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World Health Organization (WHO)
26 May 2005
FIFTY-EIGHTH WORLD HEALTH ASSEMBLY
Provisional agenda item 15
17 May 2005
Health conditions of, and assistance to, the Arab
population in the occupied Arab territories,
At the request of the Permanent Observer of Palestine to the United Nations and Other International Organizations at Geneva, the Director-General has the honour to transmit the attached report to the Fifty-eighth World Health Assembly.
Ministry of Health
HEALTH CONDITIONS OF, AND ASSISTANCE TO, THE ARAB POPULATION
IN THE OCCUPIED ARAB TERRITORIES, INCLUDING PALESTINE
Report presented to the Fifty-eighth World Health Assembly
1. In the past year the Palestinian people witnessed the sad loss of President Yasser Arafat, the Palestinian national leader of liberty, who passed away on 11 November 2004 at a military hospital near Paris, having endured the long, restrictive siege imposed by Israeli occupation authorities on his compound in Ramallah, Palestine.
2. Since September 2000, the Israeli occupation forces have escalated their immoral and aggressive policy against Palestinians in the occupied Palestinian territory. The Israeli occupation forces have perpetrated crimes against humanity, breaching international and humanitarian laws.
ISRAELI DISENGAGEMENT PLAN
3. The state of occupation in Gaza may end; Israeli control over the supply of water, fuel, electricity and gas will remain, however, and this means that Israel will continue to control movement to and from the area.
4. Based on the proposed Israeli disengagement plan, it is surprising that no attention has been given to the fate of dozens of Palestinian patients: chronically ill people who need treatment that is not available in Gaza. If no systemic solution is found, a situation will be created in which many Palestinian patients will die. Israel will continue to prevent entry of merchandise, medicine and fuel, thereby paralysing the lives of civilians and the health system.
5. The State of Israel should bear full responsibility and obligation to cooperate closely by informing the Palestinian National Authority and the international community about the location of landmines and chemical waste collection areas in the settlements which the Israelis plan to evacuate.
6. Additionally, the Palestinian people should be given the right to direct access to the outside world, and a safe passage should be opened between the Gaza, West Bank and East Jerusalem governorates, in order to pave the way for the eventual creation of a single Palestinian health system.
THE SEPARATION WALL
7. The full length of the planned separation wall (622 km) is twice the length of the Green Line (255 km); 85% of the planned wall encroaches on West Bank territory. Some 3920 Palestinian families live in areas divided between the wall and the Green Line, meaning that 32.7% of villages on the West Bank will suffer from lack of access to health services once the wall is completed.
8. Already 26 local clinics have been cut off from the general Palestinian health system. Upon completion of the wall, the number of isolated clinics will rise to 71 (out of more than 500 local clinics throughout the West Bank).
9. It is of prime importance to mention that the International Court of Justice has considered the construction of the separation wall in the occupied Palestinian territory as a violation of international law.
WATER IN PALESTINE
10. Israel uses 83% of the Palestinian water in the West Bank, while the Palestinians use only 17%. Some 10% to 14% of Palestine’s gross domestic product comes from agriculture of which 90% relies on rain-fed farming methods. Whereas Israel’s agriculture is only 3% of its gross domestic product, it
irrigates more than 50% of its land.
11. The water problem in Gaza is more complicated, as Gaza relies predominantly on wells, which are being increasingly infiltrated by salty seawater since Israel is overpumping the groundwater. As a result, United Nations scientists estimate that Gaza will have no drinking water within the next 15 years.
12. According to the Palestinian Central Bureau of Statistics, the unemployment rate in Gaza has increased from 15.5% in the year 2000 to 36.8% in 2004, while it has increased from 7.5% to 32.3% in the West Bank over the same period of time. No doubt, this would lead to acute poverty in the Palestinian society.
13. During the past four years, the Israeli authorities continued their military campaign of arrest and detention against thousands of Palestinians of all age groups ranging between 12 and 75 years and of both sexes.
14. Despite the fact that international laws and human rights ban subjecting children to harsh punishment, such as imprisonment and torture, and consider children as psychologically and mentally immature, nevertheless Palestinian children imprisoned in Israeli jails have been facing all kinds of torture: psychological pressure, immoral practices, and other forms of severe torture during their detention and interrogation. Palestinian children were also locked up in mixed rooms with people convicted of serious criminal charges.
