Errors and bias in anti-Israel diatribe of British Medical Journal and editor

Background: On October 7, 2023, Hamas terrorists from the Gaza Strip invaded Israel and perpetrated indescribable atrocities and brutal massacres, killing over 1200 people and kidnapping over 200, including infants and elderly. These vicious barbarisms were videoed and publicized by the Hamas perpetrators themselves and were celebrated on the Gazan street – and Hamas leadership promised that this was merely the first of many such attacks. Israel immediately launched a defensive military operation to eradicate Hamas and free the hostages and thereby safeguard its citizens and existence.

Within a short time, lies and anti-Semitic rhetoric began to circulate in social media as well as in mainstream news outlets. And even supposedly reputable scientific journals such as the British Medical Journal (BMJ) joined the fray and produced biased anti-Israel propaganda.

The dead from the October 7 massacre were still being identified and Israeli ground forces had yet to enter Gaza, when on October 21 the BMJ published a lie-filled, anti-Semitic creed whose very title (“Violence in Palestine demands immediate resolution of its settler colonial root causes”) reveals its agenda-driven nature. Eventually, a dozen or so responses, some trying to counter the article and some in the same vein as the original article, were published online by the BMJ, followed by a concluding statement by the editor, Dr. Seye Abimbola. The response I submitted was not published. As such, I am sharing it here for the purpose of exposing the biased and non-evidence-based nature of the BMJ, and to have in writing some of the counter-arguments to their obscene editorial.

Exchange of letters:

Below is 1) our exchange with the BMJ office, 2) our unpublished response to the article, and 3) the editor’s concluding statement in the BMJ and our private email to him in response (which he has not acknowledged nor responded to).

Initial contact with the BMJ:

I was initially certain that the journal had made an innocent lapse in judgement and so on October 24 I sent a brief letter to all of the editors and publishers. In my naivete, I believed they were misled and wanted to do the correct thing. I was unfortunately very wrong!

(sent Oct 24, 2023) Dear BMJ editors and Publishers,

As a scientist who publishes in peer-reviewed journals, I would expect that such journals, particularly journals with a reputation of excellence, would have peer review for editorials as well.

I was therefore shocked by your recently published editorial: Violence in Palestine demands immediate resolution of its settler colonial root causes. Simply put, it contains barely a word of truth.

You and all of the authors are well aware that Israel never targets intentionally health facilities or health care workers. You know that 471 people were not killed in that hospital explosion in Al-Ahli Hospital on the evening of October 17. You know that the small explosion that took place was caused by an errant Hamas rocket that was aimed at civilian (as proven beyond a shadow of doubt). You know that Israel treats Israel Arabs and Gazan Arabs in Israeli hospitals. You know that if Israel would target a medical facility it would be because Hamas is storing rockets there, rockets that they are indiscriminately launching at civilian targets within Israel. You know that the buzzwords used in the title, “settler” and “colonial” have nothing to do with the violence in this case. You know that there has not been a “complete blockade” – as evidenced by the thousands of imported missiles and weapons. You know that the recent violence was begun by an abhorrent massacre carried out against Israeli civilians and yet not a mention of it in the editorial. You know that Israel is not engaged in indiscriminate bombing, unlike Hamas. You know that the Israeli warning to evacuate was a rare example of a military trying to minimize civilian casualties, unlike Israeli civilians who receive no such warning. How dare you turn that warning into a point of criticism.

The claim about the hospital strike, like many of the “statistics”, are from Hamas sources – and yes, people who murder, rape, chop off baby heads, burn people alive, and take kids as hostages are also wont to lie. How dare you publish such drivel. It is nothing but an anti-Semitic rant. Can I ever trust an article in your publication again? Did any sane, honest person read this before it was printed?

Wishing for better days here in Israel and for your journal to learn right from wrong and a little morality,

Ari Zivotofsky

Professor of Neuroscience,

Bar Ilan University

(On Oct 25) they responded with this generic reply:

Dear Ari Zivotofsky,

Many thanks for contacting BMJ with your concerns. We take any concerns regarding the integrity and appropriateness of our content very seriously. Your letter has been passed on to the Editor in Chief of BMJ Global Health. We will come back to you with a full response as soon as possible.

Best wishes,

On behalf of

Dr Helen Macdonald and Ms Helen Hardy

Content Integrity

BMJ Journals

–

(On Oct 26) I followed up:

Thank you for the acknowledgement of my email.

I very much look forward to your full response as I believe the editorial team made an egregious error that should be corrected and publicly apologized for as soon as possible. And I believe that the authors wrote an intentionally dishonest and antisemitic article and should be barred from publishing in the BMJ journals.

all the best,

Ari Zivotofsky

Director, Brain science program Bar Ilan University

Professor, Bar Ilan University

Ramat Gan

Israel

(And on Nov 1 2023) they wrote:

Dear Ari Zivotofsky,

Thank you for contacting BMJ Global Health with your perspective on this article.

