Bodies on the line

The more I think about corpography (see also ‘Corpographies under the DOWNLOADS tab) – especially as part of my project on casualty evacuation from war zones – the more I wonder about Grégoire Chamayou‘s otherwise artful claim that with the advent of armed drones the ‘body becomes the battlefield’.  He means something very particular by this, of course, as I’ve explained before (see also here).

But let me describe the journey I’ve been taking in the last week or so that has prompted this post. Later this month I’m speaking on ‘Wounds of war, 1914-2014‘, where I plan to sketch a series of comparisons between casualty evacuation on the Western Front (1914-18) and casualty evacuation from Afghanistan.  I’ve already put in a lot of work on the first of these, which will appear on these pages in the weeks and months ahead, but it was time to find out more about the second.

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En route I belatedly discovered the truly brilliant work of David Cotterrell who is, among many other things, an installation artist and Professor of Fine Art at Sheffield Hallam University.  He became interested in documenting the British military casualty evacuation chain from Afghanistan, and in 2007 secured access to the Joint Medical Forces’ operations at Camp Bastion in Helmand.  He underwent basic training, a course in even more basic battlefield first-aid, and then found himself on an RAF transport plane to Bastion.  The Role 3 Hospital was, as he notes, a staging-ground. ‘Field hospitals are islands between contrasting environments,’ he wrote in his diary, ‘between the danger and dirt of the Forward Operating Bases and the order and convention of civilian healthcare.’  You can read a long, illustrated extract from the diary (3 – 26 November 2007) here, follow the photo-essay as a slideshow here, and explore David’s many other projects on his own website here.

THEY-WERE-SOLDIERS_by-Ann-Jones_72The diary is immensely interesting and informative in its own right, not least about the exceptional personal and professional difficulties involved in documenting the evacuation process.  Here there’s a helpful comparison to be made with journalist Ann Jones‘s no less brilliant They were soldiers: how the wounded return from America’s wars (more on this in a later post), which starts at the US military’s own Level III Trauma Center, the Craig Joint Theater Hospital at Bagram, and moves via Landstuhl Regional Medical Center in Germany, the largest US hospital outside the United States, to the Walter Reed Army Medical Center in Washington DC.

David’s visual record is even more compelling, as you would expect from a visual artist, not only in its documentary dimension but also in the installations that have been derived from it.  In Serial Loop, for example, we are confronted with a looped film showing the endless arrival of casualties at Bastion: ‘The sound of a continuously arriving and departing Chinook helicopter accompanies images of a bleak and wasted landscape; the banality of the film’s fixed perspective masks the dramas that unfold within the ambulances as they travel to triage.’

9-liner explores what David calls ‘the abstraction of experience within conflict’:

9-Liner explores the dislocation between the parallel experiences of casualties within theatre. It is a quiet study of a dramatic event: the attempt to bring an injured soldier to the tented entrance of the desert field hospital. The screens show apparently unrelated information. JCHAT – a silent scrolling codified message – runs on a central screen. Our interpretation of it is enabled through its relationship between one of two radically different but equally accurate views of the same event. To the left we see the Watchkeeper – a soldier manning phones and reading computer screens in a crowded office. On the right we view the MERT flight – the journey of the Medical Emergency Response Team in a Chinook helicopter.

SHU’s REF submission includes this summary of David’s work (one of the very few useful things to come out of that otherwise absurdist exercise):

The research made clear that soldiers recovering from life-changing injuries had limited means of reconstructing the narrative of their transformative experiences. From the time of wounding through to secondary operations in the UK, many soldiers remained sedated or unconscious for a period of up to five days. The radical physical transformation that had occurred during this period was not adequately reconciled through medical notes, and the embargo on photographic documentation of incident and subsequent medical procedures served further to obscure this period of lost memory.

A culture of secrecy meant that medical professionals were unable to access documentation of the expanded care pathway with which they, and their colleagues, were engaged. This fragmentation of experience and understanding within the process of evacuation, treatment and rehabilitation meant that the assessment of the contradictions and disorientation experienced by casualties and medical practitioners was denied to front-line staff.

Family members, colleagues and members of the public outside the immediate environment of the military were unable to visualise or understand the transformative effects of conflict on directly affected civilians and soldiers. Partly as a result, the scope for public debate to engage meaningfully with the longer term societal cost of contemporary conflict was limited.

The submission goes on to list an impressive series of debriefings, presentations to military and medical professionals, major exhibitions, and follow-through research in Birmingham.

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And it’s one of those follow-throughs that prompted me to think some more about corpographies.  I’d noted the connection between corpography and choreography in my original post, but David’s extraordinary collaboration with choreographer Rosie Kay and her dance company gives that a much sharper edge.  Again, there’s a comparison to be drawn – this time with Owen Sheers‘s impressively researched and executed body of work, not only the astonishing Pink Mist but also The Two Worlds of Charlie F (2012)which was a stage play based on the experiences of wounded soldiers who also made up the majority of the cast (see my discussion of these two projects here).

