Blocking medical and humanitarian relief

Medical relief services were denied access to Jenin refugee camp for nearly
11 days, from 12 noon on 4 April until 15 April 2002. In addition the IDF
shot at ambulances(10) or fired warning shots around them. Ambulance drivers
were harassed or arrested. Meanwhile the dead in Jenin refugee camp remained
in the street or in houses for days. The wounded lay for hours untended or
were treated at home. In several cases people are reported to have died in
circumstances where lack of access medical care may have caused or hastened
their death.

Many testimonies show families desperately telephoning for help in vain and
compelled to stay alone with dying or dead relatives. Many cases of
Palestinians killed by the IDF show the difficulty or impossibility of
obtaining medical care or an ambulance to remove the dead; three such cases -
of 'Atiya Abu Irmaila, Nayef Qasem 'Abd al-Jaber and 'Amid 'Azmi Abu Hassan
Fayed - are described below. In two cases investigated by Amnesty
International the delay in obtaining medical treatment will have long term
medical consequences for patients.

Medical personnel said that for the first 30 hours of the incursion, from
early morning on 3 April until noon on 4 April 2002, ambulances were able to
move. During this time ambulances brought five dead bodies and about 45
wounded to Jenin City Hospital. Among the first Palestinians killed was a
27-year-old nurse, Fadwa Fathi Abdallah Jamal, wearing her uniform, shot by
the IDF as she walked early in the morning of 3 April with her sister, also a
nurse, to go to a medical centre in the refugee camp.

From 12 noon on 4 April 2002 the IDF imposed a medical blockade and prevented
ambulances from entering the camp. Jenin City Hospital was surrounded by
tanks and the building opposite the hospital was used as an IDF base. All
those in the hospital at noon on 4 April were confined there: the visitors,
the staff and the sick - about 300 people: 100 medical personnel, 105
patients, and their relatives. For some days they lived largely on biscuits,
chocolate and water. On 4 April the ICRC was prevented from delivering oxygen
to the hospital, which was running out of supplies, but the deliveries were
allowed the following day. The ICRC also delivered drugs, blood and food. By
5 April the hospital had received six dead bodies (increasing to seven when
one wounded man died the next day in hospital), its morgue large enough for
only one body. IDF authorization was sought to bury the bodies in the small
patch of garden behind the hospital, and this was granted on 6 April.

On 6 April ambulances were still denied access to Jenin refugee camp. On 7
April ICRC landcruisers carrying supplies to the Jenin City Hospital were
blocked; however supplies were transferred to local ambulances and taken to
the hospital. On 8 April continuing negotiations between the ICRC, the DCO
and the army appeared to have brought about an agreement. The PRCS tried to
send three teams with the ICRC to the refugee camp to collect the wounded.
The ambulances were lengthily checked and the ambulance drivers forced to lie
on the ground. Around 5pm the IDF said that three people could be brought in;
the hospital should examine them but not ask them questions. The wounded men
were brought to hospital blindfolded. After examining them, Dr Abu Ghali, the
hospital director said that all needed urgent hospital treatment. The IDF,
however, allowed only one patient to enter the hospital.

"This whole operation and the negotiations with the IDF and the ICRC took
from 8am until 11pm and - at the end of the day - only one wounded man was
admitted into the hospital" said Dr Abu Ghali.
Between 9 and 14 April there was a standoff, day after day, outside Jenin
refugee camp, with up to five ICRC ambulances and doctors and about six PRCS
ambulances waiting in vain to be allowed by the IDF to enter the camp to
evacuate dead and wounded.

On the evening of 11 April an ICRC delegate and Dr Abu Ghali, the hospital
director, were sitting in Dr Abu Ghalis office on the top floor of the
hospital when two sniper bullets came through the window and hit the ceiling.
They telephoned the IDF commander who reportedly apologized saying an IDF
sniper had made a mistake.
On 14 April, three days after fighting had ended, Jenin refugee camp remained
cut off from the outside world. It had been nine days since the last dead
body had been brought out of the refugee camp. Only those wounded in the camp
who could struggle out themselves were in hospital.

