The ABC’s unhealthy coverage of Gaza’s antibiotic resistance problem

An ability to differentiate genuine news from propaganda is a basic skill required of journalists – whether you work for a high school newspaper or a 90-year-old, $1 billion-a-year publicly funded national broadcaster like the ABC.

A salutary illustration of what happens when this basic journalistic obligation is ignored took the form of an ABC Radio National “Breakfast” report titled “Superbugs on the rise in war zones,” broadcast on Jan. 3, 2019 which has prompted AIJAC to lodge a complaint with the ABC.

The 12-minute, 45-second segment hinged on claims originally made by an obscure UK news organisation called the Bureau of Investigative Journalism (BIJ), working in conjunction with the Guardian, to produce an article released on Dec. 31, 2018 highlighting claims there are high levels of antibiotic resistance to superbugs in Gaza and, to a lesser extent, in the West Bank.

The article was slammed by Adam Levick of UK Media Watch for attributing Gaza’s high levels of antibiotic resistance to a shortage of medicines and the absence of basic infrastructure needed to supply clean water and treat sewage, all of which were ultimately blamed on Israel’s blockade of Gaza.

With Egypt’s co-enforcement of the blockade not mentioned and Hamas nowhere acknowledged as the Strip’s long-standing government, the article implicitly held Israel totally responsible for the dismal state of affairs in Gaza.

In sharing the article’s claims with the ABC’s audience, the “Breakfast” producers went for a one-on-one interview with ANU Professor Peter Collignon – an expert in infectious diseases.

However, based on his comments, it would appear Professor Collignon does not have any clinical or research experience in, or expert knowledge directly related to, Gaza.

“Breakfast” host Cathy van Extel’s introduction did not mention the involvement of the Guardian, which has a track record of anti-Israel activism masquerading as journalism.

The Bureau of Investigative Journalism’s report was presented in terms that might have misled listeners into thinking it had scientific or medical standing, which it did not. It was simply a work of supposed journalism.

According to van Extel:

“The rise of infectious diseases that resist treatment with antibiotics is never more clear than in war zones. It’s a problem that’s been highlighted by a new report on Palestine. The Bureau of Investigative Journalism interviewed doctors in Gaza and the West Bank who say they’re battling an epidemic of antibiotic-resistant superbugs. It found that Gaza is a particularly fertile breeding ground for superbugs because its health system has suffered under the Israeli blockade, and antibiotics are in short supply.”

Professor Collignon spoke in general terms about the causes of antibiotic resistance and, rightly, did not presume to pass judgment on the political and economic causes of the alleged epidemic.

Professor Collignon said, a “major issue for the population is the water supply. Often that is wrong, so the sewage doesn’t work properly, so you spread bugs from people to people via water.”

He also noted that sewage and water infrastructure is a major factor in antibiotic resistance.

Professor Collignon said there is higher antibiotic resistance in areas where there is greater corruption:

“If you have more corruption you follow rules less often. So, substandard things get done. People don’t check the types of antibiotics, you’re going to get counterfeit ones. People dump stuff into waterways…you might have rules but nobody follows them.”

Professor Collignon’s reference to corruption was the perfect opportunity to introduce the issue of Hamas’ leadership but at no point did van Extel mention the responsibility of Hamas as the de facto government in Gaza.

Instead, van Extel asked, “So when we are talking about Palestine, for example then, and the problems there. You’re talking about this issue around water and sewage infrastructure and those problems there are very well known, what are the implications for not just Palestine but for neighbouring countries if we are talking about water and sewerage?”

Professor Collignon answered, “Well first of all it’s what water comes into them and from where and even if it is contaminated, have they the ability to chlorinate it properly so that you decrease the bug levels. But it’s got a lot of implications because where does their water go? You know, who does it travel to? And this is an issue globally…”

But he didn’t get to continue that thought because van Extel cut in to ask, “so is this an issue for Israel then? I’m just wondering given that they’re instituting this blockade, is it at their own detriment ultimately?”

Given the blockade is also enforced by Egypt, which was not mentioned at all during the ABC report, van Extel’s attribution of blame solely to Israel both in this question and the introduction is prejudicial to the report meeting the standards of accuracy and balance the ABC is obligated to meet under its charter.

Professor Collignon’s response to van Extel seemed to be speculative, saying, “Well it is, and Israel can have fairly higher, much higher levels of antibiotic resistance as well. Now whether that’s coming because it’s coming across from the Gaza to them, I can’t answer that.” This highlighted his inappropriateness as an expert to talk about the kinds of political questions that van Extel and the ABC appeared to want to discuss in the interview.

