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The Lancet brouhaha & scientific integrity

The Lancet, one of the world’s most prestigious medical journals, and its owner both stand to lose much of their lustre if a serious controversy is not resolved very soon over publication of an objectionable unscientific open letter. Retraction will ensure their integrity by warning readers that when it is discovered that material containing unreliable or inappropriate content has been unjustifiably published and it is obvious that the Lancet’s high reputation will be seriously tarnished if this offending letter is not retracted.





Sadly The Lancet, one of the most prestigious medical journals in the world, founded in 1823 and its owner Elsevier, both stand to lose much of their lustre if a serious controversy is not resolved very soon over publication of an objectionable unscientific open letter.

Under the bold headline “Lancet hijacked in anti-Israel campaign” the British Telegraph reported that senior medical figures say the well-respected journal is being used as a platform by alleged conspiracy theorists. It is not surprising that publication of an unscientific emotional one-sided political opinion letter by authors, with dubious credentials relating to the subject of the letter, has reflected so adversely on the journal. 

Five principal authors of the offending letter misleadingly declared they had no competing interests, egregiously failing to disclose that they actively promote the Palestinian cause and that two of them, Dr Paola Manduca and Dr Swee Ang who are members of pro-Palestine NGOs, distributed a video containing an extended anti-Semitic rant by the notorious white supremacist and former Ku Klux Klan Grand Wizard David Duke, who has been described as “a neo-Nazi”.  Moreover, Dr Manduca is known to have forwarded an e-mail message alleging that the Boston marathon bombings were carried out by Jews.

Because appeals to retract the Manduca letter have fallen on deaf ears, a large and increasing number of senior physicians and scientists have resigned from Lancet committees and are calling for a boycott of all Elsevier scientific publications.  This boycott includes refusing to subscribe to Elsevier publications, refusing to submit manuscripts to Elsevier publications, refusing to cite articles that appear in Elsevier publications and withdrawing chapters from Elsevier textbooks.

A sidelight to this sorry episode is eloquently detailed in a letter by Professor Eric Hassall, Emeritus Professor of Paediatrics at the University of British Columbia to Professor David Sanders, Emeritus Professor at the School of Public Health, University of the Western Cape [Footnote 1]

On a positive note, Lancet editor Dr. Horton accepted an invitation to visit the Rambam Medical Centre in Haifa after which he declared that he had revised his opinion in the light of what he learned during the three-day visit as described in more detail in a letter I submitted to the Lancet, copied below. It remains to be seen whether the Lancet will publish it.

The offending Gaza letter and Dr Horton’s visit to Israel

By Maurice Ostroff M.Sc (eng.), FIAC

The controversial “Open letter for the people in Gaza” published online on July 23, 2014 that caused wide adverse publicity for the Lancet contained over 1 500 words and as an Israeli citizen directly wounded by that letter I trust the Lancet will afford me space to exercise my right of reply.

Firstly I refer to the visit by Lancet editor, Dr Horton to Rambam Medical Centre and I commend him on his courage in revising his opinion in the light of new information.  He deserves admiration for choosing honesty above personal considerations.  As  Kathryn Schulz, author of “Being Wrong –  Adventures in the Margin of Error” wrote:

“When you are open to the idea of being wrong, when you truly believe that another path might be better and are not cowed by it, you will be a more creative and innovative person.”

As Dr Horton wrote in his People to People letter:

“At Rambam I saw an inspiring model of partnership between Jews and Arabs in a part of Israel where 40% of the population is Arab. I saw Rambam offering an open hand, gladly grasped by families from Gaza, the West Bank, and Syria, who were living with life-threatening healthcare needs. I saw Rambam as one example of a vision for a peaceful and productive future between peoples, which I learned exists throughout Israel’s hospitals”.

Most significantly he pointed to a better way. He wrote:

“What is the opportunity? First, we have to make a conscious choice. Either one can let residual anger prevail and entrench existing divisions still further – a position that has too often scarred relations in the Middle East. Or one can use this moment to nurture something positive and long lasting, which I firmly intend to do.”

And in his speech at Rambam, Horton said:

“I need, very honestly, to set the record straight with you. First, I deeply regret the completely unnecessary polarisation that publication of the letter by Paola Manduca caused… Second…I was personally horrified at the offensive video that was forwarded by two of the authors of that letter. The world view expressed in that video is abhorrent and must be condemned, and I condemn it.”

