Dr. David Sanders, Emeritus Professor at the School of Public Health, University of the Western Cape and Dr. Eric Hassall, Emeritus Professor of Pediatrics at the University of British Columbia are both Jewish pediatric physicians and academics who spent their childhoods in Rhodesia (now Zimbabwe) and both have practiced, taught, and published in their respective fields. Dr Hassall now lives in the US.

Dr. Sanders has drawn strong criticism from Dr. Hassall for having co-written and signed a letter to the British medical journal, the Lancet condemning Israel and an open letter to the South African Government demanding severance of all ties with Israel.

In a September 2014 article the Telegraph newspaper of UK  reported that senior British medical figures claimed that the Lancet has been ‘hijacked in an anti-Israel campaign’ and was being used as a platform by alleged conspiracy theorists. Two of the authors of the highly biased, largely fact-free open letter to the Lancet, Dr Paola Manduca and Dr Swee Ang are members of pro-Palestine NGOs and have sympathies with the views of David Duke, a white supremacist and former Ku Klux Klan Grand Wizard. They sent round-robin emails to their contacts promoting a video titled “CNN Goldman Sachs & the Zio Matrix” featuring an extended anti-Semitic rant by Duke, in which he claims that “the Zionist Matrix of Power controls Media, Politics and Banking”.

The editor of the Lancet, Dr Richard Horton, has published several anti-Israel articles .and as a result of the aforementioned Manduca letter and his initial rejection of responses protesting it, several prominent academic physicians resigned from Lancet committees and boycotted publications of the Lancet’s parent company, Reed Elsevier.

Earlier this month however, Dr Horton visited Israel. After spending three days with senior researchers and physicians at the Rambam Medical Center he said his visit to Israel was a turning point for him and he expressed “deep deep regret” for the “completely unnecessary polarization” the letter had caused.  Hopefully he will publish his criticism of the offending letter in the Lancet.

In an open letter to Dr Sanders, Dr Hassall criticized Sanders for singling out Israel, and using the fact of his Jewish birth and his health, professional and academic identities to support his stance. Dr Hassall initially copied his letter to 90 people. Since then, the letter has been circulated widely and posted on social network websites. I publish the letter in full with Dr Hassall’s permission.

Dr Sanders has yet to reply to Dr Hassall’s letter.

______________________________________________

September 21, 2014

David Sanders, Emeritus Professor
School of Public Health
University of the Western Cape
South Africa

An open letter regarding your public letters attacking Israel1, 2
David:

As a pediatrician and founder of the School of Public Health at the University of the Western Cape, you have published extensively on the social determinants of health – the premise that health and general welfare are dependent on political and socio-economic factors. I’m aware that you are highly respected in the field, and have advised UN agencies and governments on health policy. I mention your distinguished career to introduce you to other readers of this letter, and express my respect for the nature and importance of your work. We are both Jewish pediatric physicians and academics, having practiced, taught, and published in our respective fields. I’m South African by birth, but we both spent our childhoods in Rhodesia – as the country was called back then. Later, we were each in our own way part of anti-apartheid activities.

However, while we share some commonalities of background, profession and beliefs, from there on out I sharply part company with you, given your recent stands on Israel.

You and others recently co-wrote / -signed an “open letter” to the South African government condemning Israel’s “…completely disproportionate” bombardment of Gaza and “state-sanctioned civilian punishment.” 2 You concluded: “The impunity with which Israel behaves cannot be tolerated any longer. We believe the time has come for the South African government to sever all links with Israel.” You also co-wrote a letter to the Lancet1 expressing similar sentiments, in which you also stated that “…remaining neutral in the face of injustice is the hallmark of a lack of ethical engagement typical of docile populations under fascism.”

In your letters you and your co-authors variously identified yourselves as “Jewish health professionals in South Africa”, and “South Africans of Jewish descent”. Your letter to the Lancet included your academic appointments. By volunteering these identities, you appear to imply that your Jewishness, and your qualifications as health professionals and academics have intrinsic values that burnish the credibility of your opinions. Let’s see how you did with that.

You must be surely be aware that in addition to Israel, the following countries, among others, also have diplomatic representation in South Africa:3 China, Congo, Democratic Republic of Korea (North Korea), Egypt, the Emirates, Indonesia, Iran, Qatar, Saudi Arabia, Syria and Zimbabwe.

These nations have despotic or totalitarian governments, and systematically commit gross violations of what most right-thinking people would regard as acceptable nation-behavior.

