**4. The Syrian civil war and its effect on medical services**

In 2011, within what has ludicrously been called "the Arab Spring", one of most destructive and vicious wars recorded since the Second World War broke out in

**269**

*Treating the Enemy: Victims of the Syrian Civil War in Israel*

Syria. Although its scope and extent has subsided considerably in the last year, even now in 2019, foci of fighting continue to be active in different parts of the wrecked country. The numbers of dead have been estimated as above 500,000, and the numbers of severely wounded and injured well over 2 million. Between 2 and 5% of the pre-war population have become medical victims, but the true numbers are unknown, and estimating these has been made very complicated by the existence of millions of internal and external refugees, within Syria, in massive camps on the borders of Turkey, Iraq, Kurdistan, Lebanon, Jordan and many more thousands who have risked life and limb to reach more distant havens. It is noteworthy that the Assad government regime has made a special target of the medical system in Syria [2–7]. More than half of all doctors in Syria have fled the country, and many hundreds have been deliberately murdered, mostly by Assad forces. Entire provinces and cities have been left bereft of even basic medical services. Of special note are the brutal tactics employed by Assad and his Russian allies in this respect; it was learnt from the Nazis in the Second World War that the elimination of medical care was a cheap and efficient way of forcing people to leave their homes and cleansing an area ethnically, and the Nazis indeed made special efforts to target medical facilities, being so clearly marked. The Russian government used this criminal method in many places, for example, in Chechenia and Afghanistan. In Syria the tactic has been extensively employed. Especially cynical is the "second-wave" tactic in which after an initial assault and after numerous casualties have been concentrated in care areas; these areas are then subjected to secondary attack, thus completing the initial lethal intent. The repeated use of banned chemical weapons has exacerbated the

The northern border of Israel in the Golan Heights adjoins the Syrian province of Daraa, home to about 200,000 people in normal times, but estimates put the number of additional refugees anywhere between 1 and 3 million. The city of Daraa and the surrounding areas became known as the cradle of the revolution in 2011 after 15 boys from prominent families were arrested after writing antigovernment graffiti, thus sparking mass demonstrations. It is estimated that about 5–7% of the pre-war population has been killed in the war. The entire area has been essentially without organised health services since the war broke out; this has naturally placed an enormous strain on the civilian population and placed in jeopardy the stability of

The border area with Israel is a zone of especial sensitivity. Since 1974 the frontier has been patrolled by a special UN force (United Nations Disengagement Observer Force (UNDOF)) and for the most part was quiet and stable. In the years leading up to the civil war, the Assad regime began to adopt new tactics designed to disturb this equilibrium, mainly through the establishment of terrorist groups primarily the so-called Front for the Liberation of the Golan. This was actually a front for the Lebanese terrorist organisation Hezbollah, which later became a prime Iran-sponsored ally of Assad in the war. During the war years, the border area itself came under the control of various groups, primarily the Druze in the north around the village of Hader, Syrian Democratic Forces in the centre and a small ISIS-Daish enclave in the south. Israel for its part declared an official policy of neutrality in the Syrian war, clearly holding Assad to account for his own numerous war crimes and responsibilities but officially favouring no group; Israel restricted its own actions in Syria to surgical strikes only whenever and wherever its own interests were threatened. While none of the rebel or unofficial groups were in anyway connected with Israel, nevertheless tacit areas of mutual interests became defined. Among these from the Israel perspective were the humanitarian imperative to aid a population in severe distress, the need for stability and continued quiet along the border, the prevention of massive waves of refugees congregating in the area and on the other

*DOI: http://dx.doi.org/10.5772/intechopen.87936*

results of these barbaric actions.

continued civil life.

#### *Treating the Enemy: Victims of the Syrian Civil War in Israel DOI: http://dx.doi.org/10.5772/intechopen.87936*

*Education, Human Rights and Peace in Sustainable Development*

Conventions" [1].

**3. Syria and Israel**

man's tendency to cruelty, violence and warfare. Indeed, it has been estimated that in the last two millennia, there have been very few years in which war has not been recorded somewhere on the globe. However, in parallel with this are the positive aspects of man's nature, and among these are charity, sympathy, empathy, compassion and generosity. In relation to conflict, these have been expressed in many ways including emergency and ongoing welfare campaigns, sustainable development initiatives, peace-making and preserving, refugee care and the provision of medical services. In particular the norms regarding the treatment of civilians and respecting their rights as non-combatants or casualties of war have been codified in numerous treaties and conventions since 1864 until the present day. These are jointly now referred to as "The Hague Conventions on Humanitarian Law and the Geneva

In time of war, the victims are frequently caught in a double bind of bad fortune. On the one hand, they are often the casualties of fighting, suffering both physical trauma and psychological damage; but equally times of conflict are often marked by outbreaks of disease and famine, and indeed pre-existing routine medical conditions, which are neglected, may lead to irreversible consequences and complications. On the other hand, available medical treatment and services may typically be

