We For Gaza

Le atrocità contro il popolo gazawi sono state sintetizzate in una lettera per il presidente statunitense Joe Biden

Antonietta Chiodo

Mentre gli Stati Uniti d’America continuano a sostenere l’invio di armi a Israele, Donald Trump e Khamala Harris i due candidati alla Casa Bianca confermano che sarà volontà di entrambi proseguire la politica dell’amministrazione Biden a sostegno del governo di Benjamin Netanyahu. Nonostante una gran fetta della popolazione americana lotti quotidianamente contro il genocidio palestinese, una recente lettera inviata al presidente Joe Biden redatta da sanitari statunitensi denuncia ciò che sta accadendo sulla Striscia di Gaza nella totale violazione del diritto internazionale in merito alla distruzione di strutture sanitarie ed al sequestro e l’uccisione di medici e infermieri.

La lettera datata riporta le sconvolgenti dichiarazioni dei medici stranieri che hanno operato sulla Striscia di Gaza:

Non ho mai visto ferite così orribili, su scala così massiccia, con così poche risorse. Le nostre bombe stanno abbattendo donne e bambini a migliaia. I loro corpi mutilati sono un monumento alla crudeltà.

Dr. Feroze Sidhwa, chirurgo traumatologico e di terapia intensiva

Ho visto così tanti nati morti e morti materne che avrebbero potuto essere facilmente prevenuti se gli ospedali avessero funzionato normalmente.

Dott.ssa Thalia Pachiyannakis, ostetrica e ginecologa

Ogni giorno vedevo morire bambini. Erano nati sani. Le loro madri erano così malnutrite che non potevano allattare al seno, e non avevamo latte artificiale o acqua pulita per nutrirli, quindi morivano di fame.

Asma Taha, infermiera pediatrica

A Gaza è stata la prima volta che ho tenuto in mano il cervello di un bambino. Il primo di molti.

Dr. Mark Perlmutter, ortopedico e chirurgo della mano

La lettera è composta da 9 pagine firmate da numerosi professionisti che chiedono l’accesso libero a tutti i convogli umanitari contenenti materiale ed attrezzature mediche, descrivendo la catastrofica situazione che dal 7 ottobre sta annientando la popolazione dell’enclave, descritta attraverso la loro esperienza sul campo:

Praticamente tutti i bambini sotto i cinque anni che abbiamo incontrato, sia all’interno che all’esterno dell’ospedale, avevano sia tosse che diarrea acquosa. Abbiamo riscontrato casi di ittero(che indica un’infezione da epatite A in tali condizioni) praticamente in ogni stanza degli ospedali in cui abbiamo prestato servizio e in molti dei nostri colleghi sanitari a Gaza. Una percentuale sorprendentemente alta delle nostre incisioni chirurgiche si è infettata a causa della combinazione di malnutrizione, condizioni operative impossibili e mancanza di forniture e farmaci, compresi gli antibiotici. Le donne incinte da noi curate spesso davano alla luce bambini sottopeso e non potevano allattare a causa della malnutrizione. Ciò ha lasciato i loro neonati ad alto rischio di morte data la mancanza di accesso all’acqua potabile in qualsiasi parte di Gaza. Molti di quei bambini morirono. A Gaza abbiamo visto neomamme malnutrite nutrire i loro neonati sottopeso con latte artificiale preparato con acqua velenosa. Non possiamo mai dimenticare che il mondo ha abbandonato queste donne e questi bambini innocenti.

La lettera continua descrivendo la devastante situazione sanitaria legata alle donne incinte obbligate a sottoporsi a taglio cesareo senza anestesia, qualsiasi donna abbia partorito almeno una volta nella propria vita si renderà immediatamente conto del dolore fisico inimmaginabile che comporti una operazione di questo tipo. Inoltre sottolineano che spesso a causa della malnutrizione e della fatica nel fuggire quotidianamente dagli attacchi dell’ IDF le donne si sono trovate a partorire i propri bambini morti. L’empatia dei medici firmatari della lettera ricordano inoltre i propri colleghi uccisi dai militari israeliani:

Tutti noi abbiamo osservato i reparti di emergenza sopraffatti dai pazienti in cerca di cure per condizioni mediche croniche come insufficienza renale, ipertensione e diabete. A parte i pazienti traumatizzati, la maggior parte dei letti in terapia intensiva erano occupati da pazienti con diabete di tipo 1 che non avevano più accesso all’insulina, a causa della mancanza di farmaci e della diffusa perdita di elettricità e refrigerazione. Israele ha distrutto più della metà delle risorse sanitarie di Gaza e ha ucciso un operatore sanitario su 40 a Gaza. Allo stesso tempo, i bisogni sanitari sono aumentati enormemente a causa della combinazione letale di violenza militare, malnutrizione e malattie.

Quando abbiamo incontrato i nostri colleghi sanitari a Gaza era chiaro che erano malnutriti e devastati sia fisicamente che mentalmente. Abbiamo subito imparato che i nostri colleghi sanitari palestinesi erano tra le persone più traumatizzate a Gaza, e forse nel mondo intero.
Come praticamente tutte le persone a Gaza, avevano perso i loro familiari e le loro case. La maggior parte viveva dentro e intorno agli ospedali con le famiglie sopravvissute in condizioni inimmaginabili. Sebbene continuassero a lavorare con un programma estenuante, non venivano pagati dal 7 ottobre. Tutti erano profondamente consapevoli che il loro lavoro come operatori sanitari li aveva contrassegnati come obiettivi per Israele. Ciò si fa beffe dello status di protezione concesso agli ospedali e agli operatori sanitari in base alle disposizioni più
antiche e ampiamente accettate del diritto internazionale umanitario.

