Summary: Medecins du Monde’s report, Israeli and Palestinian Civilians, Victims of an Endless Conflict not only provides an in-depth analysis of the humanitarian dimensions of suicide bombings, it also seeks a new understanding of the phenomenon.

Medecins du Monde on ‘Democide’ Bombings


  • Paris-based ‘humanitarian medical NGO’, annual budget of 50m EURO. Uses the motto ‘There are no right or wrong victims.’
  • Their report, Israeli and Palestinian Civilians, Victims of an Endless Conflict, provides the first detailed examination of the psychological, social and political effect of suicide bombings on Israeli society.
  • Written by a clinical psychologist, the report introduced the new terminology ‘democide bombings’ instead of suicide bombings to describe human bombs in Israeli population centers.


Medecins du Monde (doctors of the world),, defines itself as a ‘humanitarian medical NGO.’ The Paris-based organization operates on an annual budget of approximately 50 million Euro of which almost 60% comes from private donations and 40% from public sources of financing. Since its founding in 1986, it has built up an international presence; sixty-eight missions operate in fifty-one countries — twenty-six of these projects focus on the Middle East alone. There are branches and representative offices throughout Europe, many of which have separate websites such as the UK branch,

Medecins du Monde’s team of surgeons has been particularly active in the Gaza Strip,(Link has expired)  where it has been operating since 1995. In Gaza, it primarily concentrates on training doctors and providing emergency surgical teams and ambulances — in July 2003 sixteen doctors received training certificates. Another focus of activity in the Palestinian Territories is the city of Nablus (Shechem) and the local hospitals of Rafidia, Ittihad, as well as the refugee camp of Bal?ta, where the NGO has been operating since December 2000. In these areas, Medecins du Monde’s energies have been devoted to working in trauma management, particularly among teenagers, and in conjunction with the Red Cross.

Alongside medical activities, the NGO has also produced two major reports in the past year. The first of these examines the Israeli army’s actions in the town of Nablus (Shechem) and was published in May 2002. The second report, published in July 2003, examines the psychological and political effect of Palestinian attacks on Israeli civilians.


"Israeli and Palestinian civilians, victims of an endless conflict"

On July 21 2003, Medecins du Monde issued a 71-page report (Link has expired), Israeli and Palestinian civilians, victims of an endless conflict.

This report, written by a clinical psychologist, stands in sharp contrast to silence of many self-declared humanitarian NGOs in addressing the rights of Israelis, and provides a more substantial examination than in HRW’s report, Erased in a Moment, of April 24 2002. Beyond the in-depth analysis of the humanitarian, medical and human rights dimensions of the waves of suicide bombings Israel has faced over the past nine years, Medecins du Monde also provides an important new definition of the phenomenon.

There are four important points raised and analyzed in this report that have not been discussed in other humanitarian NGO reports.


1. No justification for terror attacks

Firstly, this is the first instance of a report by a humanitarian NGO that condemns Palestinian bombing of Israeli targets without attempting to balance the crime by also discussing Israeli actions. The report explicitly states that there can be no justification for terror attacks (p.6):

There can be no justification, even political such as "struggling against the occupation" or military declaring, "we have no tanks or planes to fight the Israelis with."

In focusing on the humanitarian and non-political dimensions, the report also introduced the term "democide attacks" to emphasize that the bomb-laden suicide attacker intends to cause the most efficient killing and maiming of as many innocent civilians as possible. The report noted, for example, the use of mixing explosives with nuts and bolts to cause the highest possible amount of injuries over as wide an area as possible. The report rejects the term ‘suicide bombers’ and ‘kamikaze attacks’ (p.8), as used by Human Rights Watch in its report (April 2002).

"Suicide bombers" or "kamikaze attacks", neither of which is appropriate, were used indifferently. When we speak of a suicide bomber, the accent is placed not on the victims but on the attacker who takes their own life, which is unfair to the victims. Kamikaze refers to the action of Japanese military airmen during the second world war, who sacrificed their lives by dive-bombing onto enemy military targets. But in the so-called"kamikaze" attacks, the clearly identified target is not military but to kill as many civilians as possible. The term democide attack avoids misunderstandings, and makes the reality of the action more explicit

There is also mention of the 1949 Geneva Convention’s ‘principles of distinction’ (p.6), which demands that combatants must be clearly identified and that a distinction be made between military targets and the civilian population. Palestinian terror attacks are clearly an infringement of this principle. The report also makes clear that the first ‘democide’ attacks took place in 1994, after the Oslo accords were signed. Many other NGOs analyzed in NGO Monitor argue that the waves of attacks are a response to Israeli measures, thereby vindicating or excusing them.

