The Colonial Clinic in Conflict: Towards a Medical History of the Palestinian Great Revolt, 1936–1939

Abstract

This article reconstructs how Arab doctors, medical missionaries, British counterinsurgents, and Palestinian rebels negotiated and contested the legitimate role of medical workers and healthcare in times of colonial conflict. Drawing insight from a medical anthropological literature which challenges the notion of medical neutrality as normative, and setting mandate Palestine alongside other case studies of medicine in times of conflict from the interwar Middle East and North Africa, this article argues that while healthcare and medical authority could be put to work to support the colonial status quo, they could serve other, more radical ends too. To highlight the complexity of the political positioning of medical workers and healthcare, this article focuses on the town of Hebron during the great revolt which rocked the foundations of British rule in Palestine between 1936 and 1939, and relies on a range of colonial and missionary archival sources. The first part of the article uses the case study of an Egyptian medical doctor who took up political office in the town in moments of crisis to show how medical authority could be consciously transmuted into a force to uphold a besieged political order. The second part draws on the diary of a British mission doctor to reconstruct his efforts to assert medical neutrality during the great revolt, and—more strikingly still—how Palestinian insurgents participated actively in this attempt to transplant international legal protections to Hebron. The final part traces the incorporation of healthcare into the strategies of both British counterinsurgents and Palestinian rebels, with the British policy of collective punishment indirectly but appreciably degrading access to healthcare for Palestinians, and Palestinian counterstate ambitions extending to the establishment of insurgent medical services in the hills.

Full text

ORIGINAL ARTICLE
The Colonial Clinic in Conflict: Towards a Medical
History of the Palestinian Great Revolt, 1936–1939
Chris Sandal-Wilson
1
Accepted: 11 February 2022 / Published online: 22 March 2022
The Author(s) 2022
Abstract This article reconstructs how Arab doctors, medical missionaries, British
counterinsurgents, and Palestinian rebels negotiated and contested the legitimate
role of medical workers and healthcare in times of colonial conflict. Drawing insight
from a medical anthropological literature which challenges the notion of medical
neutrality as normative, and setting mandate Palestine alongside other case studies
of medicine in times of conflict from the interwar Middle East and North Africa, this
article argues that while healthcare and medical authority could be put to work to
support the colonial status quo, they could serve other, more radical ends too. To
highlight the complexity of the political positioning of medical workers and
healthcare, this article focuses on the town of Hebron during the great revolt which
rocked the foundations of British rule in Palestine between 1936 and 1939, and
relies on a range of colonial and missionary archival sources. The first part of the
article uses the case study of an Egyptian medical doctor who took up political
office in the town in moments of crisis to show how medical authority could be
consciously transmuted into a force to uphold a besieged political order. The second
part draws on the diary of a British mission doctor to reconstruct his efforts to assert
medical neutrality during the great revolt, and—more strikingly still—how Pales-
tinian insurgents participated actively in this attempt to transplant international legal
protections to Hebron. The final part traces the incorporation of healthcare into the
strategies of both British counterinsurgents and Palestinian rebels, with the British
policy of collective punishment indirectly but appreciably degrading access to
healthcare for Palestinians, and Palestinian counterstate ambitions extending to the
establishment of insurgent medical services in the hills.
&Chris Sandal-Wilson
c.w.sandal-wilson@exeter.ac.uk
1
Present Address: Department of History, University of Exeter, Exeter, UK
123
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https://doi.org/10.1007/s11013-022-09779-0
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Keywords Colonial medicine Missionary medicine Medical neutrality 
Anti-colonial revolt Counter-insurgency Palestine British mandate Palestine 
Hebron
Introduction
Between 1936 and 1939, anti-colonial rebellion rocked the foundations of British
rule in Palestine. Beginning in April 1936, with a general strike which lasted an
unprecedented six months, the great revolt aimed to overturn British rule—
formalised in the wake of the First World War as a mandate of the newly created
League of Nations—and its commitment to establishing a Jewish national home in
Palestine. It quickly morphed into a countrywide armed uprising which was paused
in October 1936, resumed in September 1937, and ultimately suppressed in the
second half of 1939 as a result of a British counterinsurgency effort which entailed,
at its height, the deployment of tens of thousands of British soldiers to Palestine
right on the eve of the Second World War. The great revolt is perhaps the most
closely studied event in Palestinian history before 1948 (Abboushi 1977; Anderson
2018; Khalidi 2006; Provence 2011; Stein 1990; Swedenburg 2003; Yazbak 2000),
while the British counterinsurgency which eventually suppressed it has also been
the subject of much historical attention both in its own right (Anderson 2019;
Hughes 2009,2010,2019; Kelly 2017; Norris 2008), as well as in relation to its
prefiguring of the strategies of the Israeli occupation in the Palestinian territories
many decades later (Anderson 2019; Khalili 2010). For all the attention the period
has received, however, the medical history of the revolt has been overlooked. This
article highlights the multiple, profound consequences of the great revolt and its
violent suppression for histories of health and medicine in British-ruled Palestine.
Focusing on the town of Hebron in the hilly interior of Palestine, it demonstrates
that medical workers adopted a range of stances in relation to the ongoing conflict,
and argues that for both British counterinsurgents and Palestinian rebels alike,
healthcare became yet another terrain of battle.
Introducing a special issue on ‘the clinic in crisis’ in this journal in 2016, Adia
Benton and Sa’ed Atshan (2016: 153) argued for the importance of ethnographic
accounts in revealing how medical neutrality is negotiated, rather than normative, in
times of crisis today. The presumption that the clinic is impartial or safe, they argue,
is not borne out by a reality in which these spaces are routinely politicised and
embroiled in conflict; medical neutrality must be understood as ‘thoroughly
political, social, and cultural’, with doctors, too, ‘always positioned socially and
politically’. Taking its cue in part from an observation by Peter Redfield (2016:
263–264), in a response to that special issue, that there is nothing necessarily new in
contemporary failures to hold the clinic and its inhabitants apart from conflict, this
article insists on the value of historical accounts in deepening our understanding of
how medical workers and healthcare services more broadly have been politically
and socially positioned in times of crisis. More particularly, attending to these
dynamics in the context of European rule in the interwar Middle East underlines
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continuities between a historic refusal to extend the protections of international law
to conflicts involving colonial powers and their non-European subjects, and the
continued exclusion of particular sites—Palestine among them—from those
international legal norms governing war today (Wilke 2014). Mandate Palestine
was certainly not unique in the interwar decades in this respect: whether in Iraq after
the First World War (Satia 2006), Syria and Morocco in the 1920s (La Porte 2011;
Pedersen 2015), or Ethiopia and Palestine in the 1930s (Pankhurst 1999; Perugini
and Gordon 2019; Redfield 2016), neither European powers nor the international
system as represented by the League of Nations regarded such conflicts as ‘proper’
wars which needed to be conducted according to international law. But in spite of a
flourishing of work on colonial violence, policing, and counterinsurgency (Linstrum
2019; Thomas 2012; Wagner 2016), historians—with notable exceptions (Mahone
2006)—have rarely turned a medical historical lens on these moments of open
confrontation between anti-colonial movements and colonial counterinsurgencies,
or explored how medical neutrality was negotiated within these contexts.
