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Salah Haj Yahya, 50, who lives in Taibeh, runs a mobile clinic on behalf of Physicians for Human Rights and leads medical teams going to Gaza. We met at a Tel Aviv café, on a Thursday morning.
Can you say something about Physicians for Human Rights? What is its agenda? What does providing healthcare as a political act mean?
“We fight for the right to health and liberty, which everyone deserves. This includes citizens of Israel, migrants, refugees, Palestinians and people with no legal status. Our teams, medical and welfare ones, extend assistance to all these populations.”
You personally are responsible for the West Bank and Gaza. As part of your job you enter the Gaza Strip frequently.
“Yes. Every few weeks I head a medical team going to Gaza. The group consists of a few physicians, all Israeli Arabs, since the army and security services don’t allow Jewish doctors to travel there.”
You’re the only civilian Israeli group going there, right?
“We’re the only ones going there from Israel, with the approval of the IDF and security services. I don’t know of any other group.”
Salah Haj Yahya Tomer Appelbaum
What kind of relations do you have with Hamas?
“We have no relationship with hem. We only treat the local populace.”
You have no contact with Hamas, not even an informal one? Don’t you need their permission? Don’t they supervise your work?
“There’s no contact. We coordinate our entry with the Israeli side, we don’t work with Hamas or its representatives. We only work with hospital directors and the Palestinian health ministry, with the health minister in Ramallah and his deputy in Gaza. They are the ones who approach us.”
Gaza has been under siege for almost a decade. We don’t really know what’s happening there. Describe what you see there.
“Gaza is cloaked in desperation. You feel it the minute you cross the border. It’s like traveling to another world. Already at the crossing you see seriously ill people, mainly cancer patients, waiting in line in a hall. They are hoping for some compassion and permission to cross the border and receive some treatment. You go by car and see ruins, thousands of destroyed houses, factories in ruin, sewage flowing through the streets.”
The UN isn’t the most popular institution in Israel right now. In its last report it stated that without a massive investment in reconstruction, Gaza will be “unsuitable for habitation” by 2020. Explain what that means.
Nabil Sha’ath, left, shaking hands with Hamas head Ismail Haniyeh in Haniyeh’s Gaza City office in 2010. AFP
“Look, we walk through the streets, we don’t just go to hospitals. We see what’s going on. More than 60 percent of the inhabitants are unemployed. There’s terrible poverty. There is simply no money. Not for food or for medications, not for warm clothes for children. People light fires in order to stay warm. It’s quite common in Gaza to see a fire outside a tent standing next to a ruined house. People are afraid to move far from ruined houses even though there’s no chance they’ll get any compensation. They know that if they move away someone will take over the land and they’ll lose that as well.
“The education system isn’t working. The health system is finished. Agriculture is dying. There are no materials, no way of working and even if there is some produce there’s no one to sell it to. I just saw something I couldn’t believe – they sell a kilo of strawberries there for 3 shekels. If that’s what the vendor in the market charges, how much did the farmer make? Water sources are contaminated. The water is unfit to drink, unfit for any use. There is hardly any electricity. Gaza is on the brink of a humanitarian disaster. There’s hardly any international aid and the Arab states aren’t succeeding in providing any assistance.”
Not succeeding or not trying?
“Not succeeding, but not really trying. Hospitals face dire shortages of medications and equipment. There are no syringes, no bandages and no tubes. When one of our surgeons asks for a specific scalpel or bandage during surgery he’s told that there aren’t any available. When we train a local doctor and teach him techniques and procedures he has nothing to work with.
“Chronic patients are always on the brink. For example, if someone miraculously recovers from a kidney transplant he can’t obtain the drugs that support the transplant. There just aren’t any. There are hardly any dialysis or MRI machines. There are many materials or types of equipment we can’t take over since they could be used for prohibited activities. Hospitals are barely functioning since they need huge amounts of diesel fuel – 360,000 liters a month.
“Let’s explain this – there is no regular supply of electricity in Gaza. Hospitals using respirators, incubators and similar equipment depend on diesel-fueled generators.
