Gaza 'Is Living In A Disaster Situation'

By Katie Stallard, Sky News Correspondent, in Gaza

The first ambulance came in at speed, tyres squealing.

Inside, was a 10-year-old boy.

They rushed him to the emergency ward, but there was nothing they could do to save his life.

We saw other children being brought in - a little girl, maybe five years old, carried in a paramedic's arms.

An ambulance brings a child to Gaza's Shifa Hospital

She looked absolutely terrified.

The doctors told us they treated a six-month-old baby for shrapnel wounds to the head.

We saw an 80-year-old woman, clearly very frail and confused and clearly seriously injured.

"Gaza is living in a disaster situation," said Dr Sobhi Skaik at Shifa Hospital.

"Again the war is coming to kill and kill and kill.

"Today is the 33rd day of this massacre in Gaza. This is inhuman and it has to be stopped."

Dr Sobhu Skaik tends to an injured 80-year-old woman

He said they need basic supplies now - surgical instruments, drugs, medication, and expertise - specifically vascular, orthopaedic and neurosurgeons.

One of the ambulances pulling up outside had blast damage to the windscreen and a bullet hole in the side.

Six medics have been killed in Gaza so far.

Paramedic Ahmed Abu-Ali said: "We feel we are targeted in any minute.

"All medical teams are now afraid they are targeted, it's very hard now.

"We wake up every day and we don't know if we are coming back to our homes or not."

We saw outgoing rockets too.

Although Hamas has not admitted firing any rockets since the ceasefire ended, Islamic Jihad and other smaller militant groups have said they fired on Israel.

But Israel says Hamas violated the ceasefire, and therefore Hamas is responsible for any resulting harm to the residents Gaza, who, it says, are being used as human shields.

But it's difficult to explain that argument to a parent carrying their child into the emergency ward.

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UK Sends NHS Staff To Gaza As Truce Stalls

'Again The War Is Coming To Kill And Kill'

Updated: 10:20pm UK, Friday 08 August 2014

By Katie Stallard, Sky News Correspondent, in Gaza

The first ambulance came in at speed, tyres squealing.

Inside, was a 10-year-old boy.

They rushed him to the emergency ward, but there was nothing they could do to save his life.

We saw other children being brought in - a little girl, maybe five years old, carried in a paramedic's arms.

She looked absolutely terrified.

The doctors told us they treated a six-month-old baby for shrapnel wounds to the head.

We saw an 80-year-old woman, clearly very frail and confused and clearly seriously injured.

"Gaza is living in a disaster situation," said Dr Sobhi Skaik at Shifa Hospital.

"Again the war is coming to kill and kill and kill.

"Today is the 33rd day of this massacre in Gaza. This is inhuman and it has to be stopped."

He said they need basic supplies now - surgical instruments, drugs, medication, and expertise - specifically vascular, orthopaedic and neurosurgeons.

One of the ambulances pulling up outside had blast damage to the windscreen and a bullet hole in the side.

Six medics have been killed in Gaza so far.

Paramedic Ahmed Abu-Ali said: "We feel we are targeted in any minute.

"All medical teams are now afraid they are targeted, it's very hard now.

"We wake up every day and we don't know if we are coming back to our homes or not."

We saw outgoing rockets too.

Although Hamas has not admitted firing any rockets since the ceasefire ended, Islamic Jihad and other smaller militant groups have said they fired on Israel.

But Israel says Hamas violated the ceasefire, and therefore Hamas is responsible for any resulting harm to the residents Gaza, who, it says, are being used as human shields.

But it's difficult to explain that argument to a parent carrying their child into the emergency ward.

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WHO Under Pressure To Support New Ebola Drug

Ebola Cure 'A Long Way Off': Facts About Virus

Updated: 12:08am UK, Thursday 07 August 2014

A cure for the deadly ebola virus, which has killed hundreds of people in West Africa, is "a very long way off", an expert has told Sky News.

David Evans, a professor of virology at Warwick University, said ebola is the latest disease to be transmitted "very efficiently" because of international travel.

More than 670 people in Sierra Leone, Liberia, Guinea and Nigeria have fallen victim to the viral illness, which has a fatality rate of up to 90%.