Though both historic and contemporary parallels can be revealing, there are
specific considerations to take into account when reconstructing the political and
social positioning of medical workers and healthcare services in the context of
mandate Palestine. Although portrayed by both the British and Zionists in Palestine
as a senseless eruption of criminal violence (Kelly 2017), the great revolt cannot be
understood apart from longer histories of Palestinian economic dispossession,
political frustration, and social mobilisation. With the British support for Zionism
expressed first in the Balfour Declaration and then enshrined in the text of the
mandate for Palestine itself, European Jewish immigration and Zionist land
purchasing fuelled a crisis of landlessness among the Palestinian peasantry from the
1920s onwards; at the same time, Palestinian demands for self-determination,
democratic rule, and an end to the British commitment to Zionism met with little
success (Anderson 2017: 41). By the 1930s, new patterns of collective organising
and non-violent action—strikes, boycotts, hunger strikes, civil disobedience—had
developed, which increasingly took aim at dislodging the British mandate itself,
rather than Zionism alone, and continued alongside the rise of armed insurrection
after April 1936 (Anderson 2021). Against this backdrop, it is unsurprising that the
Palestinian medical community did not remain outside politics. From 1933 in
particular, Palestinian doctors mobilised against what they perceived to be an
existential threat in the form of the arrival into Palestine of large numbers of
European Jewish doctors (Kozma and Furas 2020: 104–105). And during the great
revolt, as well as after, some Palestinian doctors took on highly visible political
roles, like the physician and intellectual Dr Tawfiq Canaan, who penned
manifestoes about the impact of Zionism on health conditions in Palestine (Nashef
2002: 21–23). This article, by focussing on medical missionaries as well as
government-employed doctors in Hebron, de-centres these relatively well-known
figures, and draws attention to the full range of positions which medical workers
could take across the great revolt—even when they rarely expressed themselves so
vocally as Canaan.
Reconstructing the political and social positioning of these medical workers in
the absence, often, of more explicit articulations of how they themselves conceived
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of their relationship to concepts like medical neutrality poses a challenge; similarly,
healthcare was seldom directly connected to either rebel or counterinsurgency
strategies by contemporary observers or actors. Yet a rich seam of colonial and
missionary archival material can nonetheless be used to shed light on both. This
article draws on a range of archival sources, including official reports by the health
department of the government of Palestine, confidential appraisals of government-
employed doctors, correspondence between mandate officials, Anglican clergy, and
others, as well as contemporary newspaper accounts. In particular, it makes use of a
private diary kept by a British medical doctor, Elliot Forster, who was in charge of
an Anglican mission hospital in Hebron, and held clinics in nearby villages,
throughout most of the revolt. While Forster’s diary has been used by historians to
reconstruct the violence of British counterinsurgency (e.g. Hughes 2009), in this
article Forster’s diary is read for what it can reveal about the medical history of this
period. It is in part on account of the existence of Forster’s lengthy, revealing diary
that this article focuses on Hebron, but there are other reasons too. One of the larger
towns in Palestine, with an overwhelmingly Muslim population, and located in the
hilly interior of the country where the armed rebels made their base, Hebron was
particularly affected by the revolt, right up until its eventual suppression in 1939;
more than this, it had been one of the epicentres in a significant uprising in 1929,
and, as this article argues, memories of that earlier event shaped the medical history
of the great revolt in the town in important ways.
The first part of this article situates the great revolt in Hebron within that longer
history, by focussing on one government-employed medical doctor who played an
important role both in 1929 and 1936: Dr Ahmed ‘Abd el-‘Al, an Egyptian doctor
who served as a medical officer in the mandate’s department of health for more than
two decades. While the historiography of colonial medicine has long emphasised
the ways in which medical authorities might provide a cover for the dislocations of
colonial rule (Packard 1989), formulate scientific discourses legitimising colonial-
ism (Vaughan 1991), and extend the reach of the colonial state through
interventions on the body of colonised subjects (Arnold 1993), the story of Dr
‘Abd el-‘Al reveals another facet of this relationship between medical and political
authority. In both moments of crisis in 1929 and after 1936, the colonial state sought
to transmute ‘Abd el-‘Al’s medical authority directly into political office in order to
shore up their hold over the town and area, in a strange echo of an earlier British
fantasy from Iraq of uniting the functions of the hakeem—the doctor—and the
hakim—the ruler (Dewachi 2017: 49).
The second part turns to a contrasting biographical case study, this time that of
the British missionary doctor Dr Elliot Forster, to open up more fully the question of
how medical workers negotiated questions of impartiality and loyalty in times of
anti-colonial revolt and colonial counterinsurgency. Forster insisted on treating
British police and military personnel, Palestinian civilians, and wounded rebels
alike at St Luke’s hospital, Hebron. But as medical anthropologists working on
contemporary contexts of conflict have argued, appeals to medical neutrality can
often be taken as a political stance against authorities and the status quo (Aciksoz
2016; Hamdy and Bayoumi 2016; Redfield 2013). In Forster’s case, his dogged
attempt to treat all, regardless of their status in the ongoing conflict, put him on a
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collision course with local British military authorities, and he was forced,
eventually, to abandon this assertion of medical neutrality. But, perhaps more
strikingly still, Palestinian rebels were also active participants in this bold but
unsteady attempt to transplant international legal norms to Hebron, and so extend
those protections across the perceived frontiers of civilisation.
The final part of this article shifts focus to healthcare more widely, to reconstruct
how medical services were incorporated into the strategies of Palestinian rebels and
British counterinsurgents alike. As historians of other interwar Middle Eastern
mandates have shown, experiments in public health and in ensuring colonial order
were never far apart, whether in peace or times of crisis (Dewachi 2017: 45–64;
Neep 2012: 131–164). A close reading of Forster’s diary, alongside an eclectic
range of other archival material, reveals the same to have been true of mandate
Palestine. Across the great revolt, the British pursuit of a counterinsurgency strategy
of collective punishment degraded provision of and access to medical services in
Hebron, even as clinics were for the most part left conspicuously untouched—at
least directly. For their part, Palestinian rebels seized the initiative, establishing
insurgent medical services of their own in the hills, in line with their wider
‘counterstate’ (Swedenburg 2003) ambitions. Both responses, the article concludes,
prefigured in important ways later, more systematic attempts to incorporate medical
services into the strategies of the Israeli occupation regime and Palestinian civil
society.
From Medical to Political Authority in Times of Crisis
While certainly the most significant and sustained uprising of the interwar years, the
great revolt which began in 1936 was not the only occasion on which Palestinians
rose up against British rule and its support for a Jewish national home. Even before
the British mandate for Palestine had been confirmed by the League of Nations,
there had been rioting against Zionism and the British in Jerusalem in 1920 and in
Jaffa in 1921. While the rest of the 1920s were politically quiescent, beneath the
surface roiled a deepening crisis of Palestinian landlessness and impoverishment,
driven by the twin motor of Zionist land purchasing and a British failure to address
agrarian taxation and indebtedness (Anderson 2018: 174–179). With Palestinians
pushed to precarious existence at the urban margins by deteriorating conditions in
the countryside, and against the backdrop of unrelieved political frustration, clashes
over the holy places in Jerusalem sparked widespread revolt in August 1929. In
Jerusalem’s Old City, Safad, and Hebron—densely packed urban areas where Jews
and Arabs lived in ‘dangerous proximity’ (Pappe 2004: 91)—the uprising took the
form of bloody communal violence; in Hebron alone, sixty-seven Jews were killed.
That massacre, and evacuation of the remaining Jewish residents of the town over
the subsequent decade, has resonated down the decades, taking on symbolic
meaning in particular for the Israeli settler movement since 1967 (Campos 2007).
Historians have focussed on more immediate legacies, noting how the 1929 uprising
prefigured in important ways the great revolt which followed less than a decade later
(Sela 1994; Anderson 2018). This section builds on that scholarship by exploring
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another, striking parallel: the assumption of political authority by a government-
employed medical doctor, Dr Ahmed ‘Abd el-‘Al, both in 1929 and then from 1936
onwards.