5 Soldiers started life as a stage presentation in 2010 (watch some extracts here):

A dance theatre work with 5 dancers, it looks at how the human body is essential to, and used in, warfare. 5 SOLDIERS explores the physical training that prepares you for war, as well as the possible effects on the body, and the injury caused by warfare.

Featuring Kay’s trademark intense physicality and athleticism, 5 SOLDIERS weaves a journey of physical transformation, helping us understand how soldiers are made and how war affects them.

5 SOLDIERS is a unique collaboration between award-winning choreographer Rosie Kay, visual artist David Cotterrell and theatre director Walter Meierjohann. It follows an intense period of research, where Rosie learnt battle training with The 4th Battalion The Rifles and David spent time in Helmand Province with the Joint Forces Medical Group.

Rosie explained her commitment to the project (and her training with The Rifles) like this:

“I wanted to look at how the physicality of a soldier’s job defines them –like a dancer, the soldier is drilled, trained, their responses becoming automatic, but can anything prepare you for the realities of war? It is young soldiers and their bodies that are the ultimate weapon in war – their strength and weaknesses may win or lose a battle, their ability to harm or injure others is key to victory. While war is surrounded with weaponry, uniforms, history and ceremony, the real business is human, dirty, messy, painful and happening right now.”

(She is, not coincidentally, an affiliate of the School of Anthropology at Oxford).

5 Soldiers installation PNG

And now there’s a film version that works as a multi-screen installation (screen shot above).

Instead of just creating a short film, the team wanted the web user to get a truly interactive way to watch dance, and actually feel that they can go inside the minds and the body of the work. The 80-minute work was cut to just 10 minutes long, and the company spent one week filming in a huge aircraft hangar at Coventry Airport…

Using a variety of cutting edge filming techniques, the collaborative team have created a 13 angle edit that takes you into the heart of the work, follows each of the dancers, and zooms out so that the performers appear to be like ants in a huge empty landscape.

You can see the interactive, multi-perspectival version here.  This relied on helmetcams, and there’s a fine, more general commentary on this in Kevin McSorley‘s ‘Helmetcams, militarized sensation and “somatic war”‘ here.  But here’s the short, ‘director’s cut’ version:

And look at the tag-line: ‘The body is the frontline’.  It’s not only drones that make it so.

Predator View

I’m in Zurich – many thanks to Benedikt Korf for the invitation and the wonderful hospitality – for a seminar with Benedikt’s doctoral students on the long form version of ‘The Natures of War’ (they have what I hope is the penultimate draft; I’ll post the final version once I’ve reworked it after the seminar) and then a public lecture: ‘Angry eyes: the militarization of vision and modern war’.

Part of my argument in the lecture is about the narrowness of ‘Predator View’, so let me explain what I mean.  My starting point is the illusion that the use of the intelligence, surveillance and reconnaissance capabilities of remote platforms like the MQ-1 Predator or the MQ-9 Reaper produces a transparent battlespace: in effect, a version of Donna Haraway‘s ‘God-trick’, the ability to see everything from nowhere in particular.  The most succinct version of this is the treatment of laser targeting as ‘the eye of God’:

Eye of God.001

In fact, ‘Predator View’ is remarkably narrow. First, and most directly, a common complaint is that the view provided by its Full Motion Video is literally too narrow – ‘like looking through a soda straw’.  It’s for this reason that pilots and sensor operators also use FalconView, a Windows-based mapping tool that is supposed to provide them with situational awareness.  I’ve taken the image below from a presentation by Lt Col Paul Hastert (USAF) on ‘Spiral development in wartime’ – the screenshot is the FalconView image, the small square the field of view from a Predator – but the most detailed account of FalconView is Jon Lindsay‘s ‘”War upon the map”‘: User innovation in American military software’, Technology and culture 51 (3) (2010) 619-51.

FALCONVIEW and Predator FOV

There have been several later releases of FalconView, and a version is now even open source, so it’s probably not surprising that the US military also uses Google Earth.  In fact, in two of the air strikes I consider in detail it was, in part, juggling these different views that contributed to wrong targeting decisions.  (There are projects that provide a wider field of view – the nine-camera suite of Gorgon Stare is in operation and its second increment is already in use in Afghanistan – and others that integrate imagery from multiple sources, like Raytheon’s Zeus, which is intended to supplant FalconView as the ‘primary mission execution tool‘).

