Peter Hain: one-state solution to Israeli-Palestinian conflict must be considered

The Labour MP and former cabinet minister says a one-state solution could "more easily resolve the deadlock than the two-state solution I and many others have long favoured".

For decades there has been a bipartisan consensus that a two-state solution is the best means of resolving the Israeli-Palestinian conflict. But in a lecture tonight at the University of Swansea, published exclusively by The Staggers, Peter Hain will become the first British figure with direct ministerial experience to argue that after decades of failure, a one-state solution - the establishment of binational state with equal rights for Israelis and Palestinians - must now be seriously considered. 

Hain, who served as minister for the Middle East from 1999-2001, will say: 

For two decades I have favoured a two-state solution as the best plan for peace and the fairest outcome, one backed by the US, the United Nations, the European Union and all 22 countries of the Arab League. Officially, it’s the stated policy of the current Israeli government and of the Palestinian Authority.

But I am increasingly unsure about whether it’s still achievable – mainly because, as time has marched on, and successive negotiating initiatives have come and gone, the land earmarked for a viable Palestinian state has been remorselessly occupied by Israeli settlers.

And I’m not alone. John Kerry and William Hague have both talked of "the window for a two-state solution" closing. In April 2013, prior to launching yet another peace initiative, the US Secretary of State warned: "I think we have some period of time – a year to a year-and-a-half to two years or it’s over." On 18 June 2013, the British Foreign Secretary echoed those words in the House of Commons: "time is running out for a two-state solution".

There is also a marked dissonance between popular support for a two-state solution on the one hand, and popular scepticism that it is achievable on the other. A 2012 poll by the Konrad Adenauer and Ford Foundations showed that 70 per cent of both Israelis, and Palestinians in the West Bank and Gaza, thought the chances of establishing an independent Palestinian state by 2017 were "low" or "non-existent".   

The fundamental problem is this: sooner rather than later the land available to constitute a future Palestinian state will have all but disappeared.

Indeed, in defiance of the UN, the US and the EU, the Likud-led government has continued to expand Israeli settlements in the West Bank and East Jerusalem to the point where there are now more than 550,000 settlers there, controlling 42 per cent of the land and representing nearly 10 per cent of the Israeli Jewish population. With every new settlement that is constructed, the possibility of a viable and contiguous Palestinian state recedes further.

At least rhetorically, Binyamin Netanyahu has committed to a two-state solution. In 2009, he declared that he was willing to see the establishment of a Palestinian state, albeit one barred from having an army and controlling its airspace. But through his actions he has repeatedly undermined this pledge. 

As Hain will go on to say:

[I]f Israel’s relentless expansion into Palestinian territories cannot be stopped then we must face one of two possible outcomes. The first is that all Palestinian presence in the West Bank and East Jerusalem remains in a permanent and ever-more formalized "Bantustan status", islands of minimal self-governance with the continued denial of basic rights, facing on-going pressure, perpetual insecurity and possible future physical removal. The second is that they are absorbed into a common Israeli-Palestinian state with the opportunity for pluralism and human rights advancement.

Is that solution now the only one capable of stopping the cycle of violence and preserving Israel’s potential to become a force for unity and peace, instead of a beleaguered source of division and a target for attack? And if the window for the two-state solution is indeed closing, then should the EU, the US and the UK make it plain to Israel that a one-state alternative may be the only one available to ensure its security?

A one-state solution has long been the favoured option of many secular Israelis and Palestinians for reasons of principle. What has changed is the number who now support it for reasons of pragmatism. Hain will conclude: 

[W]hat guarantees might there be for Jewish citizens both within Israel and worldwide if they agree the merger of their creation – a Jewish state which they fervently (and understandably) believe answers their post-Holocaust question: "Never Again"?  Could the Arab nations join those in the West like the US and the UK to provide such guarantees? 