When violence broke out in the streets of Hebron in August 1929, the town’s
medical services were in the midst of their own moment of transition. The British
mandate government, in line with its wider policy of devolving responsibility for
everyday hospital care to municipalities, missionaries, and other voluntary
organisations, had limited itself to operating a small dispensary and casualty post
in the town. Hospital provision was left instead to Anglican missionaries, who had
been running a small, twenty-bed hospital in Hebron since the 1890s. Although in
line with wider government policy, this arrangement left Hebron with notably fewer
hospital beds than other towns of a similar size in mandate Palestine. Both Gaza and
Nablus had roughly equivalent populations, the vast majority of whom were also
Muslim, and while both towns were home to Anglican mission hospitals, these were
not only much larger than the one in Hebron, but they also operated alongside
municipal hospitals (ARDOH 1929: 44–47). Compounding matters, the mission
hospital in Hebron had closed for extensive renovations in July 1928 (ARDOH
1928: 49), leaving the population of the town—around 16,000 in 1929—and the
surrounding villages dependent on the government dispensary, a Muslim polyclinic
which had only opened in February 1928, and a third clinic run by Hadassah, the
American Zionist medical organisation. In May 1929, Dr ‘Abd el-‘Al—the
government medical officer for Hebron and the sub-district – wrote to his superiors
in Jerusalem to point out that the closure of the Anglican mission hospital had
‘rendered the need for medical relief badly felt in this town’. The new Muslim clinic
was ‘not functioning well’, the Jewish clinic was ‘mainly for Jews although treating
a limited number of Muslim patients’, and the government dispensary, ‘Abd el-‘Al
reported, was overwhelmed and ‘refusing a good number of patients daily reporting
for treatment’ as a result.
1
Medical services were already stretched thin, then, before unrest spread to
Hebron late in August 1929. As the department of health later acknowledged, it only
had a casualty post with eight beds at its disposal to care for the sixty people
wounded in the violence; they ultimately had to be transported to Jerusalem to
receive treatment there (Shaw Commission Report 1930: 1032). In spite of the
limited resources available to the department of health in Hebron, government
medical officer Dr ‘Abd el-‘Al played a key role in the course of events in August
1929. Such was his role, indeed, that his story – ‘Arab doctor saves many’ – was
picked up by the New York Times (Levy 1929: 7), and he was awarded an honorary
O.B.E. in recognition of his actions that year.
2
In a report submitted to the Royal
Commission of Inquiry into the ‘disturbances’, ‘Abd el-‘Al described how he and
his tamurgis – medical attendants – joined the small number of police in the town in
attempting to restore order and bring the wounded to safety. ‘On more than one
occasion’, he recounted, ‘crowds of Jews in hiding, who were met with in the search
1
Dr A. ‘Abd el-‘Al, Medical Officer Hebron, to Senior Medical Officer, Jerusalem, 8 May 1929, Israel
State Archives [hereafter ISA] M[andate Series] 6552/8.
2
Annual Confidential Report for Dr A. ‘Abd el-‘Al, 1930, ISA M 5131/16.
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for the wounded, put themselves under the medical officer’s protection and were
escorted to safety’ (Shaw Commission Report 1930: 1032–1033). The New York
Times had more to say about ‘Abd el-‘Al’s ‘clever strategy’: he had taken large
numbers of Jews hiding from the violence and led them to the largest cafe
´in
Hebron, where many Arab notables were gathered, and placed the Jews under their
protection until the unrest had ended. ‘Thus some of the very instigators of the
attacks’, the paper observed, ‘found themselves with no alternative but to protect the
very persons whom they themselves had given orders to kill’ (Levy 1929: 7).
Whether exaggerated or not, the report captures the sense in which ‘Abd el-‘Al
appeared to have been able to leverage his authority as a medical doctor to
counterbalance other currents in the town’s politics.
The mandate government had made the same observation, apparently, because
shortly after the uprising had been quelled, and with the functioning of the
municipality severely broken down, ‘Abd el-‘Al was nominated to act as mayor of
Hebron temporarily, ‘in order to restore things to normal in town and incidentally
make improvements wherever possible’ (Shaw Commission Report 1930: 1033).
The value ascribed to ‘Abd el-‘Al’s ability to serve both the mandate’s medical and
political interests in Hebron is clear in the confidential annual reports made about
him across the subsequent decade. As one appraisal from 1931 put it, he ‘is well
liked in his district and has very considerable prestige among the people which is of
great value in his work’.
3
His cachet with the mandate government only increased
across the 1930s. Especially following 1933, when large numbers of European
Jewish doctors came to Palestine, medicine – as Liat Kozma and Yoni Furas (2020:
101–102) note – became ‘another realm of the Arab–Jewish conflict’, as the
Palestinian medical community increasingly organised itself to meet the perceived
economic, professional, and nationalist challenge posed by their Jewish counter-
parts. ‘Abd el-‘Al, who had been born in Egypt, qualified as a medical practitioner
in London, and taken up post in the mandate’s health department in 1924, seems to
have remained aloof from the wider Palestinian medical community, both politically
and socially.
4
It is unsurprising, then, that when the great revolt began in 1936, the memory of
the valuable role ‘Abd el-‘Al had played in restoring order in Hebron in 1929
resurfaced. Elections for a municipal council had been held in 1934, but electoral
irregularities, factional rivalries, and the poor health of a polarising mayor, all meant
that local colonial officials were already, at the start of 1935, working on ‘finding a
more satisfactory successor [to the mayor], capable, respected, and willing to stand
for election if required’.
5
It is not hard to imagine who may have been near the top
of their minds. And indeed in September 1936, with the death of the mayor, the
murder of the deputy mayor, the loss of a third member of the municipal council,
3
Annual Confidential Report for Dr A. ‘Abd el-‘Al, 1931, ISA M 5131/20.
4
Indeed, his only daughter – Marsina – would go on to be engaged to the son of a British military officer
in the early 1940s, a connection suggestive of the degree to which he and his family were socially
integrated into the British establishment in Palestine. It is important to note, however, that many
employees of the Palestine Department of Health had been born outside what became mandate Palestine:
many were Syrian, Lebanese, Armenian, and Egyptian, as well as Palestinian.
5
District Commissioner, Jerusalem, to Chief Secretary, Jerusalem, 26 February 1935, ISA M 205/41.
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and the resignation of the rest of the councillors as part of the general strike, those
same officials requested that a commission be appointed to take over the functions
of the municipality. They recommended that Dr ‘Abd el-‘Al be appointed as one of
just two members of the commission.
6
Just as ‘Abd el-‘Al had managed to translate
his medical authority into political office in the context of crisis in 1929, across the
great revolt the mandate government reported favourably on his value as both
medical officer and municipal commissioner. In 1936, government appraisals noted
both the services he had rendered to the department of health, as well as how,
‘[d]uring the disturbances his assistance was much appreciated by the military’.
7
‘His influence in Hebron and district,’ another report, this time from 1938, read, ‘is
considerable and has proved its value during the past troublesome months’.
8
Even
after the revolt had ended, the British continued to rely on him to shore up order in
Hebron during the Second World War, re-appointing him as one of the municipal
commissioners for the town in October 1940 (Palestine Post 25 October 1940, 2).
The British may have been satisfied with the medical and political service ‘Abd el-
‘Al rendered both in 1929 and from 1936 onwards. But it is clear that especially as
time wore on, criticism attached itself both to the municipal commission and to ‘Abd
el-‘Al personally. In 1938, ‘Abd el-‘Al was abducted and taken before a rebel court,
where he was tried – along with a colleague from the department of health – for
various, unspecified misdemeanours, which included ‘taking too much money from
poor patients’.
9
If this was a critique of his medical practice, the commission, too,
became increasingly unpopular. Mandate officials were swamped with successive
waves of petitions from residents of Hebron demanding the termination of the
commission and the restoration of municipal elections in the early 1940s, with the
commission notably criticised in the summer of 1941 for acting only for its own
benefit, and not that of the town.
10
This may not have been unfounded: as the British
district commissioner also noted, confidentially, ‘[a]ffairs in this commission are not
too good’.
11
By the time municipal elections were finally scheduled in 1946, ‘Abd el-
‘Al had left Hebron for Nazareth, taking up a new post in the department of health in
that town. While it is not implausible that his popularity had been compromised by his
overlong involvement with the commission, and that he had left as a result, this does
not seem to have been the case. From Nazareth, he continued to play a role in the
political and medical life of the town that had been his home for two decades,
intervening with the mandate government in support of a new polyclinic in Hebron
which would be run by the mayor and funded through voluntary contributions.
12
6
District Commissioner, Jerusalem, to Chief Secretary, Jerusalem 14 September 1936, ISA M 205/41.