Those with ebola will often be overcome by a sudden onset of fever, as well as weakness, muscle pain and headaches.

The body is then gripped by vomiting, diarrhoea, rashes, kidney and liver problems and bleeding.

The time between infection and symptoms appearing is anything from two days to three weeks.

Ebola is spread through the direct contact with the blood, organs or other bodily fluids of those infected.

The liquid that bathes the eye and semen can transmit the disease, Prof Evans said.

Horseshoe bats are believed to be the natural host of the viral disease, he said.

"These bats transmit the virus between themselves, but periodically it then ends up in probably primates or other types of bushmeat which are then hunted by villagers and the virus is then transmitted from the sick animals to humans," he said.

Transmission has also been documented through the handling of chimpanzees, gorillas and porcupines.

One of the reasons for the disease's rapid spread is a tradition at burial ceremonies for mourners to have direct contact with the body of the deceased.

"Therefore barrier methods that prevent that direct contact, including things like washing of hands and things like that provide a reasonable level of protection," he said.

Healthcare workers treating patients are particularly at risk.

Public Health England said in a risk assessment published earlier this month said that the current outbreak could increase the risk for Britons working in humanitarian and healthcare delivery.

But the threat to tourists, visitors and expatriates is still considered "very low if elementary precautions are followed".

Prof Evans said there had been "periodic outbreaks" of ebola since the first recorded instances in 1976, but this is the deadliest so far.

There were two simultaneous outbreaks in Nzara, Sudan and Yambuku, a village in the Democratic Republic of Congo located near the Ebola River.

Data from the World Health Organisation shows the previous deadliest outbreak was the one in the DRC, when 280 out of 315 people infected died.

In the same country in 1995 another outbreak claimed 254 lives, with 315 patients infected.

In 2000, there were 425 cases in Uganda and 224 people died.

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Ebola Outbreak: WHO To Set Scale Of Emergency

A Spanish missionary priest infected with ebola has become the first person to be treated in Europe during the deadly outbreak which has hit West Africa.

Miguel Pajares, who contracted it while helping ebola patients at a hospital in the Liberian capital Monrovia, is in hospital in Madrid after being flown in from Liberia.

The disease has killed at least 932 people in Guinea, Sierra Leone, Liberia and Nigeria since it first emerged in remote tropical forests earlier this year.

A specially equipped military Airbus A310 brought Mr Pajares, 75, to the Torrejon airbase along with a Spanish nun, Juliana Bonoha Bohe.

Miguel Pajares is placed in an ambulance at the Torrejon airbase

She had worked at the same Liberian hospital but did not test positive for ebola.

Immediately after landing, ambulances took the pair to Carlos III Hospital, which specialises in tropical diseases, and they were kept in isolation.

The priest was stable and showed no sign of bleeding while the nun appeared to be well but would be re-tested for ebola just in case, health officials said.

The priest was taken to hospital in the Spanish capital

The World Health Organisation will reveal this morning whether they consider the ebola outbreak to have become a global health emergency.

Meanwhile, Britain is committing another £3m on top of £2m already pledged to Sierra Leone and Liberia which will allow charities to increase specialist care and improve monitoring of the disease.

Bodies lay in Liberian streets with passers-by too scared to touch them

A state of emergency has been declared in Liberia where bodies lay in streets, with passers-by too scared to touch or help them.

In Sierra Leone, troops were sent to guard hospitals and clinics handling ebola cases.

The priest and nun have been transported to Carlos III hospital in Madrid

Two Americans who worked for Christian aid agencies in Liberia and were infected with ebola while taking care of patients in Monrovia were recently flown to the US for treatment.

They have shown signs of improvement after being given an experimental US-developed drug known as ZMapp, which is difficult to produce on a large scale.

Nigeria is holding out hope that it could receive ZMapp - a drug which is proving controversial as it not being made available to victims in Africa.

The patients were surrounded by medical staff

There is growing pressure on the World Health Organisation to sanction the use of such drugs in Africa.

But US President Barack Obama said it was too soon to send ZMapp to the continent, adding: "We've got to let the science guide us."

He said: "I don't think all the information is in on whether this drug is helpful."

Ebola - which has a mortality rate of up to 90% - cannot spread through airborne or waterborne methods, say experts.

