When Nafiz Abu Shabam received a 5-year-old patient at the Shifa Hospital early in the war between Israel and Hamas, he dressed her burns and sent her for tests. Three hours later, when he and other medical staff redressed the wound, they saw smoke coming from it.
"We found small pieces of foreign material in her body, and even when we picked it out, the wound was still smoking," he says. "We were later told [by foreign doctors and human rights workers who arrived after the war started] that it was white phosphorus."
Dr. Abu Shabam, head of the burn unit of Gaza City's main public hospital, now says that hundreds of Gazans from all parts of the strip, who were brought to the hospital during the war with unusual burns, must have been victims of white phosphorus shells used by Israel.
"We had patients who had burns over 10 to 15 percent of their body, and with that much of a burn, these people should not have died," Abu Shabam says.
His accusations about white phosphorus munitions add to the growing pool of accounts from Palestinian and foreign physicians and rights groups that suggest Israel used white phosphorus munitions in populated areas during the war and against the international norms of war.
As white phosphorus is highly incendiary, can reignite when exposed to oxygen, and causes painful chemical burns, it is not intended – or legal under international law – for use in civilian areas.
'Weapons permitted by law'
Israel initially denied that white phosphorus munitions were used in its 22-day war with Hamas. It now says, "there was no illegal use of phosphorus or any other material," according to the spokesman for Israel's Ministry of Foreign Affairs.
Amid the allegations that white phosphorus shells were used in populated areas, Israel announced an investigation.
"In response to the claims of NGOs and claims in the foreign press relating to the use of phosphorus weapons, and in order to remove any ambiguity, an investigative team has been established in the Southern Command to look into the issue," said an Israel Defense Forces (IDF) spokesman. "It must be noted that international law does not prohibit the use of weaponry containing phosphorus to create smoke screens and for marking purposes. The IDF only uses weapons permitted by law."
An Israeli foreign ministry statement pointed to findings by the International Committee of the Red Cross (ICRC), which said in mid-January that it found no evidence of illegal phosphorus use. "The investigation of this matter," the spokesman said, was part of "routine IDF checks of its internal operating procedures and in no way indicated any illegal use."
The ICRC has since clarified its position. "The fact that International Humanitarian Law does not specifically prohibit phosphorous weapons does not imply that any specific use of weapons containing this substance is legal," said Peter Herby, head of the ICRC's Arms Unit. "The legality of each incident of use has to be considered in light of all of the fundamental rules I have mentioned. It may be legal or not, depending on a variety of factors."
Mr. Herby also said: "The use of such white phosphorous weapons against any military objective within concentrations of civilians is prohibited unless the military objective is clearly separated from the civilians. The use of air-dropped incendiary weapons against military objectives within a concentration of civilians is simply prohibited. These prohibitions are contained in Protocol III of the Convention on Certain Conventional Weapons."
'Most compelling case'
In Shifa Hospital's burn unit, Yasser Khalil checks on one of their most seriously injured patients – a woman with abnormal burns on her arms and legs. Dr. Khalil says he believes the burns were caused by white phosphorus.
"It's the first time we've seen anything like this," he says. "It's completely different from the usual burns we see every day. It's very deep, and if you smell it, you have a hard time breathing. It goes beyond a fourth-degree burn. It can burn through the muscle and can reach the bone."
His description matches one about white phosphorous found on the globalsecurity.org website:
"The particles continue to burn unless deprived of atmospheric oxygen. Contact with these particles can cause local burns. These weapons are particularly nasty because white phosphorus continues to burn until it disappears. If service members are hit by pieces of white phosphorus, it could burn right down to the bone."
The woman's name is Sabah Abu Halima. She lays on a bed here, wrapped in bandages, mourning the loss of her husband and four of her children. They died in an Israeli shelling attack in El-Atatra, near Beit Lahiya in the northern Gaza Strip, an area with a mix of villages and agricultural fields. Israel says that the area around their house was being used by Hamas militants.
Two others in the house, a granddaughter and daughter-in-law, were also badly burned and transferred to Egypt for treatment. The Jan. 5 attack provides what Marc Garlasco, senior military analyst for Human Rights Watch (HRW), calls "the single most compelling case" of white phosphorus use by the Israeli army.
The Abu Halima family are farmers, growers of crops such as strawberries and cucumbers. They were eating a late lunch in the family room when Mrs. Abu Halima, mother of 10, got up to go to the kitchen to get more food. She hardly heard the shell, but she felt it. "The explosion was not that strong, but suddenly you're in the middle of fire, just fire and smoke," she says.
"I heard the little one crying 'Mama, Mama,' but I couldn't see anything or do anything because of the smoke and fire," she explains, and then begins to weep. Above her bed hangs a TV, broadcasting a buzz of somber verses from the Koran.
'We have the evidence'
Abu Shabam, head of the burn unit, complains that enough isn't being done by the international aid and rights groups to verify whether white phosphorus munitions were used in civilian areas. "The time is now," he says. "We need them to be investigating and testing the area of explosions before evidence is lost."
John Ging, the head of United Nations Relief and Works Agency (UNRWA), the main aid agency to the Palestinians, says it's clear that the shells that hit the UN compound here on Jan. 15 contained white phosphorous. When he was interviewed nine days later, in front of the warehouses in which food for distribution to Palestinians was destroyed, some of it was still smoking. Mr. Ging says this is symptomatic of white phosphorus.
"We have the evidence," he says. "We have the shell casings and we have the materials to stand by our allegations that it is white phosphorus."
New York-based HRW is expected to issue a report on the issue in the coming weeks. "When we got into Gaza, we found about 72 white phosphorus shells marked M825E1, which is the US designation for a white phosphorus shell which has been upgraded," says Mr. Garlasco.
He says he found spent and unexploded white phosphorus canisters. Of the 72, 24 were found in or adjacent to homes. Inside the Abu Halima home in particular, he says, he found the shell and a white phosphorus canister, and another two canisters outside the house. He says the burned-out walls also left behind the residue of white phosphorus.
"On top of all that, we found hundreds of pieces of felt wedges that are impregnated with phosphorus, and when they were disturbed, they would reignite," he says. "You kick it and it's on fire again."
Amnesty International says a fact-finding team here has also found evidence that white phosphorus was used in populated areas. "We now know that white phosphorus munitions were used in built-up civilian areas, although the Israeli authorities previously denied this," said Donatella Rovera, head of Amnesty International's investigation team in Gaza, in a statement on the organization's website.
Christine Gosden, a British medical expert who researched the effects of chemical and biological weapons in Saddam Hussein's Iraq, says that the international community, preferably a UN Security Council member, needs to demand an investigation.
"We have an appalling death toll, and we have to see that every option be used to find out what killed them. There might be better ways of treating the people who are injured and to do that, we need to know what was used," says Professor Gosden, of Britain's Royal Liverpool University Hospital. "You need a responsible laboratory with no ax to grind to be testing this."