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Source: World Health Organization (WHO)
12 May 1989
WORLD HEALTH ORGANIZATION


FORTY-SECOND WORLD HEALTH ASSEMBLY

Agenda item 29

HEALTH CONDITIONS OF THE ARAB POPULATION IN THE OCCUPIED
ARAB TERRITORIES, INCLUDING PALESTINE


At the request of the Permanent Observer of Palestine to the United Nations Office at Geneva, the Director-General has the honor to submit the attached report 1/ to the Forty-second World Health-Assembly; for its information.

The text of the letter, dated 28 April, addressed to the Permanent Observer, Mr Nabil Ramlawi, is reproduced below.

"Your Excellency,





_______________
1/ See Annex.


ANNEX
HEALTH CONDITIONS OF THE ARAB POPULATION IN THE OCCUPIED
ARAB TERRITORIES, INCLUDING PALESTINE

CONTENTS


Page
INTRODUCTION
PART ONE: DETERIORATION OF HEALTH CONDITIONS IN THE OCCUPIED ARAB TERRITORIES
4
4
I.Socioeconomic situation
4
A.
B.
C.
D.
Changing the demographic map
Land seizure
Seizure of water resources
Destruction of economic and social infrastructure
4
4
5
5
1.
2.
Economic policy of the occupation authorities
Social policy of the occupation authorities
5
5
II.Health conditions
6
A.
B.
C.
D.
E.
F.
G.
H.
Planning
Pharmaceutical industry
Health infrastructure in the West Bank
Health infrastructure in the Gaza Strip
Medical equipment and supplies in the occupied Arab territories
Health manpower

Numbers of hospitals and beds
Primary health care
6
7
7
7
7
7
8
8
PART TWO: DETERIORATION IN THE HEALTH STATUS OF THE PEOPLE AND IN THE HOSPITALS AND HEALTH CENTRES IN THE OCCUPIED TERRITORIES
9
A.Israeli oppressive practices and instruments and deterioration of the health status of the citizens
9
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Use of live ammunition
Tear gas bombs
Rubber bullets
Beating with truncheons, crushing of limbs, fractures
Curfews
Closure of access roads and establishment of check-points
Restrictions on provisions and medical supplies
Violation of holy places and aggression against the clergy
Aggression and oppressive practices by settlers
Demolition of houses and other measures
Detention
Expulsion
9
9
9
10
10
10
10
10
11
11
11
12
B.Deterioration of the health infrastructure in the occupied Arab territories
1.
2.
3.
4.
5.
6.
Storming of hospitals and destruction of their equipment
Attacks on doctors and health workers
Obstacles to transport of the wounded by ambulance
Making the work of hospitals impossible
Deterioration of health infrastructure in the occ. territories
Reduction of expenditure on the health sector
12
12
12
13
13
14
C.Results of oppressive practices and of the deterioration of health and social conditions in the occupied territories
15
1.
2.
3.
Martyrs
Injuries
Psychological effects
15
15
16



INTRODUCTION

The purpose of this report is to provide a realistic view of the health conditions of the inhabitants of the occupied Arab territories, which have deteriorated seriously since the start of the courageous intifada. Our people suffer continuous repression under the Israeli occupation authorities, whose methods conflict with the most elementary principles of human rights.

Naturally, in view of the occupation and repression of which you are all aware, we cannot talk about "health" as "a state of complete physical, mental and social well-being", in the words of the World Health Organization's definition. There can be no well-being in a land lacking peace, nor can there be any economic growth or stability, or any social or cultural advancement, or any physical or mental well-being, while Israel continues to do all it can to destroy the infrastructure of Palestinian society.

We yet again draw attention to the seriousness of the Israeli violations of all international and humanitarian conventions. Moreover, Israel stifles all information on its terrifying acts. Israel provides false information on the numbers of victims and on the living conditions of Palestinian inhabitants, and it prevents official delegations, fact-finding committees and journalists from visiting the occupied territories.