7
Annual Confidential Report for Dr A. ‘Abd el-‘Al, 1936, ISA M 5131/12.
8
Annual Confidential Report for Dr A. ‘Abd el-‘Al, 1938, ISA M 5131/12.
9
Diary, 31 August 1938, Elliot Forster Collection, GB165-0109, Middle East Centre Archive [MECA],
Oxford. Hereafter ‘‘Forster Diary’’. He was, however, also treated courteously by the rebel leader, who
fed both doctors and sent ‘Abd el-‘Al home with two chickens as a present for his wife.
10
Telegram from Ishaq Abu Khalaf, Hebron, to High Commissioner, Jerusalem, 28 August 1941, ISA M
205/41.
11
District Commissioner, Jerusalem, to Chief Secretary, 6 March 1943, ISA M 205/41.
12
Dr A. ‘Abd el-‘Al, Nazareth, to Director of Medical Services, Jerusalem, 1 November 1946, ISA M
6589/9.
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The scholarship on colonial medicine has long stressed the ways that medical and
political power might intersect and indeed be mutually constitutive. As historian
Megan Vaughan (1991, 45) noted, the line between colonial administrator and
medical officer could often be blurred in the eyes of colonial subjects, with good
reason. The case of Dr Ahmed ‘Abd el-‘Al complicates this in at least two ways. In
the first place, it involves far more than merely the perception of an overlap between
medical and political spheres; ‘Abd el-‘Al was both medical officer and mayor in
1929, and then medical officer and municipal commissioner for the better part of a
decade after 1936. Other medical officers certainly were involved in local and
municipal administration in mandate Palestine, but the length of time he combined
these roles, and the degree of responsibility conferred on him – as temporary mayor
in 1929, and as one half of a two-man commission for the first years of the great
revolt – are both striking. And second, ‘Abd el-‘Al was not a British colonial officer,
but rather an Egyptian doctor who – like many of his Syrian, Lebanese, Armenian,
and Egyptian colleagues in the department of health - lived permanently in
Palestine from at least 1924 onwards. Indeed, this section has tracked Dr Ahmed
‘Abd el-‘Al’s biography at such length not only because it provides an insight into
the strategies by which the British mandate sought to transmute medical authority
into political legitimacy in times of crisis, but because his trajectory is distinctive
when set alongside that of many of his peers in this period of increasingly politicised
professional organising. ‘Abd el-‘Al, then, highlights the spectrum of positions
which could be assumed by Arab doctors in times of conflict and crisis.
Contesting Medical Neutrality: Medical Missionaries and their
Palestinian Colleagues
In August 1929, Hebron’s medical services had struggled to deal with the number of
wounded as a result of the temporary closure of the Anglican mission hospital in the
town. Less than a month later, however, the hospital was reopened with enlarged
capacity under the auspices of the Jerusalem and the East Mission as St Luke’s; Dr
‘Abd el-‘Al, having previously drawn attention to the dangerous gap in provision
which had resulted from the closure of the mission hospital for renovations, joined
senior Anglican figures in Palestine in inspecting the new building shortly before it
opened (Shaw Commission Report 1930: 1032–33). Conspicuous by its absence in
1929, St Luke’s would go on to play a key role in treating the wounded during the
great revolt just a few years later. Patients treated at St Luke’s included British
police and military personnel, residents of Hebron and the surrounding villages –
and, controversially, rebel fighters. While the British mission doctor in charge of St
Luke’s, Dr Elliot Forster, doggedly defended providing medical assistance to
Palestinian rebels, he came under increasing pressure from British military
authorities as a result of this position, particularly in the last year of the revolt.
While neither he nor his critics used the term ‘medical neutrality’, this is not in itself
striking: in debates about the Geneva Conventions which established that medical
personnel in conflict situations should be free to tend, without interference, to the
wounded regardless of their allegiance, the value of the term ‘neutrality’ had been
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deeply contested from the start of the twentieth century (Rubenstein 2021: 35).
Drawing on Forster’s private diary and correspondence, this section explores the
role played by St Luke’s during the great revolt, and Forster’s—ultimately failed—
attempt to assert ‘neutrality’ as a medical missionary in the context of anti-colonial
revolt and colonial counter-insurgency.
When St Luke’s reopened in September 1929, it resumed its role not just as
Hebron’s one hospital, but as the only hospital within twenty miles. The Anglican
bishop in Jerusalem described the newly modernised buildings of the hospital as
having received ‘a great welcome from the people of the town’, and as drawing
‘considerable numbers’ of patients from the villages, ‘sometimes walking two or
three days to reach the hospital’ (MacInnes 1931: 937–938). After a succession of
short-lived appointments to the hospital, Dr Elliot Forster took charge of St Luke’s
in 1933, a post he retained until the outbreak of the Second World War when he
signed up for service in the Royal Army Medical Corps. But in the spring of 1936,
he was seriously ill, such that he was in England on sick leave when the great revolt
began. The hospital thus was left under the charge of Dr Joyce MacInnes, the
daughter of the late Anglican bishop in Jerusalem, for the initial phase of the great
revolt. With Hebron shut down almost entirely for the six-month general strike from
April, and with frequent shootings both in the town itself as well as the roads out of
it, MacInnes was praised by her superiors in the Anglican church for having ‘carried
on gallantly in very trying circumstances’. While attendance at the hospital had
dropped – ‘because patients are afraid to come’ – the local strike committee had
offered MacInnes a label for the windscreen of her car, in order to protect it from
damage while she was going about her rounds in the town.
13
This protection continued to be extended to St Luke’s in the second phase of the
great revolt, when the centre of gravity shifted from strike committees in the towns
to rebel fighters in the country. Once he had returned to Palestine late in 1936,
Forster resumed his visits to nearby villages, where he ran essential weekly clinics
for the villagers in the district. As he reported back to his superiors in April 1938,
these visits were on a set timetable, and were thus ‘well known to the gentlemen
responsible for the hold-ups and the shootings’. But in spite of this, ‘at no time have
we suffered let or hindrance’; even when they made contact with ‘the gang’, they
had been allowed to pass ‘without molestation’.
14
This was of no small significance:
the Arabic-language press is full of reports of armed gunmen holding up traffic on
the roads to and from Hebron across 1938.
15
Indeed, Forster’s diaries make clear
that this protection extended much further than simply tacit non-interference with
his work: in the second half of 1938, local rebel leadership actually provided him
with an escort for some of his journeys out of Hebron, so that he could travel
safely.
16
While the rebels assured Forster and his Palestinian colleagues at the
hospital that ‘none of the local people would touch the doctor’, the difficulty, they
13
Archdeacon, Jerusalem, to Canon Gould, 17 July 1936, MECA GB165-0161 Box 59 File 2.
14
Elliot Forster, Report on St Luke’s Hospital, Hebron, April 1938, MECA GB165-0161 Box 59 File 2.
15
See for examples al-Difa’, 9 February 1938, p.1; al-Difa’, 27 April 1938, p.1; al-Difa’, 17 June 1938,
p.1.
16
17 October 1938, Forster Diary.
Cult Med Psychiatry (2023) 47:12–36 21
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noted, was that there were ‘a good many ‘‘tough eggs’’ from foreign parts whose
behaviour could not be guaranteed’.
17
Against this backdrop of hold-ups and abductions on the road, it is unsurprising
that British authorities also voiced concerns about Forster’s frequent journeys
throughout the district, and proposed that he either stop these visits entirely or travel
with a police escort. In an attempt to ensure distance between St Luke’s and the
British civil and military authorities, however, the Anglican bishop in Jerusalem
intervened on Forster’s behalf:
‘[H]e goes amongst the villagers as a doctor and they know his errands are
those of peace and mercy and I personally should strongly deprecate any
escort for him as this might be interpreted either that he was afraid or that he
was in touch with the police or that he was a government agent.’