Intanto:

1. Tutti i valichi terrestri tra Gaza e Israele, nonché il valico di Rafah, devono essere aperti alla consegna senza restrizioni degli aiuti da parte di organizzazioni umanitarie internazionali riconosciute. Il controllo di sicurezza delle consegne di aiuti deve essere condotto da un regime
   di ispezione internazionale indipendente invece che dalle forze israeliane. Questi controlli devono basarsi su un elenco chiaro, inequivocabile e pubblico attraverso la collaborazione internazionale indipendente, verificato dall’Ufficio delle Nazioni Unite per il coordinamento degli affari umanitari nei territori Palestinesi occupati.
2. Alla popolazione di Gaza deve essere assegnata una quantità minima di acqua potabile di 20
   litri per persona al giorno, come verificato da UN Water.
3. Deve essere consentito l’accesso completo e senza restrizioni ai professionisti medici e
   chirurghi e alle attrezzature mediche e chirurgiche nella Striscia di Gaza. Ciò deve includere gli
   articoli trasportati nel bagaglio personale degli operatori sanitari per salvaguardarne la corretta
   conservazione, la sterilità e la consegna tempestiva, come verificato dall’Organizzazione
   Mondiale della Sanità. Incredibilmente, Israele sta attualmente impedendo a qualsiasi
   medico di origine palestinese di lavorare a Gaza, anche se cittadino americano. Ciò si fa
   beffe dell’ideale americano secondo cui “tutti gli uomini sono creati uguali” e degrada la
   nostra nazione e la nostra professione. Il nostro lavoro salva la vita. I nostri colleghi
   sanitari palestinesi a Gaza hanno un disperato bisogno di aiuto e protezione e meritano
   entrambi.
   Non siamo politici. Non pretendiamo di avere tutte le risposte. Siamo semplicemente medici e
   infermieri che non possono rimanere in silenzio su ciò che hanno visto a Gaza. Ogni giorno in cui
   continuiamo a fornire armi e munizioni a Israele è un altro giorno in cui le donne vengono
   fatte a pezzi dalle nostre bombe e i bambini vengono uccisi dai nostri proiettili.
   Presidente Biden e Vicepresidente Harris, vi esortiamo a porre fine a questa follia adesso!
   Sinceramente e urgentemente

Feroze Sidhwa, MD, MPH, FACS, FICS
Trauma, acute care, critical care, and general surgeon
Northern California Veterans Affairs general surgeon
Served at European Hospital, Khan Younis, March 25-April 8 Secretary/Treasurer, Chest Wall Injury Society
Associate Professor of Surgery, California Northstate University College of Medicine
Prior humanitarian work in Haiti, West Bank, Ukraine (3 deployments since 2023), and Zimbabwe
Treated victims of the Boston Marathon Bombing
French Camp, CA

Mark Perlmutter, MD, FAAOS, FICS
Orthopedic and hand surgery
Served at European Hospital, Khan Younis, March 25-April 8 President, World Surgical Foundation
Global Vice President, International College of Surgeons Prior humanitarian work in 30 countries
Treated victims of 9-11 and Hurricane Katrina
Rocky Mount, NC

Thalia Pachiyannakis, MD, FACOG
Obstetrician and gynecologist
Served at Nasser Medical Complex, Khan Younis, June 20-July 11 South Bend, IN
Adam Hamawy, MD
Plastic and reconstructive surgeon
Served at European Hospital, Khan Younis, May 1-21 Lt. Colonel, U.S. Army (Ret.)
Princeton, NJ
Bing Li, MD
Emergency medicine
Served at European Hospital, Khan Younis, June 6-13
Served at Nasser Medical Complex, Khan Younis, June 14-20 Served at Indonesian Hospital, Beit Lahia,
June 21-July 3 U.S. Army Veteran
Peridot, AZ
Thaer Ahmad, MD
Emergency medicine
Served at Nasser Medical Complex, Khan Younis & al-Aqsa Martyrs Hospital, Deir el-Balah, January 8-24
Director of Global Health, Advocate Christ Medical Center Assistant Clinical Professor, University of
Illinois Chicago College of Medicine
Chicago, IL
Tanya Haj-Hassan, BM BCh, MSc
Pediatric intensivist
Served at al-Aqsa Martyrs Hospital, March 11-25
Prior humanitarian work in the West Bank with Doctors Without Borders
Rhodes Scholar
Philadelphia, PA
Mohammad Subeh, MD, MS
Emergency medicine and ultrasound

Served at the International Medical Corps Rafah Field Hospital, February 14-March 13
Served at the International Medical Corps Deir el-Balah Field Hospital, June 25-July 18
Mountain View, CA
Nahreen Ahmed, MD, MPH
Pulmonary and critical care intensivist
Served at Nasser Medical Complex, Khan Younis, January 8-21 Served at the MedGlobal/WHO Nutrition
Center, Rafah,; al-Awda Hospital, Gaza City & Kamal Adwan Hospital, Beit Lahia March 4-18
Former medial director, MedGlobal
Previous humanitarian work in Yemen, Syria, Ukraine, and Sudan Philadelphia, PA
Ahmed Hassabelnaby, DO
Emergency medicine
Served at European Hospital, Khan Younis, March 18-April 1 Served at Indonesian Hospital, Beit Lahia,
June 20-July 3 Orlando, FL
Talal Khan, MD, FACP, FASN, FRCP
Nephrologist
Served at Nasser Medical Complex, Khan Younis, July 16-August 13
Clinical Associate Professor, University of Oklahoma College of Medicine
Currently serving in Gaza
Oklahoma City, OK
Mahmoud G. Sabha, MD
Family medicine
Served at al-Aqsa Martyrs Hospital, Deir el-Balah, March 25-April 3
Served at European Hospital, Khan Younis, May 1-17
Dallas, TX
Asma A. Taha, PhD, RN, CPNP-PC/AC, FAAN
Pediatric nurse practitioner
Served at Emirati Hospital for Women and Children, Rafah, February 15-March 1
President, Association of Faculties of Pediatric Nurse Practitioners Professor of Nursing, Oregon Health &
Science University School of Nursing
Portland, OR
Imad Tamimi, DMD
Oral and Maxillofacial Surgeon
Served at European Hospital, Khan Younis, February 8-20 Clinical Associate Professor, Rutgers New Jersey
School of Dental Medicine
President, Palestine Children’s Relief Fund Medical Advisory Board
Clifton, NJ