It is transmitted primarily through contact with bodily fluids such as saliva, blood, urine and other secretions.

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Obama: Ebola Drug ZMapp 'Not Ready For Africa'

It is too soon to send an experimental drug to Africa to treat the deadly ebola virus, according to Barack Obama.

Two Americans are already receiving the ZMapp drug in the US, but the President said efforts should focus on improving facilities and sending more aid workers to the region.

"We've got to let the science guide us," the US President said.

"I don't think all the information is in on whether this drug is helpful. What we do know is that the ebola virus - both currently and in the past - is controllable if you have strong public health infrastructure in place."

"Let's get all the health workers that we need on the ground,"  he added. "Let's help to bolster the systems that they already have in place.

"During the course of that process, I think it's entirely appropriate for us to see if there are additional drugs or medical treatments (that can help)."

Nigeria's health minister, Onyenbuchi Chukwu, told reporters he had asked the US about accessing the experimental drug, ZMapp.

However, there are "virtually no doses available", according to the US Centers for Disease Control and Prevention.

As debate over the drug continues, people are continuing to die in West Africa, with Liberia's president declaring a state of emergency.

Another 45 people died between August 2 and 4, with another 108 suspected cases identified, according to the World Health Organisation (WHO).

Dr Brantly reportedly improved after taking ZMapp. Pic: Samaritans Purse

The death toll now stands at 932.

Most of the new cases were in Liberia, where the president said he might have to limit some freedoms.

The World Health Organisation (WHO) has convened a panel of experts to explore the use of experimental treatments and will announce a plan to deal with the virus on Friday.

ZMapp, made by a company in San Diego, is being used to treat American aid workers Kent Brantly and Nancy Writebol.

Ebola treatment facilities are ready at London's Royal Free Hospital

The pair improved after being given the drug while still in Liberia, according to the group they were working for, but it is unclear whether the drug was responsible.

ZMapp has never been tested on humans and was only identified as a possible treatment in January after research by the US government and the military.

"This is an emergency compassionate use situation," Professor Erica Ollman Saphire, from the Scripps Research Institute, told Sky News.

"This is not a well-controlled laboratory study. A lot of work remains to be done on how it worked and why, and how quickly."

Experiments on monkeys suggest ZMapp may reduce fatalities in infected people.

It is slow to produce however, and the antibodies have to be grown in specially-modified tobacco leaves.

Symptoms of the incurable virus include fever, vomiting, severe headaches, muscular pain and, as the patient nears the end, profuse bleeding.

It is transmitted via bodily fluids rather than through the air and has a mortality rate of 60-90%.

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Final Arguments Due As Pistorius Trial Resumes

The Oscar Pistorius murder trial resumes today, with the prosecution and defence delivering their all-important closing statements.

State prosecutor Gerrie Nel will be first to say why he believes Pistorius is guilty of shooting dead his model girlfriend, Reeva Steenkamp, after an argument.

Defence lawyer Barry Roux will then present Pistorius' version of events; that the killing was a terrible accident as the paranoid athlete mistook Ms Steenkamp for an intruder.

Lawyer Barry Roux (right) will sum up for the defence

Pistorius, 27, faces a minimum 25 years behind bars if found guilty of premeditated murder on Valentine's Day last year.

He could also be convicted on lesser charges, such as culpable homicide or murder without premeditation.

Ms Steenkamp's mother and sisters at the Pretoria trial

The trial in Pretoria was put on hold last month after hearing from 37 witnesses.

Judge Thokozile Masipa will decide Pistorius' fate with help from two legal assistants - there is no trial by jury in South Africa.

This week's hearing will last two days before she adjourns the case to consider the verdict.

Paralympian Pistorius has repeatedly vomited and cried during the five-month long trial, with Ms Steenkamp's mother watching him impassively from the public gallery.

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Digger Topples Bus In Israel 'Terror Attack'

Key Dates In The Gaza-Israel Conflict

Updated: 10:36am UK, Monday 04 August 2014

Israel's ground offensive in the Gaza Strip continues with forces attempting to destroy Hamas' weapons arsenal and rocketing-firing capabilities.

