The Health Situation in Palestine

The health situation of Palestinians in the West Bank and Gaza reflects the historic suffering of a people living under generations of occupation. Poverty, extreme hardship, mental and physical trauma, and ongoing insecurity mark the daily experiences of Palestinians trying to survive and struggle for freedom.

The West Bank

Obstacles to movement for Palestinians living in the West Bank pose life-threatening risks. With nearly 75% of major roads blocks, there are an estimated 700 obstacles or barriers to movement in the West Bank. These barriers, about 100 of which are military checkpoints, alongside illegal Israeli settlements, serve to geographically divide, isolate and control the Palestinian population.

Inadequate medical care during pregnancy is cited as the third leading cause of mortality among pregnant women. From 2000 to mid-2007, 68 Palestinian women have given birth at Israeli check points, delayed from delivering their babies at a hospital. Instead of a travel time of 15-20 minutes with quick passage, nearly 20% of all pregnant women seeking care were made to wait anywhere from two to six hours in pain and obvious stress, frustration and humiliation. The trauma and lack of medical care has lead to miscarriage and death. Of 117,000 pregnant women in the occupied territories, 18,000, or 15%, will suffer from poor pregnancy outcomes due to a lack of access to health services throughout the duration of their pregnancy.

Continual interactions with Israeli settlers and Israeli Defense forces are a major threat to the lives and the livelihood of Palestinians. Under ‘peacetime’ conditions, the ratio of Palestinian to Israeli deaths in 2007 was 40:1 with a total of nearly 6000 Palestinian deaths since 2000, 20% of which have been children.

Physical and verbal abuse and direct shootings upon medical personnel are widespread in the occupied territories, particularly in the West Bank. In 2008 the Palestinian Red Crescent Society reported 521 incidents of abuse, including 501 incidents of delay or denial of access, 12 incidents of ambulances taking direct Israeli Army fire, and 2 incidents of settlers attacking personnel on a medical mission. As a result 7 personnel were injured and six ambulances damaged. These violations are in direct contravention with the Geneva Conventions which guarantee the respect and protection of those who engage in the search for and transport of the sick and wounded.

Gaza

Israeli military blockades in Gaza have lead to life threatening problems of sanitation, access to health care, water supply, and a sharpening of poverty, unemployment and malnutrition. Since the 2007 Israeli ‘withdrawal’ from the Gaza strip and subsequent blockade, unemployment has risen from 30% to over 45%, with poverty rates reaching 80%. Over 70% of Gazans rely on food deliveries from the World Food Program and the United Nations, but even these are severely restricted by Israeli blockades. Poverty and lack of food is rampant: 40-50% of children suffer from anemia, 21% suffer from chronic malnutrition, and 15% are developmentally stunted due to lack of adequate food and nutrition. Seventy percent of permits to seek medical attention outside of Gaza were denied by the Israeli Army, directly impacting an estimated 1800 people.

On December 27th, 2008 Israel initiated Operation Cast Lead. For 22 days, Israeli forces launched a massive bombing attack on Gaza; a captive population with no ability to flee the attacks. Palestinian casualties totaled 1324 with over 400 children, 110 women and 123 elderly; based on the deaths of militant fighters, civilian deaths comprised 85-90% of all casualties. Over 5300 people were injured including nearly 1900 children, 800 women. The use of white phosphorus and experimental munitions among heavily populated areas is a likely contributor to the horrific nature of many injuries. Severe burns, over 150 amputations and many spinal and brain injuries from collapsing buildings and explosions will impose a massive need for rehabilitation and continued care in the future. Israeli attacks have destroyed thousands of buildings and other public infrastructure, many tied directly to health: 48% of the 122 health facilities assessed were found to be damaged or destroyed; 15 of Gaza's 27 hospitals and 41 primary health care centers has suffered damage; 2 centers were destroyed, and 29 ambulances have been partially damaged or destroyed.

According to the Palestinian Red Crescent Society 14 medical personnel were killed, including one PRCS volunteer, and 24 others including 5 PRCS volunteers were injured. During the first 18 days of the attack, only 5 of 140 requests of the Palestinian Red Crescent Society to gain access to the wounded or sick were approved and of these all five had to be halted because of direct Israeli gunfire or obstacles such as collapsed buildings.