But in the air strikes that I consider those involved in these networked operations are also busy communicating via radio and – crucially – via the typed messages displayed in mIRC‘s online chat windows.  The image below is taken from the US military’s multi-service manual on Tactical Chat (see also the discussion at Public Intelligence here).

mIRC 3 chatrooms

In the case of the ‘friendly fire’ incident in the Sangin Valley in 2011, the pilot and sensor operator were unaware of crucial entries made by image analysts in mIRC and of private (or ‘whisper’) chats to the Mission Intelligence Co-ordiator.  That’s not entirely surprising.  Once permission has been given to engage a target, ‘KILL CHAIN” is typed into the room to minimise extraneous chatter that might otherwise visually distract and so ‘degrade’ the strike.  According to the Mission Intelligence Controller for the Sangin incident:

‘When we got a standby for a 9-line [strike briefing] we put [KILLCHAIN] in the mIRC room to shut down chatter so we can be heads down supporting the pilot and the sensor … as they are getting ready for a possible Hellfire shot our whatever action… That’s our job, to be their third set of eyes…’

That third set of eyes is vital, though of little use if its responses are shut down.  In this case the pilot was paying no attention to mIRC because he was fully occupied:

‘I did not see the chat in the main mission room after seeing muzzle flashes. From that point on, my focus was clear concise communications with the [Joint Terminal Attack Controller] and ensuing [Close Air Support] comms, 9 line etc. At this point I was also focused on keeping the aircraft in position to maintain FMV on the individuals. I was also getting the aircraft into the [Weapons Engagement Zone]. Winds were 30 knots out of the west so I had to make sure I kept the aircraft position and direction in cross check.’

All of this suggests that it is unduly narrow to focus the analytical gaze on the Full Motion Video feeds.

But there’s more.  Militarised vision is not limited to Predators and their successors, and it’s important to consider the clarity and resolution of the imagery captured and transmitted from other, conventional aircraft like the AC-130 (first image below), the B-1 bomber, F-15E strike aircraft or attack helicopters (second image below)  – again, this was important in two of the strikes I consider in detail.

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MMS from attack helicopter - Uruzgan.001

This leads me to two other senses in which the critical emphasis on ‘Predator View’ is too narrow.  It’s a mistake to fasten on one incident – even what has become the iconic ‘signature strike’ coordinated by a Predator on three civilian trucks in Uruzgan – because that misses the continuities, repetitions and transformations in Close Air Support (which is where most of the mistakes are made).

Better, I think, to widen the analytical gaze, which is why I examine the Kunduz air strike on 4 September 2009 (in which no remote platform was involved), the Uruzgan air strike of 21 February 2010 (which was co-ordinated by a Predator but carried out by two attack helicopters), and the Sangin Valley air strike of 6 April 2011 (which was executed by a Predator).  The Granai strike is included because it trigged McChrystal’s Tactical Directive of 6 July 2009 to minimise civilian casualties: ‘‘We must avoid the trap of winning tactical victories – but suffering strategic defeats – by causing civilian casualties or excessive damage and thus alienating the people.’  In all three cases I’ve worked through thousands of pages of official investigations – one by the German Bundestag since the ISAF report remains classified (Kunduz), and the others by the US Army and US Air Force (Uruzgan) and the US Marine Corps (Sangin Valley).

4 US air strikes in Afghanistan.001

And finally, it is also necessary to consider the multiple viewing positions involved in networked military violence.  There is a de-centralised, distributed and dispersed geography of militarised vision whose fields of view expand, contract and even close at different locations engaged in the administration of military violence.  And in all three incidents it turns out that vital mistakes in the interpretation of imagery were made at operations centres in theatre on the ground.

This has prompted me to radically revise the argument I originally set out in ‘From a view to a kill’ (DOWNLOADS tab).  There my focus was on the geography shown in the first map below – like every other commentator I’ve read, incidentally – but I’ve now widened the angle to take in the geography shown in the second map and this substantially changes the story.

Dispersed vision Uruzgan (1).001

Dispersed vision Uruzgan (2).001

It was what happened at the operations centres at Special Operations Task Force 12 in Kandahar and Combined Joint Special Operations Task Force in Bagram that turned out to be every bit as important as the Predator crew’s obvious desire to ‘go kinetic’.

I make similar arguments about Kunduz, where the F-15E pilots were clearly reluctant to strike and the ground commander and JTAC at the Forward Operating Base overrode their objections.

Sangin is even more instructive, because the official investigation of this ‘friendly fire’ incident that resulted in the deaths of two Marines largely exonerated both the Predator crew and the ground commander and JTAC at the operations centre – but a detailed, spirited counter-memorandum from the US Marines commandant refuted the findings line by line, castigated the attempt to pin the blame for what happened on the young, inexperienced lieutenant leading the patrol, and excoriated the ground commander and JTAC back at the patrol base.  More on this soon.

The (long!) essay on these  strikes is the last chapter I need to complete for The everywhere war. There is a strong sense, so I shall argue, in which it was the view ‘on the ground’ that mattered much more than any ‘light of God’ from above.  And as for transparency….

Inhumanitarian mapping

It’s strange how things sometimes come together – or collide and crash.  Two weeks ago I wrote about satellite imagery and ‘remote violence’, and over the summer I discussed several projects that mapped Israel’s military assault on Gaza and its people,  including the Gaza Crisis Atlas produced by the UN’s Office for the Coordination of Humanitarian Affairs (which makes extensive use of hi-res satellite imagery).

The links between those two posts are obvious enough, but today I have something altogether different in my sights.  ‘Judge Dan’ (Dan Smith), who blogs for Israellycool, has used the Gaza Crisis Atlas to construct a series of maps to geo-wash Israel’s military campaign.

