The Israeli army massacre after freeing four hostages in Gaza: ‘The bombings came from all directions’
By Antonio Pita, El Pais, 11 June 2024
Israel admits nearly 100 people were killed in Saturday’s operation in the Nuseirat refugee camp, while the Hamas-controlled Ministry of Health puts the number at 274, including dozens of children and women.
Julud Shalaq, a displaced Gazan, holds a small child with a bandaged head and wounds on his face. “He is the only one of the family that has survived,” he explains. “Him and his mother. The rest are gone [died], about 14. Even more than 14, because they are there among the rubble. The streets are full of corpses.” It is one of the stories, collected by the Al Jazeera television network, that have come to light of the massacre that occurred in the Nuseirat refugee camp on Saturday, when the Israeli army freed four hostages in a surprise operation involving hundreds of soldiers. While Israel has celebrated the success of the rescue (the largest of the war), the Gazans have been discovering the cost of it as the hours go by. Although the death toll is not clear, it is one of the largest massacres in eight months of war.
On Sunday, the Ministry of Health of the Hamas government in Gaza raised the death toll to 274 (including 64 children and 57 women) and the number of wounded to 698. Israeli military spokesman Daniel Hagari admitted he was aware of a death toll “below 100.” “I don’t know how many of them are terrorists,” he clarified. A day later, another army spokesman, Peter Lerner, refused to give figures or confirm civilians among the victims: “Hamas also doesn’t know how many civilians have been killed,” he posted on X (formerly Twitter).
The victims were transferred to two hospitals: Al-Awda, which had to extend its facilities and reported receiving 116 bodies; and Al-Aqsa Martyrs, which depends on a single electrical generator to function, has been operating above its capacities for months, and collapsed after receiving up to 94 bodies. “Total chaos,” was how Karin Huster, medical coordinator for Doctors Without Borders at Al-Aqsa Martyrs, described the situation, saying the emergency room was “completely packed with patients on the floor coming from the bombings in Nuseirat.” In a short time, up to hundreds of wounded people were in the hospital, including children and women, with “the gamut of war wounds,” she said in an audio recording released by the NGO. The Gaza Ministry of Health asked people to come and donate blood and lamented that the ambulances could not respond to all requests for help.
The images broadcast by television channels with a presence on the ground (Israel has banned the international press from entering Gaza) and by witnesses on social media show intense aerial bombardments causing columns of smoke, as well as buildings in ruins and dead and injured people on the floor. Artillery and automatic rifle fire can also be heard in the background, while dozens of civilians run for cover, scream in fear, or try to record the scene with their cell phones.
“The bombing and gunshots came from all directions. I didn’t even know where they were coming from. I am 32 years old, and I never thought I would live a moment like this,” recalled Mohamed Al Tahrani, one of the residents of the refugee camp. Three unidentified children cry uncontrollably on camera in nearby Deir al-Balah as they explain that they come from the Al-Dawa mosque area, which is in Nuseirat, an hour’s walk away. “We went to buy bread, and they did this to us,” explains one, referring to the bombings. They don’t know where their parents are.
Another resident of Nuseirat, Nidal Abdo, who was shopping at the market, estimated that around 150 rockets fell in less than 10 minutes. “While we were running away more fell on the market,” he told CNN. In a video, a boy is seen crying as he explains that he saw his friend die in front of him: “We saw him die with our own eyes. He was at the Abu Sarar roundabout [one of the bombed areas of Nuseirat], they bombed it, and he died on the bicycle.” There is an image of a dead child in the middle of the road, still on the bicycle.
The armed wing of Hamas, the Izz ad-Din al-Qassam Brigades, has claimed that the Israeli Defense Forces (IDF) killed three hostages (of the 120 remaining in Gaza) in the bombings to free the four captives, and that one also has U.S. nationality. Shortly after, it released a video of psychological warfare showing three bodies, but the footage is unclear and their identities and cause of death cannot be determined. The Israeli army has “categorically” denied this.
The IDF has admitted that they opened fire on land, sea and air, as various militiamen tried to prevent the rescue with intense fire from all directions. One border police officer was killed. The undercover Israeli troops were discovered and word spread. In the images, Palestinians are seen fleeing the bombed area while shouting to others to stay away because there are “violent explosions” and “special forces.”