We encourage you to consider submitting your perspective on the article as an online comment linked to the article. In writing any response, please focus on adding a new perspective and or highlighting any matters which you consider are factually incorrect. Instructions for writing online comments for BMJ Journals can be found here.

Please note that a correction has been made to the article regarding the description of the Al-Ahli hospital explosion.

Best regards,

On behalf of

Dr Helen Macdonald and Ms Helen Hardy

Content Integrity

BMJ Journals

————————-

We submitted a response to the original editorial:

Our submitted (unpublished) response:

BMJ recently published an article [1] full of blatant inaccuracies of both omission and commission, far too great to detail in a short response. As a scientist and as a clinician familiar with peer-reviewed journals we expected peer review for editorials as well. We were shocked by this article.

An article that mentions a “horrific escalation of violence”, might have mentioned that the escalation began with a barbaric massacre by Gaza-based Hamas of over 1400 people, many of whom were burned in their homes, shot during a music festival, raped, beheaded, etc. This was accompanied by the kidnapping of over 200 people, including children and senior citizens. Over a month later, Hamas has yet to permit a visit by the Red Cross. In a medical journal, it might have been interesting to mention that some of the perpetrators of this pogrom were found to be in possession of Captagon, presumably fueling their maniacal rampage. [2]

While mentioning the internally displaced Gazans, the article neglects the half million displaced Israelis due to the ongoing Hamas shelling directed towards Israeli civilian centers. [3] And accompanying the mention of 700,000 violently displaced Palestinians in 1948, there is a glaring omission of the 850,000 Jews violently expelled from Arab lands (who are now productively settled in Israel and other western countries instead of being perpetuated as pawns in refugee camps). [4]

The Gaza healthcare has been fully under Hamas control for 15 years and contra the claim, there is no Israeli “systematic obstruction to access of healthcare”, and Arabs know that.

The Syrian civil war has claimed hundreds of thousands of lives. Thousands of injured, knowing that Israel would not turn away their pleas for help, approached the border and the Israeli healthcare system has provided lifesaving care, some complex and long term. This was done with utmost sensitivity even to the smallest details – discharge letters in Arabic without any mention of the facility so as not to endanger them upon their return to Syria. Staff even removed labels from the clothes and toys. [5]

In Gaza too, the locals know that Israel will not intentionally target a hospital. Hamas continues its long-standing tradition of using schools, mosques, and medical facilities, including Al Shifa Hospital, for terrorist activities. [6] Yet on October 28, 2023 more than 60,000 (!) people were sheltering Al Shifa Hospital. [7] Why? They knew it was a safe place because Israel does not intentionally target medical facilities.

Yahya Sinwar, the current leader of Hamas and the mastermind of the brutal October 7 massacre, was jailed in 1989 for masterminding the abduction and killing of two Israelis and four Arabs. In 2008 he suffered head pain, was taken to an Israeli hospital where he was diagnosed with a brain tumor, successfully operated on, and made a full recovery. [8]

Hamas political leader Ismail Haniya has had several relatives treated in Israeli hospitals: in 2012 his sister and brother-in-law chose Israel over Egypt for cardiac care. [9] In 2013 and 2014, his daughter, granddaughter, and mother-in law were all treated in Israeli hospitals. [10] According to a World Health Organisation report in 2014, every year thousands of Gazans were treated in Israeli medical facilities. [11] Since 1995, Save a Child’s Heart has treated over 6,600 children suffering from congenital and rheumatic heart disease; approximately 50% from the Palestinian Authority, Gaza, Iraq, and Morocco. [12]

Two aspects of this are note-worthy. First is that Israel has provided medical care even to those who swear to destroy them. And perhaps more significant is that everyone seems to know the truth – the Israeli people and their medical establishment adhere to moral principles.

One of the most egregious lies in the article, which the editors and authors know to be false, is the claim that 471 people were killed in an explosion at Al-Ahli Hospital on the evening of October 17. Serious analysis by the Wall Street Journal confirmed the source of the explosion was a rocket fired by a Gazan terrorist organization towards Israeli civilians and that the death toll was closer to 50. [13] This blood-libel against Israel is being promulgated by BMJ.

There has not been a “complete blockade” of Gaza – as evidenced by the thousands of imported missiles and weapons. And unlike Hamas, Israel is not engaged in indiscriminate bombing.