15. The number of Palestinians who have been killed as a result of illegal, intentional assassination was 552, among which 250 innocent civilians were assaulted. These assassination operations were perpetrated with different kinds of weapons against public buildings and civilian vehicles, including shelling and firing missiles from Apache helicopters and F16 aircraft.
16. These immoral and inhuman operations constitute a flagrant violation of human and international laws, in particular Article 147 of the Geneva Convention relative to the Protection of Civilian Persons in Time of War (1949). These assassinations are considered as war crimes, according to the Statute of the International Criminal Court of 1998.
17. Destruction of the Palestinian family is one of Israeli’s aggressive policies against the Palestinian people. Demolition of houses is part of Israeli collective punishment. This is in violation of international humanitarian law, in particular the Geneva Convention relative to the Protection of Civilian Persons in Time of War (1949), whose Article 33 prohibits punishing any protected person for an offence he or she has not personally committed.
18. The Israeli forces demolished 7729 houses and razed lands using bulldozers. According to statistics, 73 505
were razed, 231 300
were confiscated, and 1 185 264 trees were uprooted.
CLOSURE OF RAFAH TERMINAL
19. The Israeli closure of borders and restrictions imposed on international routes of passage have negatively affected many aspects of Palestinian life. These procedures delayed the departure of patients who were transferred by the Ministry of Health for treatment abroad through Rafah Terminal (the crossing point between the Egyptian and Palestinian borders).
20. The closure also hindered the arrival of medical supplies, goods and vaccines into the occupied Palestinian territory. The restrictions have dramatically affected Palestinian students who were studying abroad and denied passage through Rafah Terminal.
NAKED SPY MACHINE
21. The Israeli authority in Rafah Terminal violates the Palestinian people’s right of privacy and poses a potential violation to their right to health. At the Terminal, the Israeli occupation authorities are using the SafeView Millimeter Wave Radar device, an American-made advanced portal system using millimetre-wave holographic technology, to screen Palestinian passengers. The radar penetrates clothing, thus imaging Palestinian civilians completely naked.
22. The Israeli authorities have confirmed the plan of transforming waste on the occupied Palestinian territory, and extensive Israeli work has already begun to transform large quantities of solid waste emanating from Israel (the Sharon and Dan areas) and from several Israeli settlements in Abu Shusha Quarry near Deir Sharaf Area in the occupied territory. Leachate resulting from the waste is forming a pool of filthy, black, stagnant water, and transforming waste is causing a high risk of pollution of adjacent Palestinian wells and areas, not to mention it being a high-risk source of pollution of groundwater, air and soil.
23. Since September 2000, the Palestinian Ministry of Education has lost 576 students, 3417 students have been wounded and hundreds arrested. In addition, 199 university students have been killed and 1245 wounded. The university staff has lost 32 martyrs among lecturers, while 54 were wounded and 176 arrested.
24. Palestinian women have not been spared from oppression and attacks made against all Palestinian civilians.
25. Throughout the occupied Palestinian territory, Palestinian women suffer owing to violations of human rights perpetrated by the Israeli Occupation Forces (IOF). Women often have to deal with extra hardship as their husbands are frequently imprisoned by the Israeli occupation authorities, and they and their families are deprived from their main source of income. Palestinian women are also often direct victims of the Israeli occupation; they are being killed, injured and arrested and have their land and houses destroyed.
26. Attacks by IOF during the intifada have led to the death of 169 Palestinian women, including 65 children; 24 sick women died when IOF obstructed their passage through military checkpoints and border crossings, and 55 women were forced to give birth at checkpoints. Currently, there are 126 Palestinian women detained in severe conditions in Israeli jails. House raids and demolitions by IOF have had a particularly devastating impact on women.
27. Altogether 239 health clinics in the Ministry of Health provide paediatric health services, including preventive and curative care. Some 185 415 visits of children under three years of age to maternal and child health clinics were reported. Breastfeeding was one of the most important measures to promote child health, especially against infectious diseases. The percentage of children who were breastfed was 95.8%, with an average duration of breastfeeding of 12.8 months. Vaccination against infectious diseases according to the child immunization schedule is given free of charge to all Palestinian infants and children. Treatment is free of charge until the age of three years. There is also a free programme of supplementation with iron, vitamin A and vitamin D, in addition to growth monitoring. Blood samples for the neonatal screening programme for phenylketonuria and congenital hypothyroidism are collected in early life; blood samples are also taken at the age of nine months to test for the child’s haemoglobin concentration.