These “special forces” were mista’aravim, the unit of soldiers who learn to blend in with the Arabs to infiltrate Palestinian territory, portrayed in the well-known television series Fauda. They carried mattresses in the vehicle to pose as one of the hundreds of thousands of displaced people from the Rafah area (where Israel began an offensive last month) who were looking to rent an apartment in Nuseirat. Others were disguised as Hamas militiamen.
Israeli television, witnesses and images have provided details of the rescue operation, which lasted about two hours from the first bombings. The soldiers were in two vehicles, “a small Nissan brand; and a big truck,” according to what a witness told television. Israel has denied it was a truck used to bring in humanitarian aid. In the images captured in the area, it appears to be a commercial one.
Forces from an operational unit of the intelligence services and an elite unit of the border police then got out of the vehicles and moved quickly between tents, while aircraft continued bombing the area as support. “I made sure that there would be a rain of fire at a relatively high rate to ensure that no one approached the vehicle,” the commander of the air mission, a captain identified only by the call sign Alef, told the military correspondent of Israeli television Channel 12, Nir Dvori. A drone killed a militiaman with a grenade launcher who was preparing to shoot at the truck.
The troops made a hole in a wall to access one of the two buildings. They entered the two apartments simultaneously to prevent anyone from notifying the other captors. In one building was Noa Argamani; in the other, about 200 meters away, the three men: Almog Meir Jan, Andrey Kozlov and Shlomi Ziv. The four had been taken hostage in the Hamas October 7 attacks on an open-air festival near Gaza.
The evacuation vehicle had a technical problem and could not move off the street. To prevent it from being surrounded by militiamen, the IDF mobilized several tanks that were stationed nearby for emergency situations. The air force continued to bombard the entire area extensively, according to the captain. Fifteen minutes later, they towed the vehicle to the coast, where helicopters took the hostages out of Gaza. The United States has denied that the helicopters left from the temporary pier it has installed for the entry of humanitarian aid.
Strategic threats
A typical strategy to maintain the secrecy status quo is the threat to boycott markets.
“I have done hundreds of these negotiations,” says Francis Arickx, head of pharmaceutical policy at the Belgian National Institute for Health and Disability Insurance. “The threat that the company is not going to sit at the negotiating table, we hear it all the time and we hear it everywhere.”
KCE, a state-funded institute in Belgium, tried in 2016 to examine the secret discount deals signed by national authorities. They wanted to present results without divulging any protected data about specific deals. Yet after pressure from the Belgian Pharmaceutical Association, a watered-down study was released, excluding any analysis of those deals. The study did however reveal that the association had threatened to sue prior to publication.
When a big Swiss drugmaker pushed for a higher price in Austria, Clemens Auer alleges that a representative reminded him of the investments they had made there, implying that those were at risk if a favourable deal was not agreed. “It's always the same stupid, very primitive game,” he says.
Denmark and Germany, two countries that allow companies to initially set official prices freely, are usually the first entry points in Europe.
In practice, Denmark places some ‘voluntary’ price limits, while Germany reviews each medicine one year after introduction and can then ask for price changes. Meanwhile, the initial high prices are used as a reference by others, while setting their own official prices. What happens next in the two countries is shrouded in secrecy. Danish hospitals procure the most expensive medicines with confidential discounts, but these deals do not appear on Euripid, the European pricing database, Danish officials say.
Germany is even more opaque. It vetoed a World Health Organisation resolution on price transparency and it is not even part of Euripid.
“We always ask the companies ‘tell us, please, the real price in Germany’. They say they don’t know,” says one European negotiator, who requested anonymity. “I just can’t believe [there are no confidential discounts] because they have a really powerful market, they could get the best prices in Europe. Maybe it’s possible but I really can’t believe it.”
The rest of Europe is starting from a step behind. A pharmacist working for a Hungarian subsidiary of a multinational drugmaker puts it bluntly: "For a company like Novartis or Pfizer, the Hungarian market is a rounding error.”
Worst situation in Hungary, Malta and Cyprus
Investigate Europe found that Hungary is among several states locked out of access to critical medicines.
German research institute IQWiG compiled a list of 32 medicines for Investigate Europe and its German partners NDR, WDR and Süddeutsche Zeitung. These drugs, according to the scientists, have a "significant" or "considerable" additional benefit to existing therapies. They included treatments for conditions including breast cancer, leukaemia and cystic fibrosis.