Chandra Hassan, MD, FACS, FRCS
General, bariatric, minimally invasive, and robotic surgeon Served at Nasser Medical Complex, Khan Younis
& al-Aqsa Martyrs Hospital, Deir el-Balah, January 9-23
Board Member, MedGlobal
Prior humanitarian work in Ukraine and Syria
Associate Professor of Surgery, University of Illinois College of Medicine
Chicago, IL
Hani El-Omrani, MD
Obstetric and regional anesthesiologist
Served at European Hospital, Khan Younis, March 4-18 Assistant Professor of Anesthesiology, University of

Washington School of Medicine
Seattle, WA
Zaher Sahloul, MD, FCCP
Pulmonary and critical care intensivist
Served at Nasser Medical Complex, Khan Younis, January 9-25 President, MedGlobal
Associate Clinical Professor of Medicine, University of Chicago Pritzker School of Medicine
2020 Gandhi Peace Award recipient
Chicago, IL
Mike M. Mallah, MD
Trauma, acute care, critical care, and general surgeon Served at European Hospital, March 4-18
Assistant Professor of Surgery
Director of Global Surgery Program
Charleston, SC
Mohamed Elfar, MD, MSc, FACS, FCCM
Plastic and reconstructive surgeon
Served at European Hospital, Khan Younis, February 8-20 Assistant Professor of Surgery, SUNY Upstate
Medical University Adjunct Professor of Surgery, Touro University New York College of Osteopathic
Medicine
New York City, NY
Hisham Qandeel, MD
Cardiac and thoracic surgeon
Served at European Hospital, Khan Younis, March 18-April 1 Clinical Assistant Professor, Michigan State
University Medical Schools
Lansing, MI

Mohammed J. al-Jaghbeer, MD, FCCP
Pulmonary and critical care intensivist
Served at European Hospital, Khan Younis, March 25-April 8 Cleveland, OH
Waleed Sayedahmad, MD, PhD
Anesthesiologist
Served at European Hospital, Khan Younis, March 25-April 8 Parkland, FL
Amer Afaneh, MD, FACS
Trauma, acute care, critical care, and general surgeon
Served at European Hospital, Khan Younis, March 25-April 8 Toledo, OH
Omer Ismail, MD, FACS
Trauma, acute care, critical care, and general surgeon Served at European Hospital, Khan Younis, May 1-21
Des Moines, IA
Ammar Ghanem, MD, FCCP
Pulmonary and critical care intensivist
Served at European Hospital, Khan Younis, May 1-17
Clinical Assistant Professor, Michigan State University College of Osteopathic Medicine
Lansing, MI
Abeerah Muhammad, MSN, RN, CEN
Emergency and critical care nurse
Served at European Hospital, Khan Younis, May 1-17 Dallas, TX

Abdalrahman Algendy, MD
Anesthesiologist
Served at European Hospital, Khan Younis, February 19-March 5 Toledo, OH
Ayman Abdul-Ghani, MD, FACS, FRCS
Cardiac and thoracic surgeon
Served at European Hospital, Khan Younis, March 25-April 8 Honolulu, HI
Mohamad Abdelfattah, MD
Pulmonary and critical care intensivist
Served at European Hospital, Khan Younis, May 1-17 Los Angeles, CA
Irfan Galaria, MD, MBA
Plastic and reconstructive surgeon
Served at European Hospital, Khan Younis, January 29-February 7 Chantilly, VA
Mohammed Khaleel, MD, MS
Orthopedic and spine surgeon
Served at European Hospital, Khan Younis, April 3-10 Fort Worth, TX
Salman Dasti, MD
Anesthesiologist and interventional pain specialist
San Francisco, CA
Served at European Hospital and Nasser Medical Complex, Khan Younis, June 20-July 4
Bashar Alzghoul, MD, FCCP
Pulmonary and critical care intensivist
Served at European Hospital, Khan Younis, March 25-April 8 Gainesville, FL
Lana Abugharbieh, BSN, RN, CEN
Trauma, operating room, and emergency nurse
Served at European Hospital, Khan Younis & Primary Care Clinics, Rafah, January 24-February 7
Ashburn, VA
Rana Mahmoud, RN, BSN
Emergency and critical care nurse
Served at European Hospital, Khan Younis, January 22-February 6 & March 25-April 8
Wesley Chapel, FL
Tarek Gouda, RN, AACN
Critical care nurse
Served at European Hospital, Khan Younis, March 5-13 San Diego, CA
Ndal Farah, MD
Anesthesiologist
Served at European Hospital, Khan Younis, February 8-20 Toledo, OH
Hina Syed, MD
Internal medicine and geriatric medicine
Served at al-Aqsa Martyrs Hospital, Deir el-Balah, April 1-10 College Park, MD
John Kahler, MD, FAAP
Pediatrician
Co-founder, MedGlobal
Served at Primary Care Clinics, Rafah, January 8-24
Served at Kamal Adwan Hospital and Nutrition Center, Beit Lahia, March 4-25

Chicago, IL
Aman Odeh, MBBS, FAAP
Pediatrician
Served at Emirati Hospital for Women and Children, Rafah, March 20 to April 1
Assistant Professor of Pediatrics, Dell Medical School
Austin, TX
Tamer Hassen, BSN
Trauma and emergency nurse
Served at European Hospital, Khan Younis, April 29-May 22 Bedford, MA
Gamal Marey, MD, FACS, FACC
General, cardiac, and thoracic surgeon
Served at European Hospital, Khan Younis, March 25-April 8 Lt. Colonel, U.S. Army Reserve
Stockton, CA
Ahmad Yousaf, MD, MBA
Internal medicine physician and pediatrician
Served at al-Aqsa Martyrs Hospital, June 24-July 16 Little Rock, AK
Ahmed Ebeid, MD
Anesthesiology and pain specialist
Served at Kamal Adwan Hospital, Beit Lahia, March 25-April 13 Portland, OR
Nadia Yousef, MD
Nephrologist
Served at Nasser Medical Complex, Khan Younis, June 18-July 3 Modesto, CA

CC: Jake Sullivan, National Security Advisor
Anthony Blinken, Secretary of State
Samantha Power, Administrator, USAID
Senator Benjamin Cardin, Chair, Senate Foreign Relations Committee
Senator Jim Risch, Ranking Member, Senate Foreign Relations Committee
Congressman Michael McCaul, Chair, House Foreign Affairs Committee
Congressman Gregory Meeks, Ranking Member, House Foreign Affairs Committee

In recent days the specter of the spread of polio has emerged in Gaza, a very serious disease of which we have a distant memory but which recurs where hygiene conditions are seriously compromised. It is not surprising that it emerged in Gaza, where for eleven months the population has been living crowded together, waste and sewage are spilled on the streets and everything is missing, especially clean water.