28. Owing to the current situation and the Israeli violence practised against Palestinian civilians, large numbers of children suffer from psychological trauma. There was a noticeable increase (20.3%) in patients’ visits to mental health clinics, with reported cases including epilepsy, schizophrenia, mental retardation, nocturnal enuresis and affective disorders. In addition, there was an 11.9% increase in cases of neurosis in the population.
29. The frequency of anaemia among children under the age of five years was 44% but in women the figure was 53% in Gaza and 44% in West Bank. Anaemia in infants aged nine months was 68%. More than 53% of refugees and populations of villages suffer from food shortages. About 80% of women of reproductive age suffer from vitamin A and E deficiencies, with 19% of them suffering from folic acid deficiency and 12% from calcium deficiency. In April 2004, the Israeli Government brutally prevented UNRWA and other international agencies from transporting food aid into Gaza.
30. The crude death rate was 2.7 per 1000 population in 2003, and the infant mortality rate was 24 per 1000 live births. The most common leading cause of death was cardiac diseases (20.1% of total deaths), cardiovascular conditions (11.1%), conditions in the prenatal period (9.7%), cancer (9%), accidents (8.8%), senility (5.7%), hypertension (4.9%), pneumonia and other respiratory diseases (4.8%), diabetes mellitus (4.1%) and renal failure (3.4%). The leading causes of death for children under five years were conditions in the prenatal period (20.1% of total deaths) and congenital malformations (14.4%). The leading cause of death for children in the age groups 1-4, 5-19 and 20-59 years were accidents, including shooting by the Israeli army, with proportions of 23.6%, 51.6% and 25.1%, respectively, of total deaths. This indicates the impact of the Israeli aggression practised against Palestinian children and adults.
ISRAELI VIOLATIONS AGAINST THE PEOPLE, HEALTH TEAMS AND
SERVICES IN PALESTINE
Access to health services
31. The results of a study by the Palestinian Central Bureau of Statistics in 2004 indicated that 53.6% of households have problems in accessing health services because of military checkpoints, 52.5% due to Israeli closures, 44.2% due to the high cost of medical treatment, and 10.7% because of the expansion and separation wall.
Impact of restrictions on movement and the training of medical personnel
32. The Israeli occupation forces put Palestinians under a complete siege by strengthening the existing restrictions on movement and imposing new ones. Israel has imposed various forms of restrictions on movement as part of its collective punishment policy against Palestinian civilians. Curfews and internal and external closures have been imposed to various degrees on Palestinians since the beginning of Al-Aqsa intifada. Unless patients from Palestine are able to obtain access to uninterrupted treatment, patients requiring treatments not available in the area may die.
Restrictions on humanitarian services and insecurity of health personnel
33. The Ministry of Health and other numerous health institutions, such as the International Committee of the Red Cross, the Palestinian Red Crescent Society, UNRWA and nongovernmental organizations, have been targeted by incessant Israeli aggression, in violation of international conventions. Attacks by the Israeli army against Palestinian civilians and health services, illegal killing of individuals, and the army’s action against the movement of people and humanitarian assistance intensified and hampered such movement. Details of some attacks and violations between 29 September 2000 and 15 February 2005 are:
(a) ambulances belonging to the Palestinian Red Crescent Society, Ministry of Health and other health providers have been fired at by the Israeli army; 372 ambulances were hit, 38 were destroyed, and 1918 were denied access to health facilities;
(b) altogether 369 health facilities were attacked, with some hospitals and primary healthcare centres partially destroyed;
(c) 444 health workers and ambulance drivers were injured while on duty;
(d) 36 health workers and ambulance drivers were killed while on duty;
(e) more than 75% of health personnel were unable to reach their workplaces, thus affecting the quality of health services, immunization coverage, antenatal and postnatal care, and growth monitoring of children.
34. The Ministry of Health warns the international communities and organizations of the re-emergence of infectious diseases that threatens not only Palestinian infants and children but also children in neighbouring countries, as infectious diseases do not recognize borders or checkpoints.
35. Due to the high unemployment rate and border closures, public revenues from taxation and health insurance have been frozen.
36. The Ministry of Health has sent many appeals to the international community in order to stop the Israeli aggression against health teams and institutions.
37. The Ministry of Health appeals to the international community to intervene and save the lives and health of Palestinian children and women from the practices of the Israeli occupation forces against the Palestinian people in the occupied Palestinian territory.
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