During his visit, Dr Horton expressed his clear opposition to boycotts in general and to BDS in particular.  He also expressed the desire to receive manuscripts from Israel, and to promote collaboration between Rambam and The Lancet to further the cause of healthcare at all levels of society for all peoples worldwide.

The ombudsman’s report

As the ombudsman states that she has not found sufficient grounds for retraction of the offending letter, I offer with respect the following compelling reasons:

1. The letter should have been disqualified ab initio for failing to meet the Lancet’s minimum criteria that “Authors should say how they assessed the quality of evidence, ie, how they selected and how they combined the evidence”.

2. The authors’ claim that they “witnessed” the events they described is misleading. Equally egregious is their claim that they were presenting facts whereas they were expressing their opinions.

3. The ombudsman’s report states that shocking images and statistics reported from Gaza justify the use of emotive language. To the contrary, there is absolutely no justification for the unscientific emotional false accusations in that letter which completely avoid the context that is essential to enable a reader to understand matter under discussion. As omission of relevant information is as deceptive as providing false information it is unacceptable in intellectually honest journalism and even more so in a scientific journal.

4. Before the letter was published in print on August 2, 2014, a great deal of information was already available indicating that extreme caution was necessary in evaluating press reports from Gaza and apportioning blame.

For example on July 21 the WSJ’s Middle East correspondent posted a photo on Twitter of a Hamas leader giving an interview from a room in Gaza’s Shifa Hospital confirming Israel’s claim that the medical facility was being used as a “de facto headquarters for Hamas leaders” along with other civilian institutions such as mosques, schools and private homes.

Similarly, the correspondent for Radio Popolare Milano reported that Hamas rockets, not IDF strikes, hit the UN Shati refugee camp, killing nine children.

5. Intellectual honesty demands that no person who purports to express an informed opinion on the Gaza conflict in general, or Manduca’s allegations in particular, can ignore readily available important and relevant information. For example the following articles throw some light on the credibility of reports from Gaza [footnote 2].

6. The extremely prejudiced outlook of the authors of the letter was confirmed by Dr Horton who was horrified to discover that two co-authors of the Manduca letter had forwarded a vile and offensive video that is “abhorrent and deserves universal condemnation”.  Publishing unscientific emotional letters by such extremely openly biased authors degrades the prestige of the Lancet,

7. Since the outcome of the offending letter was extreme polarisation Dr Horton proposed that editors should always pause, reflect and consult before publishing any manuscript that might unnecessarily polarise, or foster or worsen political division.

Contrary to this recommendation, the offending letter was not reviewed.

8. The report states that some letters received were unacceptable in scholarly or political debate being inappropriate in tone. By the same standard the entire tone of the Manduca letter is even more inappropriate, couched as it is in unverifiable assumptions and accusations which have no place in responsible media let alone a scientific journal.

9. Although readers should be able to rely on the validity of information contained in scientific journals this does not apply to the Manduca letter since Dr Horton said he saw for himself that the letter does not describe the full reality.

10. Retraction is intended to ensure the integrity of a journal by warning readers when it is discovered that material containing unreliable or inappropriate content has been unjustifiably published and it is obvious that the Lancet’s high reputation will be seriously tarnished if this offending letter is not retracted.

The seriousness of the matter is emphasised by the resignation of several distinguished professors from the editorial boards of specialised Lancet publications and their decisions to avoid submitting further contributions until this matter is resolved.



[2] and and  

  • Maurice Ostroff is a founder member of the international Coalition of Hasbara Volunteers, better known by its acronym CoHaV, (star  in Hebrew), a worldwide umbrella organisation of volunteers active in combating anti-Israel media and political bias and in promoting the positive side of Israel

Maurice is a regular contributor to Jewish Report Online. 
CLICK HERE to see 16 more items by Ostroff on this website.

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1 Comment

1 Comment

  1. Denis Solomons

    Dec 11, 2014 at 7:53 am

    ‘It is difficult to understand how a prestigious journal like the Lancet became embroiled in a political debate ; on the middle-east conflict !

    this is a minefield in itself but the ramifications are catastrofic with resignations , etc.