Have you called for South Africa’s diplomatic ties to be severed with any other of the above countries, when – just to give a few examples…
– China jails political dissidents, has the highest number of executions in the world, forcibly relocates people on a massive scale, and systemically pollutes the planet..?
– Millions die in Congo in bloody strife to which the government is party..?
– Egypt kills more than 1500 protesters during the ‘Arab Spring’; mass arrest, systematic torture; authorities fail to intervene when women are sexually assaulted in Tahrir Square; more recently, in sham trials, hundreds of people are simultaneously sentenced to death..? Women’s’ rights..?
– The Emirates (UAE) detains and jails Prof Cyril Karabus (UCT Prof of Pediatric Oncology – one of my former teachers) on preposterous charges. The Emirates, in several cases of women claiming rape and assault, prosecutes and jails the women..? Women’s’ rights..?
– Indonesia promotes the slashing and burning of forests, creating massive planetary pollution..?
– Iran regularly issues Holocaust-denying statements, jails, silences protesters..? Women’s’ rights..?
– Qatar allies itself directly with Hamas, a recognized terrorist organization, and hosts its leader Khaled Meshal…? In the process of readying to host the 2022 World Cup soccer, it enforces slave-like conditions for its foreign workers, hundreds of whom die on the job..? Women’s’ rights..?
– Saudi Arabia. Does anyone have any rights here other than the ruling family..?
– Syria kills ~300,000 of its own people; uses chemical weapons; engages in systemic torture..?
– Russia invades Ukraine, 3000 are dead; its proxies shoot down a civilian passenger airliner; oppression of LGBT people..?
– Zimbabwe operates a 25-year-long kleptocracy, torturing and jailing opponents. Robert Mugabe, in the newly-independent Zimbabwe slaughters upwards of 20,000 Ndebele opposition..?

In March 2014, The UN Commission of Inquiry on Human Rights in the Democratic People’s Republic of Korea reported:4 “The Commission has found systematic, widespread and grave human rights violations…a disturbing array of crimes against humanity… The gravity, scale, duration and nature of the unspeakable atrocities committed in the country reveal a totalitarian State that does not have any parallel in the contemporary world. The rest of the world has ignored the evidence for too long. Now there is no excuse, because now we know.”

An internet search (including PubMed) failed to reveal journal publications or public declarations from you decrying the injustices perpetrated by the above rogues’ gallery of nations, or calling for South Africa to sever ties. Regarding your statement that “remaining neutral in the face of injustice is the hallmark of a lack of ethical engagement typical of docile populations under fascism” – did my search simply miss your expressions of “ethical engagement”? Did you write to any publication or have you called for South Africa to sever diplomatic ties with North Korea, whose Ambassador Extraordinary & Plenipotentiary His Excellency Mr Yong Man Jo is stationed in Pretoria?

In South Africa, over a several-year period, Thabo Mbeki’s ANC Government’s “AIDS denial” policy resulted in ~300,000 deaths and massive morbidity, including catastrophic social disruption. Did you call for Mbeki to step down, or for other countries to boycott South Africa or sever relations with it?

The endemic, systemic corruption in the ANC / SA Government is well-known. The billions of Rands stolen by those in power, from the President down, could have provided housing, running water, food, preventive health care, job creation, education and relief from desperation for many South Africans. This ongoing corruption and theft directly affects the social determinants of health, prejudicing especially the underclasses in South Africa. Where are your voices?

Instead it seems you reserve your condemnations exclusively for Israel, a country founded on social democratic principles, a modern democracy with an independent judiciary, a vibrantly free press, strong labor unions, human rights for gays and women, and rule of law. Human rights organizations operate freely. Government officials who perpetrate corruption come before the courts. The national health service affords free medical treatment to its citizens; it has long afforded such to Palestinians, and more recently to Syrian war refugees. In other words, while some of Israel’s actions are very much deserving of criticism, e.g., the settlements in the West Bank, the recent appropriation of land, etc., it can safely be concluded that in general, Israel is a country that, despite many odds, manages to largely embody the Western democratic values one would expect Jewish academic health professionals to acknowledge or approve.