Here are the key events from the fighting that preceded and have followed Israel's operation:

:: July 8 - Israel launches "Operation Protective Edge" in a bid to quell near-daily militant rocket attacks in the aftermath of the abduction and killing of a Palestinian teenager in what appeared to be a revenge attack for the seizure and slaying of three Israeli teenagers in the West Bank in June.

:: July 9 - Hamas rockets rain deep into Israel as the military pummels Palestinian targets. The military says 74 rockets landed in Israel, including in the northern city of Hadera, the deepest rocket strike ever from Gaza. Prime Minister Benjamin Netanyahu says Hamas will pay a "heavy price".

:: July 10 - Israel intensifies its bombardment. UN Secretary-General Ban Ki-moon urges an immediate ceasefire but neither side shows much interest in halting the fighting.

:: July 11 - Mr Netanyahu vows to press forward with a broad military offensive. The Israeli military says it has hit more than 1,100 targets, mostly rocket-launching sites, while Palestinian militants fired more than 600 rockets at Israel. The Lebanese military says militants there fired three rockets toward Israel and the Israelis retaliated with about 25 artillery shells.

:: July 12 - Gaza City becomes a virtual ghost town as streets empty, shops close and hundreds of thousands of people keep close to home. The death toll rises to more than 156 Palestinians after more than 1,200 Israeli air strikes.

:: July 13 - Israel widens its campaign, targeting civilian institutions with suspected Hamas ties, and briefly deploys ground troops inside Gaza to raid a rocket launching site. Four Israeli soldiers are hurt during the brief incursion. Egypt, a key mediator between Israel and Hamas, continues to work behind the scenes.

:: July 14 - Israel says it's downed an unmanned drone along its southern coastline. Egypt presents a cease-fire plan that is praised by President Barack Obama at a White House dinner celebrating the Muslim holy month of Ramadan.

:: July 15 - Israeli Cabinet accepts Egypt's truce plan, halting fire for six hours but Hamas rejects the proposal, instead unleashing more rockets at Israel and prompting Israel to resume heavy bombardment. Rocket fire kills an Israeli man delivering food to soldiers, the first Israeli fatality in the fighting. Four Gaza boys, all cousins, are killed on a beach by shells fired from a navy ship.

:: July 16 - Hamas fires dozens of rockets into Israel, vowing not to agree to a ceasefire until its demands are met. The Gaza Interior Ministry's website says Israeli warplanes carried out dozens of airstrikes, targeting 30 houses, including those of four senior Hamas leaders. Later, both Israel and Hamas agree to a five-hour UN brokered "humanitarian" pause to start the following day.

:: July 17 - both sides trade fire in run-up to the brief truce, which Gazans use to restock on food and other supplies. Israel says it foiled an attack by 13 Gaza militants who infiltrated through a tunnel. Fierce fighting resumes after the truce expires, including an airstrike that kills three Palestinian children. After nightfall, the Israeli military launches a ground invasion into Gaza Strip.

:: July 18 - eight members of the same Palestinian family - two men, two women and four children - are killed by Israeli tank fire as the ground offensive to date claims the lives of 51 Palestinians and one Israeli soldier.

:: July 19 - Mr Ban says he wants to meet both sides to try to secure a truce as Israel pledges to step up its ground offensive. Hamas says its fighters are "behind enemy lines" as security alerts are triggered in southern Israel.

:: July 20 - Fresh airstrikes, artillery shelling and gun battles overnight kill 12 Palestinians and two more Israeli soldiers, as Israel intensifies its ground offensive in Gaza. Israeli minister Naftali Bennett defends the ground offensive in Gaza and accuses Hamas of "self-genocide" by using women and children as human shields.

:: July 21 - another airstrike kills 26 members of the same family, while seven more Israeli soldiers die in gun battles with Hamas fighters. Thirty of those wounded in the attack are reportedly medical staff.

:: July 22 - the Palestinian leadership proposes a ceasefire plan to mediators in Egypt which would be followed by five days of negotiations to stop the fighting which has claimed the lives of more than 600 Palestinians, many of them women and children, and 29 Israelis, including 27 soldiers.