    Perhaps medical journals should only report on medical topics and leave politics to the politicians .

    But perhaps there is a grey zone where there is an overlap between health issues and political agendas.

    Stethoscopes are for medical doctors and board rooms are for politicians and emissaries .

    We live in interesting times !

    Perhaps the Ebola crises will have political ramifications and what involves West Africa may soon take on a global stand.

    Role on an effective Ebola vaccine ! ‘

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SA Jewish leadership confront Israeli PM over travellers’ ordeal



Orthodox spiritual leaders in South Africa have expressed their shock and dismay over the treatment of South African travellers turned away from Ben Gurion Airport last Friday night.

Chief Rabbi Dr Warren Goldstein, South African Rabbinical Association Chairperson Rabbi Yossi Chaikin, and the dayanim of the Beth Din of South Africa wrote to Israeli Prime Minister Naftali Bennett on 30 November expressing their unhappiness.

The group of five travellers from South Africa included two who were going to Israel to comfort the Kay family after the murder of their son and brother, Eli Kay, in a terrorist attack on 21 November.

They were in the air when Israeli authorities decided to ban South African travellers in light of a new COVID-19 variant discovered by South African scientists. On landing in Israel, they were forced onto a flight back to South Africa via Dubai on Shabbat.

“We were shocked and dismayed to hear that a group of Jewish travellers from South Africa, who arrived at Ben Gurion Airport this past Friday, were denied entry into Israel and forcibly returned to their country of origin, and as a result were compelled to desecrate Shabbat,” wrote our religious leaders.

“That this took place in the Jewish state is simply unconscionable,” they wrote. “To further compound the trauma, two of the passengers were making their way to Israel to spend Shabbat with the Kay family, who are mourning the loss of their beloved Eli in last week’s terror attack in Jerusalem. From the reports we received, no attempt was made to accommodate the passengers by allowing them to remain in quarantine over Shabbat.

“To force fellow Jews to desecrate Shabbat is a violation of the Jewish identity and Jewish values of the state,” they wrote. “The manner in which the religious rights of these individuals have been infringed isn’t something one would expect of any country, and certainly not the Jewish state. On behalf of South Africa’s rabbis and the communities we represent, we wish to record our strongest objection to the forced desecration of Shabbat.”

One of these travellers, Ilana Smith, says the incident led to more stress and trauma for the Kay family, who tried to help the travellers in spite of being in mourning. “I was going to Israel only to be there for the Kay family. I was staying nearby, and was going nowhere else. And now the Kay family had this extra stress on their hands – the last thing they needed! Kasriel Kay was phoning the rabbi in Dubai, trying to help us. My family back home went into Shabbos not knowing if I would be stuck in Dubai. There are post-traumatic repercussions from this ordeal.”

Melissa Genende was travelling to Israel from South Africa to see her grandchildren on the same flight as Smith. “We had no knowledge of the flight ban, and weren’t stopped until we arrived in Israel on Friday afternoon. Our passports were taken from us. We were marched underground and came up at the departure gate for the flight going back to Dubai.

“We were threatened that if we didn’t board the plane, the police would be called,” she said. “This in fact did happen while we explained that we didn’t want to fly on Shabbat. At this point, we had no choice but to get on the plane. I’m not fully shomer Shabbos, but I would never travel on a plane on Shabbat. I have travelled many times in my life, and always make a plan that I don’t travel on Shabbat, often with a lot of extra cost.”

She’s angry that all the other people on the plane entered Israel with no problem. “We came from South Africa on the same plane, so why were we not giving any other option? We could have gone into bidud [quarantine] for a few days. We had all been tested, and I had already prepaid for PCR tests at the airport. I understand the panic. What I don’t understand is how they make a decision for five people and let everyone else in the country.”

The group had no opportunity to get food or water while waiting in the airport. “Kosher food was also unavailable to us for the entire two flights. When we landed in Dubai, it was already Shabbos. We had nowhere to wait all night until our flight at 05:00. We managed to find a lounge that would allow us to pay $32 [R513] for four hours. There was no kosher food there. We arrived back in South Africa at 12:00 on Saturday. Our luggage didn’t arrive, and we still have no idea where it is or when will get it back.”

