Doctor at Israeli Field Hospital for Detained Gazans: ‘We Are All Complicit in Breaking Law’

The doctor at the Sde Teiman facility describes deplorable conditions and violations medical ethics and the law. ‘Two prisoners had their legs amputated due to handcuff injuries, which is a routine event,’ he says in a letter to ministers, attorney general.

In a letter sent to Israel’s defense minister, health minister and attorney general, a doctor at the field hospital set up at the Sde Teiman detention center to hold arrested Gazans describes conditions that he says can compromise the inmates’ health and put the government at risk of violating the law.

“Just this week, two prisoners had their legs amputated due to handcuff injuries, which unfortunately is a routine event,” the physician said in the letter. He said inmates are fed through straws, defecate in diapers and are held constant restraints, which violate medical ethics and the law.

The Sde Teiman facility was established immediately after the outbreak of the Gaza war to hold Hamas terrorists, including those who took part in the atrocities of October 7, until they could be moved to a regular prison.

At the time, the Knesset approved an amendment to the law on holding detainees that specified the conditions in which they could be held. Since the start of the ground operation in the Gaza Strip, most of the Gazans who have been arrested have been sent to Sde Teiman to be investigated for involvement in terrorism. Those cleared of suspicion are then sent back to Gaza.

“From the first days of the medical facility’s operation until today, I have faced serious ethical dilemmas. More than that, I am writing [this letter] to warn you that the facilities’ operations do not comply with a single section among those dealing with health in the Incarceration of Unlawful Combatants Law,” the doctor writes.

He stressed that all the patients at the hospital set up at Sde Teiman are handcuffed by all four limbs, regardless of how dangerous they are deemed. They are blindfolded and fed through a straw. “Under these conditions, in practice, even young and healthy patients lose weight after a week or two of hospitalization,” the physician said. He added that the hospital doesn’t receive regular supplies of medical equipment or medicine.

The Israel Defense Forces Spokesperson’s Unit said in response that detainees were given enough food for their health needs and had access to the toilet in accordance with their medical condition. If their movement is restricted, it said, they are provided with diapers.

Gazan detainees in December. According to the physician, after surgery patients are quickly returned to a facility which has only one doctor and staff who are not sufficiently trained.Credit: Motti Milrod

The procedures for care at field hospitals when the patient is handcuffed and blindfolded were issued by the Health Ministry last December. A ministry official said the policy on shackling detainees was instituted after a medical staffer was attacked by a patient. As a rule, detainees at Sde Teiman are handcuffed 24 hours a day.

According to the doctor, more than half of the patients at the facility’s hospital are there due to injuries sustained due to constantly being handcuffed during their detention in Israel. The handcuffs, he said, cause serious injuries that “require repeated surgical interventions.”

An IDF spokesman stated that the way detainees are handcuffed was determined “in accordance with the law and according to an individual determination of the dangerousness of each detainee, with the aim of ensuring the safety of the troops and the medical staff.”

He also noted that the decision of whether to handcuff a detainee takes into account his medical condition and the recommendations of medical officials. The army said that due to the injuries, the handcuffs used at the facility have been changed for another type, and that guards ensure that there is sufficient space between the handcuffs and the detainees’ limbs.

Haaretz has learned that the plastic handcuffs used in the first few months after Sde Teiman was established have been replaced with metal ones.

In addition to the allegations made by the doctor, three other sources told Haaretz that at the start of the war, a detainee whose hands were injured because they were in plastic handcuffs for a prolonged period of time had one hand amputated. An IDF spokesperson stated that the incident was investigated, but because no criminal offense was found, it was decided not to open a military police investigation.

One source said that many detainees were in poor physical condition. Many were injured due to fighting or over the course of the war, and their injuries often worsened due to the conditions of their imprisonment and the lack of hygiene at Sde Teiman. He added that others suffer from chronic conditions but since the outbreak of the war, there has been a continual shortage of medicine. Some detainees have suffered from lengthy epileptic seizures.

The source said that although many detainees suffer from medical problems, most of them are not treated in Sde Teiman’s hospital but remain in the regular prison and are treated by medics. That source said the hands of many of the detainees got cuts and subsequently became infected due to the handcuffs. The claim is supported by detainees who had been released to Gaza showing the injuries to their hands in photos. Sources who spoke to Haaretz said that the supply of drugs for chronic diseases has since improved.