Working from the data in the Atlas, Smith produces four maps to disaggregate the severity of destruction (the four levels, increasing from left to right, are based on OCHA’s own assessment):

DAN SMITH Gaza-Damage-Points-Vertical-All

His conclusions from this exercise are the following:

The attacks are in no way “random” or “indiscriminate”. One can clearly see the spatial distribution of the damage in several aspects. We find 8,952 of the 12,433 total points (72%) are within a 3 KM buffer abutting the border with Israel. The main objective of Operation Protective Edge was to find and destroy dozens of terror tunnels dug from Gaza into Israel.

That the most intensive damage was caused to the area where the tunnels naturally originated is thus perfectly understandable. Furthermore, of the 4,441 destroyed structures, 3,481 of them (78%) are within the 3 KM buffer, as are 2,531 of 3,303 (77%) of the lowest intensity damage (simple craters), which are mostly strikes on rocket launchers and tunnels.

Most of the attacks are grouped around certain neighborhoods or villages, such as Shuja’iyya, Johur ad-Dik, Sureij, and Khuza’a. These were probably the result of the ground operations that took place in dense urban areas also within the 3 KM buffer that housed multiple tunnel entrances and shafts, as well as launch sites for mortars and rockets.

Smith then takes the Israeli military’s map of ‘terrorist infrastructure’ in Shuja’iya and overlays this on what he calls ‘OCHA’s damage points’: ‘the correlation is uncanny.’

Smith’s next manoeuvre is to sweep aside OCHA’s focus ‘on the civilian aspect’ because it ‘misses the big picture’ (really – or perhaps Israelly): ‘the overall intensity of the strikes’.  So he constructs a kernel density map or a ‘damage intensity heat map’:

It now becomes very clear that most of the damage was caused to 5 locations right on the border with Israel. The rest of the Gaza Strip was, for the most part, undamaged. The main population areas of Gaza city, Jabaliya, Khan Yunes, Rafah and Deir el-Balah were disproportionately undamaged (sic).

DAN SMITH Gaza-Damage-Heatmap-Vertical2

He continues:

If we do a rough estimate of the damage area, it is once again clear the vast majority of the Gaza Strip was unscathed. With a fairly generous estimation that a damage point has a 25 meter radius – the footprint of a house, or the blast radius of a bomb – the total damage area of the 12,433 impacts was in the order of 15 KM2. The land area of the Gaza strip is 360 Km2. In other words, less than 5% of the land was affected.

There’s a follow-up post on ‘damage clusters’ here, but in this commentary I’ll focus on Smith’s ‘big picture’.  I take the basic points to be these:

(1)  Smith’s approach makes an appeal to the supposed objectivity and even facticity of the map (and, by extension, the satellite image), but there is a substantial body of scholarship that goes back 25 years and underscores the multiple ways in which mapping is an exercise in the production of power.  For a depressingly relevant example of the ways in which maps can speak power to truth, taken from Israel’s attack on Gaza in November 2012, see my discussion here (scroll down to the maps).

(2)  Appealing to the map and its manipulations as the single source of authority is designed to disavow the testimony of witnesses on the ground: precisely the point sharpened by Andrew Herscher in his timely critique of ‘Surveillant witnessing’ (see my discussion here) and a far cry from the incorporation of photographs in (say) the Gaza War Map.

(3) Smith’s methodology reduces Gaza to an object space of structures and buildings, craters and points; he constructs a kernel density map (more on this in a moment) but provides no population density map that would at least gesture towards the people killed, wounded and traumatised by the Israeli offensive and who are wholly absent from his account.  Here, by contrast, is a map I posted previously showing deaths in Gaza to 6 August:

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The Gaza Crisis Atlas focuses on damage to buildings and infrastructure because it is a tool directed explicitly towards reconstruction, so the same criticism doesn’t apply (particularly if you look at OCHA’s work more generally, including the information it provided for the map I’ve just reproduced). But if we are to limit ourselves to gazing on structures from space, UNOSAT’s analysis of satellite imagery provides a sharp reminder that these buildings included schools and hospitals (see also here and here); the report also provides a telling comparison between the intensity of destruction in 2009 and 2014:

UNOSAT_GAZA_REPORT_OCT2014_WEB (dragged)

(4) Smith prefers to construct his own generalised map of damage density using kernel density estimation, a smoothing algorithm that converts point data into a continuous surface.  I discussed the way in which the US military uses this technique in ‘Seeing Red’ (DOWNLOADS tab), and what I said there bears repeating:

The maps are known for their dramatic visual impact, and the desired message can be engineered into the production process. One of the most influential handbooks on KDE is published by the US National Institute of Justice and describes how to map crime ‘hot spots’…  The authors of the NIJ handbook acknowledge that ‘map production is an iterative process’ and that ‘the first map produced is very rarely the one presented to the target audience.’ They continue: ‘The intended message should also be seen as the driving force behind what the map should look like’ (US National Institute of Justice, 2005: 26, 33).