18
The care taken here not to be too closely associated with British police or military
forces can be understood as part of a wider attempt by the Anglican church across
the mandate period to position itself as a ‘third party’, between the mandate
government and the Palestinian population (Okkenhaug 1999; Sma
˚berg 2013).
Beyond simply maintaining distance between St Luke’s and the British military
authorities on the ascendance across the second half of the great revolt, Forster was
a vocal – and well-connected – critic of the military’s counterinsurgency methods
(e.g. Hughes 2009: 339–341). The most notable instance of this came in August
1938, when, following a night-time raid on the town by a sizeable rebel force, the
police and military responded by imposing a curfew the next morning which was
poorly publicised but ruthlessly enforced. In addition to two dozen men injured,
many of them with broken crowns, two men – one of them an elderly deaf man –
were shot and killed outright, and a further six Palestinians – two of them old men,
three of them children – were brought to Forster with gunshot wounds for treatment.
One – a boy of fifteen – later died. Forster sent his ‘personal impressions’, complete
with detailed descriptions of the gunshot wounds inflicted and the amputations he
had had to perform on two of the wounded, straight to the High Commissioner.
19
Such private reports never, as Matthew Kelly (2017: 126) notes, gained public
traction, not least because of the injunction placed on all Palestinian newspapers
against reporting the details of military or police operations unless authorised by the
government. Forster’s ‘personal impressions’, as he called them, are nonetheless
striking for the way they marshal his first-hand, clinical experience to draw out in
graphic detail the consequences of the policing method adopted by the British in
Hebron in August 1938. If ‘Abd el-‘Al’s medical authority could be put to work to
shore up colonial administration, Forster’s clinical expertise was here deployed to
critique the British counterinsurgency regime. Yet in an ironic turn of events,
Forster’s ‘unwearying, sympathetic, and gratuitous treatment of the large number of
17
27 September 1938, Forster Diary.
18
Bishop in Jerusalem to District Commissioner, Jerusalem, 20 July 1938, MECA GB165-0161 Box 59
File 2.
19
Elliot Forster, ‘Personal impressions of the night of Friday 19th August 1938 and the morning of
Saturday 20th August 1938’, 27 August 1938, MECA GB165-0109.
22 Cult Med Psychiatry (2023) 47:12–36
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casualties’ was credited with having ‘done much to counteract popular indignation’;
the assistant district commissioner went so far as to call him ‘the greatest asset that
government has in this town and sub-district’.
20
While the commissioner shared
Forster’s criticisms of the military’s excesses, he nonetheless suggested that
Forster’s actions – as a British doctor, in an Anglican mission institution – had
helped take the edge off this episode. And indeed, it was the strenuous efforts of
Forster, the rest of the staff at St Luke’s, and the other government medical doctors
in the town which were highlighted in an initial report on the incident in al-Sirat, a
Jaffa-based daily paper (22 August 1938: 2).
21
While Forster’s travels around the countryside to hold village clinics, and his
responses to British counterinsurgency tactics, both necessitated a degree of careful
– if not always successful – distancing from the military authorities, it was in
relation to the question of Palestinian access to treatment at St Luke’s that he sought
to assert his neutrality in the most explicit and sustained way. In October 1938,
Forster complained that wounded Palestinians were not coming to St Luke’s for
treatment, ‘fearing not so much from us as from the police and soldiers who must
have access to the hospital and who bring here their own wounded’.
22
They had
good reason to be concerned. In January of that year, a man had been admitted to St
Luke’s as an in-patient for treatment of a peritonsillar abscess, and while he was at
the hospital, the police arrived with a warrant for his arrest as a member of one of
the local rebel leaders’ ‘gang’. A constable was set to guard him in the ward, while
they waited for a police vehicle to arrive with which to remove him, but the man
simulated violent abdominal pain, and when the other patients all corroborated his
story that he had been given a purge – that is, a laxative – the constable allowed him
to go to the lavatory. ‘After about half an hour’, Forster recounted, as ‘the
policeman was still sitting with his mouth open, someone asked him if he was going
to sit there all day’. The next day, the escaped patient arranged for his hospital
clothes to be returned, along with the fee due for his treatment, and even a bunch of
flowers for Forster as a token of thanks.
23
While in this instance the man had been able to escape, the episode was part of a
wider pattern of police targeting suspected rebels while in hospitals (Hughes 2019,
383). In the most notorious example of this practice, British police entered a private
hospital in Jaffa and shot and killed an injured man, Ibrahim ibn Khalil, while he
was still lying in his hospital bed, in June 1939. The police subsequently reported
that he had been ‘shot while trying to escape’. As it turned out, the police had been
seeking another target, the principal witness against a British police sergeant and a
Jewish advocate who were to be tried for conspiracy, and had killed the first
wounded man they could find in their rush to secure a reward. After the
assassination, the director of the hospital, Dr Dajani, had his own house searched,
20
Report by Mr. A. Lees, Temporary Assistant District Commissioner, Hebron, on the events of Friday
night, the 19th August, and Saturday morning, the 20th August, 1938, 23 August 1938, MECA GB165-
0109.
21
al-Sirat, 22 August 1938, p.2 (‘Telephone message from Hebron’).
22
15 October 1938, Forster Diary.
23
15 October 1938, Forster Diary.
Cult Med Psychiatry (2023) 47:12–36 23
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and his family intimidated (Hughes 2019: 327–328). And a British solicitor based in
Jaffa, acting as the deceased’s legal representative, later complained he had had ‘a
battle’ with the coroner in the case, the district officer, over the shooting: the
coroner had refused to grant the solicitor access to the coroner’s inquest
proceedings, in spite of the fact that he was representing the deceased.
24
Although this particular incident was in the future, by 1938 Forster’s own
experiences would have made it perfectly clear to him that his hospital and patients
were not automatically afforded any special, inviolable status which set them apart
from the general conditions of the country at this time of revolt and counterinsur-
gency. In October 1938, then, he worked to secure that status for his hospital,
reaching an agreement with the local British civil and military authorities in Hebron
by which all patients at St Luke’s were to be ‘exempt from interrogation without
[Forster’s] express permission, to be refused at [his] discretion’.
25
This agreement,
which Forster referred to as ‘our Geneva convention’, became well known to the
rebels, at least some of whom appeared to quickly place their trust in its protection.
That same month, the man who had escaped from the police while a patient in the
hospital earlier that year, was brought to St Luke’s with a bullet wound – precisely
the kind of injury which would have marked him out as a probable rebel in the eyes
of the authorities, and invited interrogation and detention. While he ultimately
succumbed to his wound, ‘[t]he fact that his people brought him here again after this
first incident’, Forster remarked, ‘shows that they place confidence in our more
recently established Geneva convention’.
26
Others were a little less trusting: later
that year, Forster was asked for ‘a guarantee of good faith in respect of our Geneva
convention for the treatment of [rebel] wounded’.
27
But once one of the staff at the
hospital – Khalil Jubrail, who regularly served as Forster’s go-between in
communicating with the rebels – declared himself willing to be killed if any harm
came to the rebels while at the hospital, wounded rebels were indeed brought to St
Luke’s for medical care.
That the inviolability of St Luke’s and its patients had to be explicitly negotiated
by Forster is unsurprising. His local ‘Geneva convention’ was necessary in view of
the systematic failure to extend the norms of international law – including the
‘actual’ Geneva conventions – to conflicts outside Europe across the interwar years,
evident in the French bombing of Damascus in 1925 (Pedersen 2015), the use of
chemical weapons by the Spanish in Morocco in the same decade (La Porte 2011),
and – beginning just before the great revolt in Palestine – the Italian bombing of Red
Cross facilities in Ethiopia (Pankhurst 1999; Perugini and Gordon 2019; Redfield
2016). These were not aberrations: as Adom Getachew (2019: 66–67) has recently
argued, Italian war crimes in Ethiopia followed the same logic which had
underpinned the unequal integration of Ethiopia into the international community
across the previous decade. If ‘the international law of armed conflict was…not’,
Christiane Wilke (2014) reminds us, ‘intended to protect colonized peoples from
24
S.O. Richardson, Jaffa, to Attorney General, Jerusalem, 27 December 1940, ISA M 711/12.