:: July 23 - an international inquiry into Israel's actions in Gaza is launched, after the UN's Human Rights Commissioner says there is a "strong possibility" the country is guilty of war crimes. Several major airlines from the US, Europe and Canada suspend flights to and from Israel after a rocket fired from Gaza lands near Tel Aviv's Ben Gurion international airport.

:: July 24 - British Foreign Secretary Philip Hammond warns Mr Netanyahu the West is losing sympathy for Israel amid the rising number of civilian deaths during its offensive in Gaza, as international efforts to end the conflict intensify. However, hopes of an effective ceasefire quickly diminish after Israel vows to continue hunting Palestinian cross-border tunnels under any humanitarian truce, while Hamas also rejects a truce without the lifting of Israel's eight-year blockade of Gaza.

:: July 26 - the number of Palestinians killed in the Gaza offensive reaches 1,000, according to the territory's health ministry. Meanwhile, Israel agrees to extend a temporary humanitarian ceasefire for a further day.

:: July 27 - Hamas agrees to a 24-hour temporary truce ahead of the Muslim festival of Eid.

:: July 28 - the UN Security Council calls for an "immediate and unconditional humanitarian ceasefire" in Gaza following an emergency session in New York. Both sides criticise the presidential statement, which is one step below a legally-binding resolution.

:: July 30 - a reported 128 Palestinians die in the bloodiest day of the three-week conflict. One attack, on the Jebalya refugee camp, provokes international condemnation, with UN Secretary General Ban Ki-moon saying there is "nothing more shameful than attacking sleeping children".

:: July 31 - the UN says the total number of displaced people in Gaza now stands at 440,000.

:: August 1 - the Israeli army says 23-year-old Second Lieutenant Hadar Goldin has been kidnapped as a three-day ceasefire collapses within minutes.

:: August 2 - tanks and troops begin withdrawing from some parts of the Gaza Strip as an army spokesman says Israel is "quite close to completing" the destruction of Hamas' tunnels.

:: August 3 - Israel confirms missing soldier Second Lieutenant Hadar Goldin died in combat.

:: August 3 - Ban Ki-moon describes an apparent Israeli airstrike on a UN school-turned-shelter in Rafah as a "moral outrage and a criminal act". The US says it is "appalled" by reports of a "disgraceful shelling" in which 10 casualties are reported.

:: August 4 - Israel begins a seven-hour humanitarian truce but is immediately accused of breaching it with an attack on a refugee camp in Gaza City.

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Israel-Hamas Ceasefire Begins As Troops Leave

The Battle To Win The War And Keep The Peace

Updated: 5:07pm UK, Monday 04 August 2014

By Sam Kiley, Foreign Affairs Editor

Israeli tanks chew through the rubble at Rafah. Another child is killed. Some ceasefire. Some war.

For all the bluster and public relations stunts attached to several 'humanitarian truces', the claims to be the 'most moral army in the world', and the blaming of Hamas for deliberately getting fellow Palestinians killed, the Israel Defence Forces prosecute conflict with a bald honesty.

The purpose of war is to bend an enemy's will to one's own.

It's about smashing and maiming, dismemberment and mass grief.

When the threat is perceived as existential, it's conducted without rules but with great deliberation.

The firebombing of Dresden and the nuclear attacks on Hiroshima and Nagasaki targeted women and children, the innocent, their homes, parks and pets - on purpose.

The Allies intended to break the will of the Axis powers utterly.

And that is the intent of the Israelis in Gaza.

The aim of the IDF is officially to 'dismantle the military capacity of Hamas (and other militant groups)'. It is to rid Israel of the threat posed by Gaza's rocket arsenal, and of its tunnel network with its tentacles that extend inside Israel.

The vast majority of Palestinian casualties, now numbering more than 1,700, are civilians, and many of them are women and children.

Israel's 'pinpoint accurate' munitions have been used to target hospitals and United Nations schools housing thousands of refugees with monotonous regularity.

It is true that Hamas has stored weapons in schools, fired rockets from close to playgrounds and hospitals, and used mosques as combat operations rooms.

Nonetheless Israel has come in for some bitter criticism from long-time ally the United States, from the United Nations, which the Israelis see as a hostile entity, and now from France.

On Monday French Foreign Minister Laurent Fabius called for a political solution to be "imposed" by the international community in the Gaza conflict.

