Last year, I spent nine months in Jerusalem as the medical director of an eye hospital that primarily serves Palestinians from Gaza and the occupied territories. What I saw of the occupation reveals an insidious form of the misuse of power by Israel.
On Friday, July 21 last year, as I was working in my East Jerusalem office, I received a call asking me to examine a seriously injured young man who had clashed with Israeli security forces while protesting the plan to place metal detectors at entrances to the Al Aqsa Mosque.
By the time I reached the patient, he was in the operating theater asleep under general anesthetic. One of his eyes was completely destroyed. The bones and soft tissues around the eye remnants were damaged beyond recognition.
My mind went back to my first visit to Jerusalem in 2003, when I examined a 14-year-old who had sustained a direct eye injury from a rubber-coated bullet with a steel core. Known as a "baton round," this is an example of a "non-lethal" projectile used to control crowds.
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A CT scan revealed the bullet’s trajectory through the soft tissues of the child’s eye socket, leaving debris in its wake and the steel ball lodged in a sinus just underneath the skull base. The bones framing the eye socket, however, were intact.
Looking at my patient on that day in July last year, I could find no rubber debris or steel core amid the gruesome mess. Then the penny dropped: This wasn’t caused by a baton round, but by a projectile with a larger diameter, such as a tear gas canister, fired at close range.
As if to confirm my suspicions, a young teenager was admitted an hour or so later with identical injuries: a destroyed eye globe, multiple orbital fractures and soft tissues damaged beyond repair. These injuries could only have been caused by directly firing at the eyes, and two sequential cases of blunt ocular trauma caused by tear gas canisters could hardly be a random coincidence.
Recalling my service in Northern Ireland as a doctor in the British Army, I knew that soldiers are instructed to aim tear gas canisters at the ground to disperse crowds, and not at individual protesters. In general, troops are trained to aim towards the lower limbs when firing baton rounds, mindful of the terrible harm they can produce. In contrast, these cases in Jerusalem suggest a deliberate misuse of power by security forces.
My colleagues at Hadassah Hospital in Jerusalem are familiar with a number of such cases, including an 11-year-old boy from Al Esawiyya who was shot in the eye while buying groceries. When his distraught father tried to seek compensation, he was dismissed with the implausible assertion that the Israeli security forces had nothing to do with it. The cost of a prosthetic eye replacement is beyond the family’s reach, portending a lifetime of disfigurement and suffering for an innocent child.
These injuries, generally thought of as rare, seem to arise with alarming frequency among Palestinians, including bystanders, journalists and children.
There have been numerous reports documenting them in Israeli and international media, as well as a number of testimonies collected by B’Tselem. In addition, Breaking the Silence has published testimony from an Israeli artillery sergeant who was instructed to doctor baton rounds for maximal effect and to aim directly at the eyes. In 2010, an American protester named Emily Henochowicz lost an eye to a tear gas canister fired by Israeli security forces. In contrast to the injuries suffered by young Palestinians, this case received widespread coverage in the United States.
The U.S.-based NGO Physicians for Human Rights has documented similar injuries caused by misuse of weapons in crowd control situations around the world, noting that they are crimes that have the capacity to escalate demonstrations into violent confrontations.
This body of evidence indicates an insidious practice by some members of the Israeli security forces over a period of several years. These cases may represent a wider problem, with possibly hundreds of such injuries going unreported across the West Bank, Gaza and Jerusalem. I resolved to bring up the matter with the Israeli authorities, but concluded that an account of my findings would not bring an end to these horrific violations.
A few experiences in Jerusalem offered me clues about the mentality behind the act of pulling a trigger with the intent of permanently maiming a vulnerable human being.
I met an avowed Kahanist at the Jerusalem Book Fair, a woman originally from Dallas, who offered without irony that even if Iran surrounded its nuclear facilities with a million children, "we would still bomb them, because our existence would be at stake." I witnessed a Haredi teen casually spitting at a Christian nun, and a policeman wrenching a Palestinian flag out of the hands of a middle-aged woman. At the heart of these words and actions lies a culture of violence.
Crossing into Gaza brought home the vast gulf that separates Israelis from Palestinians. The blockade has severe consequences on the health of Gazans, many of whom are denied permits to travel for medical treatment. Medical expertise is getting harder to come by, with many Gazan doctors denied the opportunity to undertake specialist training abroad.
Such healthcare limitations impose disproportionate consequences on Gazans suffering from chronic diseases such as diabetes, including permanent vision loss. The thousands of Gazans requiring reconstructive surgery and rehabilitation due to conflict-related injuries compounds the situation by overwhelming an already fragile healthcare system.
These and myriad other anecdotes reflect a dehumanization of Palestinians. In this narrative, crimes such as deliberately shooting at the eyes do not have to be justified or atoned for, and the medical needs of Palestinians can be neglected with impunity.
I contend that nobody – not even a demonstrator throwing stones – deserves to have an eye summarily destroyed.
I call upon the Israeli authorities to stamp out these abhorrent practices and to give the medical needs of Palestinians the priority they deserve. And at a time when Palestinian health services – including the hospitals in East Jerusalem that treat them - are under imminent and severe threat due to U.S. President Donald Trump’s decision to cut aid, this responsibility is more pressing than ever.
Dr. Gerry Clare is an ophthalmic surgeon based in the United Kingdom, and has a Ph.D. in ocular injuries. He was a consultant ophthalmologist to the British Army and has worked in conflict zones and resource-poor settings around the world, including for Medicins Sans Frontieres.