Genende has since been ill from dehydration and travel sickness. “I’m taking this as far as can. I’m hoping that the Israeli government will do something about the staff at the airport. At the very least, I want a new ticket to Israel. I will fight until I get answers and compensation.” Emirates, she says, won’t reimburse her as she has “used” the return flight.

Even though she was able to get home, she says she would have preferred to be stuck in Israel than to have experienced this. She says she and the other South Africans have since been asked to go to the Israeli Embassy in Pretoria to meet the ambassador. She’s waiting “with bated breath” to hear what’s said. She’s had no other communication from anyone in Israel.

Former MK and olim advocate, Dov Lipman, has worked tirelessly with his organisation, Yad L’Olim, to assist olim and their families to deal with travel restrictions throughout the pandemic. In the past few days, he has barely slept as Israel went from one extreme to the other in a matter of hours.

“It’s been a really difficult time for South African Jewry,” he says. “I hear their pain, I hear their cries. The incident last Friday was nothing short of tragic, and I use that word deliberately. It’s a tragedy when someone arrives in Israel legally and is turned away.”

He says the incident has been covered extensively by the Israeli media, “with strong criticism of the government for the way it was handled from all segments of Israel’s population. At the very least, this kind of thing won’t happen again because of the degree of criticism.”

He was involved in trying to assist the South Africans. “I had a hard time enjoying my Shabbat knowing that people were in transit to who knows where. It was very painful. I’m now even more motivated to help olim and their families around the world. I believe all of our efforts will lead to a better situation.”

In response to queries from the SA Jewish Report, the Israeli Embassy in Pretoria released an official statement. “We deeply regret the unfortunate incident that occurred at Ben Gurion Airport on 26 November when a group of South African citizens were deported and had to violate their religious beliefs. The incident took place immediately after the imposition of new strict COVID-19 regulations. The incident is being investigated, and necessary conclusions will be drawn. Needless to say, if the embassy had been informed of these events in time of the occurrence, this unfortunate chain of events could have been prevented.”

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Citizens take government to court over Miss SA bullying



Citizens for Integrity (CFI) has accused the government and the minister of sports, arts, and culture of acting unconstitutionally and irrationally in its “bullying” of Miss SA.

The non-governmental organisation has filed papers in the North Gauteng High Court taking the government and Minister Nathi Mthethwa to task for withdrawing its support for the local beauty queen in November, and for calling for her to withdraw from the 70th Miss Universe pageant to be held in Israel in less than two weeks.

In a press statement issued this week, CFI said that as an organisation “aimed at protecting the rights of citizens and the public against abuse, unconstitutional action, and irrational government decisions which affect citizens’ rights”, it took issue with the government and the minister.

It has demanded an apology and an immediate retraction of the statement withdrawing its support for the Miss SA organisation and Miss SA, Lalela Mswane.

Mswane, a University of Pretoria LLB graduate who was born in KwaSokhulu in Richards Bay, KwaZulu-Natal, has consistently stood her ground through a steady stream of harassment and vilification by Israel-haters and politicians hell bent on scuppering her once-in-a-life time opportunity to participate on the international stage.

In spite of this, she left for Israel at the weekend in preparation for the pageant, with the full backing and support of the Miss SA organisation and countless fans who have steadfastly continued to support her in her decision to participate.

Following weeks of intimidation by anti-Israel lobbyists, Mswane, dressed in a bright yellow, summery jumpsuit left the country telling her fans, “We will Rise”, and expressing how grateful she was for the opportunity to represent her country.

The Miss SA organisation posted, “We stand united with you @lalela_mswane. You have already made us so proud, and we know you will continue to do so. We love and adore you.”

Willie Hofmeyr, the retired head of the asset forfeiture unit at the National Prosecuting Authority, and also one of the founders and directors of CFI, said this week that it was an “important issue to address”.

“We need to ensure that all citizens in the country are treated equally well and fairly. It appears as if Miss SA has not been treated fairly,” he said.

Sibongile Cele, the deputy chairperson of the African National Congress (ANC) Women’s League Johannesburg, also insisted that Miss SA’s rights had been infringed upon. “As a committed Christian, I felt it was important to look at her rights as a woman and her rights as Miss SA,” said Cele, who is also a spokesperson for the CFI.