"How many more deaths will it take to stop what must be called the carnage in Gaza?" Mr Fabius stormed.

"The tradition of friendship between Israel and France is an old one and Israel's right to security is total, but this right does not justify the killing of children and the slaughter of civilians."

The cold truth is that Mr Fabius has missed the point here.

Israel sees itself engaged in a near-perpetual existential struggle against Palestinian militants, especially Hamas, which is committed to the destruction of the 'Zionist entity'.

Israelis are generally horrified and outraged by any suggestion that civilians are deliberately targeted by the IDF which, they point out, regularly conducts investigations into the actions of its forces when they are accused of egregious killing.

But Israel's tactical aims are clear.

To crush Hamas and to send a clear message to Gazans that their future does not rest with the militant group.

The IDF has used devastating force to deliver that message and to try to wreck Hamas' military and civil structures.

And the Israeli government enjoys overwhelming support for the way that Operation Protective Edge has been conducted.

It accepts that war is not a sport.

But does not, yet, appear to comprehend that in Gaza Israel may have won another battle but is very far from winning the war - much less the peace it so craves.

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Ebola Doctor Flown Home To US For Treatment

One of two Americans infected with ebola in West Africa has arrived in the US, where doctors say they are confident the deadly virus will not escape.

Dr Kent Brantly was flown from Liberia, in a specially equipped plane to contain infectious diseases, to Marietta in Georgia, where he will continue to receive treatment in a special isolation unit.

After arriving at Emory University Hospital in an ambulance, the 33-year-old was seen leaving the vehicle dressed head to toe in white protective clothing, with another person in an identical suit who was holding both Dr Brantly's gloved hands.

Dr Brantly is the first ever ebola patient to be transported to American soil for treatment.

Dr Kent Brantly and missionary Nancy Writebol were infected in Liberia

A second US patient, missionary Nancy Writebol, is due to arrive on a later flight as the plane is only equipped to carry one patient at a time.

Dr Brantly's wife Amber, who left Liberia with their two young children for a wedding in the US days before the doctor fell ill, said in a statement: "It was a relief to welcome Kent home today. I spoke with him, and he is glad to be back in the US.

"I am thankful to God for his safe transport and for giving him the strength to walk into the hospital."

Fears that the outbreak, which has killed over 700 people in Africa, could spread in the US has raised concerns among some Americans - but infectious disease experts insist the public faces no risk.

Emory University Hospital in Atlanta has a dedicated containment unit

The specialist unit at Emory University Hospital was opened more than 10 years ago to care for federal health workers exposed to some of the world's most dangerous diseases.

Dr Bruce Ribner, who will be treating both patients, said: "Nothing comes out of this unit until it is non-infectious.

"The bottom line is: We have an inordinate amount of safety associated with the care of this patient. And we do not believe that any health care worker, any other patient or any visitor to our facility is in any way at risk of acquiring this infection."

Dr Brantly and Ms Writebol were described as critically ill after treating ebola patients at a missionary hospital in Liberia, one of three West African countries hit by the largest outbreak of the virus in history.

On Thursday both patients were said to be in a "stable but grave condition".

More than 700 people have died in the latest ebola outbreak

There is no proven cure for the virus. It kills an estimated 60-80% of the people it infects, but American doctors in Africa say the mortality rate would be much lower in a functioning health care system.

There are experimental treatments, but Dr Brantly had only enough for one person, and insisted that his colleague receive it.

His best hope in Africa was a transfusion of blood including antibodies from one of his patients, a 14-year-old boy who survived thanks to the doctor.

Dr Philip Brachman, an Emory public health specialist, said that since there is no cure, medical workers will try any modern therapy that can be done, such as better monitoring of fluids, electrolytes and vital signs.

"We depend on the body's defences to control the virus," he said. "We just have to keep the patient alive long enough in order for the body to control this infection."

Dr Brantly went to medical school at Indiana University and did a four-year residency at a hospital in Fort Worth, Texas.

Last October, he began a two-year fellowship with Samaritan's Purse to serve as a general practitioner at a mission hospital outside the Liberia capital of Monrovia. He directed the hospital's ebola clinic when the outbreak reached the nation.