The passive acceptance of the BIJ/Guardian report’s claims without any apparent attempt to confirm or put them in context resulted in the ABC failing to meet its basic statutory requirements to be fair and accurate.

The report therefore requires a comprehensive debunking. Part of the following analysis relies upon the excellent work of UK Media Watch and its American sister organisation, CAMERA.

The Bureau of Investigative Journalism

In its mission statement, the Bureau of Investigative Journalism describes itself as “an independent, not-for-profit organisation that holds power to account.”

It also says its “aim is to inform the public about the realities of power in today’s world… We inform the public through in-depth investigative journalism, with no corporate or political agenda.”

It has been involved in at least one major journalistic scandal – the Newsnight McAlpine affair in November 2012, in which false paedophilia allegations were made against a prominent conservative peer, leading to the resignation of both the BBC director-general and the BIJ’s managing editor.

Maybe it should have placed more emphasis on establishing the truth and fact finding, instead of focusing on the “realities of power”?

The blockade of Gaza

The implication by van Extel, that Israel alone is responsible for the blockade of Gaza, is obviously false. It is enforced by Egypt as well as Israel. This is a basic fact that has been reported by the ABC numerous times.

An AP/Reuters report on the ABC website on Nov. 14, 2018 states:

Hamas, an Islamic militant group that opposes Israel’s existence, seized control of the Gaza Strip from the internationally recognised Palestinian Authority in 2007.

Israel and Egypt immediately imposed a blockade on Gaza to contain Hamas.

Egypt and Gaza share a border that is totally independent of Israeli control.

The Egyptian Government determines its own policy on the movement of people and goods into and out of its territory from Gaza.

According to authoritative Arab journalist Khaled Abu-Toameh:

Since 2009, the Egyptian authorities, with few exceptions, have kept the Rafah border crossing with Gaza closed. That year, the terminal was open for a total of only 35 days. 2014 was a bit better, with the terminal open for 125 days. In 2015, it was open for only 32 days, while in 2016, it was open for only 41 days. Last year, 2017, was the worst: the Egyptians opened the terminal for a total of just 29 days.

Moreover, this limited traffic mostly relates only to people and not goods.

According to a Reuters story by Nidal al-Mughrabi from January 2017 looking at the Rafah crossing:

Egypt had insisted for years that the Rafah crossing – which it opens for a three-to-five day period about once every 40 days – would handle the passage of only people, not goods.

The report stated the reasons for the tight restrictions on people and goods:

Egypt’s government has accused Hamas of aiding the Islamic State-linked militant groups in the Sinai and of intervening on behalf of Islamist allies in Egyptian politics. Hamas denies those allegations.

In contrast, Israel lets in, through its crossings with Gaza, most goods except those items that have the potential to be diverted by Hamas for military purposes.

Shortages of medicines and the blockade 

The imputation in van Extel’s introduction that the blockade of Gaza is responsible for the shortage of antibiotics there is also false.

On July 13, 2017, the ABC’s then Middle East correspondent Sophie McNeill reported on the deliberate decision by the Palestinian Authority on the West Bank to halt shipments of medicines into Gaza.

According to McNeill’s report:

It has been 10 years since the militant Islamist group Hamas took control of Gaza from the Palestinian Authority in the West Bank in June 2007.

Since then, Gaza has been subjected to a tight blockade by Israel and then Egypt, but Hamas has maintained its grip on power.

Now, the designated terror group is coming under new pressure. Its political rival, Fatah, which runs the Palestinian Authority led by President Mahmoud Abbas in the West Bank, is sick of paying the bills for Hamas to run Gaza.

Fatah is trying to squeeze the militant group by decreasing services to the Strip — like electricitysalaries, and now health care.

“The last few months we’ve seen this confrontation between the Palestinian Authority and Hamas … that’s translated into some pretty tough measures that are being felt across the Gaza Strip,” Robert Piper, the UN Humanitarian co-ordinator for Gaza, said….

Mr Piper says the first impact was seen when the amount of medicine the Ministry of Health sent to Gaza sharply diminished.

“There was an unambiguously substantial drop in the availability of essential drugs in Gaza. Some 35-40 per cent of essential drugs are now not available,” he explained.

“It’s been almost three months since a bulk shipment of essential drugs has come from the West Bank to Gaza.”