“There is power for four hours and then a break for 12. Gazans used to buy cheap diesel from Egypt but this is no longer an option, and they can’t afford gasoline and diesel that comes from Israel.
“The cardinal problem is in the hospitals. Beyond the issue of diesel fuel, you can’t operate a generator for so many hours. They’re not built for that. They are meant for emergencies, not for ongoing operation day and night, year after year. When the power goes there are a few difficult and life-endangering moments until the generators kick in. We see the terrible results, especially in neonatal units. People pay with their lives on an almost daily basis.”
I wonder how much Israelis can empathize with Gazans. I can already see the online conversations. ‘Let them kill each other, they’ve brought it on themselves, they elected a Hamas government, they fire missiles at Israel.’
“I don’t defend Hamas or any other group. I’m only interested in this population, which is living in substandard conditions, in the densest collection of people anywhere in the world.”
What do you hear from them about their relations with their government?
“Some of them support it.”
From what little I know, there is a lot of anger.
“Of course there is, a lot. On the other hand Hamas wields a lot of power.”
I saw a big rally held by Hamas a few weeks ago. There were a lot of people in the streets.
“Yes, they still hold a lot of power. They can bring out hundreds of thousands of people. But there are many angry people who are very frustrated with Hamas. Many people tell me they dream of returning to Israel to work, as they once did. They feel that no one cares about them, not the Israelis, not the Egyptians and not the Palestinian Authority.”
Is there tension between residents of the West Bank and Gaza? Are relations worsening?
“Yes. They’ll say there isn’t any tension, but there is. The feeling among ordinary Gazans is that Abu Mazen [PA President Mahmoud Abbas] and his people have stopped caring about Gaza. They feel ostracized, as if they don’t belong to the Palestinian nation. In Ramallah they don’t allow them to visit. Even ministers from Gaza can’t usually leave and participate in cabinet meetings in Ramallah. There are two million people there. They aren’t all Hamas. There are many factions and in any case the population is paying a steep price. It isn’t taken into consideration by Israel, Egypt or the authorities in Ramallah.”
Let’s talk a bit about water. There is no running water in many parts of the strip, and concerns of epidemics breaking out.
“During Operation Protective Edge many main pipelines were broken and they aren’t able to repair them. A large proportion of water sources are contaminated since the dysfunctional sewerage system leads to seepage into the drinking water.”
Do you drink the water there?
“No, I don’t allow myself to drink water in Gaza because I know I’ll get sick from it. Residents have no other choice and they drink it. We see many children who have been affected by contaminated water, some suffering from amoeba infection.”
Clean water is a privilege enjoyed by rich people?
“Yes. You can buy mineral water from Israel or Ramallah. Not everyone can afford it.”
What’s the average per capita income?
“Someone who has a job makes up to 30 shekels ($7.8) a day. Most people don’t have work. They roam the streets, looking for a way to make a living. Across the Gaza Strip there are many people simply selling coffee or tea in the street, preparing a pot at home and walking around with it. A cup of coffee costs half a shekel (13 cents). The main thing is to make some money.
Palestinians atop a destroyed car in August 2014, in the Gaza town of Rafah, a site of heavy fighting in the two-month war. Khalil Hamra/AP
“Why do 18-year-old men go digging tunnels even though they know there is a good chance one will collapse on them and kill them? They and their families are promised $100 a day, so they take the risk. Palestinian media report that 300 young men have died in these tunnels. They work under very dangerous conditions, worried about being hit by Israelis or Egyptians, who constantly flood tunnels with water or diesel in order to destroy them. They sometimes set fire to tunnels. Despite this, some continue to work there for the money. People are constantly looking for what is being distributed by aid agencies. They pounce on everything. Gaza is a place that lives on welfare.”
I assume there is a lot of violence.
“A lot; there’s a fatality almost every day due to fighting. People are very edgy and frustrated. There are many conflicts between people. Overcrowding and unemployment squishes people together, with nothing to do, leading to many fights. They shoot and kill each other.”
What about suicides?
