The northern Gaza strip seen from the Israel side. Photo: Getty
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My time in Israeli Defence Force tells me the level of casualties in Gaza is avoidable

What will ultimately stop the deaths of innocent Palestinians and Israelis is a peace deal putting an end to the conflict. But in the meantime, a modification of the Israeli rules of engagement could reduce the number of innocent casualties.

In the 1982 Lebanon war I served as an Israeli artillery forward observer, my task to pinpoint the PLO’s positions and call in fire from our artillery units. We stayed in the evacuated Al Jamous School, overlooking Beirut. The routine was simple enough: I would pop into the classroom next door from where I would collect the co-ordinates and description of my military targets: “a military camp”, “a mortar”, “an antenna”. I would then return to my room and, looking out of the windows, I would direct our fire on the targets.

From time to time I would pause to let the air force get in to drop its munitions; and the navy would fire from the sea. Beirut, in the summer of 1982, was all burning up – a city on fire.

There was a purpose to this massive bombardment: to hit Yasser Arafat’s guerrilla force and its weapons – and also put pressure on the Lebanese, particularly those living inside Beirut with no water, food and electricity, so they demanded Arafat get out of Beirut which would then stop our assault.

In the end, a Lebanese military officer by the name of Jonny Abdu confronted Arafat who left Lebanon and moved to Tunisia.

Looking back now, I’m appalled by our brutal bombing of Beirut. Was it justified to turn this beautiful city into a Middle Eastern Dresden and kill hundreds of innocent civilians in the process?

Now to Gaza where, like in 1982 Beirut, the Israeli army is using overwhelming military power to locate and destroy Hamas’s tunnels, to stop them firing rockets into Israel – and also to put pressure on the Gazans (as we had pressured the Beirutis) so they turn their backs on Hamas as a political force.

In the process, just as in Lebanon, hundreds of innocent Palestinians have been killed and parts of Gaza, as some sections of 1982 Beirut, have been turned into wastelands. Even worst, UN schools in Gaza which are shelters to more than 250,000 refugees, and their hospitals have also been hit by Israeli artillery and bombs.

Wayward artillery

Can anything be done so that in the next round between Israel and Hamas, which is inevitable, there would be fewer innocent civilian casualties?

The answer to this question is yes. It is indeed possible to reduce the number of casualties on the Palestinian side, but this would require a modification of the Israeli army’s rules of engagement, namely the way it operates, particularly when in close proximity to schools, hospitals and other shelters.

For example, as an artillery officer I know that even now – with advanced technologies – artillery fire is unreliable. As an artillery forward observer, I always looked up to the sky, praying my shells hit the targets and not land on my head. Artillery shells have a strange habit of going astray.

In 1996, in southern Lebanon, wayward Israeli artillery shells landed on a UN compound near the village of Qana, killing 106 innocent people. In the current Gaza war many of the innocent casualties were victims of artillery shells landing in the wrong place. What’s needed here is to ensure that heavy artillery is not used in Gaza’s urban areas – particularly not near schools and hospitals.

As for Israeli attacks from the air, at the moment, Israeli pilots, or those who dispatch them, can choose from a range of bombs weighing from 250-1,000kg. They often opt for the latter, as they are big enough to destroy the target completely – and the pilots are confident they can hit the target accurately, as they often do.

The problem is that the collateral damage of such big bombs is catastrophic in densely populated Gaza; it destroys not only the intended targets but also causes massive damage to nearby structures and kills non-combatants. Such big bombs must be banned altogether from being used in the vicinity of shelters, schools and hospitals.

Hannibal Protocol

Finally, certain practices employed by the Israeli army should not be allowed to be used, most notably the “Hannibal Protocol”, which is the IDF’s procedure for preventing soldiers from falling into enemy hands.

The Hannibal Protocol is yet another product of Israel’s Lebanon wars: a procedure to be used in the first minutes and hours after a possible abduction of an Israeli soldier. It calls on the military to dramatically escalate attacks in the vicinity of any kidnapping – to strike at bridges, roads, houses, cars – everything, in fact, to prevent the captors from disappearing with the abducted soldier.

When the IDF thought – wrongly as it turned out - that one of its officers had been abducted by Hamas in the southern Gaza Strip, the Hannibal protocol was activated to a most devastating effect. The army used everything at its disposal – tanks, artillery, aeroplanes, drones – and pounded vast areas in Rafah, causing enormous damage, killing and wounding scores of innocent Palestinians.

The brutal Hannibal procedure seems to me to break all rules of war. It should be thrown out of the window and never used again in Gaza.

