for civilians.

      Unfortunately these will also be no match for bunker busters possessed by the Israeli Army.

      Conclusion

      Taking the above points into consideration, the next assault on Gaza would be just as disastrous. The people of Gaza are extremely vulnerable and defenseless in the event of another attack. If the International Community is serious about preventing such a large scale of deaths and injuries in the future, it will have to develop a some sort of defense force for Gaza. Otherwise, many more vulnerable civilans will continue to die.

      ===

      Dr Swee Ang Says:
      February 2nd, 2009


      Since we wrote this account, we have spoken to senior Palestinian surgeons who described to us strange “penetrating wounds without shrapnels”. The wound track in such patients also has clean sharp margins. Some of them treated the wounds as clean wounds but after several days - mostly 3 days onwards there is necrosis of tissue around the wound track. In the case of skin, it can take the form of
      abscesses. In the abdomen there are extension of organ necrosis around the track such as liver necrosis, gangrenous bowel and kidney damage. We suspect these wounds are caused by Tungsten DIME explosives.

      In experimental animals tungsten is highly carcinogenic, malignant tumours appearing around 5-7 months. However the long term carcinogenic effect on human is not known yet. The Ministry of Health in Gaza is calling for any one who has shrapnel wounds which are unusual or does not heal to present themselves to any Health clinic.

      ===

      Dr Swee Ang Says:
      February 2nd, 2009


      The lesson from these wounds without shrapnel is that Tungsten toxicity should always be suspected and primary wide excision of the wound track is mandatory to minimise tissue reaction to it. They must not be confused with what is traditionally thought to be clean cut wounds and merely washed out and closed.

      Tissue biopsies are crucial if we are to understand more about these wounds. There is a pressing urgency given that there is a potential carcinogenic effect. DIME as an explosive is highly anti-personnel and can be used safely by an invading neighbouring army without the fear of the side effect of radioactive fallout which other radioactive warheads might carry. Its effect is localised to the target population only - in this case the people of Gaza, with no danger to its neighbour, cf nuclear weapons.

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