And how dare the authors turn the humanitarian gesture of Israel’s warning to evacuate into an accusation. That warning was the sign of the most humane military on the planet. [14] It was a rare example of a military trying to minimize civilian casualties. Contrast with the Israeli civilians who received no such on October 7 and for years received no warnings of incoming missiles directed at homes and hospitals. How dare you attempt to turn that warning into a point of criticism!

The claim about the hospital strike, like many of the “statistics”, or the claim of white phosphorous munitions are from Hamas sources or “personal communication” – and yes, people who murder, rape, chop off babies’ heads, burn people alive, and take kids as hostages are also wont to lie. How dare BMJ publish such stuff. This “article” is nothing but an anti-Semitic rant. Can we ever again trust a BMJ article? Did any sane, honest person read this before it was printed?

BMJ asserts [15]: “a set of ethical editorial principles, an ethics advisory committee, and a commitment to transparency.” This was not obvious in this piece. We believe that the editorial team made an egregious error that should be corrected and publicly apologized for by removing this article from the website. And we believe that the authors wrote an intentionally dishonest and antisemitic article and should be barred from publishing in the BMJ journals as well as other scientific journals.

As Israel pursues this just war of self-defense, it will protect civilians and health care. Hamas will not. While innocents will inevitably and tragically be killed, the Israeli military can be counted on to do all in its power to protect innocent life. Hamas will not.

[1] Smith, J., Kwong, E. J. L., Hanbali, L., Hafez, S., Neilson, A., & Khoury, R. (2023). Violence in Palestine demands immediate resolution of its settler colonial root causes. BMJ global health, 8(10), e014269.

[2] https://www.businessinsider.com/hamas-militants-high-poor-mans-cocaine-oct-7-attacks-report-2023-10

[3] https://www.i24news.tv/en/news/israel-at-war/1697526771-around-half-a-million-people-displaced-in-israel#:~:text=Approximately%20500%2C000%20people%20displaced%20in%20Israel,-i24NEWS%20October%2017&text=Nearly%20500%2C000%20people%20in%20Israel,near%20the%20border%20with%20Lebanon.

[4]https://www.europarl.europa.eu/meetdocs/2004_2009/documents/fd/il20062006_07/il20062006_07en.pdf

[5] Bahouth, H., Shlaifer, A., Yitzhak, A., & Glassberg, E. (2017). Helping hands across a war-torn border: the Israeli medical effort treating casualties of the Syrian Civil War. The Lancet, 389(10088), 2579-2583.

[6] https://www.nytimes.com/2023/10/28/world/middleeast/gaza-al-shifa-hospital-israel.html?smid=nytcore-ios-share&referringSource=articleShare ; El-Khodary, Taghreed; Bronner, Ethan (29 December 2008). “In the midst of war’s horror, a terrible vengeance”. New York Times.; “Gaza: Palestinians tortured, summarily killed by Hamas forces during 2014 conflict” ( https://www.nytimes.com/2008/12/29/world/africa/29iht-gaza.4.18986499.html ). Amnesty International. 27 May 2015. Retrieved 9 October 2023 ( https://www.amnesty.org/en/latest/news/2015/05/gaza-palestinians-tortured-summarily-killed-by-hamas-forces-during-2014-conflict/ ); https://www.washingtonpost.com/news/morning-mix/wp/2014/07/31/why-hamas-stores-its-weapons-inside-hospitals-mosques-and-schools/ ; Exposed: Hamas’s hospital hideouts – a grave abuse of Gaza’s medical lifelines – editorial https://www.jpost.com/opinion/article-772168

[7] New York Times, Israel Says Al Shifa Hospital Conceals Hamas Underground Command Centers The group denies the accusation, saying Israel has offered “fabricated” evidence. By Vivian Yee Reporting from Cairo Oct. 28, 2023

[8] https://www.al-monitor.com/originals/2017/02/israel-gaza-new-hamas-leader-yahya-sinwar-security.html

[9] https://english.alarabiya.net/articles/2012/08/08/231069

[10] https://www.reuters.com/article/us-mideast-gaza-hamas-daughter-idUSKCN0I80LO20141019

[11] https://english.alarabiya.net/News/middle-east/2014/10/21/Israel-hospital-treats-daughter-of-Palestinian-arch-foe-

[12] https://saveachildsheart.org/our-impact

[13] https://www.wsj.com/video/video-analysis-shows-gaza-hospital-hit-by-failed-rocket-meant-for-israel/120A1C22-BA32-418E-8837-BC4141FEFB00 and https://www.wsj.com/world/middle-east/israel-tries-to-back-up-claims-it-didnt-attack-gaza-hospital-a8cc3405

[14] And it is a fulfillment of Article 19 of the Geneva Convention (IV) on Civilians, 1949.

