State of Israel
Ministry of Justice
The Department for International Agreements and International Litigation

1) Since September 2000, Israel has been fighting a terrorist onslaught by Palestinian organizations that seek to achieve their political objectives by murdering innocent civilians.

2) In order to understand the scope of the terror activities facing Israel, one need only consider the following statistics: Since the Palestinians began their terrorist offensive, at the end of September 2000, terror organizations have perpetrated more than 19,000 terror attacks. These attacks have taken the lives of over 1,000 Israelis and wounded over 6,000 people, many of them severely. Every day, every week, the list of Israelis slaughtered is longer and the number of families affected grows.

3) Palestinian terror is extensive; it permeates organizations and institutions and its activities include shooting Israelis, sabotage, launching mortar shells at homes and schools, kidnapping Israeli citizens and murdering them, bombing public buses and restaurants and many other terror attacks. No country can be expected to tolerate these extreme forms of terrorism.

4) The Palestinian terrorism’s most evil feature is the phenomenon of suicide bombers. Terror organizations deliberately recruit men, women, and teenagers to commit suicide by acting as "living bombs" in Israeli population centers in order to destroy the lives of innocent citizens.

5) One of the issues that most hampers the IDF in its fight against terror is the intentional blurring of distinctions between Palestinian terrorist groups and the innocent Palestinian population. Terror groups operate from within residential centers, in civilian dress, assimilating in the local population and taking refuge in public institutions. Terrorists exploit civic buildings, hospitals and ambulances, religious institutions and schools as covers for their activities.

6) Under international law, the IDF is obligated to allow medical teams to operate during times of conflict. IDF guidelines consider humanitarian obligations to be both legal and moral requirements and, in fact, humanitarian aid is a priority for IDF forces serving in Judea and Samaria and Gaza Strip areas.

7) IDF authorities, in addition to securing the free passage of Palestinian ambulances in emergency cases, have instituted special measures to allow the transport of patients, usually those suffering from chronic conditions, even during those periods when other traffic is restricted for security reasons. Under these arrangements, the authorities enable the passage through checkpoints in Judea and Samaria of approximately 700 ambulances a month.

8) Furthermore, Israel enables the transfer of Palestinians in need of medical treatment to hospitals in neighboring states as well as to hospitals in Israel. Patients with medical conditions who need treatment that is not available in the Palestinian Authority (for example, dialysis) are also granted permits. Under this arrangement, 600 permits are issued every month and approximately 100 civilian ambulances enter Israel from Judea and Samaria, headed to Israeli hospitals.

9) Each year, approximately 7,000 Palestinians enter Israel seeking medical treatment, in addition to the approximately 100 ambulances that transfer patients from Jordan and dozens of Palestinian children who travel abroad for medical treatment, at the expense of Israeli, Palestinian, and other groups devoted to this cause.

10) Realizing the importance of humanitarian issues, IDF authorities constantly try to find ways to improve the assistance they grant the Palestinian population. For example, a year ago, the civilian administrator for Judea and Samaria established a "humanitarian conditions" center to provide information and assistance to inquiries from Palestinians on matters related to health. Billboards in Arabic throughout Judea and Samaria advertise the center and how to contact it.

11) Last year, the center dealt with 2,380 inquiries, among them 314 concerning health matters and medical treatment, 107 from the "Checkpoint Watch" and 91 from “Physicians for Human Rights”. (The vast majority of the inquiries related to matters of privacy).

12) Finally, we stress that IDF soldiers are ordered to permit the passage of Palestinian health workers and public health teams, for example those distributing vaccines to the local population. In addition, transport of medications, medical equipment, oxygen, food, fuel and other supplies to local civilian hospitals must also be permitted.

13) However, while the IDF does its utmost to conduct its campaign against terror within the framework of international law, Palestinian violations of the laws of neutrality hamper security efforts and ultimately harm the Palestinian population.

14) Unfortunately, there have been documented cases of Palestinians abusing the neutrality of ambulances and medical facilities for terrorist purposes.

15) On March 26 2002, Ahmed Jibril, a Tanzim operative, was detained at an IDF roadblock near Ramah Bridge, south of Ramallah. Jibril worked as an ambulance driver for the Palestinian Red Crescent (PRC). He was arrested while driving an ambulance belonging to the PRC in which were found an explosives belt and explosives. Jibril admitted that Mahmoud Titi, a Tanzim leader in Samaria, told him to deliver them to Tanzim operatives in Ramallah.

16) In addition to Jibril, a woman and three children, aged 6 months, three and four years old, were in the ambulance. The explosives belt held sixteen pipes containing approximately 10 kilograms of explosive materials. The belt was hidden under the mattress of the stretcher on which one of the children was lying.

17) Nidal Abd al Fatah Abdallah Nidal, an ambulance driver from Qalqilya employed by UNWRA, was arrested in August 2002 by IDF forces. He admitted using the ambulance to transport weapons and explosives for Hammas. Waffa Idris, a PRC employee, perpetrated the suicide bombing on Jaffa Street in Jerusalem in January 2002. She was dispatched by a PRC ambulance driver who is also a Tanzim operative, and she was assisted by another PRC employee. It is also believed she may have traveled in a PRC vehicle, and used PRC documents to go through IDF checkpoints.

18) These incidents are not exceptional. There have been others in which Palestinian terror organizations abused the privileged status of ambulances, as well as many intelligence warnings of their intentions to do so. There is also abundant evidence that terrorists operate from within hospitals and health clinics; that terrorist organizations recruit PRC employees; and that wanted terrorists frequently travel in Palestinian ambulances to escape capture.

19) In light of these Palestinian practices, the IDF is forced to stop and search ambulances, which unavoidably results in impacting the Palestinian population, despite the IDF’s efforts to minimize the disruption caused.

20) International law may mandate safeguarding the neutrality of ambulances, medical transports and personnel. However, it has also long recognized that when ambulances and medical transport are used for military purposes, they can no longer keep their protected status.1

21) The IDF’s procedures were upheld by a Supreme Court decision that rejected a petition by Physicians for Human Rights protesting the IDF’s searching of ambulances during Operation Defensive Shield.

“[T]he situation derives from the conflict itself, in the course of which several incidents were discovered in which explosives were transported in ambulances and wanted terrorists were found seeking refuge in hospitals. Despite this, the IDF sees itself obligated to uphold humanitarian law, not just because it is obligated by international law, but also because of natural law, despite utilitarian necessities to the contrary. … combat forces were issued directives in accordance with these rules and the IDF devotes much effort to promoting these guidelines and to providing humanitarian aid in the areas in which they operate.”
[Physicians for Human Rights v. Commander of IDF Forces in the West Bank.]

22) The security situation requires that the IDF search ambulances and, unfortunately, experience has repeatedly proven that the IDF’s fears that Palestinians would cynically misuse medical services and abuse the protection granted ambulances by international law, were well founded.

23) The IDF is conscientious in conducting itself in accordance with international laws of war. In the last few years, many of its actions have been brought for review before the Supreme Court, in the framework of hundreds of petitions to the High Court of Justice. The subject of some of these petitions has been restrictions in traffic and health services to the Palestinian population.

24) This year, the IDF troops were provided with a pocket manual outlining operational procedures in Judea, Samaria and the Gaza Strip, that includes guidelines for dealing with emergency medical cases and medical teams.

1 See, for example, the Convention for the Amelioration of the Condition of the Wounded in Armies in the Field, 1864, Article 1, "Ambulances and military hospitals shall be recognized as neutral, and as such protected and respected by the belligerents as long as they accommodate wounded and sick. Neutrality shall end if the said ambulances or hospitals should be held by a military force."