Having survived the existential threats of the 1967 and 1973 wars of aggression by neighboring states, Israel gave up Sinai and forcibly removed its own settlers from Gaza. Yet in recent years, it has come to face thousands of rockets directed at its civilians by Hamas, as well as guerilla infiltration from tunnels, the sole purpose of which is to kidnap or kill. Hundreds of millions of dollars that could have been used to buy food, medicines, and build infrastructure for ordinary Gazans were instead used to fund tunnels and rockets to attack Israelis. Why do you fail to condemn this?

Extraordinarily, you declare in your open letter “..there is virtual unanimity that the scale of the Israeli assault is completely disproportionate.” 2 You also allege intentionality of the part of the State of Israel with respect to adverse civilian impacts of its Gaza campaign.2

This “virtual unanimity” appears to be among yourselves alone as the letter’s authors. You somehow leapt to a conclusion on this complex question of fact and international law5-9 within days of cessation of hostilities. No expert inquiries, whether UN, Israeli or other have yet issued any authoritative reports. Reports concerning the ratio of civilian-to-combatant deaths in Gaza have almost all been based on Hamas-issued data during the conflict.

After the previous Israel-Gaza conflict in Dec 2008-Jan 2009, Richard Goldstone, who led a UN fact-finding mission into that conflict which reported in September 2009, then reversed his findings in April 20117, 10 on several questions including Israel’s intentionality and proportionality. That context and Goldstone’s reversal should be instructive; your rush to judgment on proportionality and intentionality is at best foolhardy and arrogant, otherwise it is ill-founded and propagandistic.

In any case the absolute number of dead is a simplistic measure of proportionality. One can easily reach the conclusion that more Gazan civilians than Israelis were killed simply because Hamas wages war from within the civilian population, and deliberately invites such deaths; and therefore, as Norman Geras points out (see below),11 the tragic deaths of innocent Gazans is a Hamas war crime.

How did you, as academics, jump to your premature and simplistic conclusions? Furthermore, terribly tragic though the loss of life is in Gaza and Israel, if your case for proportionality is based on numbers of deaths, the number is but a tiny fraction of the numbers killed in any of the rogue nations above, whom you have chosen to ignore; so why are you suddenly concerned here? It’s evident from Israel’s military power that it could flatten Gaza and kill most of its population if it so wanted or intended. The population of Gaza is 1.82 million. If ‘numbers’ is the key criterion, the fact that the civilian death toll was less than 1500 even by Hamas’ assertions indicates just how much restraint and caution Israel exercised in the context of Hamas operating under cover of civilians. Did Hamas use any restraint at all? Obviously not. They threw all their rocket power at Israeli civilians. Had Israel not had the Iron Dome defense, imagine the death toll in Israeli cities. You demand restraint only of Israel, which indeed exercised it. But in your book, Hamas is off the hook in all matters. This is what I’d call seriously disproportionate, i.e., fundamentally biased.

It is uncontestable that Hamas stores its weapons in mosques, schools, hospitals, residential areas, and even UN-controlled facilities, and fires rockets directly from them. It makes deliberate, widespread use of civilian and residential buildings, including those containing children, for preparation and conduct of war against Israel.

To quote Norman Geras:11 “The commission of war crimes, far from being incidental to the way Hamas fights, is integral to it; Hamas fights from within the civilian population. It fights so that its enemy, Israel, can only with maximum difficulty hit military targets – Hamas fighters or weapons or installations – without at the same time endangering Palestinian civilians. Israel is obliged, nonetheless, by the laws of war to take every step it reasonably can not to jeopardize these lives.

The point is that Hamas has exactly the same responsibility, one which it flouts by the very methods of self-defence it uses, methods putting “its own” civilians at risk and leading to regular violations of the laws of war.”

How is it that you and your angry chorus fail to denounce it in the strongest terms?

Again from Norman Geras:11 “It is unambiguous in the laws of war what Hamas’ responsibilities are.
Article 28 of the Fourth Geneva Convention states: “The presence of a protected person may not be used to render certain points or areas immune from military operations.” Article 51/7 of the Protocol Additional to the Geneva Conventions (June 1977) specifies:
“The presence or movements of the civilian population or individual civilians shall not be used to render certain points or areas immune from military operations, in particular in attempts to shield military objectives from attacks or to shield, favour or impede military operations. The Parties to the conflict shall not direct the movement of the civilian population or individual civilians in order to attempt to shield military objectives from attacks or to shield military operations.”

In your opinion, what would be a “proportionate response” by Israel to keep its civilian population safe and degrade Hamas’ ability to strike again? What should Israel have done differently to take out arms caches, destroy tunnels, and neutralize militants who hide among civilians?