[15] https://www.bmj.com/about-bmj/resources-authors/forms-policies-and-checklists

Statement of the editor and our response to him:

On November 16, the BMJ published a “Response of the Editor-in-Chief regarding the publication of this editorial” by Seye Abimbola, Associate Professor of Health Systems School of Public Health, University of Sydney, Australia

It stated:

BMJ Global Health has served as a platform for highlighting the global forces that underpin inequities in health and wellbeing everywhere in the world. The journal has published similar articles in relation to wars and conflicts, and in doing so have consistently privileged the voices, needs, experiences, and perspectives those who are marginalised in those wars and conflicts. As with many other manuscripts submitted for consideration as editorials, this article, although unsolicited, was published with only internal peer review. As we have consistently done with papers published in the journal, we welcome rebuttals, contestations, and alternative interpretations. Some of these are being included as online ‘rapid response’ comments. In time, others will be published in the journal and on our blog.

Those of us who do global health have a responsibility to respect the dignity of people and communities who are marginalised as knowers, and to represent their interpretations of their own reality. The article is in fulfillment of that responsibility. To be socially/politically marginalised is to be interpretively (or hermeneutically) marginalised; or to have interpretations from one’s standpoint under-represented in the collective pool of legitimised knowledge. For every complex reality, there may be multiple and even competing interpretations. Our responsibility as a field must include allowing space in our heads and on knowledge platforms for that multiplicity, while also striving to privilege interpretations that are marginalised; including how marginalised people and communities see the world and their place in it.

Publication of this editorial is consistent with the nature, mission and rationale of global health and its commitment to equity and justice. This includes hearing voices and perspectives that are otherwise unheard, especially of marginalised people and communities. The content is also consistent with the field’s commitment to the upstream determination of health and wellbeing, including focussing analysis and action on ‘root causes’ – such as the impacts of colonisation, globalisation, hyper-capitalism, the climate/environment and social/political discrimination on inequities in health and wellbeing.

There was no opportunity to respond to this in press, so we emailed him the following. To date (March 11, 2024), we have heard nothing from Dr Abimbola despite repeated attempts.

Dear Editor Dr. Seye Abimbola

We are shocked (although maybe it is time to stop being shocked) by your statement as Editor in Chief of the BMJ. We would even be shocked if such a statement came from a non-STEM discipline such as sociology, but especially coming from a supposed scientist, we wonder if we inhabit different universes and different academic worlds than you do.

Your main point seems to be the need to give voice to a “marginalized” group. Who decided the definition of the term “marginalized”, and who decided which group is marginalized? While we can see the reasoning to offer a platform to a “marginalized” group, in this particular conflict/issue, by a review of the news, it certainly does not appear that the “Palestinians” are marginalized by any definition of the word. For a group their size they receive far more media bandwidth, international donations, and public support than any other group. And indeed, their healthcare, by most measures, beats any truly marginalized community (see below*).

Even if there were justification to give more room to the “voice” of Gazans, there can be NO justification for a lying, half-truth, lacking context, anti-Semitic diatribe. And that is what this original “editorial” was. Shame on you and shame on the BMJ. Giving succor to Hamas (which is what you essentially did) is the equivalent of giving a forum to ISIS or Boko Haram – something we suspect even the BMJ would understand is morally reprehensible.

Looking forward to the world health community realigning its moral compass,

and looking forward to hearing from you,

Ari Zivotofsky PhD, Naomi Zivotofsky MD

PS- We submitted an online rapid response which was not posted. There is much to discuss on the topic. If you are truly interested, we would be happy to dialogue (and at the same time, we can discuss my fascinating visit to Nigeria several years ago).

*Gaza health stats as per the CIA:

The maternal mortality rate is 20 deaths/100,000 live births, better than Ethiopia (267), South Africa (127), Cyprus (68) and even the US (21).

Infant mortality is 14.87 deaths/1,000 live births, far better than Nigeria (55) or India (30), and comparable to Egypt (17) and Venezuela (14).

Life expectancy at birth (75.66 years) is comparable to its neighbors – Egypt (74.7), Syria (74.5), and Saudi Arabia (76.9).

Physicians per capita (2.71 physicians/1,000 population) is greater than Lebanon (2.21), Egypt (0.75), or even the US (2.61) and similar to Saudi Arabia (2.74).

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Post Script:

We are now five months into this war, with over 100 people still held hostage and the Red Cross has not yet visited any of them. The world medical community, including the BMJ, has not raised a hue and cry about this evil. A true disgrace and stain which will be hard to clear. The BMJ’s publishing of the initial editorial and its subsequent handling of it are exceedingly disappointing. One would have expected doctors and medical professionals to be honest, caring people. And medical journals to be data-driven not agenda-driven. We can only hope for better days.