Meanwhile a number of petitions had been brought to the Israeli High Court of
Justice. On 8 April the court, commenting on a petition which challenged the
Israeli army's "prevention of access to medical treatment for the sick and
wounded in Jenin and Nablus; restriction of access of medical personnel and
transport to the areas; and obstruction of the right to bury the dead in a
respectful manner", had stated:

"Although it is not possible to address the specific incidents in the
petition that on their face look harsh, we have to stress that our fighting
forces are obliged to apply humanitarian rules which refer to treating the
injured, in the hospitals and the bodies of the dead. Wrongful use of medical
teams and of hospitals and ambulances obliges the IDF to act in order to
prevent such activity; however, this by itself does not allow a sweeping
violation of humanitarian rules. In fact, this is also the declared position
of the State. This attitude is not only required by international law, on
which the petitioners are relying, but also by the values of the State of
Israel as a Jewish and democratic state."(11)

On 14 April three petitions were heard by the High Court of Justice including
a request that the ICRC and PRCS enter the camp to remove dead bodies. They
had been brought by Knesset members Muhammad Barakeh and Ahmad Tibi, and by
the human rights organizations Adalah and LAW. The representative of the
Attorney General initially stated that the Israeli army could not permit
humanitarian organizations to enter the area because some of the bodies might
be booby-trapped with bombs; it then agreed to allow entry. The court
dismissed the petitions but ordered that the ICRC be allowed to accompany and
assist the Israeli army in locating bodies and that the PRCS also be
permitted to join them.

After the High Court judgment, for the first time for 11 days, ICRC and PRCS
ambulances were allowed into the camp. They left at 6.30am on 15 April but
were delayed by the routine IDF searches. One team was told to remain with
their IDF escort; apparently the army limited their access and they found no
bodies. Dr Abu Ghali accompanied the other ambulance and described the scene:


"I went in with my small video camera and I first saw one body. Then I saw a
second body. The third body I saw was a woman of 59, lying two metres from a
door, hit in the chest and head, her body was decomposed. So the IDF said:
'That is all you have. In the centre of the camp you have no survivors'. I
went on. In a room of a house I found a man of 85, alone, with no water,
dehydrated. I said, 'I must go further to see.' The IDF said: 'This is the
only region cleared by the Israeli army, if you go further we don't guarantee
you.' I walked 35 metres into the region not cleared and found 10 bodies.
Five were in one house; we could not collect them, the ICRC told the IDF to
bring them. I saw a lot of people looking from the windows and doors of their
houses, afraid, I said 'I will bring you food. Have you anything to eat?'
They said, 'Nothing'. I asked to be allowed to bring food and medication for
the survivors, the IDF said: 'You have two hours in the camp'."

During the two hours the IDF allowed them in the camp on 15 April Palestinian
and international medical and humanitarian teams were able to distribute some
food, water and milk into the camp. On 16 April the IDF allowed ICRC and
UNRWA personnel to enter the camp; the ICRC reported, in its daily summary:
"Part of the camp looks as if it had been hit by an earthquake ... Civilians
in the camp are under shock and report urgent need for medicine, water and
food."

On 16 April Jenin City Hospital contained 15 bodies - with one more brought
during the day. The High Court statement had ordered the ICRC and Israeli
army to identify the bodies in accordance with the requirements of
international humanitarian law. However, the entrance to the hospital was
still blocked by an IDF checkpoint with tanks. Dr Abu Ghali asked the IDF to
allow Professor Derrick Pounder, delegated by Amnesty International, access
to the hospital to perform autopsies, but an IDF doctor who was stationed at
the checkpoint told Professor Pounder: "If you were a doctor treating people
we would allow you in, but we are not interested in a forensic doctor".
On 16 April Professor Pounder telephoned Amnesty International's headquarters
in London:

"There is no forensic expertise in Jenin and no one in the hospital with any
forensic training. Under international humanitarian law there is a
requirement to examine decomposed bodies in order to obtain evidence as to
the cause of death. This is in order to elucidate the circumstances of death
and also to help in identification of the body. The identification is
necessary so that the family may know and bury the body and for
documentation. The longer a body deteriorates the more the evidence
deteriorates and the fewer hard facts there are in order to get the
evidence."

But it was only on the following day, after the Israeli Attorney General
Elyakim Rubinstein agreed that Professor Pounder should be given access, that
he was able to enter Jenin City Hospital where he carried out two autopsies
and three examinations. Examinations were performed on three of the five
bodies found in a single house and brought in that day by the IDF; they all
appeared to be combatants. The findings of the autopsies, according to
Professor Pounder "gave rise to suspicion"; they were on bodies later
identified as those of 'Ali Na'el Salim Muqasqas and Wadah Fathi Shalabi (see
above).

Amnesty International delegates discussed the failure to allow access to
medical aid in Jenin, Nablus and elsewhere on many occasions with members of
the IDF. The Head of Plans and Policy Directorate, Major-General Giora
Eiland, denied that ambulances had been prevented from entry to Jenin for
more than two days, and this was only because the PRCS refused to allow their
ambulances to be checked. He mentioned a number of incidents when ambulances
were said to have been misused in order to carry healthy men, bodies to
increase the number of alleged dead in the refugee camp, or a suicide
belt.(12) He accepted there were difficulties in coordinating medical
assistance with ICRC and UNRWA. "Some problems were caused by our mistakes,
some difficulties were not necessary. But we gave Palestinians food, water
and medication in Jenin, and even electricity. We tried to evacuate injured
Palestinians."