“Her rights shouldn’t be infringed because of politics. The Miss Universe pageant shouldn’t be politicised, and as a citizen of this country, she has the right to compete in the pageant. She shouldn’t be held back, she won the title of Miss SA, and she is our ambassador,” Cele said. She isn’t afraid of a backlash from the ANC saying, “ I am a Christian before I am a member of the ANC, we report to G-d first.”

The CFI said in papers before the court that the government’s decision also “didn’t constitute a legitimate purpose of government” as it didn’t “fall within the legitimate powers and objectives conferred upon the government by the Constitution”.

“The government has not only failed, but has deliberately transgressed its obligation to respect and protect the human rights guaranteed to all in the Bill of Rights,” it said.

Although Mswane is already in Israel, the CFI launched an urgent application in the Gauteng North High Court to be heard on Tuesday, 7 December to have the government’s statement declared unconstitutional, said Cele.

She said the organisation’s attorneys had written to President Cyril Ramaphosa demanding an apology to South Africans “for exceeding the bounds of the government’s authority, and interfering in the rights of citizens”.

“The South African government’s decision to support a boycott of a country with which it has diplomatic relations and withdraw its support for a citizen – who will participate in a non-political cultural event in that country – is also irrational, especially in light of the fact that countries that don’t have diplomatic relations with Israel are allowing their citizens to participate and are furnishing them with due support,” said the CFI.

“That agents of the South African government approached Miss South Africa and attempted to coerce her to withdraw from her legitimate participation in the Miss Universe pageant is unconscionable and disgraceful by all normal standards of governance,” it said.

The decision constituted “a standard of bullying by government” and also induced “a sense of unease” that the government may arbitrarily and unconstitutionally pick on any citizen “regarded with disfavour”.

Meanwhile a smiling and ecstatic Mswane has posted pictures of herself on Instagram in Israel dressed in locally designed outfits.

After a long silence, the 24-year-old took to social media before she left, saying attending Miss Universe was “not only an honour but also a huge responsibility”.

“I am determined to serve our country proudly in the best way I can. I stand today as an empowered woman because of so many before me who fought for our voices to be heard. I feel my duty is to do the same for the women of the past, the women of today, and the women to come.

“There is no greater time to shed light on issues affecting women, to choose courage over comfort, and to be steadfast in my beliefs regarding the advancement of women and our rights.”

Mswane said she viewed her participation in the pageant as a “unique opportunity” hopefully to contribute to the process of dialogue and peace.

“I am deeply thankful to all the amazing people who have supported and uplifted me, and brought me joy and comfort during the lead-up to this moment. I wish to compete with the support of South Africans and do my country proud,” she said.

In spite of the anti-Israel lobby’s attempts to harass contestants into pulling out of the pageant, not one country is boycotting. Several have pulled out due to COVID-19, but none have withdrawn for political reasons. The Israel-haters spread fake news that countries such as Greece and Barbados had withdrawn because they were boycotting Israel, however this was proven false.

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The terrorist attack that struck very close to home



It’s noteworthy that two days after British Interior Minister Priti Patel announced that she was banning the Palestinian militant group, Hamas, Eliyahu David Kay was shot dead by one of its activists.

The United States and European Union had already listed Hamas as a foreign terrorist movement whereas South Africa, Russia, China, Iran, and others don’t regard it as one.

Official Hamas delegations have visited these countries especially in the years following 2007 when its leaders took control of the Gaza Strip and removed rival Palestinian Fatah officials from office. Tensions between the two groups are rife.

Mahmoud Abbas, the president of the Fatah-controlled areas of the Palestinian territories, fears a similar takeover in the West Bank. Years ago, it was difficult to get Hamas supporters in cities like Ramallah, Jenin, Hebron, and surrounding villages to talk freely on television without their faces being blurred and location hidden. I remember being sworn to secrecy for the select few who agreed to meet with foreign journalists.

There’s no such problem today. The movement’s green flags mark the entrance to many buildings across the West Bank and graffiti to match emblazons walls with a single word: Hamas. Abbas has indefinitely postponed planned parliamentary elections for fear its outcome could result in gains for his rival.

The latest surge in Hamas’ popularity is a direct result of the May war in which Gaza militants fired about 4 000 rockets into Israel, terrorising residents in Tel Aviv and other cities. That performance earned Hamas newfound admiration among Palestinians not only in Gaza, but also crucially in the West Bank.

