Last week, the Palestinian Ministry of Health appealed to the international community, UN agencies, WHO, the ICRC, the Arab health ministers' council and human rights organizations to pressurize the Israeli government to stop destruction of health foundations in Palestine, to allow ambulances and medical staff the right to free movement to evacuate the injured and transport patients to hospitals.
In Nablus, the health situation is very difficult. Dr. Munzer Sharif, the Deputy Minister of Health, has warned of the deteriorating health conditions in Nablus governorate that has been under Israeli curfews and strict siege for three months. During this
period movement has been impossible, with medical staff and health personnel
unable to reach their work places, whilst mortality has risen among chronic diseases patients and the threat of epidemics is present.
This issue of the newsletter will discuss access and its impacts on the health sector in the occupied Palestinian territories.
Why Access is a Problem?
Israel has dramatically tightened its restrictions on the free movement of Palestinian people, vehicles and goods since the second intifada (uprising) began in September 2000.
The Israeli army started their policy of restrictions in movements of the Palestinian population, with the isolation of rural and urban areas at district level, in addition to severe restriction of movements and closure between the different districts in West Bank and Gaza.
This type of curfew regime does not make any provisions for health services and vital service providers. Patients can’t arrive at health facilities and health personnel can’t reach their work.
According to the “OXFAM” study ”The Forgotten Villages in the West Bank”, closure denies village families access to basic services available in towns and cities. Health and water are now, for many households, either too expensive or simply not available. Increasingly families are forced to use dangerous or inappropriate alternatives – such as riding donkeys to hospital, or unplanned home births – or to simply do without. Scores of villages without water networks are facing severe water shortages, as water tankers either cannot access villages or people can no longer afford the price of tanked water.
Closure is creating a growing number of destitute families that are suffering from malnutrition, chronic health problems, welfare dependency, and psychological stress. As the main household managers, women are bearing the brunt of closure impact.
The health sector is severely affected by the closures regime. The absence of regular monitoring particularly in environmental health services is causing food and water born diseases, vector born diseases, in addition to other environmental health problems, including garbage, sewage vector, water, food, and animal (zoonotic diseases) control.
The vaccination program was also severely affected with delays of 3-4 months in many places in the West Bank and Gaza.
Curfew, closure, and strict siege, created a lot of problems and constrains to the vaccination program, concerning coverage, vaccine efficacy, vaccine preventable disease surveillance and monitoring and planning.
MOH can’t provide this service to Palestinian children without the help of international organizations and UN agencies. The assistance of the international community has provided transport, drivers and foreign staff consultants as MOH staff are not allowed to move on their own.
Access to health services:
Restrictions of access continue to prevent Palestinians requiring medical treatment from accessing health care services. Over 70 percent of the Palestinian population live in rural areas, which do not provide hospital services; closure therefore severely restricts the majority of the population from secondary and tertiary health care facilities.
The Palestinian Ministry of Health published recent data concerning the impacts of closures and curfews on patients since the 19 September 2000 until 1st September 2002.
Assaults Against Ambulances And Medics since 29 September 2000 until 1st September 2002
Water, Environment and Natural Resources
Water resource damage is occurring through damage to environmental facilities, particularly sewage infrastructure, and due to restrictions imposed on proper waste disposal. Owing to the internal closures, outlying Palestinian villages are being denied access to drinking water. Many infrastructure projects supported by the international aid community to improve the Palestinian environment have been brought to a halt because of the closures.
The Emergency Environmental Health Project (USAID sponsored) indicated that 100% of water delivered by tanker in Nablus is below any acceptable standards for drinking water. MOH reported problems with contaminated water in the Balata and Askar camps due to the destruction of both the water network and sewage pipes.
In the last meeting of the “WHO” Emergency Meeting (11 September 02), it was reported that chlorine distribution was being hampered by the closures and curfews.
Outbreaks of Shigellosis were reported in the Nablus area due to water contamination arising from damaged sewage and water pipes infrastructure.
MOH can’t bring the water and food samples from different districts to check in the Central Laboratories in Ramallah without the help from international organizations.
Medical Supplies Distribution:
Due to the current curfews and the closures in the West Bank, Ministry of Health staff and trucks cannot gain access to local areas to reach their hospitals and clinics to supply them with the urgently needed medicines and supplies.
To ensure that these essential medical supplies reach the hospitals and clinics in the West Bank, International organizations and donor countries have had to step in and support the Ministry with International trucks and drivers.
Help Needed for Chronic Individual Cases
Due to the current situation, many chronic cases and hospitals are calling Health Inforum asking if there is any organization that can offer support to these cases (most are children with congenital anomalies).
The increased number of these individual requests is due to:
§ Increased number of unemployed persons
§ High cost of medical treatment and medical examinations
§ The absence of special organizations dealing with specific diseases.
§ Certain cases not covered by the health insurance.
Health Inforum is raising this issue to assess if there is any organization working or interested in this field.
Please contact us: email@example.com
Health Inforum will start to highlight in its Bi-weekly Newsletter one of the health stakeholders; for those who like to publish about their organization’s profile, please email a short background on the organization and its activities.
Health Inforum posts daily news and announcements concerning health issues on our website: Http://hart.itcoop-jer.org. We welcome your inputs, comments and suggestions.
FOR MORE INFORMATION
Please feel free to contact us for information at:
Health Inforum, c/o the Italian Cooperation
Sheik Jarrah, East Jerusalem
Tel: 02 532 7447 Fax: 02 532 2904
Email: firstname.lastname@example.org Http:// hart.itcoop-jer.org