So let’s turn to the rest of Smith’s message.

(4) Smith justifies the pattern of destruction shown on his maps by claiming that ‘the main objective of Operation Protective Edge was to find and destroy dozens of terror tunnels dug from Gaza into Israel.’  In fact, the stated objectives of the Israeli assault changed throughout the campaign.  The attacks were supposedly sparked by the kidnapping and murder of three Israeli teenagers – in the West Bank not Gaza – and as the mission was ratcheted up so their central objective changed: according to the IDF the aim was to put an end to Hamas rockets being fired into Israel (for a radically different view, see Graham Liddell‘s more general discussion at Mondoweiss here).  The rhetoric of ‘terror tunnels’ came later.  And while Smith is right to draw attention to the swathes of destruction to the east of Gaza’s central spine, he never addresses the human consequences of successive Israeli expansions of this so-called ‘buffer zone’ until it covered more than 40 per cent of Gaza: see my post here for more details.

(5) Towards the end of his analysis, Smith concedes that destruction is not punctiform.  Bombs are not ‘pinpoints’ (cf. Nathan Guttman‘s report on Smith’s work and ‘the pinpoint accuracy of Israel’s strikes’), not only because they rarely land exactly on target but also because their blast radiates outwards from the point of impact.  But Smith’s ‘fairly generous estimate that a damage point has a 25 meter [82 feet] radius‘ – is in fact a serious underestimate that at the very least halves the blast radius of a 155 mm shell.  Here is Mark Perry‘s report that I cited previously, which includes testimony from senior US military officers about the shelling of Shuj’aiyya:

Artillery pieces used during the operation included a mix of Soltam M71 guns and U.S.-manufactured Paladin M109s (a 155-mm howitzer), each of which can fire three shells per minute. “The only possible reason for doing that is to kill a lot of people in as short a period of time as possible,” said the senior U.S. military officer. “It’s not mowing the lawn,” he added, referring to a popular IDF term for periodic military operations against Hamas in Gaza. “It’s removing the topsoil.”

“Holy bejeezus,” exclaimed retired Lt. Gen. Robert Gard when told the numbers of artillery pieces and rounds fired during the July 21 action. “That rate of fire over that period of time is astonishing. If the figures are even half right, Israel’s response was absolutely disproportionate.” A West Point graduate who is a veteran of two wars and is the chairman of the Center for Arms Control and Non-Proliferation in Washington, D.C., he added that even if Israeli artillery units fired guided munitions, it would have made little difference.

Even the most sophisticated munitions have a circular area of probability, Gard explained, with a certain percentage of shells landing dozens or even hundreds of feet from intended targets. Highly trained artillery commanders know this and compensate for their misses by firing more shells. So if even 10 percent of the shells fired at combatants in Shujaiya landed close to but did not hit their targets — a higher than average rate of accuracy — that would have meant at least 700 lethal shells landing among the civilian population of Shujaiya during the night of July 20 into June 21. And the kill radius of even the most precisely targeted 155-mm shell is 164 feet. Put another way, as Gard said, “precision weapons aren’t all that precise.”

(6) Finally, let’s take Smith’s central claim that ‘less than 5% of the land [of Gaza] was affected’ – and reverse it.  If Hamas were to say that less than 0.00005% of Israel had been hit by its rockets – to be fair, it’s a difficult calculation to make because Israel has never fixed its borders and so it’s not possible to determine its area – and that the rest of Israel was ‘disproportionately undamaged’, would Israelis have simply shrugged them off?

 

War and demise

Tanisha Fazal has an important article in the latest International Security: ‘Dead wrong? Battle deaths, military medicine and exaggerated reports of war’s demise.’

It is, in part, an artful response to what must surely seem the increasingly astonishing claim that we live in a time of unprecedented peace.  It depends, in part, on who ‘we’ are, of course, but the general thesis has been shouted from the rooftops by (for example) Joshua Goldstein‘s Winning the war on war (2011) and Steven Pinker‘s The better angels of our nature (2011).  Pinker’s thesis is the more general, to be sure: he claims a decline in ‘violence’ in general, not only in military and paramilitary violence.

StevenPinker

Tanisha’s argument hinges on the reliance on ‘battle deaths’ as an index of the incidence of war; these statistics are a minefield of their own, though they are used by most of the major databases, but Tanisha argues that many contemporary wars have been distinguished by a diminution in battle deaths and a marked increase in the numbers of wounded who now survive injuries that would previously have killed them.

She identifies four key changes.  The first two are pre-emptive: soldiers in advanced militaries are now healthier, and so they  can survive disease and injury much better than in the past, and they are equipped with protective equipment that reduces their vulnerability (she’s thinking here not only of MRAPs but more particularly of personal equipment that affords the head and trunk some protection against blast injuries).

