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Source: World Health Organization (WHO)
1 February 2004

Health Inforum News
Volume 3, No.44, 01 February 2004

Welcome to the forty-fourth issue of the Health Inforum Newsletter.
In our ongoing efforts to provide useful information to the health community, we welcome any comments or suggestions that you might have to help us to improve this newsletter. Please help us to distribute this update by forwarding it to your colleagues and friends. If you wish to subscribe, please send an email to

In this Issue:

§ Impact of the Jerusalem Barrier on UNRWA health services
§ Health Incidents in oPt
§ Press Conference on the release of Health Development Information and Policy Institute report: “Health and Segregation”
§ Health sector support programme: EC project

Impact of the Jerusalem Barrier on UNRWA services

UNRWA has recently published (January 2004) a report on the impact that the construction of the separation barrier will have on UNRWA’s operations and service delivery in the Jerusalem area.

The report constitutes an early assessment - as the construction of the barrier continues - and it is the first of a series of regular updates on the conditions of refugees in the area. Furthermore, the profile of some localities will be regularly presented, in order to draw attention on particular conditions of isolation and ‘livelihoods restrictions’ resulting from the barrier’s construction.

Impact on Health Care
Jerusalem town is an important center for the provision of health care services to refugees. Construction of the barrier will directly affect access to the UNRWA Jerusalem Health Center; two other UNRWA Health Centers and two Sanitation stores will be separated from surrounding areas (Shufat and Kalandia Camps); also the referral of refugees to secondary and tertiary care in Jerusalem hospitals will be severely hampered.

The UNRWA Jerusalem Health Center (JHC) is located in the Old City of Jerusalem. Over the past three months (August-October 2003), over 28,000 PHC visits were delivered at the Center;. About 60% of patients come from the outskirts and surroundings of town; the access of this people to health care will be delayed or obstructed by the barrier. Furthermore, the doctor heading the clinic, one nurse, the laboratory technician and the pharmacist of the JHC reside out of town, and must go across the barrier to reach their working place. Regular delivery of care is therefore restricted by delays and difficulties experienced by both medical staff and patients.
Random interviews to the people attending the JHC highlighted that, on average, the time needed to go from their village nearby Jerusalem to the Health Center was three hours. The trip always involved climbing over, or squeezing through, the concrete blocks which presently constitute the barrier in Abu Dis. The health center personnel also reported cases of refugees seeking care to the Center for barrier-related accidents, i.e. falling or slipping from the Barrier. They referred about the presence of grease, spread at the bottom of the barrier to discourage the crossing.

In a room made available by the Biddo local council, a temporary PHC clinic has been established by the JHC, in order to cope with increasing problems of access to its services.. However, due to lack of doctors, the clinic has not been operating for the past two months.

Two UNRWA health centers and two sanitation stores are located in Shufat Camp and Kalandia Camp. Both camps are going to be East side of the barrier. Although primarily serving refugee patients from the camp, access to these health centers of medical personnel and neighboring communities will be restricted.

For more information, please visit

Press Conference on the release of Health Development Information and Policy Institute report: “Health and Segregation”

Health Development Information and Policy Institute “HDIP” released on January 28, 2004, its latest report “Health and Segregation”, which represents the first detailed mapping on how health service provision in the West Bank has been affected by the completion of the first phase of the “Wall”. The report provides projections on the impact of the subsequent phases of the wall, now under construction.

Dr. Mustafa Barghouthi explained that the “wall” has affected 750,000 Palestinians in nearly 40% of Palestinian communities and has had a serious effect on the delivery of health care, particularly on the referral system, with difficulty of access to secondary and tertiary care.

Juan Jubran referred to the main findings, describing how during the wall first phase 26 primary healthcare clinics have been either isolated in between the wall and the Green Line or enclaved by in-depth barriers. If the second and third phases of the wall were completed, a total of 71 primary healthcare clinics would also be isolated. Looking at specific areas, in the Jenin and Tulkarm enclaves, emergency care is hardly accessible. In the enclaves North and South of Qalqilia health facilities are insufficient, including somewhere any healthcare services is not available at all.

For more information, please visit


Background on EC projects:

The EC support to the health sector of the WBGS includes (i) emergency support and relief programmes through the ECHO programme; (ii) budget support to the social sectors, including health, through the World Bank managed Emergency Social Support Programme; (iii) two projects to support the hospital sector in East Jerusalem (see HI Newsletter n. 42) (iv) a project to support the development and implementation of a national strategy for population and family planning; (v) support for the renovation of health facility infrastructure and (vi) Hospital Planning and Management Project.

Project Title: Health Sector Support Programme
Project Duration: Three years (January 2004-Decemeber 2006)
Project budget: 5 million Euros
Implementing Agency: MoH-EC

Overall aim:

The aim of this project is to improve the health system performance in West Bank and Gaza Strip (WBGS) by developing and utilizing health planning, health economics and budgeting skills to improve MoH planning activities. It will provide the means to implement priority actions derived from the Health Sector Review (HSR) exercise in management and cost-effective interventions at primary, secondary and tertiary care level, as well as prevention.

Main Objectives:

i. Improvement in MOH planning and priority setting capacity
ii. Development of annual action plans based on the National Strategic Health Plan
iii. Development of a transparent MoH budget reflecting, in its implementation, the identified health policy priorities
iv. Development and implementation of pilot action plans for innovative responses to priority public health problems
v. Improvement in the MOH capacity to develop and implement cost-effective services, alternatives to high-cost Treatment Abroad referrals.

vi. Development of strategies to react more effectively to changing situations
vii. Enhancement in the MoH capacity of coordinating external partners
viii. Enhancement of MOH role and capacity of strengthening the entire health sector

Main Activities & Budget Breakdown:

EC Contribution
Technical Assistance
2,275,00045.5 %
Capacity Building (Workshops/ meetings, training, study tours & scholarships ) and project management structure
1,018,00020.4 %
National health Plan & Interim Action Plans for priority health problems and studies
1,475,00029.5 %
Contingencies, to respond to emergencies
Audit, Monitoring and Evaluation (external EC)

Health Incidents in oPt

Breaking into Union of Health Care Committees Medical Center in Azoun

On January 24th, 2004, Israeli army broke in Azzoun medical center that belongs to UHCC in Qalqilya District. The Incident started at 8:30 Am and lasted for half an hour, in which the soldiers checked the employee’s identity cards and searched the center.

PRCS Health Incidents at Checkpoints (January 17-28, 2004).

PRCS Branch DateCheckpointDelay of access (unless indicated 'denied access')Notes
Gaza 20/1/2004 Tal-Al sultan area 60 minutes
22/1/2004Al Tufah 60 minutes
23/1/2004 Al Mawase 60 minutes
28/1/2004Al Zaytouna Driver’s eye injury, due to Israeli shooting on the ambulance
Nablus 22/1/2004 Howwara 120 minutes
23/1/2004The entrance of Balatah Refugee CampDenied access
Bethlehem 18/1/2004 Gallo 60 minutes and denied access
Hebron25/1/2004Bani Na’emIsraeli army used the ambulance as a human shield
For more information please contact Press Office at: phone: +972 2 240 6515/6/7



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