Change ordinarily involves a shock. To Israelis, the Palestinian uprising, known as the Intifada, was a great shock. In January 1988, one month after the uprising began, I organized a group of physicians, and together we visited Shifa' Hospital in Gaza. It was my first visit to Gaza. We walked into an old hospital that smelled of urine and filth. The walls were covered with mold; operating rooms were supplied with minimal and outdated medical equipment. We saw wounded people, many with broken limbs and head injuries; some were unconscious after having been beaten. Others had been shot at short range. We heard horrible stories of physical and mental cruelty.
I saw a 14-year-old boy; the palm of his hand had been broken in three places. I asked him what had happened. The boy looked at me, did not was a word and lifted his plastered hand above his head, in a protective gesture. I was silent, speechless, and flooded by great shame followed by deep anger. As our group left Gaza, each of us carried a heavy emotional load. We did not return directly to Tel Aviv, but sat at a kiosk along the road and talked about what we had seen. That was the beginning of the Association for Israeli-Palestinian Physicians for Human Rights (PHR).
We innocently thought that if we would share the terrible facts which we had witnessed with the Israeli public, many would react as we did: with utter shock, great shame, and an intense need to fight against this situation. What we did not know then, is that powerful psychological forces and entrenched political interests would cause other Israelis to react very differently to the same reality.

Avoiding the Reality

The Poet T.S. Eliot stated that humans "cannot bear very much reality." The Israeli human-rights violations in the occupied territories have produced an overdose of reality. Two different psychological processes are at work here. The first is the unconscious denial of reality, which is the dominant defense mechanism employed by the public. The second is a conscious and deliberate disregard of uncomfortable facts.

The two groups together, each with its mode of reaction, make up the national consensus and the positions held by the policy makers. Thus, the policy makers' disregard for reality intends to minimize and flatten public debate. The self-serving restriction of public discussion actually defines the "national consensus." It receives full cooperation from the public for whom the denial of facts is a way of protecting a valued self-image. In this way the national consensus is constructed by leaders interested in concealment and mystification, and by followers interested in remaining oblivious.

Denying the Facts

The Israeli-Zionist world view which underlies the consensus is based, among other things, on several basic assumptions relevant to the subject of human rights. As a collective we are always victims, always right, always humane and, most importantly, must always be united. Complementary and opposite to the way in which we perceive ourselves is the way we perceive the other, in this case, the Palestinians: as inhumane aggressors, unscrupulous and treacherous.

In the course of the last ten years, since our first visit to Gaza, we have seen that our initial expectation - that the Israeli public would be as shocked as we were by the facts, and would respond to them as we did - was indeed naive. Our activities have been looked upon with disdain, hatred and fear. People did not want to confront the facts. As chair of PHR, this rage was often directed against me. For several years, I received frequent phone calls threatening me and accusing me of being a traitor, and a self-hating Jew.
World-view is highly resistant to change, and modifying it requires a stubborn persistence. The activities of an NGO such as PHR may, through a prolonged and complicated process, change individual and societal perceptions of reality as well as governmental policies. We strive to bring to the public facts and information which were previously ignored. In order to do so, we attempt to develop effective strategies which counteract the psychological defenses used by the groups. Thus, intervention of human-rights NGOs such as PHR involves a constant struggle against the psychological comfort and convenience of both the public and government officials.
Through the legal system, the domestic and international media, through reports that we publish, and through NGOs working outside of Israel, we insist on bringing the facts as they are into the public arena. Thus we try to prevent policy-makers from employing a strategy of disregard and deligitimization.
But once the facts do manage to enter the public domain, policy-makers use another tactic in order to justify the existing policies. For example, torture, or the prevention of movement of patients and doctors at border crossings, are justified as "crucial for achieving security." Saying "security" and taking up the victim position is deeply rooted in the Israeli Jewish collective experience. Our efforts to question and shake that powerful word - security - have had little, if any, success.
We often cooperate with other NGOs that share similar tactics. Increasingly over the last few years. PHR's views and activities have also elicited some positive changes, both on the level of government policy and on the level of Israeli public opinion. What follows are two short episodes which illustrate different forms of intervention, success and failure in the PHR stand.