The State of Israel was officially declared on May 14,1948, following the partition resolution 181 passed in the United Nations on November 29, 1947. This was the legal and political basis for the establishment of two states "for two peoples", and it was accepted by the Jewish state but rejected by the entire Arab world and most Moslem states then and until this day. Immediately Israel was invaded by five regular Arab armies with the intent of strangling the new Jewish state at birth, and among these was the Syrian army. An armistice with Syria was signed on July 29, 1949, notably being the last agreement to be signed and illustrative of the fact that Syria has traditionally been the most ferocious and inflexible of Israel's enemy neighbours. This reputation was reinforced after the 6-day war of 1967 and the Yom Kippur War of 1973. Israel prisoners of war were particularly badly treated by Syria including illegal denial of Red Cross rights, torture and other criminal acts. Syrian hostility and hatred for Israel has been a constant feature of its Middle East posture, and this has included gross anti-Semitic statements by Assad himself and other members of the regime. In addition, Syria has rejected various peace feelers sent out over the years even after Egypt, and later Jordan signed peace agreements with Israel in 1979 and 1994. On the Israeli side, attitudes towards Syria have similarly been marked by disdain and disgust. This intransigence and immovable hostility form the background for the state of relations between the two states and help inform the reader as to the mentality and attitude of the Syrian population which has been exposed throughout its life to the monopoly of hatred and fear provided by the Assad regimes. In the light of these facts, the campaign of humanitarian and medical aid for Syrians that took place in Israel between 2013 and 2018 is even more

very limited and of poor quality, especially for the civilian population.

**268**

remarkable than the facts themselves.

**4. The Syrian civil war and its effect on medical services**

In 2011, within what has ludicrously been called "the Arab Spring", one of most destructive and vicious wars recorded since the Second World War broke out in

Syria. Although its scope and extent has subsided considerably in the last year, even now in 2019, foci of fighting continue to be active in different parts of the wrecked country. The numbers of dead have been estimated as above 500,000, and the numbers of severely wounded and injured well over 2 million. Between 2 and 5% of the pre-war population have become medical victims, but the true numbers are unknown, and estimating these has been made very complicated by the existence of millions of internal and external refugees, within Syria, in massive camps on the borders of Turkey, Iraq, Kurdistan, Lebanon, Jordan and many more thousands who have risked life and limb to reach more distant havens. It is noteworthy that the Assad government regime has made a special target of the medical system in Syria [2–7]. More than half of all doctors in Syria have fled the country, and many hundreds have been deliberately murdered, mostly by Assad forces. Entire provinces and cities have been left bereft of even basic medical services. Of special note are the brutal tactics employed by Assad and his Russian allies in this respect; it was learnt from the Nazis in the Second World War that the elimination of medical care was a cheap and efficient way of forcing people to leave their homes and cleansing an area ethnically, and the Nazis indeed made special efforts to target medical facilities, being so clearly marked. The Russian government used this criminal method in many places, for example, in Chechenia and Afghanistan. In Syria the tactic has been extensively employed. Especially cynical is the "second-wave" tactic in which after an initial assault and after numerous casualties have been concentrated in care areas; these areas are then subjected to secondary attack, thus completing the initial lethal intent. The repeated use of banned chemical weapons has exacerbated the results of these barbaric actions.

The northern border of Israel in the Golan Heights adjoins the Syrian province of Daraa, home to about 200,000 people in normal times, but estimates put the number of additional refugees anywhere between 1 and 3 million. The city of Daraa and the surrounding areas became known as the cradle of the revolution in 2011 after 15 boys from prominent families were arrested after writing antigovernment graffiti, thus sparking mass demonstrations. It is estimated that about 5–7% of the pre-war population has been killed in the war. The entire area has been essentially without organised health services since the war broke out; this has naturally placed an enormous strain on the civilian population and placed in jeopardy the stability of continued civil life.

The border area with Israel is a zone of especial sensitivity. Since 1974 the frontier has been patrolled by a special UN force (United Nations Disengagement Observer Force (UNDOF)) and for the most part was quiet and stable. In the years leading up to the civil war, the Assad regime began to adopt new tactics designed to disturb this equilibrium, mainly through the establishment of terrorist groups primarily the so-called Front for the Liberation of the Golan. This was actually a front for the Lebanese terrorist organisation Hezbollah, which later became a prime Iran-sponsored ally of Assad in the war. During the war years, the border area itself came under the control of various groups, primarily the Druze in the north around the village of Hader, Syrian Democratic Forces in the centre and a small ISIS-Daish enclave in the south. Israel for its part declared an official policy of neutrality in the Syrian war, clearly holding Assad to account for his own numerous war crimes and responsibilities but officially favouring no group; Israel restricted its own actions in Syria to surgical strikes only whenever and wherever its own interests were threatened. While none of the rebel or unofficial groups were in anyway connected with Israel, nevertheless tacit areas of mutual interests became defined. Among these from the Israel perspective were the humanitarian imperative to aid a population in severe distress, the need for stability and continued quiet along the border, the prevention of massive waves of refugees congregating in the area and on the other

side the urgent need for humanitarian assistance for the local and refugee population including the provision of medical assistance for civilians and combatants alike. Thus a remarkable and in some ways unique programme of medical assistance was born, provided at no charge by Israel, for the citizens of its enemy neighbour Syria. There has never been a precedent for a campaign similar in scope and duration between two hostile neighbours, and therefore the nature of this event and its effects on Israelis and Syrians are of considerable interest and importance.