The UN organizations and the WHO have asked to vaccinate around 640,000 children, for the first time those born from 2023 and with a booster those up to ten years old. Israel has apparently allowed a suspension of attacks for 9 hours a day for 3 days in each of the areas into which it keeps Gaza forcibly divided. Which will therefore resume after 3pm and until 6am daily.

WHO and UN organizations on the ground began preparing to be active on Sunday, September 1, but expressed skepticism about whether these time windows will be respected by Israel or whether they are adequate for the task. One of WHO’s concerns is whether safe access is permitted even during these limited periods for both staff and children’s families. And they have reasons, even fresh ones: 3 days ago, due to yet another “mistake”, the IDF repeatedly hit a World Food Program car to which it had “allowed and coordinated” passage. Today it targeted cars from Anera, a humanitarian organization that was “allowed” to travel to distribute aid. The attack killed 5 people under the pretext that there were “suspicions” around the cars.

We are convinced, along with the WHO, that the operation may not be effective, puts the lives of vaccinators and the families who approach them at risk, and that the conditions imposed are not adequate for the purpose of widespread vaccination. There is no doubt that families and the Ministry of Health in Gaza are alarmed by the spread of polio in addition to other diseases, and that they too will do everything possible to protect children, already seriously decimated or ill and often malnourished. All of them will still try to make it a useful intervention.

What is outrageous and deeply disturbing in this context in which we try to protect the health of children is that nothing is done to prevent them from becoming possible and apparently favorite victims of the IDF – see the many children who are victims of sniping documented by doctors international organizations operating in Gaza – and it is also the incompetence of European and Italian political representatives. Who, at the very least, should know and be aware of their responsibilities and capable of using the tools they have to stop the genocide.

Instead, we heard the High Representative for Foreign and Security Policy of the European Union, Josep Borrell, call for 3 days of ceasefire, as if they were the panacea for Gaza. Naturally following the same US request. It seems that Borrell has never seen even a photo of what Gaza is now and how it is under attack and does not ask himself what sense there is in vaccinating children and then not protecting their lives.

But how come this anxiety about the vaccination saving in just a few hours (27) for approximately 210,000 recipients for each area, welcomed with caveats and skepticism by the UN delegated bodies who “know what they should do” and say how it is almost impossible to do it, has had a lot of echo in the EU buildings and apparently in its governments and was praised by the US representative at the United Nations?

What its “true and certain” outcome will be, however, is clear. And if only part will be vaccinated, if perhaps none of the convoys and people who converge, on foot and under the sun to vaccinate their little ones will be attacked by “misunderstanding” between 6 and 3 pm, if not even after 3pm of the fateful 3 days, if and if…even if, certainly having “granted this vaccination truce” has already achieved with the announcement alone the result of protecting Israel from an additional crime against humanity and genocide in addition to as already documented, and any incident will be condoned like all other IDF “mistakes”.

And we are convinced that at least this outcome is clear to the politicians, that both Borrell, the majority of European governments and the USA are clear about this role of “protection of the criminal”, having practiced for a long time and successfully in this activity. An exercise so well done that after 11 months the EU does not even talk about suspending economic and research agreements, although required by compliance with Article 2 of its own rules, nor about sanctions on the state of Israel, in compliance with the Court’s ruling International Criminal Law while, also late on the USA, Borrell timidly suggests sanctioning some settlers, individually.

We therefore denounce the proposal for a humanitarian truce for vaccinations, however necessary, as insufficient and hypocritical. The apparent humanitarian value of the request by Borrell and the USA actually covers an objective complicity with Israel, which could improve its international image, without giving any guarantee that vaccinations are actually feasible. A bit like with the US bridge for humanitarian aid? only this time the UN pays.

Vaccinating the population, and especially children, is absolutely necessary, but we cannot allow and ignore that, at the end of the truce, the situation in Gaza will become dramatic again, with daily massacres, an average of 40 deaths per day, the majority of which are women and children, and that the population continues to survive in the complete destruction of schools, hospitals, infrastructures, and in the impossibility of accessing humanitarian aid. The EU and the states of Europe and the world have the tools in their regulations and legally permissible and invoked by the International Criminal Court to stop the massacre in Gaza and the extension of the genocide into the occupied territories in the West Bank.

They all have to use them.

We no longer accept this political ignorance and bad faith. As also stated by the Director General of the World Health Organization Tedros Adhanom Ghebreyesus, he also underlines how “the only lasting medicine is peace” and “the only way to completely protect all the children of Gaza is a ceasefire”

We add: a permanent ceasefire, the reconstruction of Gaza, the end of the Israeli occupation. Otherwise, any humanitarian initiative, however necessary and desirable, unfortunately covers up the ethnic cleansing at the hands of Israel which continues and extends it, and also pays the price for it.

We therefore ask the EU to take a position so that vaccinations are accompanied by a permanent ceasefire, abandoning the complicit policy it has pursued until now and finally sanctions Israel for failure to respect humanitarian law and for war crimes.