2. Psychological Toll

Secondly, the report examines the psychological toll on the Israeli population and has a strong emphasis on the large numbers of sufferers of post-traumatic stress disorder, as well as the high level of fear found among Israeli children, not to mention the hardships of those who remain injured for life. There is also an overview of the ‘democide bombings’ in the historical context of modern Israel (p.43):

… it is the whole of Israeli society that is concerned, first of all symbolically, as the survivors of the Shoah being the victims of attacks, then in its very way of life, where security imperatives modify daily habits, and on an economic level.

Furthermore, the report points out that most of the victims are not only innocent women, children and the elderly but also the most vulnerable members of society in socio-economic terms. This is because the attacks have centered on buses and other forms of public transport and open-air markets.

3. Effect on Israeli Society

Thirdly, without bringing forward political or ideological arguments the report states the political consequences within Israeli society (p.7):

the main political consequence is to annihilate the development of peace camps in Israel.

This is precisely what the Islamic extremists openly stated that they wish to achieve. They have been opposed to any accommodation with Israel and believe that these attacks could only strengthen those in Israeli society least likely to make peace with the Palestinians and offer concessions.

4. Responsibility of the Palestinian Authority leadership

Fourth, Medecins du Monde acknowledges the failure of the Palestinian Authority in clamping down on these attacks and bringing their perpetrators to justice. The report explains the logic of some of the policy decisions made by Israeli governments against the Palestinian Authority (p.7);

The perpetrators of these acts of violence targeted against civilians are clearly known, since organisations such as Hamas, the Islamic Djihad, Al-Aqsa Martyrs Brigades or the PFLP, to mention but the most active, have claimed responsibility for such "operations". The organisers and their accomplices, but also those at the top of the chain of command of these movements, who give the orders, are responsible for serious breaches in International Humanitarian Law.

The Palestinian Authority cannot evade responsibility, even if only because of its ambiguity.

This attribution of responsibility to the chain of command, although not mentioning Yassir Arafat by name, stands in sharp contrast to HRW explicit unwillingness to hold the Palestinian Authority and Fatah leadership to account. Importantly too, the report makes clear that many of the attackers were minors (p.7), "this report carries the reminder that on several occasions children under 18 were used in ‘democide attacks’ and other armed actions" in a deliberate fashion. Thus, in an apolitical and non-ideological fashion, the report explains the contextual background of the terrorism that led the Israel government to implement a series of anti-terror policies that have been widely and unjustifiably condemned in the humanitarian NGO community. Of course the Palestinians are suffering from roadblocks and city closures. However, in the context of the suicide bombings or ‘democide attacks’ and the role of the Palestinian Authority, one can understand the ethical and moral basis for Israel’s decision to defend itself.

The conflict from the Palestinian perspective

It should be made clear that Medecins du Monde is far from a pro-Israel body. The NGO makes every effort to understand the conflict from the Palestinian perspective, and has been scathing of Israeli policy in the past. Its report, published May 5, 2002 jointly with the French NGO, FIDH, can be found in English translation here (Link has expired). In this report, Medecins du Monde condemns the Israeli army’s actions in Nablus (Shechem) and accuses Israel of breaches in international humanitarian law (p.43) and even war crimes (p.41). Importantly, however, the first report too maintained a sense of balance. While talking at length of Palestinian casualties as well as Israeli military actions, it includes the context of Palestinian attacks on Israeli civilians, and gives voice to the concern of Israeli army commanders.

"There are no right or wrong victims"

Medecins du Monde’s website states that "there are no right or wrong victims." In contrast to many other humanitarian NGOs active in the West Bank and Gaza Strip, this NGO has made good the pledges that it sets itself in its mission statement and its "concern to provide medical care for civilians and to bear witness to the traumatic experiences of civilian populations caught up in countless conflicts" without engaging in political and ideological activities. Its reports and web pages make clear that both sides have suffered a heavy toll in the conflict and this approach is reflected in the links and historical context the NGO offers on its website.


A real commitment to universal humanitarian rights is impossible and flawed without understanding events from all relevant perspectives and contexts. International treaties and NGO mission statements often declare that ‘human rights are absolute’ and that the right to live free from suffering is an established right. In contrast, the blanket condemnation of Israel and the use of selective morality as practiced by humanitarian NGOs such as Amnesty International, Human Rights Watch and Miftah, (included in previous editions of NGO Monitor), violates these basis terms of reference.

Medecins du Monde provides an important contrast to this pattern. Its two reports, moreover, show an effort to provide understanding of the complexities of the Middle East conflict from both an Israeli and Palestinian perspective.