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The second two are reactive, and their emphasis on military medicine and evacuation chains intersects directly with my present research on combat casualty care 1914-2014 (see here and here).  From Tanisha’s summary over at Political violence @ a Glance:

‘… battlefield medicine itself has improved via the availability of anesthetics and antibiotics, which make for more effective surgeries as well as a greater likelihood of avoiding or surviving post-operative infections. Similarly, the return of the tourniquet as part of a general focus on hemostatics appears to have dramatically reduced the percentage of soldiers dying from preventable blood loss.

‘… military evacuation practices have gone from soldiers laying on the ground for weeks waiting for transport by stretchers to mechanized ambulances to medevac helicopters. States invest heavily in military transport for this purpose today; NGOs like the ICRC, however, were at the vanguard of this particular shift.’

Medevac

That last sentence raises a series of other, crucial questions that I’m also trying to address in my own project: not only the involvement of civilian/humanitarian organisations (and here I’m presently exploring the role of the Friends Ambulance Service on the Western Front in the First World War and in the Western Desert in the Second) but also the part played by militaries in caring for civilian casualties.  How far have they enjoyed the benefits of improved military medicine and trauma care, and how far down the evacuation chain do they move before they are diverted to (often less advanced) civilian hospitals and clinics?

MAP and the meat-grinder

I’ve updated my previous posts on the medical geographies of Gaza several times (see herehere and here), and I’ve drawn on the testimony of Dr Mads Gilbert in extenso, but this testimony from another brave volunteer doctor deserves its own notice.

I met Ghassan Abu Sitta at a wonderful workshop in Paris in December 2012 on War and Medicine, and I learned so much from that one meeting (from everyone there: see my note about War and therapeutic geographies) that I was inspired to develop my own research project on the medical evacuation of casualties from war zones, 1914-2014.

Ghassan Abu Sitta

Ghassan is a reconstructive surgeon who used to work at Great Ormond Street in London but is now based in Beirut.  He’s recently returned from Gaza where he worked as a Medical Aid for Palestinians (MAP) volunteer at al Shifa hospital carrying out five, six and sometimes seven surgeries a day.

You can read some of the background in this excellent report by Robert Tait for Britain’s Telegraph, published ten days ago and from which I’ve borrowed the photograph above, but Ghassan has just been interviewed in depth by Yazan al-Saadi for Al Akhbar; you can read the full version here.

Ghassan says the attack on Gaza was like ‘a meat-grinder’, which he attributes to:

The amount of ordinance that the Israelis fired, the indiscriminate use of these bombs that are capable of bringing down whole buildings, the use of artillery shelling which is indiscriminate because the shell will hit the first thing it reaches, the fact that they were attacking from the air, from the sea, and by land with artillery at the same time. And there was a night they were doing this and then they lit all of Gaza’s sky with these flares just so people will know that this is what’s happening.

He also provides compelling testimony of his experience at al-Shifa, the main trauma centre for Gaza, that adds important detail to the accounts I’ve noted previously:

‘It looked like a refugee camp. The campus of the hospital has a lot of the families that escaped the bombing or lost their houses and they were living inside the walls of the hospital. Everywhere you go you see makeshift dwellings made out of laundry lines and bed sheeting turned into tents. And the hospital was completely full. Single rooms had four beds in them. In some wards we had two patients per bed.

‘The difference between this conflict and the one before is that nobody was allowing the patients out. So you had 7,000 injured – at the time I was there it was 6,000 and by the time the conflict ended the injured were 10,000. An overwhelming majority have still not been able to get out of Gaza. There have been some numbers, but not significant numbers to break the back of this problem….

‘The contingency plans were that all diesel was kept for the al-Shifa Hospital, so people did not have electricity at home, they would donate the diesel to the hospital. The wells that supply Shifa, like the rest of the water in Gaza, had become so contaminated with sea water, it’s salty. People do the best with what they have….

‘… the majority of the killing was happening because they were dropping ammunition designed to penetrate mountain caves. [The Israelis] were dropping them on civilian dwellings made out of breeze block. And so these four or five storey buildings were being pulverized by these one-ton bombs. That was what was wiping out whole families. And in Gaza, because land is so much in shortage, people come along and build their house, they build enough foundations that when their kids grow up, they can build a floor on top. So when you take out a four storey building, you take out four generations of a family. That was what happened to, I think, 60 families that have been completely wiped out…

The graphic below shows 26 members of just one extended family, the Abu Jame family, killed at home in Bani Suheila on 20 July; it comes from a sequence that is shockingly far too large to reproduce here, compiled by B’Tselem and available here. The infographic lists ‘members of families killed in their homes in 59 incidents of bombing or shelling’ in which 458 people were killed, including 108 women under the age of 60, 214 minors, and 18 people over the age of 60.  If you follow the link, you can hover over each image for the names and ages of those killed.

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Ghassan continues:

‘… they started inventing these humanitarian ceasefires, where people would go out and they would start killing them. We had this on the day of Eid, they said there was a humanitarian ceasefire and the kids went out to a local fair ground and they bombed them. The other time was in al-Shujayeh market, there was a humanitarian ceasefire, they got them into the market, they killed them, then they waited for the ambulances to get there, and then they shelled the ambulances again.