Prof.ssa Paola Manduca, Genetista, NWRG-odv

Dr. Giorgio Mariani, Sapienza Università di Roma

Dr. Antonello Petrillo, sociologo, Università degli Studi S.O. Benincasa, Napoli

Carla Pagano, dottoranda, Università di Napoli L’Orientale

Prof.ssa Laura Guazzone,  Sapienza Università di Roma

Dr. Maria Elena Indelicato , CEEC Individual FCT Researcher, University of Coimbra, Center for Social Studies | UNPOP Researcher 

Dott.ssa Chiara Tenti, ASIT – Università degli Studi di Padova

Antonio Banfi, biblioteca sede Medicina, Università di Milano Bicocca

Dr. Giulia Rossi, TNPEE Milano e Torino

Dr. Mariasilvia Giamberini, ricercatrice, Consiglio Nazionale delle Ricerche

Dr. Paolo Cuttitta, Università di Genova

Dr. Stefano Portelli, Università Roma T

In questi ultimi giorni a Gaza è emerso lo spettro della diffusione della poliomielite, malattia gravissima di cui noi abbiamo un lontano ricordo ma che si ripresenta dove le condizioni igieniche sono gravemente compromesse. Non stupisce che sia emersa a Gaza, dove da undici mesi la popolazione vive ammassata, i rifiuti e i liquami sono riversati per strada e manca tutto, soprattutto acqua pulita.

Le organizzazioni dell’ONU e l’OMS hanno chiesto di vaccinare circa 640.000 bambini, per la prima volta i nati dal 2023 e con richiamo per quelli fino ai dieci anni. Israele ha apparentemente concesso che per 9 ore al giorno per 3 giorni e in ognuna delle aree in cui mantiene divisa con la forza Gaza, ci sia una sospensione degli attacchi, i quali riprenderanno dunque dopo le 15 e fino alle 6 quotidianamente.

L’OMS e le organizzazioni ONU sul territorio hanno iniziato a prepararsi per essere attive domenica 1 settembre, esprimendo però scetticismo sul fatto che queste finestre temporali saranno rispettate da Israele e che siano adeguate al compito. Una delle preoccupazioni dell’OMS è che sia permesso accesso sicuro, anche in questi periodi limitati, alle vaccinazioni al personale medico e alle famiglie dei bambini. E hanno ragione:  3 giorni fa, per un ennesimo “errore” l’IDF ha colpito ripetutamente un’auto del World Food Program a e di cui avevano “concesso e coordinato” il passaggio. Oggi ha mirato a un’auto di Anera, organizzazione umanitaria a cui era stato “concesso” di spostarsi per distribuire aiuti. L’ attacco ha ucciso 5 persone con il pretesto che ci fossero “sospetti” intorno alle auto.

Siamo convint*, come l’OMS, che l’operazione possa non essere efficace, che metta a rischio le vite dei vaccinatori e delle famiglie che si recano a fare vaccinare i figli, e che le condizioni imposte non siano adeguate allo scopo di effettuare una vaccinazione capillare. Non c’è dubbio che le famiglie e il Ministero della salute di Gaza siano allarmati dal diffondersi della polio, in aggiunta a quella di altre malattie, e che anche loro faranno il possibile per proteggere i bambini di Gaza, già gravemente decimati o malati, e spesso malnutriti. Tutti i soggetti coinvolti proveranno certamente a fare un intervento utile.

Quello che indigna, e che disturba profondamente in questo contesto in cui si cerca di proteggere la salute di bambini, è che non si faccia nulla per impedire che restino le vittime possibili, e apparentemente predilette, dell’IDF. Infatti sono molti i bambini vittime di cecchinaggio, come documentato da medici internazionali operanti a Gaza. Indigna inoltre l’incompetenza dei rappresentanti politici europei ed italiani, i quali, al minimo, dovrebbero conoscere ed essere consapevoli delle loro responsabilità e capaci di usare gli strumenti che hanno per fermare il genocidio.

Invece, abbiamo sentito l’Alto rappresentante per la politica estera e di sicurezza dell’Unione europea, Josep Borrell, chiedere 3 giorni di cessate il fuoco come se fossero la panacea per Gaza, a seguito della stessa richiesta espressa dagli USA. Sembra che Borrell non abbia mai visto neanche una foto di cosa è adesso Gaza e di come sia costantemente sotto attacco, e che non si domandi che senso abbia vaccinare i bambini per poi non proteggere la loro vita.

Ma come mai arriva ora questa ansia della vaccinazione come se salvifica in poche ore (27) per circa 210.000 destinatari in ciascuna zona e accolta con caveas e scetticismo dagli organismi ONU coinvolti? Come mai questa iniziativa ha avuto tanta eco nei palazzi UE e apparentemente nei suoi governi, ed è stata lodata dal rappresentante USA alle Nazioni Unite?

Quale sarà il suo “vero e sicuro” esito è chiaro. Anche se solo in parte si riuscirà a vaccinare, anche se nessuno dei convogli e delle persone che convergeranno, a piedi e sotto il sole, a far vaccinare i propri piccoli sarà per “malinteso” attaccato tra le 6 e le 15, l’aver concesso questa “tregua vaccinale” ha già ottenuto, con il suo solo annuncio, il risultato di fornire a Israele una protezione dalle accuse di ulteriori crimini contro l’umanita e di genocidio in aggiunta a quanti già documentati, cosicché, più facilmente, se vi saranno attacchi  si parlerà di incidenti e di  altri “errori” dell’IDF.

Noi siamo convint* che questo esito di miglioramento di immagine pubblica sia chiaro ai politici, a Borrell, alla maggior parte dei governi europei,  e agli USA, considerato che si sono esercitati a lungo e con buon risultato nell’attività di proteggere Israele dalle responsabilità penali. Un esercizio tanto ben fatto che dopo 11 mesi la UE non parla nemmeno di sospensione degli accordi economici o della cooperazione scientifica e tecnologica, persino quando l’utilizzo militare di questa è evidente e nonostante questo venga richiesto dal diritto umanitario, né parla di sanzioni allo stato di Israele, in ottemperanza al pronunciamento della Corte Penale Internazionale mentre, in ritardo anche sugli USA, Borrell suggerisce timidamente di sanzionare qualche colono, individualmente.