What will ultimately stop the death of innocent Palestinians and Israelis is a peace deal putting an end to the conflict. But in the meantime, a modification of the Israeli rules of engagement could reduce the number of innocent casualties.

In 2010, following Israel’s Operation Cast Lead in the Gaza Strip which resulted in hundreds of Palestinian casualties, the IDF produced a document calling on military commanders, operating in densely populated areas, to “exercise judgement and use more accurate weapons, or lower-impact weapons”.

It seems, judging from the sheer number of Palestinian casualties in the current Gaza war, that the Israelis are not following their own rules – or the rules were produced at the time as a PR exercise to silence international criticism.

There’s no reason to think the Israelis couldn’t change their rules, though. We have international conventions banning, for instance, the use of chemical weapons in war, so it is possible, I believe, to also prohibit the use of heavy artillery, big bombs and cruel procedures in densely populated areas such as the Gaza Strip. After all, it is also in Israel’s interest, as the horrific pictures coming out of the Gaza Strip ruin the country’s already tarnished reputation.

The ConversationAhron Bregman does not work for, consult to, own shares in or receive funding from any company or organisation that would benefit from this article, and has no relevant affiliations. This article was originally published on The Conversation. Read the original article.

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A swimming pool and a bleeding toe put my medical competency in doubt

Doctors are used to contending with Google. Sometimes the search engine wins. 

The brutal heatwave affecting southern Europe this summer has become known among locals as “Lucifer”. Having just returned from Italy, I fully understand the nickname. An early excursion caused the beginnings of sunstroke, so we abandoned plans to explore the cultural heritage of the Amalfi region and strayed no further than five metres from the hotel pool for the rest of the week.

The children were delighted, particularly my 12-year-old stepdaughter, Gracie, who proceeded to spend hours at a time playing in the water. Towelling herself after one long session, she noticed something odd.

“What’s happened there?” she asked, holding her foot aloft in front of my face.

I inspected the proffered appendage: on the underside of her big toe was an oblong area of glistening red flesh that looked like a chunk of raw steak.

“Did you injure it?”

She shook her head. “It doesn’t hurt at all.”

I shrugged and said she must have grazed it. She wasn’t convinced, pointing out that she would remember if she had done that. She has great faith in plasters, though, and once it was dressed she forgot all about it. I dismissed it, too, assuming it was one of those things.

By the end of the next day, the pulp on the underside of all of her toes looked the same. As the doctor in the family, I felt under some pressure to come up with an explanation. I made up something about burns from the hot paving slabs around the pool. Gracie didn’t say as much, but her look suggested a dawning scepticism over my claims to hold a medical degree.

The next day, Gracie and her new-found holiday playmate, Eve, abruptly terminated a marathon piggy-in-the-middle session in the pool with Eve’s dad. “Our feet are bleeding,” they announced, somewhat incredulously. Sure enough, bright-red blood was flowing, apparently painlessly, from the bottoms of their big toes.

Doctors are used to contending with Google. Often, what patients discover on the internet causes them undue alarm, and our role is to provide context and reassurance. But not infrequently, people come across information that outstrips our knowledge. On my return from our room with fresh supplies of plasters, my wife looked up from her sun lounger with an air of quiet amusement.

“It’s called ‘pool toe’,” she said, handing me her iPhone. The page she had tracked down described the girls’ situation exactly: friction burns, most commonly seen in children, caused by repetitive hopping about on the abrasive floors of swimming pools. Doctors practising in hot countries must see it all the time. I doubt it presents often to British GPs.

I remained puzzled about the lack of pain. The injuries looked bad, but neither Gracie nor Eve was particularly bothered. Here the internet drew a blank, but I suspect it has to do with the “pruning” of our skin that we’re all familiar with after a soak in the bath. This only occurs over the pulps of our fingers and toes. It was once thought to be caused by water diffusing into skin cells, making them swell, but the truth is far more fascinating.

The wrinkling is an active process, triggered by immersion, in which the blood supply to the pulp regions is switched off, causing the skin there to shrink and pucker. This creates the biological equivalent of tyre treads on our fingers and toes and markedly improves our grip – of great evolutionary advantage when grasping slippery fish in a river, or if trying to maintain balance on slick wet rocks.

The flip side of this is much greater friction, leading to abrasion of the skin through repeated micro-trauma. And the lack of blood flow causes nerves to shut down, depriving us of the pain that would otherwise alert us to the ongoing tissue damage. An adaptation that helped our ancestors hunt in rivers proves considerably less use on a modern summer holiday.

I may not have seen much of the local heritage, but the trip to Italy taught me something new all the same. 

This article first appeared in the 17 August 2017 issue of the New Statesman, Trump goes nuclear