At the same time, Abbas was widely criticised – even among fellow Fatah members – for his limp response to Israeli attacks. Long before the most recent round of fighting, Abbas, the 85-year-old heir to Arafat, was flailing. He’s intensely disliked, and it’s not difficult to get Palestinians, especially youngsters, to openly admit it.

Many describe his government as an autocracy in which there are few checks on Abbas’s internal power. He’s criticised for being corrupt, ineffective, inept and tellingly, blamed for remaining beholden to Israel for his ultimate authority.

Hamas has no such problems. Its charter defines historic Palestine – including present-day Israel – as Islamic land, and rules out any permanent peace with the Jewish state. While Abbas is bound by international agreements, Hamas isn’t.

Kay’s murder has heightened Israeli security forces’ attention once again on Hamas and the role it could play in stirring unrest in the West Bank. The group praised Sunday’s attack as a “heroic operation” carried out by a high-ranking member of its organisation.

The group is likely to continue to encourage terrorism in Jerusalem and the West Bank in the hope that it will destabilise the rule of Abbas’ Palestinian Authority (PA) and its ties with Israel.

What’s important to note is that Kay’s attacker, a 42-year-old high school teacher, Fadi Abu Shkhaidem, hailed from the East Jerusalem neighbourhood of Shuafat. Hours after he was shot dead by security forces, clashes broke out at the entrance to the neighbourhood between police and rioters, some of whom threw rocks at the forces. Israeli authorities said the attack appeared to have been planned because Abu Shkhaidem’s wife had left the country days earlier. They’ve arrested several members of his family.

The concern here is that this isn’t the West Bank or Gaza. This is inside Israel. The neighbourhood lies within the boundaries of the Jerusalem municipality, where support for Hamas has been on the increase.

It’s perceived as having initiated the most recent Israel-Gaza war to stop evictions in the East Jerusalem Sheikh Jarrah neighbourhood. It’s also believed to be behind forcing Israel to rescind its strict security measures in Jerusalem’s Old City and the al-Aqsa mosque compound. Hamas leader Ismail Haniyeh was in direct contact with the Sheikh Jarrah families threatened with eviction.

Like many Palestinians in the West Bank and Gaza Strip, the predominantly Muslim residents of East Jerusalem are part of a conservative and religious society that supports any group that’s associated with Islam.

The PA, by contrast, is loathed by many Palestinians because it’s regarded as a corrupt secular regime that operates in violation of Islamic teachings.

In the wake of Kay’s murder, Israeli police have beefed up their forces in the Old City and the army is refining the preparedness of its units in the West Bank. Israel’s defence establishment is worried about another showdown between Israel and Gaza, and is closely watching to see if Kay’s murder will have an impact on the situation inside Gaza.

Another concern is copycat attacks. Particularly in light of the fact that Sunday’s attack was in the vicinity of the Temple Mount, it engenders religious sensitivities and the possibility that other Palestinians might seek to follow in the path of the dead terrorists.

Foreign Minister Yair Lapid on Monday demanded that Istanbul shut down Hamas offices operating in Turkey after Israel announced the arrests of a sophisticated 50-member West Bank Hamas cell being directed from Istanbul.

According to the Israel Security Agency, Shin Bet, the Hamas cell was led from Turkey by Saleh al-Arouri, the deputy head of the group’s politburo, and Zacharia Najib, a member of the organisation who was released from Israeli prison in the 2011 Gilad Shalit exchange. They are believed to continue to operate there on behalf of Hamas. Both al-Arouri and Najib live in Turkey, which has long had a close relationship with Hamas, which is politically linked to Turkish President Recep Tayyip Erdogan.

During the Shin Bet operation, security forces captured weapons and materials for preparing four suicide-bomb belts. A senior Shin Bet source said the disruption of a “broad, significant, dangerous terror cell” prevented a series of severe attacks. Its objective was to “undermine regional stability while creating a heavy price tag for local [Palestinian] residents”.

Kay’s murder naturally made headlines in Israel. The government, army, and police are doing their best to try to prevent future incidents, but the sad Israeli reality is that it’s only a matter of time before another family and community is ripped apart. What South African Jewry felt this week is unfortunately what Israelis feel on an ongoing basis.

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