Denunciamo quindi la proposta di tregua umanitaria per le vaccinazioni: essa è necessaria, ma è insufficiente e ipocrita. L’apparente valenza umanitaria della richiesta da parte di Borrell e degli USA copre in realtà un’oggettiva complicità con Israele, che potrebbe migliorare la propria immagine internazionale grazie ad essa, tuttavia senza essere costretto a dare nessuna garanzia che le vaccinazioni siano concretamente fattibili. Un po’ come è stato per il ponte USA per gli aiuti umanitari, solo che questa volta paga l’ONU.

Vaccinare la popolazione, e soprattutto i bambini, è assolutamente necessario, ma non si può permettere e ignorare che, al termine della tregua, la situazione di Gaza torni drammatica, con stragi giornaliere, una media di 40 morti al giorno di cui gran parte donne e bambini, e che la popolazione continui a sopravvivere nella più completa distruzione di scuole, ospedali, infrastrutture, e nell’impossibilità di accedere agli aiuti umanitari. L’UE e gli altri stati europei hanno strumenti legalmente leciti e invocati dalla Corte Penale Internazionale per fermare il massacro di Gaza e l’estensione del genocidio nei territori occupati in Cisgiordania.

Devono usarli tutti.

Non accettiamo più questa ignoranza e la malafede politica. Come dichiarato anche dal Direttore Generale dell’OMS, Tedros Adhanom Ghebreyesus, “l’unica medicina duratura è la pace” e “l’unico modo per proteggere completamente tutti i bambini di Gaza è un cessate il fuoco”.

Aggiungiamo noi: un cessate il fuoco permanente, la ricostruzione di Gaza, la fine dell’occupazione israeliana. Altrimenti, qualsiasi iniziativa umanitaria, per quanto necessaria e auspicabile, purtroppo copre la pulizia etnica per mano di Israele, che la continua ed estende in Cisgiordania.

Chiediamo quindi alla UE di prendere posizione perché le vaccinazioni siano accompagnate dal cessate il fuoco permanente, abbandonando la politica complice che si è perseguita fino ad ora e finalmente sanzioni Israele per mancato rispetto del diritto umanitario e per crimini di guerra.

Prof.ssa Paola Manduca, Genetista, NWRG-odv

Dr. Giorgio Mariani, Sapienza Università di Roma

Dr. Antonello Petrillo, sociologo, Università degli Studi S.O. Benincasa, Napoli

Carla Pagano, dottoranda, Università di Napoli L’Orientale

Prof.ssa Laura Guazzone,  Sapienza Università di Roma

Dr. Maria Elena Indelicato , CEEC Individual FCT Researcher, University of Coimbra, Center for Social Studies | UNPOP Researcher 

Dott.ssa Chiara Tenti, ASIT – Università degli Studi di Padova

Antonio Banfi, biblioteca sede Medicina, Università di Milano Bicocca

Dr. Giulia Rossi, TNPEE Milano e Torino

Dr. Mariasilvia Giamberini, ricercatrice, Consiglio Nazionale delle Ricerche

Dr. Paolo Cuttitta, Università di Genova

Dr. Stefano Portelli, Università Roma Tre

Dr. Francesca Geymonat, Università di Torino

Dr. Greta Persico, Università di Milano-Bicocca, 

Dr. Michele De Sanctis Università Sapienza di Roma

Dr. Simone Sibilio, Università Ca’ Foscari Venezia

Dr. Monica Zoppè. Istituto di Biofisica, CNR

Dr. Caterina Bori, Università di Bologna

Dr. Antonino Adamo, CNR

Dr. Matteo Bassoli, Università degli Studi di Padova

Dr. Annalisa Pascarella, IAC-CNR

Alice Franchini, dottoranda, Scuola Normale Superiore

Dr. Lorenzo Iannuzzi, Università di Firenze

Dr. Antonio Barrocu, Università degli Studi di Torino

Dr. Francesco Vacchiano, Università Ca’ Foscari, Venezia

Dr. Lea Nocera, Università di Napoli L’Orientale

Dr. Monica Dall’Asta, Università di Bologna

Dr. Simona Troilo, Università dell’Aquila

Dr. Vladimiro Andrea Boselli, Istituto per il Rilevamento Elettromagnetico dell’Ambiente CNR-IREA, Milano 

Dr. Giulia Gozzelino, Università degli Studi di Torino

Dr. John W. Gilbert, Dipartimento FORLILPSI, Università di Firenze

Dr. Chiara Pilotto, Università di Bologna 

Dr. Alberica Bazzoni, Università per Stranieri di Siena 

Dr. Melania Del Santo, Istituto Nazionale di Astrofisica

Dr. Mariateresa Crosta, Istituto Nazionale di Astrofisica

Dr. Antonella Peli, Assegnista di Ricerca – Università Iuav di Venezia

Dr. Mariagiulia Agnoletto, Psichiatra, Salaam ragazzi dell’Olivo Onlus, comitato di Milano

Dr. Lucia Amorosi, Assegnista di ricerca, Scuola Normale Superiore 

Dr. Claudio Musicò Università degli studi Roma Tre

Dr. Vittorio Agnoletto, medico, professore a contratto, Università degli Studi, Milano

Dr. Stefano Luisi, Chirurgo, Univ. Pavia

Dr. Achille Marotta, Ricercatore, Istituto Universitario Europeo (Firenze)

Dr.ssa Francesca Collotto, Educatrice Professionale, ASL Toscana centro

Dr.ssa Maria Elvira Renzetti ginecologa ospedaliera in pensione 

Dr. Alessia Carnevale, Università degli Studi di Napoli l’Orientale

Dr. Gianna Palmieri CNR-IBBR

Dr. Costanzo Frau Psicoterapeuta Manchester Metropolitan University (MMU)

