A group of Israeli public health experts have blasted human rights organizations for alleged bias regarding their criticism of Israel's policy on allowing sick Gazans to enter or pass through Israel to receive hospital care. The attacks came in a letter of protest sent by Prof. Elliot Berry, Elihu Richter and Ted Tulchinsky and Dr. Ronny Shterksall to the director of the World Health Organization (WHO) in Geneva, Dr. Margaret Chan, as well as in an article published in October by The Jerusalem Center for Public Affairs. In his article, Richter wrote that the WHO regional branch and Physicians for Human Rights-Israel (PHR-I) charge that the state is denying sick Gazans access to hospitals in Israel, Jordan and the West Bank by blocking them at the Erez crossing. In fact, however, the number of permits granted to Palestinians to exit Gaza for medical treatment increased by 45 percent between 2006 and 2007 and the trend continued during the first six months of 2008. This, even though during these years, Palestinian terrorism against targets in Sderot and the Gaza periphery increased dramatically, including attacks against the Erez crossing point itself. According to Richter's figures, 4,932 Palestinians received permits to cross into Israel in 2006, compared with 7,176 in 2007 and 8,796 in the first half of 2008. At the same time, the proportion of applications that were accepted by Israeli authorities fell drastically during the same period. Accepted applications constituted 90.2 of all applications made in 2006, 81.5 percent in 2006 and 66 percent at the end of the first six months of 2008. Richter also traced the number of rockets and mortars fired by terrorists at Israel during the same period, and found that the increased frequency of attacks did not have a negative influence on the absolute number of permits granted sick Palestinians from Gaza. At the same time, he wrote that the increase in the proportion of applications rejected by Israeli authorities between 2006 and mid-2008 was "mostly because of security reasons." As for the dramatic increase in applications for medical treatment outside the Gaza Strip, Richter quoted Prof. Rafael Walden, head of vascular surgery at Tel Hashomer Hospital, as explaining that it resulted from "system-wide breakdowns in the infrastructure of medical care in Gaza." He added that PHR-I doctors who visited Gaza hospitals reported severe shortages of basic equipment, replacement parts, broken equipment and shortages of medication. However, Richter failed to mention that the most important reason for the increase in applications to leave Gaza via Erez is the closure of the Rafah crossing between Gaza and Egypt following the Hamas takeover of Gaza in June 2007. Since then, Erez has been the only way for any Palestinian to leave the Gaza Strip, even if he wants to go to Egypt. This fact was noted in a response by PHR-I to Richter's claims. "Richter's interpretation of the facts is inaccurate," wrote the director-general, Hadas Ziv. "Since the Rafah crossing was closed on June 9, 2007, it has continued to be closed most of the time and therefore the number of sick people going through the Erez crossing has increased. This increase finds expression in the growth in the number of permits but also in the large increase in the number of rejections." In a number of High Court cases, PHR-I has charged that even after sick Palestinians have been granted permits to cross Erez, they are interrogated by the Shin Bet (Israel Security Agency) and ordered to divulge details about family members and others as a condition for being allowed to cross the border. In responding to this charge, Richter described these interrogations as non-coercive and defended them. "Non-coercive interrogation of many patients to obtain security information on those who are dangerous would seem to be an elementary precautionary measure for protecting the right to life and safety, in the light of Hamas' use of patients as suicide terrorists and its terror attacks directed at the Erez patient crossing," he wrote. In its response, PHR-I wrote that it did not oppose security checks "at the entry to Israel from Erez, but is strongly opposed to the fact that today Israel uses a permit regime and bureaucratic and psychological terrorism against people who cannot receive proper medical treatment in Gaza and are dependent on favors from Israel, even when all they ask is to cross into the West Bank or Jordan. "Richter relies on what the ISA tells him as though it is God's own truth, even though the ISA, as an organization, is not supervised by anyone and hides behind security arguments and closed doors." The human rights organization added that one of the reasons Gaza cannot provide more of its population's medical needs is because Israel controls all the border crossings and can prohibit entry of goods, including medicines and medical equipment. Israel, for example, prohibits the entry of all radioactive material, so Gaza hospitals cannot provide radiology treatment to cancer patients. On another issue, PHR-I strongly rejected Richter's charge that it did not condemn the attacks on Sderot and the treatment of IDF captive Gilad Schalit. The head of the WHO Regional Office, Tony Lowrance, charged that Richter's claims that access to hospital care for Palestinians from Gaza had improved over the past two years was "selective and misleading." Referring to the figures of applications filed and permits granted in the first six months of 2008, Lowrance said, "The bottom line is that 4,400 patients have been denied access to specialized care which they cannot receive in Gaza. This includes cardiac, cancer and orthopedic patients, some of whom are facing life-threatening situations." Lowrance described the treatment of the sick at Erez junction as "inhuman." Ambulances coming from Gaza may not cross the border and the patients, many of them too sick to walk, are wheeled to the Israeli side, where they are interrogated. According to Richter, "The interrogations, delays and refusals at checkpoints are a consequence of applying the same precautionary principles that guide questioning, frisking, body checks and baggage checks at airports, where tens of millions are forced to endure inconveniences and delay to detect and deter danger from a tiny number of terrorists." In their letter to Chan, the public health experts accused the WHO office of "continuing its tradition of focusing on referrals to Israeli hospitals as its main concern." Its failure to promote dialogue for health and human rights and to address continuous official incitement to genocide and abuse of the children of Gaza by genocidal propaganda and even training in terror bespeaks to ethical tribalism." Lowrance said in response, "We appreciate the wider issues but our concern is with health care and our mandate is the West Bank and Gaza."