25
15 October 1938, Forster Diary.
26
30 October 1938, Forster Diary.
27
2 December 1938, Forster Diary.
24 Cult Med Psychiatry (2023) 47:12–36
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oppression’, historians have nonetheless drawn attention to demands by Syrians,
Moroccans, Ethiopians, and others for those norms to be extended. While attention
has been given to these lobbying efforts as they reached Geneva and other European
capitals, including by Palestinians (Wheatley 2015), the story of Forster’s local
‘Geneva convention’ suggests that Palestinian rebels engaged with the project of
extending the protection of these international norms on the ground, too, and not
merely as petitioners.
For their part, the British military became increasingly furious at Forster’s
medical aid to the rebels. By April 1939, Forster suspected that the local military
authorities considered him ‘a centre, if not of sedition, at least of a general
resistance to authority’, in part because of his ‘Geneva convention’.
28
He was later
warned by the assistant district commissioner at Hebron that the local battalion were
growing ‘more and more dissatisfied with our ‘‘Geneva convention’’’.
29
Forster
protested – in writing – that the army had never raised their concerns directly with
him, continuing: ‘if the military authorities are discontent with our poor little
convention, it is surely not too much to hope that they will say so openly, rather than
maintaining a strong, silent – is sulky too strong a word? – and unconstructive
disapproval.’
30
Eventually, Forster got what he wanted, and in August 1939 the
divisional commander communicated his wish that the convention be ‘indefinitely
suspended’.
31
By this point, as Forster himself confessed, it had become ‘a matter
more of principle than of practice’; the hospital had admitted no wounded rebel
fighters already for some time before the convention was formally suspended.
32
Throughout this fraught, largely silent stand-off between Forster and the military
authorities in Hebron, what is striking is the extent to which Forster came to
perceive his medical neutrality as putting a question mark over his loyalty to his
country in the eyes of others. In spite of the fact that the convention had been
initially approved by the authorities, Forster found himself having to repeatedly
protest his neutrality – ‘I have never given any assistance and comfort to the rebels
except of a medical kind’
33
– and indeed later his loyalty – ‘I do not believe it [i.e.
giving medical assistance] to be incompatible with loyalty’
34
– to his countrymen in
Palestine. ‘What sticks in my gills…is the implication that my attitude is disloyal, if
not positively dishonourable’, Forster seethed privately in his diary in the summer
of 1939.
35
The guilt experienced by Forster is clearly not on a par with the tremendous risks
and pressures from the authorities which doctors in other, contemporary contexts
have faced for their work (e.g. Aciksoz 2016: 211–214; Hamdy and Bayoumi 2016:
226), nor did the suspicion which attached to his hospital as a ‘centre of resistance’
28
7 April 1939, Forster Diary.
29
27 June 1939, Forster Diary.
30
Elliot Forster to Assistant District Commissioner, Hebron, 1 July 1939, MECA GB165-0109.
31
29 August 1939, Forster Diary.
32
27 June 1939, Forster Diary.
33
7 April 1939, Forster Diary.
34
Elliot Forster to Assistant District Commissioner, Hebron, 1 July 1939, MECA GB165-0109.
35
27 June 1939, Forster Diary.
Cult Med Psychiatry (2023) 47:12–36 25
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lead to the kind of infrastructural violence which Omar Jabary Salamanca (2011)
has argued follows from the Israeli resignification of life-sustaining public utilities
in Gaza as ‘terrorist infrastructures’ in the early twenty-first century. Yet those
Palestinians working at St Luke’s – that is to say, the majority of the staff at the
hospital – were more vulnerable to being directly targeted by the military authorities
in Hebron as a result of their work.
Khalil Jubrail – Forster’s principal go-between with the rebels – is a case in point.
Khalil had been working at the hospital since well before Forster arrived to take
charge in the 1930s; in fact, it seems he had been attached to the hospital even
before the First World War, serving as the dispenser in the hospital’s pharmacy – in
spite of his lack of any formal qualifications.
36
Although the department of health
would issue occasional, half-hearted demands that he sit the assistant pharmacist
examinations even into the early 1930s,
37
his long experience was clearly
considered to counterbalance this lack of formal qualifications. In the great revolt,
Khalil had enabled Forster to communicate with the rebels, and indeed offered
himself up as the guarantee for the ‘Geneva convention’. But in January 1939, he
was arrested when his photo – complete with a message of ‘affection and loyalty on
the back’ – was discovered in the pocket of a local rebel leader’s coat, seized during
a raid; it had been, Khalil explained to a furious Forster, part of his guarantee.
38
Only Forster’s strenuous lobbying with influential contacts in the civil government
prevented him from being sent to Acre central prison.
39
Across the great revolt,
medical workers were forced to negotiate difficult questions around neutrality,
complicity, and loyalty. But the fact that Forster’s neutrality, or his ability to
position himself as almost a third party in relation to both the rebels and the British,
depended to a great extent on Khalil and other Palestinian colleagues risking arrest
by acting as his go-betweens, underlines that the room for manoeuvre, as well as
stakes, for British doctors like Forster were of a different order of magnitude than
those which confronted his Palestinian colleagues.
Healthcare, Collective Punishment, and Counterstate Formations
In 1940, looking back on the great revolt and its suppression, a report on colonial
development and welfare services concluded that ‘of all departments the work of the
department of health was least interfered with by the recent disturbances’.
40
It is
clear that this was a relative judgement: across the years of the great revolt,
government-employed doctors and nurses were murdered (ARDOH 1936, 12),
36
Farid Haddad, Inspector of Pharmacies, to Director of Health, Jerusalem, 4 April 1924, ISA M 6552/8.
37
Director of Health, Jerusalem, to Senior Medical Officer, Jerusalem, 2 January 1932, ISA M 6552/8.
38
2 December 1938, Forster Diary.
39
4 January 1939, Forster Diary.
40
Report of the Committee on Development and Welfare Services (1940), Israel State Archives [ISA]
P 4187/10, p.61.
26 Cult Med Psychiatry (2023) 47:12–36
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ambulances and hospital buildings attacked,
41
and long-awaited and much-needed
extensions and improvements repeatedly postponed (ARDOH 1937, 9; 12).
Notwithstanding this attempt to understate the impact of the great revolt, the
department of health had to concede that Hebron and its sub-district had been an
area where services had been more dramatically interrupted by the ‘disturbances’
(ARDOH 1939: 12). The previous sections of this article focussed on two doctors –
Dr ‘Abd el-‘Al and Dr Forster – to highlight the very different positions medical
workers in one town in Palestine could take up in times of colonial conflict. While
keeping its focus on Hebron and the surrounding area, this section zooms out from a
biographical approach to consider how healthcare more broadly was not simply
affected by but incorporated into the strategies of both British counterinsurgents and
Palestinian rebels between 1936 and 1939.
Ill-defined in the department of health’s official reports, the ‘disturbances’ which
they credited with disrupting the provision of healthcare in the Hebron area during
the great revolt were above all those conditions of insecurity on the roads to and
from the town which Forster was only able to navigate with the help of rebel escorts.
Even then, Forster himself sometimes had to stay at home, having been warned
obliquely by local rebel leadership that ‘the weather was very bad’
42
; at other times,
it was the British military authorities who forbade his journeys out to the villages to
run his weekly clinics.
43
In spite of these interruptions, Forster appears to have been
able to continue with his work in the villages longer than his counterparts in the
department of health. Across the 1930s, two of the most important public health
schemes in the Hebron area targeted acute conjunctivitis and endemic – that is, non-
venereal – syphilis. The department of health had invested in both schemes on the
eve of revolt, assigning two medical officers – Dr Samir Shihab, and Dr Fawzi
Khalil ‘Abla – to take charge of these campaigns. Both Shihab and ‘Abla had a more
typical educational background than their more senior colleague, Dr ‘Abd el-‘Al,
having graduated with medical degrees from the American University of Beirut;
they were also seen as notably less reliable by the department, with Shihab, in
charge of the ophthalmic campaign, criticised for ‘[l]acking in co-operative spirit
with his colleagues’, and ‘Abla, in charge of the syphilis campaign, described as
‘not very interested in this branch of work’.