‘So the issue isn’t the type of weapons, but the intent to kill. The amount of ordinance they used and the tonnage of the bombs they used were intended to wipe out whole neighborhoods. That’s what they have done. They have completely wiped out Shejayeh, they wiped out Khuza’a, they wiped out a big part of Rafah, a big part of Khan Younes, and parts of Beit Hanoun….

‘ All the areas around the hospital were being bombed all the time. You would hear it. We heard something we knew it was close, but didn’t know how close it was. We then got a call to the emergency room and we were told that the administration and the out patients building had been hit – a lot of families had taken refuge in that area – so we had to go and help.’

Asked directly whether Hamas or other factions were firing rockets from the vicinity of the hospital, Ghassan is unequivocal:

‘Around Shifa? No, no, no. But in other places you would see them in the sky or hear them. You would learn to distinguish the whoosh of the rocket. Gaza is so small and so flat, I mean you are not going to hide them in the mountains or the jungle because there are no mountains or jungle. People are literally on top of each other. It’s going to happen. But around the hospital there were none.’

Destructive Edge

In a previous post on ‘The Death Zone‘, I suggested readers compare Israel’s extended ‘buffer zone’ in Gaza by following the line of the main highway, Saladin Street.  Hugh Naylor has followed that route on the ground – what he calls ‘Desolation Road’ – and his report is accompanied by an interactive map showing some of the vast panorama of destruction:

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I’ll have more to say about the caption – about the Israeli military’s targeting in Gaza – shortly.  The Guardian has just published a graphic by Nadja Popovich showing the UNRWA-run schools sheltering refugees (many of them from the expanded ‘buffer zone’) that were struck by the Israeli military:

Gaza schools hit by Israeli military

 Amnesty International reports growing evidence that health facilities and workers were deliberately targeted by the Israeli military:

Testimonies from doctors, nurses, and ambulance workers who have spoken to Amnesty International paint a disturbing picture of hospitals and health professionals coming under attack by the Israeli army in the Gaza Strip, where at least six medics have been killed. There is growing evidence that health facilities or professionals have been targeted in some cases.

Since Israel launched Operation “Protective Edge” on 8 July, the Gaza Strip has been under intensive bombardment from the air, land and sea, severely affecting the civilian population there. As of 5 August, according to the UN Office for the Coordination of Humanitarian Affairs, 1,814 Palestinians had been killed in the Gaza Strip, 86 per cent of them civilians. More than 9,400 people have been injured, many of them seriously. An estimated 485,000 people across the Gaza Strip have been displaced, and many of them are taking refuge in hospitals and schools.

Amnesty International has received reports that the Israeli army has repeatedly fired at clearly marked ambulances with flashing emergency lights and paramedics wearing recognizable fluorescent vests while carrying out their duties. According to the Palestinian Ministry of Health, at least six ambulance workers, and at least 13 other aid workers, have been killed as they attempted to rescue the wounded and collect the dead. At least 49 doctors, nurses and paramedics have been injured by such attacks; at least 33 other aid workers were also injured. At least five hospitals and 34 clinics have been forced to shut down due to damage from Israeli fire or continuing hostilities in the immediate area.

Hospitals across the Gaza Strip suffer from fuel and power shortages (worsened by the Israeli attack on Gaza’s only power plant on 29 July), inadequate water supply, and shortages of essential drugs and medical equipment. The situation was acute before the current hostilities, due to Israel’s seven-year blockade of Gaza, but have been seriously exacerbated since…

Amnesty International is aware of reports that Palestinian armed groups have fired indiscriminate rockets from near hospitals or health facilities, or otherwise used these facilities or areas for military purposes. Amnesty International has not been able to confirm any of these reports. While the use of medical facilities for military purposes is a severe violation of international humanitarian law, hospitals, ambulances and medical facilities are protected and their civilian status must be presumed. Israeli attacks near such facilities – like all other attacks during the hostilities – must comply with all relevant rules of international humanitarian law, including the obligation to distinguish between civilians and civilian objects and military targets, the obligation that attacks must be proportional and the obligation to give effective warning. Hospitals and medical facilities must never be forced to evacuate patients under fire.

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The report includes detailed testimony from Palestinian paramedics and ambulance crews who describe the extraordinary difficulty and danger they faced in attending to casualties from Israeli shelling (see also my post on ‘Gaza 101‘, the emergency number for Gaza, and the update here).  Not surprisingly, Israel has rejected Amnesty’s claims and denied targeting hospitals, but when Netanyahu’s spokesperson, Mark Regev, explained that ‘What we’ve had to do on a number of occasions is to hit terrorist targets in the immediate vicinity of hospitals and things like that, where they’ve abused them,’ he failed to address the violations of international law summarised in the last paragraph above.