On Feb. 8, 2018, a United Nations Office for the Coordination of Humanitarian Affairs (OCHA) bulletin blamed the shortage of medicines in Gaza on the Palestinian Authority’s conflict with Hamas:

By December 2017, 44 per cent of essential medicines and 28 per cent of essential disposables at the MoH’s Central Drug Storage in Gaza were at zero stock, which is defined as less than one month’s supply. The PA is responsible for the funding, purchase and delivery of medicines from the West Bank to government hospitals and clinics in the Gaza Strip. The escalation in internal Palestinian divisions in March 2017 led to a decline in deliveries from the West Bank and the gradual rise in the percentage of essential medicines at zero stock. 

Hamas refuses to accept medicines or fuel from Israel

Another significant factor affecting the availability of medicines in Gaza is the deliberate decision by Hamas to reject aid if it is of Israeli origin.

According to the Coordinator of Government Activities in the Territories (COGAT) – the Israeli department responsible for liaising with Hamas in Gaza and the Palestinian Authority on the West Bank – on May 16, 2018:

Last night trucks loaded with Israeli medical supplies were returned from Gaza to Israel. Why? Because the humanitarian aid came from Israel. The Hamas terrorist organization prefers that Gazans die from lack of proper medical care, rather than to receive equipment from Israel.

According to a report in the Times of Israel, the delay in the shipment to Gaza, was due to:

Four of the shipments were from the Palestinian Authority, two from the United Nations Children’s Fund and two were provided by the Israel Defense Forces’ Technological and Logistics Directorate. According to Israel, the IDF shipments included IV fluids, bandages, pediatric equipment and disinfectants, as well as fuel for hospital generators. However, on Wednesday morning, after the trucks passed through the crossing, Hamas officials saw that the two shipments from Israel had labels identifying them as coming from the IDF and sent them back, according to the Coordinator of Government Activities in the Territories liaison unit.

On Feb. 8, 2018, in the Israeli newspaper Haaretz, which is a major and trusted source for ABC correspondents, Amira Hass reported:

Some argue that the shortages are politically motivated, constituting part of the pressure the PA applies on Hamas. The question of why Hamas spends money on rearmament and on electricity for mosques and not on public health is being asked, but not openly.

Hamas’ policy is not a one-off, either.

In 2012, the Palestinian news service Maan reported:

The Gaza government… is reluctant to accept fuel to be delivered via the Israeli-controlled Kerem Shalom crossing.

And when Hamas is not actively preventing medicines or fuel from reaching Gaza, the Palestinian Authority is also trying to stop it.  

Hamas blames Palestinian Authority and Egypt

Hamas itself also blames the shortages of medicines on the actions of the Palestinian Authority.

An Aug. 6 2015, article in al-Monitor noted the comments of Gaza Ministry of Health spokesperson Ashraf al-Qudra who:

accused the Palestinian consensus government of not fulfilling its duties toward Gaza, saying, “The Ministry of Health under the consensus government should transfer 40% of its medicine in Ramallah, most of which is provided by international parties, to the Gaza Strip, while 60% remains for the West Bank. However, only around 5% to 7% actually reaches the strip.”

Al-Qudra also blamed Egypt which, unlike Israel, actually does block the entry of medicines into Gaza:

“That the Egyptian side has been preventing convoys of support and relief to enter through the Rafah crossing on the border with Egypt since former President Mohamed Morsi was overthrown in 2013 led to depriving the strip of 30% of its medical needs, gradually resulting in a decline in pharmaceutical [reserves].”

In September 2012, the Palestinian news service Maan reported a Hamas spokesperson saying that Egypt under the then presidency of the Muslim Brotherhood’s Mohamad Morsi was refusing to transfer fuel to Gaza:

Egyptian authorities refuse to transfer the fuel from Qatar to the Gaza Strip,” the authority said. “The Gaza power station needs urgent help as it is at half its capacity due to the lack of power.

Gaza had been plagued by a fuel crisis since mid-February, when Egypt cut off supplies via a tunnel network running under its border with the enclave.

New York Times’ correction on blockade and medicines 

On Sept. 15 2016, the New York Times issued a correction for an earlier article that had claimed Israel restricts the flow of medicines into Gaza, as the ABC strongly implied in its January 3 “Breakfast” story.

The correction admitted that:

The article also overstated the impact of Israeli restrictions on travel and trade in the Gaza Strip…Although the restrictions have made the import of some medical equipment difficult, the import of medicine is not restricted.

Gaza’s water quality

Similarly, the quality of the water accessible to Gazans is not only linked to the blockade, but to the legacy of decades of poor water management practices by both the Hamas Government and the Palestinian Authority.