44
While they continued to tour the
villages of the sub-district across the first years of the revolt, by the second half of
1938 both campaigns stumbled; the village clinics had to be discontinued ‘owing to
the increasing lack of security’ (ARDOH 1938: 62). At this stage, even the
mechanisms for the notification of births and deaths in the villages around Hebron
were breaking down, underlining the scale of the retreat of the mandate government
in the countryside (ARDOH 1938: 17).
Medical services were certainly disrupted by the revolt, and medical workers
were sometimes the targets of violence and threats. One of Dr Forster’s assistants at
41
[n.d.] October 1936, Forster Diary; Medical Officer, Government Hospital Gaza, to Senior Medical
Officer, Jaffa, 27 July 1938, ISA M 6599/3.
42
10 October 1938, Forster Diary.
43
12 April 1939, Forster Diary.
44
As per their respective annual confidential reports for 1938, in ISA M 5131/12.
Cult Med Psychiatry (2023) 47:12–36 27
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St Luke’s, a Syrian doctor by the name of Khoury, received a letter – purportedly
from ‘Rebel G.H.Q., Palestine’ – threatening him with death if he did not leave the
country within a week; Forster felt it might be a hoax, but Khoury took it more
seriously, and left the hospital the following day.
45
Though the department of health
laid the blame for these disruptions squarely at the feet of the rebels, the colonial
state had itself, as part of a broader strategy to undermine popular support for the
rebels (Kelly 2017: 142), helped create the conditions for chaos and criminality. As
Charles Anderson (2017: 47) argues, this was not only through the state’s retreat
from the administration of ordinary criminal justice, but even, on occasion, by
encouraging brigands and others to impersonate rebels. Medical services, like many
other aspects of Palestinian everyday life, were collateral damage in this drive to
fracture the cohesion of the revolt.
But a second element in the British counterinsurgency strategy impacted perhaps
more profoundly, if still indirectly, on both provision of and access to medical
services during the revolt: the use of collective punishment. The principle of
collective punishment had been enshrined in law by the British mandate more than a
decade before the outbreak of the great revolt, sanctified by an understanding of
Palestinian village life as oriented towards mutual protection rather than justice
(Hughes 2009: 317). This legal framework was expanded over the course of the
great revolt, guiding British counterinsurgents as they demolished Palestinian
property, imposed heavy collective fines, demanded forced labour, and installed
punitive village occupations between 1936 and 1939. Recent work on the
suppression of the great revolt has shifted attention away from instances of
particular brutality towards the biopolitical targeting of the conditions of everyday
existence for the Palestinian population as a whole (Anderson 2019), and shown
how both the revolt and the world war which immediately followed pushed the
mandate to reach more deeply into the lives of subjects than ever before, calculating
‘basic needs’ and measuring out the calories needed to stave off the threat of hunger
and ensure bare life (Seikaly 2016: 77–102). A close reading of Forster’s diary
extends this analysis, by highlighting how the ability of St Luke’s – the only
hospital in Hebron and the surrounding area – to provide medical care for the sick
and wounded was profoundly disrupted by the British adoption of a counterinsur-
gency strategy of collective punishment.
While the hospital itself, as we have seen, was unevenly protected from direct
intrusions by police and military personnel across the revolt, in at least three ways
British counterinsurgency methods constrained its workings. In the first place, the
periodic imposition of curfews put a severe strain on the hospital. While Forster was
exempt, these curfews – which often lasted a number of days – meant it was difficult
and dangerous for both patients and orderlies to access the hospital without being
ferried by Forster himself; they also caused supply problems for the hospital, which
again Forster had to resolve himself. Following a frustrating meeting with the local
military commander who had imposed one such curfew in October 1938, Forster
fumed in his diary that the question of hospital supplies had clearly not occurred to
this officer. It was, he wrote, ‘quite a new idea to him’; he must have ‘thought a
45
11 October 1938, Forster Diary.
28 Cult Med Psychiatry (2023) 47:12–36
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48-hour fast for sick people was nothing’.
46
But for patients and their families, the
implications of the curfew in terms of access were stark. Forster recounts the chaos
which engulfed the hospital one September’s day, when an indefinite curfew was
announced for later that same morning:
‘There followed a hectic hour…Each of the many patients of course
demanded immediate treatment before rushing home for the curfew. As it was
visiting day, there was another section that wished to see their relatives at
once, as the midday visiting time was quite impracticable.’
47
Here, counterinsurgency measures very clearly intruded on the space of the
hospital itself, wrenching routine and dislocating patients’ and families’
experiences.
Second, the introduction of new military road regulations from November 1938
which forbade all drivers and passengers from travelling on the roads unless they
had a military pass with a photograph impeded Forster’s ability to visit surrounding
villages where he conducted weekly out-patient clinics. Again, while Forster
himself was able to travel, a general rebel order forbidding Palestinians from taking
out these passes meant that those Palestinians with whom he worked did not dare
apply for them. Forster could not run the village clinics single-handedly, and so had
to temporarily give them up, leaving villagers without accessible medical services.
These difficulties were compounded by the closure of key roads with enormous road
blocks by the army.
48
Finally, although the hospital itself was exempt both from the
punitive searches and demolitions which saw Palestinian homes ransacked and
destroyed, it was not altogether unaffected by these. In September 1939, for
instance, a number of houses in Hebron were demolished using explosives after an
army patrol was hit by a rebel landmine. One of the houses was just below the
hospital. ‘Although we opened every possible window, at least a hundred panes of
glass were broken,’ Forster noted, ‘and the poor old hospital clock, ‘‘the best time-
keeper in Hebron’’, fell on its face from a height, and was picked up insensible’.
49
In
all these cases, though the hospital was not the direct or explicit target of collective
punishment measures, it was affected in ways which were consistent with the
overall punitive purpose of these measures, as degrading the conditions of life for
the Palestinian population as a whole in order to render continued rebellion
unsustainable (Anderson 2019).
Faced with the degradation of medical services as a result of the wider British
counterinsurgency, Palestinian rebels developed their own response in order to
ensure medical attention for the wounded. Forster’s diaries, of course, make clear
that he treated wounded Palestinian rebels in 1938 and 1939, and some Palestinian
doctors – like the grandfather of the historian Sonia Nimr, Dr Sa’id Nimr, a doctor
in Jenin in the 1930s (Nimr 2007: 85) – also extended medical care to rebels on an
ad hoc, furtive basis across the revolt. But these arrangements do not seem to have
46
17 October 1938, Forster Diary.
47
4 September 1939, Forster Diary.
48
1 November 1938, Forster Diary.
49
6 September 1939, Forster Diary.
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been enough on their own to have compensated for the wider drop in the number of
admissions to government hospitals, which was evident as early as 1936 (ARDOH
1936, 12). This decline was understood as driven by the not-unjustified fear among
wounded Palestinians that entering a government hospital with a bullet wound, for
instance, would draw unwanted police attention – or worse, as we have seen. The
decline in hospital admissions left British authorities with the question of how
exactly, if at all, wounded Palestinian rebels were being treated, and here –
alongside the ad hoc care extended to them by government and mission doctors
alike – there were reports of more systematic organising around health among
rebels. One Anglican clergyman in Jerusalem recounted Palestinian boasts ‘of
hospitals in caves’, and ‘of young Arab women being offered good pay to act as
nurses’.
50
Forster heard something similar in Hebron, recording in his diary in
October 1938 that ‘wounded rebels have been treated in the hills by their own
doctors, of whom, I am told, there are not a few throughout the country’
51
; the next
month he had indirect dealings with one of those rebel doctors, apparently a German
permanently attached to one of the rebel leaders in the Hebron area.