Notwithstanding the remarks of Major-General Giora Eiland, the evidence of
the blocking of medical and humanitarian aid to Jenin refugee camp for over
10 days is overwhelming.(13)

'Atiya Hassan Abu Irmaila
'
Atiya Abu Irmaila, aged 44, was killed on 5 April by a single IDF gunshot
wound to the head. At the time he was shot he was in his home with his wife
and three children. According to his family, he was not involved in
fighting.(14) The case is an example of the IDF's failure to distinguish
between fighters and those not involved in fighting. It also illustrates the
impact of the IDF's refusal to allow the ICRC or the PRCS to operate
ambulances to collect the dead and care for the wounded.
'Atiya's wife, Hala, told Amnesty International:

"The night before Ati was killed, there were many shells that had fallen on
our house so we slept in the kitchen. The following day, at about 1pm, a tank
had sent a rocket that landed between our house and the neighbour's house.
Later that afternoon, we began to assess the damage to our house. My husband
was crawling through the house. The balcony did not have any windows and
faces on to the street. There is a clear view from there to the street. I was
the first to move about the house and came back and told my husband that the
windows had been blown in. In the beginning, he said he would go and see the
damage, but I convinced him not to move. We moved to the sitting room of the
house. After a while, the shooting calmed a bit and my husband decided to go
and check the rest of the house. He crawled to the next room, which is a
guestroom. When he reached there, he found broken glass on the floor, so came
back to the sitting room to get his shoes. It was about 5.25pm. If you are
wondering why I know the time so precisely it is because we were just sitting
and doing nothing, so I kept checking my watch.

"I could see the tanks and soldiers just opposite to my house and I could
hear the helicopters. When Ati went back to the guestroom, about two minutes
or so passed and I heard him say 'Hala, Hala, come, come.' Just before he
called me, I had heard a single gunshot. I took my children and ran to where
my husband was. I entered the room and I found him standing. I asked him
'what's up, what's up?' He intended to say something but didn't manage. I
then saw him bleeding from the mouth and nose. I ran toward him, he was
slowly moving and then falling down. When he fell on the floor, I asked him
where he was injured. I had thought he was shot in the chest as I could see
blood on his shirt. The children were screaming. Ati did not speak. He looked
at me one more time and then convulsed. I had a feeling he died then.

"I went back to the sitting room with my children. I don't remember how I
went back. My three children were holding on to me crying. I tried to reach
an ambulance by mobile phone. Finally, I managed to remember my brother's
number and rang him and told him Ati was injured and asked him to please call
an ambulance. I didn't tell him that I thought Ati had died. He told me he
would ring and to be patient. When I was waiting for him to call back, Ati's
brother-in-law called. I told him what had happened and asked him to phone
ambulances. After a while he rang back and said that the ambulances have no
access to reach us, and told me to try and give Ati some help. I then told
him that I thought Ati had died. He told me that I was just afraid and he is
probably unconscious. I told him, 'No. He is dead'.

"At this moment, I was convinced no ambulance would reach us; I started to
shout for help from neighbours. It was getting dark. I broke a window in a
room that was close to one of our neighbours and started shouting for help.
One of the neighbours replied and I asked for a ladder. They could not reach
me with one, so I tried to jump from the first floor but the neighbours
started shouting that it was too high. I went back inside. My children told
me that they were scared. I managed to get them to sleep and then I used the
mobile to try and call people for help. It became dark. I had no electricity.
I was alone. My brothers and sisters rang but then the battery on my mobile
phone died. I had tried to use the mobile to see when it grew dark. At this
time, I remembered Ati had no blankets. I brought him some blankets and put
them over him. I then went back and stayed with my children. I didn't sleep.

"The next morning, I decided to try and reach Ati's family. I tried to jump
from the balcony but didn't manage. It was just too high. I went back into
the sitting room and asked my son Muhammad, who is seven years, if he would
jump down. I tied some of my scarves together and put around his waist. I
lowered him to the ground and told him to go to his grandfather's house and
to tell them that Ati was killed. Muhammad went and reached his grandfather's
house and told his grandfather and his aunt. Together with Ati's mother, they
made their way back to my house.

"It is a week I will never forget. Imagine someone you live with, you talk
with and now he is just a dead body. My children kept speaking with him as if
he were alive. My four-year-old son would go to his father, asking him things
- he would say to his father that he wanted cake and milk. When the children
would fight, they would go to him.
"Ati's body remained with us for seven days. When I knew that the ambulance
was not coming, I cleaned the blood off his face. Ati's mother stayed with us
and slept next to his body during the nights. On the seventh day, when the
curfew was lifted for two hours, an ambulance came and took his body. He was
buried in the East Cemetery in Jenin..

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