What sort of common state might then be politically feasible and deliverable? Could a federal or confederal state provide a way forward, with common security, a unified economy, common civil rights and guarantees of religious freedom for Jews and Muslims, but considerable political autonomy for the territories within it of "Israel" and "Palestine"? How then might Israeli and Palestinian security forces be integrated?

These are fundamental, difficult and complex questions – but, if successfully answered, could a common state solution more easily resolve the deadlock than the two-state solution I and many others have long-favoured?

I remain uncertain. But I ask because I do not see how either the Israelis or the Palestinians can secure their legitimate objectives by perpetuating for still more decades their unsustainable and unstable predicament, with a two-state solution slipping away while violence and terrorism lurks constantly.

His questions are ones that no responsible leader can now afford to ignore. 

Update: Labour has been swift to slap down Hain. A spokeperson told me this afternoon: 

Peter Hain does not speak for Labour on foreign affairs and his views on the Middle East Peace Process do not represent Labour Party policy. Labour is fully committed to a two-state solution with a viable Palestinian state living side-by-side with Israel, and we support the ongoing work of US Secretary of State, John Kerry, to help re-start negotiations towards achieving this goal.

The spokesperson also pointed me to Douglas Alexander's speech in July 2013 in which he said: 

"…to those who say a two state solution is now a fantasy, I say it is a fantasy to think a one state solution could ever be either sustainable or consistent with Israel’s democratic values.

A one state solution is simply not a solution at all.  It would mean either the demise of Israel as a Jewish state or the demise of Israel as a democratic state. It would be the end of the dream of national self determination for the Jewish people."

Labour MP Peter Hain, who served in the cabinet from 2002-2008 and as minister for the Middle East from 1999-2001. Photograph: Getty Images.

George Eaton is political editor of the New Statesman.

Flickr/Michael Coghlan
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Why does the medical establishment fail to take women in pain seriously?

Women with mesh implants have been suffering for years. And it's not the only time they have been ignored. 

Claire Cooper’s voice wavered as she told the BBC interviewer that she had thought of suicide, after her mesh implant left her in life-long debilitating pain. “I lost my womb for no reason”, she said, describing the hysterectomy to which she resorted in a desperate attempt to end her pain. She is not alone, but for years she was denied the knowledge that she was just one in a large group of patients whose mesh implants had terribly malfunctioned.

Trans-vaginal mesh is a kind of permanent “tape” inserted into the body to treat stress urinary incontinence and to prevent pelvic organ prolapse, both of which can occur following childbirth. But for some patients, this is a solution in name only. For years now, these patients – predominantly women – have been experiencing intense pain due to the implant shifting, and scraping their insides. But they struggled to be taken seriously.

The mesh implants has become this month's surgical scandal, after affected women decided to sue. But it should really have been the focus of so much attention three years ago, when former Scottish Health Secretary Alex Neil called for a suspension of mesh procedures by NHS Scotland and an inquiry into their risks and benefits. Or six years ago, in 2011, when the US Food and Drug Administration revealed that the mesh was unsafe. Or at any point when it became public knowledge that people were becoming disabled and dying as a result of their surgery.

When Cooper complained about the pain, a GP told her she was imagining it. Likewise, the interim report requested by the Scottish government found the medical establishment had not believed some of the recipients who experienced adverse effects. 

This is not a rare phenomenon when it comes to women's health. Their health problems are repeatedly deprioritised, until they are labelled “hysterical” for calling for them to be addressed. As Joe Fassler documented for The Atlantic, when his wife's medical problem was undiagnosed for hours, he began to detect a certain sexism in the way she was treated:

“Why”, I kept asking myself, when reading his piece, “are they assuming that she doesn’t know how much pain she’s feeling? Why is the expectation that she’s frenzied for no real reason? Does this happen to a lot of women?”

This is not just a journalist's account. The legal study The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain found that women report more severe levels of pain, more frequent incidences of pain, and pain of longer duration than men, but are nonetheless treated for pain less aggressively. 