The Sde Teiman facility. Most of the detainees brought to the facility from the Gaza Strip are interrogated on suspicion of involvement in terrorism, but many are released after it turns out that they have no such ties.Credit: Eliyahu Hershkovitz

The Sde Teiman facility comprises enclosures, where the detainees are kept, and a field hospital. According to sources, at any given time the facility houses between 600 and 800 Gazans, while a handful in need of critical medical attention are in the hospital, and it is their conditions that are described in the doctor’s letter.

Some of the detainees are eventually moved to prisons in Israel and others are returned to Gaza if an investigation reveals there is no reason to continue holding them. According to Israel Prison Service figures provided to HaMoked Center for the Defense of the Individual, as of April 1, 849 Gazans were held in Israeli prisons, not counting those held at Sde Teiman.

Orthopedist and gynecologist

The Sde Teiman facility is supposed to operate according to the Incarceration of Unlawful Combatants Law amended last December. In the letter, the doctor claims that the facility does not comply with the law’s conditions, including the right to medical treatment and equipment in accordance with detainees’ medical condition, their right to hygienic conditions and adequate sleeping arrangements that don’t endanger their health or harm their dignity. They also have the right to exercise outside for two hours a day.

In his letter, the doctor asserted that detainees don’t receive appropriate care, even when they are moved to a hospital: “No patient who was referred to a hospital has remained there for more than a few hours. It happens that patients after major operations, such as abdominal surgeries for intestinal resections, are brought back after about an hour of post-op observation during recovery to the Sde Teiman medical facility, which is staffed most of the day by a single doctor, accompanied by a nursing team, some with no more than medic training.”

He said that in some cases that single doctor is an orthopedist or gynecologist. “This ends in complications and sometimes even in the patient’s death,” the doctor wrote.

“This makes all of us – the medical teams and you, those in charge of us in the health and defense ministries, complicit in the violation of Israeli law, and perhaps worse for me as a doctor, in the violation of my basic commitment to patients, wherever they are, as I swore when I graduated 20 years ago,” he wrote.

A released Palestinian detainee showing the marks on his wrists after he was sent back to the Gaza Strip.Credit: Screengrab from the Al Jazeera Mubasher YouTube channel

In response, the IDF spokesperson said that the army and Health Ministry “take care of the supply of medicine and medical equipment as required in the medical facility. Evacuation of patients to the medical facility is done according to their medical condition, and the decision on the matter is made exclusively in accordance with professional standards.”

Officials who have seen the doctor’s letter say they are treating it with “great seriousness” and that they have not yet been able to either confirm or refute its allegations. However, an investigation into the facility is expected.

Haaretz has learned that in recent weeks, even before the letter was sent, several meetings have been held on the matter, and they have included Avital Sompolinsky, the deputy attorney general for constitutional affairs; Health Ministry legal adviser Dana Neufeld, and officials from the military prosecutor’s office.

In his letter, the physician claimed that he had warned the Health Ministry director general in the past about problems at Sde Teiman. “The facility was staffed by Health Ministry officials; a procedure for proper restraints was issued, which was not strictly enforced; and a bioethical committee was formed to monitor the facility. Unfortunately, despite all this, and despite the good intentions and good will of the committee, there have been no substantial changes in the way the facility operates,” he wrote.

The ethics committee visited the facility at the end of February.

In his letter, the doctor claimed that the fact that the committee’s members “are worried about their legal exposure and coverage in view of their involvement in a facility that is operated contrary to the provisions of the existing law is worrying.”

Detainees at the Sde Teiman facility.

The IDF spokesperson stated in response: “The IDF operates according to the law and within the framework of the law when it comes to the treatment of detainees. Every procedure is documented and monitored, and is done with extreme care for the human dignity of the detainees, in accordance with the principles of Israeli and international law.

“The [Sde Teiman] medical facility treats detainees who are terrorist operatives or suspected terrorist operatives captured during IDF operations in the Gaza Strip, among whom are those considered very dangerous and intent on harming any Israeli, even the medical staff,” it said.

The Health Ministry said that “the medical treatment provided at the Sde Teiman complies with the international rules and treaties to which Israel is committed. To ensure this, the ministry relies on legal advice and the support of an ethics committee. Evacuation of patients is done in coordination with all the security forces. It is important to note that senior ministry officials visit the facility from time to time and closely monitor the treatment being given and are in contact with the medical staff.”