According to Reuters reporter Nidal al-Mughrabi in January 2017 the water sources for Gaza have become contaminated:

The causes of the problem are multiple, but stem largely from the contamination of the aquifer. Gaza’s main water source contains 55 to 60 million cubic meters of water over the course of a year, but demand from Gaza’s two million population exceeds 200 million cubic meters. That means the aquifer is over-strained, allowing seawater from the Mediterranean to seep into it, along with sewage and chemical run-off.

A World Bank article from November 2016 on Gaza’s water crisis quoted Adnan Ghosheh, its senior water and sanitation specialist, who explained the problems with the water were due to overuse of the main aquifer that supplied the territory:

Adnan Ghosheh, Senior Water & Sanitation Specialist, remembers a time not so long ago when everyone in Gaza could drink water from their tap. That was in the late 1990s, but so much water has been pumped out of the natural aquifer underneath Gaza since then that seawater has seeped in, making it too salty to drink. These and other factors mean that only 10% of Gaza’s population has access to safe drinking water, compared to 90% in the West Bank or about 85% in MENA in general.

In an interview with Haaretz, Ghosheh explained that poor maintenance of water pipes significantly affects the amount of water in Gaza:

“There are things the PA can do – like, for example, efficiency. Before Israel started to desalinate water, it tackled reducing the loss of water in pipelines. About 38 percent of the water in Gaza gets lost.”

Gaza’s $100 million waste treatment plant shut

In the ABC Radio National interview, Professor Collignon raised the issue of sewage as an important factor in antibiotic resistance – but Gaza’s sewage problems are larger than the Israeli blockade, as was implied in the ABC broadcast.

A $100 million waste plant was built many years ago but it often sits idle, either because Hamas refuses to allocate the electricity needed, or the Palestinian Authority pulls rank and tells Israel to stop supplying power, as the Washington Post reported in September 2017:

About 100,000 cubic meters of raw or partially treated sewage have flowed into the sea each day since early summer, when Palestinian President Mahmoud Abbas asked Israel to cut the power supply to Gaza amid a worsening feud with Hamas, the militant movement that controls the enclave. The power shortage means that sewage-treatment plants can’t function.

Hamas does not believe it should pay for the fuel needed to run the power plant either.

The sewage also affects Israel, threatening its coastline, as van Extel noted in her questioning, but the blockade is irrelevant to this fact, despite the implication made by van Extel.

A new sewage plant in north Gaza was completed in March 2018 paid for with international funding. Its construction was not impeded by the blockade. According to the World Bank, it will meet the needs of 400,000 Gazans.

Significantly the World Bank notes that, “the Palestinian stakeholders need to reach an agreement on financing the cost of operating [the North Gaza Wastewater Treatment Plant] including cost recovery measures.”

Also in March 2018, the European Union announced that 456 million euros had been raised to build a desalination plant in the Gaza Strip, to provide around two million people with safe drinking water. Israel’s defence minister at the time, Avigdor Liberman, was quoted saying that “Israel will not impede any internationally funded projects designed to improve the quality of life for Gazans”.

Hamas refuses to build infrastructure 

Beyond the issue of contamination and overuse is the simple reality that Hamas has refused multiple efforts to invest money in the technology needed to ensure clean water is available in Gaza.

As this New York Times editorial on Feb. 13, 2018, that was harshly critical of Israel noted, Hamas has had other priorities:

While the blockade and Israeli military attacks have ruined Gaza, there is no defending Hamas, which regularly fires rockets across the border into Israel. Money that should have gone to hospitals and medicine has been spent on futile confrontation with Israel and digging tunnels that the Israelis are now spending a small fortune to block…Israel recently called on donor countries to fund $1 billion in desperately needed water and energy.

Israel has repeatedly proposed or backed efforts to build plants to deal with water and sewage issues.

In 2009, a plan to build a $50 million sewage and sanitation facility was agreed to by the Palestinian Authority, Gaza’s mayor and his counterpart in the nearby Israeli city of Ashkelon.

The deal was to be signed at the XVII International Media Seminar on Peace in the Middle East, a conference on Middle East peacemaking co-hosted by the United Nations’ Department of Public Information and the Brazilian Government.

It was scuttled by Hamas, which refused to issue exit permits for the relevant Gaza officials to attend the signing ceremony in Brazil.

Conclusion

It is disappointing that ABC listeners were given an unbalanced and misleading understanding of the health and infrastructure landscape in Gaza, and its role in the antibiotic-resistance problem there.

These shortcomings arose from what appeared to be an uncritical acceptance of the source material, followed by inadequate research to verify the details of the original report, and compounded by the reliance on a single expert who lacked the knowledge and background to speak to important aspects of the specific claims.

It is not a good start to 2019 for the ABC.