Data collected from across Europe reveals that in six EU countries one-in-four of these important medicines is missing. Without purchasing agreements between countries and companies, which are the basis for reimbursement, health authorities have to resort to other costly methods to obtain a drug, or miss out on access altogether.
The situation is particularly dramatic in Hungary, where 25 out of 32 medicines are not available, and in Malta and Cyprus, where 19 and 15 medicines respectively are not generally reimbursed. Patients in Cyprus and Hungary can get some drugs by applying for individual access – but often at extortionate costs to the state. In the Baltic states and Romania, a high number of important medicines are also unavailable.
Even when medicines are made available to smaller states, prices can be excessive.
Giorgos Pamboridis, Cyprus’s former health minister, occasionally discovered that their prices were “double, triple or even five times those paid by other countries”. He is appalled that the EU allows industry to treat its members so differently. “NDAs [non-disclosure agreements] are tools for the abuse of dominant position that industry has vis-a-vis its clients, the states. Without the slightest consideration, the EU is giving up on its sole advantage, its size.”
Siloed negotiations amplify inequality, says a former Irish health official: "The 27 member states negotiating for themselves is astonishingly inefficient and leads to inequality for European citizens.”
When 10 countries including Cyprus, Greece, Italy, Malta, Portugal and Spain joined forces and signed the Valletta Declaration to cooperate on medicines procurement in 2017, industry showed zero interest, several participants told Investigate Europe.
Further north, the Beneluxa collaboration – Austria, Belgium, Ireland, Luxembourg and the Netherlands – has negotiated prices for a few high-cost drugs, mostly with small firms. Two negotiators involved said bigger companies are reluctant to join.
“The small companies say, ‘yes, with one negotiation I can access more markets, so I agree’, while the big companies seem to be boycotting this kind of initiative,” says Paolo Pertile, an economics professor at the University of Verona.
Covid-19 case
The one-time major companies negotiated EU-wide was for Covid vaccines. It showed that if pressured, industry can conceivably agree to not play one country against the other. But prices again were secret. “If the EU had used its joined forces to not agree to confidentiality clauses, this could have been a game changer,” says Sabine Vogler, head of pharmacoeconomics at Austria’s national public health institute.
Pharmaceutical companies are able to “blackmail governments”, says Luca Li Bassi, former head of the Italian Medicines Agency, who has campaigned for greater price disclosures. “If transparency is demanded, the pharmaceutical companies threaten not to give the drug.”
Meanwhile, the suspicion that every time there is a confidentiality agreement, someone else is being ripped off, was proven right when the price of the AstraZeneca Covid vaccine was leaked. In South Africa it was double that of the EU.
“Any member states’ collaboration... should guarantee the confidentiality of pricing and reimbursement agreements,” Efpia’s Moll says. “Industry participation in any member states’ collaboration on pricing, reimbursement and access-related issues should be voluntary.”
The idea that industry is the only real winner of this secrecy is widespread among negotiators like Francis Arickx, who says Belgium tried and failed to limit confidential clauses. “The opposite actually is happening; we see a very clear industry push to maintain contracts until generics or biosimilars arrive.”
EU health commissioner Stella Kyriakides is aware of the myriad issues. "Where you live shouldn't determine whether you live or die," she said when presenting a new set of laws last year. But the EU’s planned ‘pharma package’ legislation has been met with resistance. It includes no measures to tackle secrecy or confidential prices. Even an attempt to reduce market exclusivity of pharmaceutical firms was clipped by industry and member-state lobbying.
“Medicine prices are an area of national competence and linked to national health budgets,” a European Commission spokesperson told Investigate Europe. “However, as acknowledged in the Pharmaceutical Strategy for Europe, greater transparency around price information could help member states take better pricing and reimbursement decisions.”
The spokesperson said that the commission supports the work of Euripid, the European pricing database. Yet when contacted, Euripid refused to provide any data on the rising number of confidential agreements between states and pharmaceutical companies.
Now the veil of secrecy could become even thicker. A new law for “Medical Research” is under discussion in the German Parliament. If it passes, every time authorities order a price cut because a drug does not perform as promised, the rest of the world will not know. The artificially high ‘official’ prices are all they will see. Industry will be thrilled if it happens, says Josef Hecken, head of the national committee for approving new drugs. “Medicines that get steep discounts here will be sold elsewhere as gold,” he says. “Champagnes will pop in many corporate offices.”
This article is a co-publication with Investigate Europe.