An extreme example is “Yentl Syndrome”. This is the fact that half of US women are likely to experience cardiovascular disease and exhibit different symptoms to men, because male symptoms are taught as ungendered, many women die following misdiagnosis. More often than should be acceptable, female pain is treated as irrelevant or counterfeit.

In another significant case, when the news broke that the most common hormonal birth control pill is heavily linked to a lower quality of life, many uterus-owning users were unsurprised. After all, they had been observing these symptoms for years. Social media movements, such as #MyPillStory, had long been born of the frustration that medical experts weren’t doing enough to examine or counter the negative side effects. Even after randomised trials were conducted and statements were released, nothing was officially changed.

Men could of course shoulder the burden of birth control pills - there has been research over the years into one. But too many men are unwilling to swallow the side effects. A Cosmopolitan survey found that 63 per cent of men would not consider using a form of birth control that could result in acne or weight gain. That’s 2 per cent more than the number who said that they would reject the option of having an annual testicular injection. So if we’re taking men who are afraid of much lesser symptoms than those experienced by women seriously, why is it that women are continually overlooked by health professionals? 

These double standards mean that while men are treated with kid gloves, women’s reactions to drugs are used to alter recommended dosages post-hoc. Medical trials are intended to unearth any potential issues prior to prescription, before the dangers arise. But the disproportionate lack of focus on women’s health issues has historically extended to medical testing.

In the US, from 1977 to 1993, there was a ban on “premenopausal female[s] capable of becoming pregnant” participating in medical trials. This was only overturned when Congress passed the National Institutes of Health (NIH) Revitalisation Act, which required all government funded gender-neutral clinical trials to feature female test subjects. However, it was not until 2014 that the National Institutes of Health decreed that both male and female animals must be used in preclinical studies.

Women’s exclusion from clinical studies has traditionally occurred for a number of reasons. A major problem has been the wrongful assumption that biologically women aren’t all that different from men, except for menstruation. Yet this does not take into account different hormone cycles, and recent studies have revealed that this is demonstrably untrue. In reality, sex is a factor in one’s biological response to both illness and treatment, but this is not as dependent on the menstrual cycle as previously imagined.

Even with evidence of their suffering, women are often ignored. The UK Medicines and Healthcare Regulatory Agency (MHRA) released data for 2012-2017 that shows that 1,049 incidents had occurred as a result of mesh surgery, but said that this did not necessarily provide evidence that any device should be discontinued.

Yes, this may be true. Utilitarian thinking dictates that we look at the overall picture to decide whether the implants do more harm than good. However, when so many people are negatively impacted by the mesh, it prompts the question: Why are alternatives not being looked into more urgently?

The inquiry into the mesh scandal is two years past its deadline, and its chairperson recently stepped down. If this isn’t evidence that the massive medical negligence case is being neglected then what is?

Once again, the biggest maker of the problematic implants is Johnson&Johnson, who have previously been in trouble for their faulty artificial hips and – along with the NHS – are currently being sued by over 800 mesh implant recipients. A leaked email from the company suggested that the company was already aware of the damage that the implants were causing (Johnson&Johnson said the email was taken out of context).

In the case of the mesh implants slicing through vaginas “like a cheese-wire”, whether or not the manufacturers were aware of the dangers posed by their product seems almost irrelevant. Individual doctors have been dealing with complaints of chronic or debilitating pain following mesh insertions for some time. Many of them just have not reported the issues that they have seen to the MHRA’s Yellow Card scheme for identifying flawed medical devices.

Shona Robison, the Scottish Cabinet Secretary for Health and Sport, asked why the mesh recipients had been forced to campaign for their distress to be acknowledged and investigated. I would like to second her question. The mesh problem seems to be symptomatic of a larger issue in medical care – the assumption that women should be able to handle unnecessary amounts of pain without kicking up a fuss. It's time that the medical establishment started listening instead. 

 

Anjuli R. K. Shere is a 2016/17 Wellcome Scholar and science intern at the New Statesman

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