Dott.ssa Roberta Atzas, Infermiera, Asl Oristano

Dr Ennio Cocca CNR-IBBR

Prof. Giovanni Piccoli, Università di Trento 

Sandro Frassanito infermiere Roma

Dr Susanna Rossi medico Empoli

Dr. Alessia Di Eugenio, Università di Bologna

Gianmarco Giovannardi, ricercatore, Università di Firenze

Dr. Diego Luis Gonzalez, ricercatore associato, IMM-CNR, Bologna

Dr. Antonella Lanotte, medico d’emergenza urgenza, Bologna

Prof.ssa Marcella Corsi,  Sapienza Università di Roma

Dr Carmine Pecoraro, Pediatric Nephrologist, National Ethics Committee for Pediatric Trials

Dr.Bruno Cigliano, Pediatric surgeon, Università Federico II , Napoli

Dott.ssa Cinzia Tani, UFC Neuropsichiatria Infantile, USL Toscana centro

Dr. Simona Taliani, Università L’Orientale Napoli

Dr. Cipriani Francesco medico d’ emergenza -urgenza ordine dei medici di Arezzo

Maria Assunta Patrizia Longo, Medico Supervisor Counselor / Trainer Counselor

Dr. Jacopo De Leo, Tecnico Sanitario di Laboratorio, AOUP, Pisa

Dott.ssa Valeria Volonté, Fisioterapista, libera professionista, Saronno (VA)

Dr Aldo Infantino, chirurgo in pensione, Padova -SpGV

Dr Chiara Sambalino, medico medicina interna,USL Toscana Centro

Dr Franco Camandona ginecologo Genova NWRG -odv 

Dr Marco Camandona farmacista Genova

Michela Negro Savona infermiera

Dr. Danilo Aceto Zumbo, Università di Roma Tor Vergata – Grant Office

Nicola Mancini, dottorando, Università di Urbino Carlo Bo

Dr. Giovanna Citti, Università di Bologna

Dr. Rosy Galbo, Terapista della Neuro e Psicomotricità dell’ Età Evolutiva

Dr. Jalna Rossi, Ordine medici veterinari di Milano

Dr . Alberto Del Nero , Urologo , Milano

Dr. Paola Rivetti, Dublin City University

Dr. Marco Ammar Università di Genova

Dr. Stefania Bertonati, Università di Pavia

Dr. Sevgi Doğan, Assegnista di ricerca, Scuola Normale Superiore 

Dr. Gabriella Martis, Psichiatra, Ordine Medici di Cagliari

Dr. Danilo Aceto Zumbo, Università di Roma Tor Vergata – Grant Office

Prof. Roberto Beneduce, Anthropologist and Psychiatrist, University of Turin

Mario Zazzaro fisioterapista

Surgeons who worked in European and al-Aqsa hospitals describe extensive wounds caused by ‘fragmentation’ shrapnel experts say is designed to maximize casualties

Israeli-made weapons designed to spray high levels of shrapnel are causing horrific injuries to civilians in Gaza and disproportionately harming children, foreign surgeons who worked in the territory in recent months have told the Guardian.

The doctors say many of the deaths, amputations and life changing wounds to children they have treated came from the firing of missiles and shells – in areas crowded with civilians – packed with additional metal designed to fragment into tiny pieces of shrapnel.

Volunteer doctors at two Gaza hospitals said that a majority of their operations were on children hit by small pieces of shrapnel that leave barely discernible entry wounds but create extensive destruction inside the body. Amnesty International has said that the weapons appear designed to maximise casualties.

Feroze Sidhwa, a trauma surgeon from California, worked at the European hospital in southern Gaza in April.

“About half of the injuries I took care of were in young kids. We saw a lot of so-called splinter injuries that were very, very small to the point that you easily missed them while examining a patient. Much, much smaller than anything I’ve seen before but they caused tremendous damage on the inside,” he said.

Weapons experts said the shrapnel and wounds are consistent with Israeli-made weapons designed to create large numbers of casualties unlike more conventional weapons used to destroy buildings. The experts question why they are being fired into areas packed with civilians.

The Guardian spoke to six foreign doctors who have worked at two hospitals in Gaza, the European and al-Aqsa, in the last three months. All of them described encountering extensive wounds caused by “fragmentation” weapons, which they said have contributed to alarming rates of amputations since the war began. They said the injuries were seen in adults and children but that the damage done was likely to be more severe to younger bodies.

“Children are more vulnerable to any penetrating injury because they have smaller bodies. Their vital parts are smaller and easier to disrupt. When children have lacerated blood vessels, their blood vessels are already so small it’s very hard to put them back together. The artery that feeds the leg, the femoral artery, is only the thickness of a noodle in a small child. It’s very, very small. So repairing it and keeping the kid’s limb attached to them is very difficult,” Sidhwa said.

Mark Perlmutter, an orthopaedic surgeon from North Carolina, worked at the same hospital as Sidhwa.

“By far the most common wounds are one or two millimetre entry and exit wounds,” he said.

“X-rays showed demolished bones with a pinhole wound on one side, a pinhole on the other, and a bone that looks like a tractor trailer drove over it. The children we operated on, most of them had these small entrance and exit points.”

Perlmutter said children hit by multiple pieces of tiny shards often died and many of those who survived lost limbs.

“Most of the kids that survived had neurologic injuries and vascular injuries, a major cause of amputation. The blood vessels or the nerves get hit, and they come in a day later and the leg is dead or the arm is dead,” he said.

Sanjay Adusumilli⁩, an Australian surgeon who worked at the al-Aqsa hospital in central Gaza in April, recovered shrapnel made up of small metal cubes about three millimetres wide while operating on a young boy. He described wounds from fragmentation weapons distinguished by the shards of shrapnel destroying bone and organs while leaving just a scratch on the skin.

Explosives experts who reviewed pictures of the shrapnel and the doctors’ descriptions of the wounds said they were consistent with bombs and shells fitted with a “fragmentation sleeve” around the explosive warhead in order to maximise casualties. Their use has also been documented in past Israeli offensives in Gaza.

Trevor Ball, a former US army explosive ordnance disposal technician, said the explosive sprays out tungsten cubes and ball bearings that are far more lethal than the blast itself.