Gaza is run by what is acknowledged, including by the EU, the UK, the US and others to be a terrorist movement whose stated goals and military strategies include the elimination of a UN member state, Israel, and the furtherance of fundamentalist Islamic dictatorship. The Hamas Charter – a document of Islamic extremism – quotes the Koran to enshrine the destruction of Israel and the killing of Jews everywhere among its core goals. By failing to condemn Hamas and its charter of global jihadism, by default you align yourself with the camp of Islamic extremism – as stated by your fellow South African, noted apartheid opponent Paul Trewhelas in his article, “Two Charters: ANC and Hamas.” 12

I conclude with a few questions for you.

You state:2 “The impunity with which Israel behaves cannot be tolerated any longer.” So you view Israel as deserving of punishment. How will South Africa will be a better, more righteous place for having severed diplomatic ties with Israel? What other punishments do you think Israel deserves? Are you in favor of boycotts, and if so, of what?

The five co-authors of your Lancet letter are women, some of whom work in the field of ‘gender and sexual and reproductive rights’. How is it that the fact of systematically highly compromised women’s’ rights among the rogues’ gallery of nations and the Islamic extremists is insufficient on its own independent merits to warrant any call by you all for censure or expulsion from South Africa, but Israel, a country where women have equal rights, comes in for a shellacking for defending itself and its values? Where is the high morality of the Jewish health professional academics here?

As a lifelong progressive Zionist,13 and a Jewish physician and academic myself, I’m curious to learn what it is you invoke from your Jewishness, and from your values as health professionals and academics, that results in your singling out Israel, where Israel is so obviously quite unlike those rogue nations? What are the special criteria you’ve managed to select for Israel that it deserves your particular enmity and demand for punishment? In contrast, regarding China to Hamas to North Korea to Zimbabwe, why have you “remained neutral in the face of injustice”?

I look forward to your response. Like your letters, mine is open. I’ve copied it to some 90 people I thought might be interested, so you’ll have an audience for your response.

Shana Tova.

Eric

Eric Hassall MBChB (UCT), FRCPC
San Francisco, CA

Emeritus Professor of Pediatrics
University of British Columbia
Vancouver BC

References

1. London L, Sanders D, Klugman B, Usdin S, Baldwin-Ragaven L, Fonn S, Goldstein S. Israel-Gaza conflict. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61443-4/fulltext?rss=yes 2014.
2. Sanders D, London L, Favish J, et al. A petition signed by Jewish South Africans http://www.citypress.co.za/you-say/sa-jews-against%E2%80%89israeli-attacks/ 2014.
3. Government. Foreign Representation in South Africa. http://www.dfa.gov.za/foreign/forrep/index.htm 2014.
4. Kirby M. North Korea: UN Commission documents wide-ranging and ongoing crimes against humanity. http://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=14255&LangID=E#sthash.i7idUAL8.dpuf 2014.
5. Bohrer Z, Osiel, M. Proportionality in Military Force at War’s Multiple Levels: Averting Civilian Casualties vs. Safeguarding Soldiers. Vanderbilt Journal of Transnational Law 2013;46:747-822.
6. Feinstein B. Proportionality and War Crimes in Gaza under the Laws of Armed Conflict. Rutgers Law Record 2009;36:224-256.
7. Yihdego Z. The Gaza Mission: Implications for International Humanitarian Law and UN Fact-Finding. Melbourne Journal of International Law 2012;13.
8. Bryen S. The Doctrine of Proportionality. http://www.gatestoneinstitute.org/4462/proportionality-doctrine 2014.
9. Cohen A. Proportionality in Modern Asymmetrical Wars. http://jcpa.org/wp-content/uploads/2011/11/proportionality.pdf 2010.
10. NYTimes. Goldstone retraction. http://www.nytimes.com/2011/04/03/world/middleeast/03goldstone.html?_r=0 2011.
11. Geras N. One-eyed in Gaza. http://normblog.typepad.com/normblog/2009/02/oneeyed-in-gaza.html 2009.
12. Trewhelas P. Two charters: ANC vs Hamas. http://www.politicsweb.co.za/politicsweb/view/politicsweb/en/page71639?oid=672099&sn=Detail&pid=71639 2014.
13. Freedland J. The Liberal Zionists. http://www.nybooks.com/articles/archives/2014/aug/14/liberal-zionists/ 2014;The New York Review of Books.