Torture is Taboo

In June 1993, PHR organized the first and only international conference on Torture in Israel. As a result, I was invited to talk about PHR's activities on a popular TV talk show. I brought with me Z., a Palestinian who became catatonic as a result of torture. At the time, the use of torture against Palestinians was extremely widespread. People were taken from their homes in the middle of the night and did not return for many weeks. In most cases the families didn't and couldn't know where the detainee was being held. During detention people were brutally beaten, and various legally sanctioned "physical pressures" were used against them.
(Such "moderate physical pressure" had been declared permissible by the Israeli authorities.)
Z. was detained in September of 1992. At the same time, four other Palestinian men were detained. All were taken to prison in Tulkarem. One died during investigation; that is, he died of torture. Z. lost his sanity and remains in a catatonic state today. He is no longer in touch with reality. We were able to learn what had happened in the investigation from the stories of the other three prisoners, which tell of cruel actions I prefer not to describe here.
In 1993, the term "torture" was still taboo in Israel. The systematic use of torture completely contradicted the self-image that "we are human and untainted." As a result, there was a complete denial of torture in the Israeli public and the media. So much so that the Israeli Minister of Justice, Professor David Liba'i said: "There isn't any torture in the State of Israel. Our security services do not torture.
In the TV show to which I brought Z., we were scheduled to be included in the circle of guests and to speak for 15 minutes. The host of the show saw us and immediately placed Z. in the audience. I was seated far from the camera. When I realized that most of the program was over and we had not been called to speak, I stood up and said loudly: "While you and the audience at home are having fun, people are losing their minds because of pain and fear. I call it torture." I pointed to Z., who was sitting stone-like. The camera followed my hand.
Yossi Peled, an important Israeli general who was the prime guest at the show shouted back: "It is inconceivable that torture is practiced in Israel." The audience applauded. I answered: "You are applauding because you are hearing what you want to hear. I can tell you, this man and thousands like him are being systematically tortured by Israeli interrogators." No one spoke and no one applauded. Peled's phrasing is revealing: "It is inconceivable" that in the State of Israel torture is carried out. That is to say, Israelis cannot possibly carry out torture. The possibility that torture is practiced in Israel is antithetical to our self-image to the extent that it becomes inconceivable.
In the TV show, all the elements of the Israeli situation played a part: General (Res.)Peled as a policy maker; Z. as the victim of torture; myself as the critic of the consensus, and the audience representing the majority of the Israeli public. In that drama the official spokesperson lies, and the the audience is glad to be offered an idealized image of itself; the victim stays silent, and the critic cries out, trying to undo the fabric of the comfortable national consensus. The silence at the end of my dispute with Yossi Peled was a sign that the audience experienced a certain shock. This shock might have opened the eyes of some and perhaps even initiated the need for better reality testing.

How 'We Israelis' Look

In the past eight years, PHR has conducted monthly mobile clinics in the West Bank. Specialist physicians, some of them heads of hospital departments, nurses, physiotherapist and other volunteers take part in this activity. We go out once a month, on a weekend, to a village, set up a clinic at the local school, or in the municipal building and examine about 300 patients in one such day. The mobile clinic cannot and odes not pretend to solve medical problems on a national (Palestinian) scale. It is a relatively small part of PHR's activities, and not at the top of our list of priorities - yet it has been significantly covered by the media, far more than other projects.
Why? The answer lies in the way we are presented. We are described as a group of Israelis who help out on a voluntary basis, making a humanitarian gesture of mercy. We are depicted as the benevolent and non-political segment of society, trivializing the political aspect of our activity. PHR intended to show a more precise picture of the reality, but instead of presenting the grave medical problems resulting from intentional neglect during 30 years of occupation, "we Israelis" are made to look altruistic, humane and helpful to the Palestinians. Instead of building a bridge between people, we are portrayed as patronizing; instead of acting in solidarity, we are portrayed as condescending; instead of making a political protest, our activity is illustrated as a non-political humanitarian mission. In such ways, Israeli society protects the basic assumptions of its consensual worldview while identifying itself with PHR or other groups who actually object to this worldview.

NGO or Instrument of GOvernment?

We forced Israeli society to confront things which it did not wish to deal with at all. We insisted on seeing Palestinians as persons with human rights. This was expressed, for example, in taking to court demands for reparations for damages to body and soul resulting from torture and other kinds of injuries. We insisted on fighting torture and on raising public discussions about it. For years we insisted on free passage for physicians and patients in times of curfews and closures. Patients who in the past received an unsigned and unreasoned refusal of medical treatment now receive a signed refusal, which includes an explanation of what is lacking in their request. Now the patient at least knows what s/he is supposed to do and can initiate an appeal. In other words, we managed to initiate an attitude of respect for the Palestinians instead of an attitude of humiliation. This is significant.
We believe that organizations for human rights must necessarily define themselves as detached from the consensus and remain critical of it. The courage to be on the outside, and the awareness of the consequences of having chosen this role, determine whether a human-rights NGO will be able to do its work or will be coopted by the regime and become a fig leaf for the existing political order. In the final analysis, it determines whether an NGO is really a non-governmental organization or merely an instrument of the government.
It is clear to Physicians for Human Rights that human-rights violations demand political discussion, and moreover that human rights cannot be separated from politics. Neither can the connection between medicine, politics and human rights be ignored. Without this understanding, it is impossible to comprehend our existence as an NGO for the last 10 years and the obligation which motivates to constantly intervene.

This article was enabled due to a grant of the Jeanne and Joseph Sullivan Women's Middle East Peace Fellow at the Bunting Institute of Radcliffe College.