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'Missing' Israeli Soldier Declared Dead

Why Obama's Hands Are Tied Over Gaza

Updated: 4:38am UK, Friday 01 August 2014

By Dominic Waghorn, US Correspondent

On the day the White House said the Israeli military should do more to protect Palestinian civilians in Gaza, the US confirmed it had agreed to supply the same military with more ammunition.

The Obama administration has hardened its criticism of the shelling of a UN school in Gaza calling it "indefensible" and saying there is little doubt the Israelis were responsible.

"We need our allies in Israel," said administration press secretary Josh Earnest "to live up to the high standards they have set themselves". Meanwhile those same allies were being invited to help themselves to more of the US arms stockpiles in Israel.

Duplicitous double standards or another sign of the complexity of US-Israeli relations? Depends on your point of view.

There is no doubt the Obama administration is concerned and frustrated by Israel's conduct. There is also no doubt the administration will continue to support it to the hilt for as long as required.

Frustrated not least because of the trashing of the US Secretary of State John Kerry by Israeli cabinet ministers and media after his efforts to broker a ceasefire.

The Obama administration has not hidden its fury at the personal attacks on America's chief diplomat by senior members of the Netanyahu government.

The mounting civilian suffering is a concern to the US, for humanitarian and diplomatic reasons.

What's left of America's standing in the Arab world is further undermined by gruesome pictures of slaughter caused by US-supplied weaponry being fired into Gaza.  

A lot has been made of the dysfunctional relationship of the two countries' leaders. 

Bibi and Barack have had more than their share of differences, and none of the political intimacy of George W Bush and Ariel Sharon. 

But these days Israel can take US support for granted far more than it could back then.

When Ariel Sharon wanted to send his military into Jenin refugee camp in the West Bank in 2002 he personally asked Bush to let him do so and give him enough time to finish the job.

The destruction in Jenin is nothing compared to what Israel has wrought in Gaza and it has done so without needing to ask for American permission. 

There are many reasons for US support for Israel, some historic, others more current.

The US-Israeli relationship is one of the fundamental constants of American foreign policy in the Middle East. With a region in ferment and in a state of flux, that is more important to Washington than ever.

The Israeli lobby is also hugely powerful in the US. 

Capitol Hill has been called Israeli-occupied territory; such is the sway the Jewish state holds over US politicians.

Multifarious pro-Israel organisations, millions given to Israel supporters at election time and masterful use of the media all mean that is unlikely to change.

Israel has the same hold on everyday Americans as it has on politicians.

US public opinion has been overwhelmingly sympathetic to Israel since the second intifada when the Palestinians began blowing up women and children on buses and since 9/11, which hardened US attitudes to violent Muslims of any description.

More often than not the US media is inclined to accept the Israeli narrative. 

Coverage of tunnels out of Gaza is a case in point.

When Israeli military PR shifted the focus from rockets to tunnels, US coverage followed.

Too much talk of rockets is a threat to Israel economically now the country's main airport is within range.

Israel now claims Hamas tunnels are their main casus belli.

There has been little questioning of Israeli claims they are a terrorist threat to women and children, when thus far they have only been used by Hamas militants for military purposes to target Israeli soldiers. 

US support of Israel is mirrored by the attitude of some Arab nations in the region.

Egypt's recent ceasefire plan angered Hamas by including many of Israel's demands and few of the Palestinians'.

The Saudis and Jordanians are also quietly cheering the Jewish state from the sidelines. 

Since the last major Israeli operation in Gaza the faultlines have shifted in the Middle East because of the deepening chasm among Muslims, between Sunnis and Shia. 

On one side, Iran and its allies, the Assad regime in Damascus, and Hezbollah in Lebanon. 

On the other Tehran's enemies in the Gulf and Egypt who are in no mood to help out Iran's Sunni allies, Hamas in Gaza. 

While much of the Middle East remains silent as the carnage continues in Gaza, Israel will assume it is carrying out the wishes of at least some of its neighbours.

Washington will continue dishing out carefully worded criticism if Israel keeps facing claims it has shelled children sleeping in UN buildings.

But it is not going to be reducing its support for its closest ally in an increasingly troubled region.

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