“These balls and cubes are the main fragmentation effect from these munitions, with the munition casing providing a much smaller portion of the fragmentation effect. Most traditional artillery rounds and bombs rely on the munition casing itself rather than added fragmentation liners,” he said.

Ball said the metal cubes recovered by Adusumilli are typically found in Israeli-made weapons such as certain types of Spike missiles fired from drones. He said the doctors’ accounts of tiny entry wounds are also consistent with glide bombs and tank rounds fitted with fragmentation sleeves such as the M329 APAM shell, which is designed to penetrate buildings, and the M339 round which its manufacturer, Elbit Systems of Haifa, describes as “highly lethal against dismounted infantry”.

Some of the weapons are designed to penetrate buildings and kill everyone within the walls. But when they are dropped onto streets or among tents, there is no such containment.

“The issue comes with how these small munitions are being employed,” said Ball. “Even a relatively small munition employed in a crowded space, especially a space with little to no protection against fragmentation, such as a refugee camp with tents, can lead to significant deaths and injuries.”

Amnesty International first identified ammunition packed with the metal cubes used in Spike missiles in Gaza in 2009.

“They appear designed to cause maximum injury and, in some respects, seem to be a more sophisticated version of the ball-bearings or nails and bolts which armed groups often pack into crude rockets and suicide bombs,” Amnesty said in a report at the time.

Ball said that weapons fitted with fragmentation sleeves are “relatively small munitions” compared with the bombs that have a wide blast area and have damaged or destroyed more than half the buildings in Gaza. But because they are packed with additional metal, they are very deadly in the immediate vicinity. The shrapnel from a Spike missile typically kills and severely wounds over a 20-metre (65-ft) radius.

Another weapons expert, who declined to be named because he sometimes works for the US government, questioned the use of such weapons in areas of Gaza crowded with civilians.

“The claim is that these weapons are more precise and limit casualties to a smaller area. But when they are fired into areas with high concentrations of civilians living in the open with nowhere to shelter, the military knows that most of the casualties will be those civilians,” he said.

‘I panic when my phone rings’: the plight of Palestinians in Jordan

In response to questions about the use of fragmentation weapons in areas with concentrations of civilians, the Israel Defense Forces said that military commanders are required “to consider the various means of warfare that are equally capable of achieving a defined military objective, and to choose the means that is expected to cause the least incidental damage under the circumstances.

“The IDF makes various efforts to reduce harm to civilians to the extent feasible in the operational circumstances ruling at the time of the strike,” it said.

“The IDF reviews targets before strikes and chooses the proper munition in accordance with operational and humanitarian considerations, taking into account an assessment of the relevant structural and geographical features of the target, the target’s environment, possible effects on nearby civilians, critical infrastructure in the vicinity, and more.”

The UN children’s agency, Unicef has said that “staggering” numbers of children have been wounded in Israel’s assault on Gaza. The United Nations estimates that Israel has killed more than 38,000 people in Gaza in the present war of which at least 8,000 are confirmed to be children, although the actual figure is likely to be much higher. Tens of thousands have been wounded.

In June, the UN added Israel to a list of states committing violations against children during conflict, describing the scale of killing in Gaza as “an unprecedented scale and intensity of grave violations against children”, principally by Israeli forces.

Many of the cases recalled by the surgeons involved children severely injured when missiles landed in or near areas where hundreds of thousands of Palestinians are living in tents after being driven from their homes by the Israeli assault.

Perlmutter described repeatedly encountering similar wounds.

“Most of our patients were under 16,” he said. “The exit wound is only a couple millimetres big. The entrance wound is that big or smaller. But you can see it is extremely high velocity because of the damage it does on the inside. When you have multiple small fragments travelling at insane speeds, it does soft tissue damage that far outweighs the size of the fragment.”

Adusumilli⁩ described treating a six-year-old boy who arrived at the hospital after an Israeli missile strike close to the tent where his family was living after fleeing their home under Israeli bombardment. The surgeon said the child had pinhole wounds that gave no indication of the scale of the damage beneath the skin.

“I had to open his abdomen and chest. He had lacerations to his lung, to his heart, and holes throughout his intestine. We had to repair everything. He was lucky that there was a bed in the intensive care unit. But, despite that, that young boy died two days later,” he said.

An American emergency room doctor now working in central Gaza, who did not want to be named for fear of jeopardising his work there, said that medics continue to treat deeply penetrating wounds created by fragmentation shards. The doctor said he had just worked on a child who suffered wounds to his heart and major blood vessels, and a build up of blood between his ribs and lungs that made it difficult to breathe.

Sidhwa said that “about half of the patients that we took care of were children”. He kept notes on several, including a nine year-old girl, Jouri, who was severely injured by shards of shrapnel in an air strike on Rafah.

“We found Jouri dying of sepsis in a corner. We took her to the operating room and found that both of her buttocks had been completely flayed open. The lowest bone in her pelvis was actually exposed to the skin. These wounds were covered in maggots. Her left leg she was missing a big chunk of the the muscles on the front and back of the leg, and then about two inches of her femur. The bone in the leg was just gone,” he said.

Sidhwa said doctors were able to save Jouri’s life and treat septic shock. But in order to save what remained of her leg, the surgeons shortened it during repeated operations.

The problem, said Sidhwa, is that Jouri will need constant care for years to come and she’s unlikely to find it in Gaza.

“She needs advanced surgical intervention every one to two years years as she grows to bring her left femur back to the length it needs to be to match her right leg, otherwise walking will be impossible,” he said.

“If she does not get out of Gaza, if she survives at all, she will be permanently and completely crippled.”

Adusumilli⁩ said fragmentation weapons resulted in high numbers of amputations among children who survived.

“It was unbelievable the number of amputations we had to do, especially on children, he said. “The option you’ve got to save their life is to amputate their leg or their hands or their arms. It was a constant flow of amputations every day.”

Adusumilli operated on a seven year-old girl who was hit by shrapnel from a missile that landed near her family’s tent.