52
Against this
backdrop, what might otherwise have appeared to be random looting of government
property in ‘the thefts of medical supplies from government depots, police stations,
and medical kits from various [doctors] in Jerusalem’
53
took on a different meaning
to some contemporary observers, as the supply lines which served rebel medical
services.
This assembling of alternative structures of healthcare might well be understood
as one strand within the wider attempt by Palestinian rebels to create what the
anthropologist Ted Swedenburg (2003: 133–136) has called ‘counterstate appara-
tuses’. Swedenburg and others (Anderson 2017; Kahba 2011) have focussed in
particular on the establishment of rebel courts, in favour of which Palestinian
villagers deserted British colonial courts en masse. It appears that these courts were
also put to work in ensuring that the poorest Palestinians had access to medical
services. In August 1938, as we saw, Dr ‘Abd el-‘Al and his colleague, Dr ‘Abla,
were held up on the road out of Hebron and taken to a rebel court in the hills, where
they were tried for misdemeanours which included ‘taking too much money from
poor patients’.
54
This was part of a wider pattern, Forster noted, in which those
suspected of ‘oppressing the poor, refusing money to the rebels, giving information
to the government and the like’ were kidnapped and put on trial in rebel courts in the
Hebron area across 1938.
55
Just as individual medical workers in Hebron took up a range of positions in
relation to the mandate government and Palestinian rebels, so too was healthcare
more widely implicated in the politics of the great revolt. The health department
blamed disruption to access to medical provision on the conditions of insecurity
50
Canon C.T. Bridgeman, Jerusalem, to Bishop in Jerusalem, 29 August 1938, MECA JEM 61/3.
51
15 October 1938, Forster Diary.
52
1 November 1938, Forster Diary.
53
Canon C.T. Bridgeman, Jerusalem, to Bishop in Jerusalem, 29 August 1938, MECA JEM 61/3.
54
31 August 1938, Forster Diary.
55
6 September 1938, Forster Diary.
30 Cult Med Psychiatry (2023) 47:12–36
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which plagued the countryside as a result of the revolt, but it is clear that British
counterinsurgencies strategies – though never identified as a motor of those
conditions of disturbance – also played a role in degrading healthcare. To put it
another way, the conditions of healthcare at St Luke’s hospital – the periodic
panicked rushes for diagnosis, treatment, family visits; the uncertainty and anxiety
around supplies, around travel, around access; the injuries which the hospital had to
tend to, and the damage which its own physical fabric experienced – had a political
aetiology (Hamdy 2008: 554), tied above all to the British pursuit of a strategy of
collective punishment. Although the effects of this strategy were in line with the
wider aim of making continued Palestinian support for the revolt unsustainable, it
also had the unintended consequence of pushing rebels to set up their own medical
services, just as the British abnegation of responsibility for enforcing ‘ordinary’
criminal law during the revolt served to strengthen the need for the rebel courts.
While Palestine, and European colonies more broadly, have long been seen as
testing grounds for new methods of policing and counterinsurgency, more recent
work has insisted that the great revolt was also a laboratory for evolving new anti-
colonial tactics and visions (Anderson 2021; Winder 2021). The incorporation,
however uneven and experimental, of healthcare into the strategies of colonial
counterinsurgents and anti-colonial rebels alike makes clear that these insights can
be extended to the medical history of the great revolt too.
Conclusion
For a number of historians, the strategies adopted by both British counterinsurgents
and anti-colonial rebels in the second half of the 1930s prefigure or anticipate in
important ways the strategies which have been deployed in the decades since by the
Israeli occupation regime and Palestinians (Anderson 2019; Khalili 2010; Winder
2020). While not the focus of this article, similar connections might be traced for the
medical history of the great revolt. The British incorporation of healthcare into a
counterinsurgency strategy of collective punishment may have been uneven and
uncalibrated, especially when set alongside the control of access to medical care as a
‘tactic of war’ in the occupied West Bank today (Giacaman et al. 2009; Pfingst and
Rosengarten 2012;Puar2017; Sousa and Hagopian 2011), but it nonetheless might
be taken to represent, in embryonic form, the colonial roots of contemporary Israeli
practices. In their effort to ensure access to medical services amongst the poorest,
meanwhile, the rebels of 1930s Palestine seem to share the priorities of the popular
health movement which emerged in the occupied Palestinian territories in the 1970s,
and which sought to meet the health needs of the people through the creation of a
health infrastructure of resistance, often in defiance of the Israeli permit regime
(Barghouti and Giacaman 1990; Wick 2008).
While delineating such genealogies is possible, the ubiquity of these patterns
should give pause for thought. Medical anthropologists have made clear that the
deliberate degradation of medical provision and access to healthcare as a form of
collective punishment can be found in many contexts in the contemporary world
(e.g. Varma 2020: 80); the possibilities and perils which face medical workers as
Cult Med Psychiatry (2023) 47:12–36 31
123
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they negotiate questions of medical neutrality in times of crisis, meanwhile, are
equally widespread (Aciksoz 2016; Hamdy and Bayoumi 2016; Redfield 2013).
Rather than treat Palestine as exceptional, then, a medical historical perspective on
the great revolt suggests that it was one site at which these wider dynamics played
out. Indeed, parallels are evident elsewhere across the Middle East and North Africa
in the interwar years, whether in the British recognition in Iraq that political and
medical authority might be welded together for colonial advantage (Dewachi 2017:
49); the contested nature of medical neutrality, with Red Cross medical workers and
facilities targeted by Italian bombs in Ethiopia (Rubenstein 2021: 36–37); or the
conjoined nature of mandatory experiments in evolving new strategies of colonial
counterinsurgency and public health management in French Syria (Neep 2012:
131–164). All these cases, including the case of Palestine, underline the broader
refusal on the part of European states and the League of Nations to extend
international legal norms protecting medical workers in times of war to conflicts
between European colonial powers and non-European peoples.
If medical neutrality was far from normative in these interwar colonial contexts,
appeals to it nonetheless deserve attention; as Adia Benton and Sa’ed Atshan (2016:
158) conclude, it is precisely in recognising that medical neutrality cannot be taken
for granted that we can come to understand medical neutrality ‘as its own potent
political stance’. This article has argued that Arab doctors, medical missionaries,
British counterinsurgents, and Palestinian rebels were all actively engaged—albeit
unequally—in negotiating the legitimate place of medical workers and healthcare
during conflict. While colonial counterinsurgents and some doctors understood
healthcare and medical authority as means to preserve the status quo, for medical
missionaries like Forster and—more particularly—those Palestinian rebels who
participated actively in the instantiation of international legal norms and protections
on the ground in Hebron, medicine might be put to the service of more radical ends:
not simply counterstate formation, but the erasure of those ‘perceived frontiers of
civilization’ (Redfield 2016: 263) which the British, like other European powers,
cited to avoid recognising these struggles between anti-colonial rebels and colonial
counterinsurgents as being a form of war, governed by rules, at all.
Acknowledgments I am very grateful to the anonymous peer reviewers for their highly constructive and
encouraging comments, and to the organisers and participants in the ’Power in Medicine: Interrogating
the Place of Medical Knowledge in the Modern Middle East’ workshop which took place in April 2019,
particularly Lamia Moghnieh and Edna Bonhomme. I also wish to thank, as ever, Hakan Sandal-Wilson
for his feedback and support.
Funding No funding to disclose.
Declarations
Conflict of interest Chris Sandal-Wilson declares that he has no conflict of interest.
Ethical Approval This article does not contain any studies with human participants or animals per-
formed by the author.
32 Cult Med Psychiatry (2023) 47:12–36
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Research Involved in Human and Animal Rights This article does not contain any studies with human
participants or animals performed by the author.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License,
which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as
you give appropriate credit to the original author(s) and the source, provide a link to the Creative
Commons licence, and indicate if changes were made. The images or other third party material in this
article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line
to the material. If material is not included in the article’s Creative Commons licence and your intended
use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain
permission directly from the copyright holder. To view a copy of this licence, visit http://
creativecommons.org/licenses/by/4.0/.
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