There’s more.  B’Tselem, now back on line, is also providing detailed testimony from Gaza, including (so far) two ambulance drivers, Rami ‘Abd al-Haj ‘Ali and Ahmad Sabah.  Here is an extract from the first statement (all testimonies are linked to B’Tselem’s interactive map):

B'Tselem map Beit HanounOn Friday afternoon, 25 July 2014, I was working at the medical emergency call center in Beit Hanoun. At around 4:30 P.M., we received a call reporting injured people in al-Masriyin Street in Beit Hanoun. We asked the International Red Cross to coordinate our going there. About 15 minutes after we received the call, we got authorization and an ambulance headed over there with paramedics ‘Aaed al-Bura’i, 25, Hatem Shahin, 38, and driver Jawad Bdeir, 52. The team didn’t make it to the wounded people. Soon after they reached the street, they reported back that a tank had fired at them and they were injured. They asked for another team to come and rescue them.

The call center coordinated the arrival of another team with the International Red Cross and got authorization to go rescue the injured team. I drove the second ambulance, and there were two medics with me – Muhammad Harb, 31, and Yusri al-Masri, 54. The street is only about 200-300 meters from the call center, so we were there within minutes. When we reached the entrance to the street, we were surprised to see three tanks and a military bulldozer in the street, about 100 meters away.

Suddenly, with no warning, they opened heavy machine-gun fire at us. The bullets penetrated the ambulance. I tried to turn the ambulance around to get out of there, but the steering wheel must have been hit. Suddenly, I felt sharp pain in my leg and realized I’d been hit by a bullet or shrapnel. Then the windshield shattered. Because I couldn’t turn the ambulance around, I decided to try reversing. They kept firing as I backed up, until we got far enough away. When they stopped, I managed to turn us around and head back to the center.

On the way there we met Hatem Shahin, one of the paramedics from the first ambulance. He’d been hit by shrapnel in his shoulder and leg. He told us that a shell fired from a tank had hit the front part of the ambulance. He said he’d managed to get away but the other paramedic, ‘Aaed, had been hit. He told us that after he ran away from there, he saw the tank fire another shell at the ambulance, completely destroying it. He thought ‘Aaed must have been killed, but we didn’t know for sure.

The next day, on Saturday, a ceasefire was declared from 8:00 A.M. to 8:00 P.M. An ambulance team went to the spot and found ‘Aaed’s body in the burnt ambulance.

To put all of this in context, the BBC has mapped the deaths of 1,890 Palestinians – ‘mostly civilians’, as its accompanying chart shows – killed during the Israeli offensive to 6 August.  As you can see, Palestinians were killed ‘right across Gaza’ – not only in the expanded buffer zone shown on the map, though the carnage in Beit Hanoun and Shejaiya is clearly visible – with high concentrations also produced in the killing grounds of Gaza City and Khan Younis:

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Finally, in case you’re puzzled by the title for this post: Israel’s attack on Gaza is codenamed Tzuk Eitan in Hebrew, meaning ‘Firm Cliff’ or ‘Resolute Cliff’.  According to Yagiv Levy, ‘The operation’s name signals the power, commitment and resilience of the Israeli people.’  But the official English-language version, ‘Protective Edge’, was changed ‘to give it a more defensive connotation’ (really). As Steven Poole explains, ‘the bombing was supposedly “protective”, though not of those bombed’. All of this is of course in line with the designation of the Israeli military as the ‘Israeli Defence Forces’.

I decided I’d prefer to use a version that provides a more accurate rendering of what has happened – in Hebrew, English or Arabic.

Scoping Afghanistan

BOIJ Tracking drone strikes in AfghanistanThe marvellous Bureau of Investigative Journalism has just published a preliminary report on its new study  of drone strikes in Afghanistan, ‘the most heavily drone-bombed country in the world.’  The study, carried out with the support of the Remote Control Project, has been prompted by analyses which show that ISAF has persistently under-estimated civilian casualties from its strikes (‘“We only count that which we see… You can do a tremendous amount of forensics … [but] seldom do we see the actual bodies.”)

I have my doubts about the wisdom of severing ‘drone strikes’ from air strikes carried out by conventional aircraft that are networked in to ISR feeds from drones; I’ve elaborated this before, and it is a crucial part of my own work on militarised vision, where I’m working through the military investigations into air strikes in Kunduz, Sangin and Uruzgan.  I’ll start posting about this work next month.

The irony, I think, is not (quite) that we know so little about the ostensibly ‘public’ strikes in Afghanistan compared with the ‘covert’ campaigns in Pakistan, Yemen, Somalia and elsewhere: it is, rather, that we know a lot about how the USAF (though not the RAF) conducts strikes in Afghanistan but remarkably little about the victims, whereas in Pakistan we know much less about how the strikes are carried out (apart from the bureaucratisation of ‘kill lists’ in Washington) and, thanks to the work of the Bureau, much more about the victims.

It is true, though, that while the official US military investigations released through FOIA requests are often immensely informative, even in redacted form (more on this next month), there is often also a remarkable reluctance to release even basic information to the public.  Spot the difference between these two tables; the first release (on top) was subsequently overwritten by the second (below)…

Airpower statistics 2007-2012

As I say, more to come.  In the meantime, the ‘scoping study ‘ from the Bureau is here, and well worth reading.