“This is a growing phenomenon. Many people try to hide or whitewash it, but there are a lot of cases. Young people kill themselves due to feelings of hopelessness. There is a lot of despair. We also try to provide mental assistance for these people, as well as for children suffering from serious post-war trauma. We are in touch with many agencies. Many Jewish physicians from Israel want to come and help, joining our missions, but they are prohibited from doing so.”
There are patients from Gaza who get treated in Israel.
“One thousand patients a month can’t get help in Gaza hospitals. They are diverted to Israel, East Jerusalem or the West Bank for treatment. Cancer patients can’t get radiation therapy in Gaza, for example. Chemotherapy is also frequently unavailable.”
What is the procedure for such patients?
“First they turn for help locally. When the hospital realizes it can’t help them they get a form called Form Number 1, in which it states that treatment is unavailable in Gaza and they are directed to a hospital in Israel. Then they get Form Number 17 from the PA, which includes a commitment to pay for services. These forms go to a Palestinian committee which decides whether to issue a permit. In most cases such a patient will be summoned for questioning by the Shin Bet security service.”
Is that part of the procedure, this questioning?
“Yes. A request is submitted to the Israeli side and a summons is received to appear at a specific time for questioning.”
How does Hamas allow this?
“Hamas warns people not to provide any information. There are even signs on the Palestinian side of border crossings warning people going for questioning not to divulge anything, telling them to remember that the homeland is more precious than anything else.”
Doesn’t it make patients give up?
“Many people do. They are simply afraid. Even those who aren’t afraid aren’t guaranteed that they’ll get a permit. It can take months. Sometimes there is no reply at all. Many people die while waiting. There is also the issue of blackmail.”
Meaning what?
“Their travel permit is granted only on condition that they collaborate – information in exchange for an entry permit.”
You’re saying that the Shin Bet blackmails these patients? Can you prove that?
“We have filmed documentation of patients being threatened or blackmailed in exchange for a permit. We’ve written a report on this. The questioning often deteriorates into unpleasant and humiliating situations. Violence is sometimes resorted to. There are also all sorts of regulations, such as prohibiting the entry of men aged between 18 and 45. So if there is a sick child, they won’t allow the parents to accompany the child. We often see grandparents accompanying children to treatments and hospitalization. Even when it’s a baby they separate it from its parents. Many times, when we pressure the Shin Bet or the Israeli side, all of a sudden the patient gets a permit. In other words, there wasn’t really a reason for denying a permit in the first place.”
I saw a report by Shlomi Eldar in al-Monitor, claiming that since Avigdor Lieberman became defense minister there has been a harsher policy, with many permits revoked.
“It’s true. Often people come and meet me, delivering equipment or information about patients. They tell me they waited for hours, their permits were taken and they were returned to Gaza. Overall we see, based on appeals we receive, that there is a significant increase in the number of denied requests, with very few patients receiving permits. They are questioned repeatedly. Israeli hospitals no longer agree to set up appointments for them since they don’t come on time or at all.
“After serving for 30 years in this job, I see no changes in Gaza, it’s only gotten worse. It’s a sad place. There are great restaurants on the beach, for 50-60 shekels a meal. They stand empty. There are three floors there but when we go there we’re the only customers. The fancy hotels that were built there remain empty, except for an occasional guest from an aid agency.”
The head of military intelligence, Maj. Gen. Herzl Halevi, said that the economic situation in Gaza could lead to an explosion that would be directed at Israel. How do you understand this statement?
“I understand why he’s saying that. There are two million people there who are really suffering. I haven’t spoken with each and every person there but I can tell you that they are very weary. They’ve gone through three wars and are fed up. The vast majority there only want to lead a normal life, earn a living, educate their kids and have food and clothes for them. This simply doesn’t exist there. A father faces his children and can’t give them a thing. It pains him. That’s what I’m hearing from people there. I don’t hear them saying they want to come to Israel and blow themselves up here. I hear desperation.”
The Shin Bet spokesperson did not comment by the time this column went to press.
Ayelett Shani
Haaretz Contributor
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