PART ONE

DETERIORATION OF HEALTH CONDITIONS IN THE OCCUPIED ARAB TERRITORIES

In view of the World Health Organization's definition of health as "a state of complete physical, mental and social well-being", and in order to provide a clearer picture, we must provide a brief description of the socioeconomic situation in the occupied Arab territories. The deterioration of the socioeconomic situation has disrupted the organic cohesion of health conditions.

I. SOCIOECONOMIC SITUATION

The policy of the occupying authorities in the occupied Arab territories aims at undermining the economy of these territories and destroying the social infrastructure. The following practices serve as evidence of this:

A. Changing the demographic map

Despite the high population growth rate, the total number of Palestinian citizens in the occupied territories is stable because of the migration caused by the difficult economic conditions. This is one of the schemes of the occupation authorities aimed at the displacement of the inhabitants of the occupied territories.

B. Land seizure

The Israeli colonial policy is reflected in:

(1) Settlement in the West Bank. Israel has implemented intensive settlement projects around Hebron and constructed settlements in many other areas.

(2) Settlement in Gaza. More than one-third of the Strip's area has been seized. Israel has constructed more than 22 settlements on the seized land.

(3) Settlement in the Golan. Israel has annexed the Golan Heights in violation of international law and has established 40 settlements there.

(4) Contraction of cities. The Israeli authorities seize land which is needed for building in the Arab cities to cater for the population increase. They also refuse to extend city boundaries, do not grant I Arab citizens the required building licenses and destroy houses in an arbitrary way. The lack or unsuitability of houses, and the economic conditions caused many young people to delay marriage in previous years.

C. Seizure of water resources

1. The Israeli authorities draw millions of metric tons of water from the Jordan river.

2. They, seize certain artesian wells and destroy others. They also destroy the water pumps which irrigate the Ghors.

3. The Israeli authorities limit the digging of new wells. They allow only the digging of wells whose specifications make them useless.

4. The Israeli authorities limit the amount of water to be used by Arab citizens.

5. They exert pressure on town and village community leaders to ensure that Arab water supply systems are connected to Israeli ones.

D. Destruction of economic and social infrastructure

1. Economic policy of the occupation authorities

The Israeli occupation authorities try to undermine the national economy. This is reflected in:

(a) Arbitrary practices such as requisitioning of land and water resources, condemning agriculture, industry" tourism, education and housing.

(b) Weakening and undermining of productive enterprises in the occupied territories through prohibiting assistance or loans to these enterprises, placing constraints on the marketing of produce, or imposing high taxes. The struggle of our people in the occupied territories his led to their being deprived of their right to market their produce in the European market.

(c) Attempts to incorporate the economy of the occupied Arab territories into the Israeli economy for the benefit of the latter, by exploiting cheap factors of production in the occupied Arab territories. The Israeli authorities have also monopolized the markets of the occupied territories in order to sell Israeli produce, through emptying the occupied territories of their products and imposing high taxes on imports.

(d) Discontinuation of certain projects and summary dismissal of Arab workers without any compensation.

2. Social policy of the occupation authorities

Israeli social policy aims at hindering social progress in the occupied Palestinian territories by preventing the establishment of any social development plans or programmes. Such practices have affected education and cultural activities, as well as the services and facilities sectors in the occupied territories.

(a) Education

The occupation authorities do not provide the necessary budgetary funds for the promotion of education or the development of educational programmes and curricula; nor do they provide any employment opportunities for graduates. Large numbers of students have therefore abandoned their studies and are seeking work instead. The Israeli authorities have, moreover, closed down schools and universities for prolonged periods during the past two years. For lack of classrooms, existing schools do not meet the needs of all pupils. The occupation authorities also terrorize teachers and students alike by throwing gas bombs into classrooms full of pupils.

(b) Public amenities and services

The Israeli authorities completely neglect the public services sector; all local administrative, transport, communications, and services facilities have deteriorated, not to mention services such as family care and welfare.

The occupation authorities constantly amend the laws governing trade union activities in line with their own interests, so as to facilitate direct intervention in Arab trade union affairs. They force citizens to present lists of candidates for administrative posts, and invest the Israeli Labor Officer with the authority to cross out any name he considers undesirable. They also deny trade union freedom; trade-unionists are constantly exposed to harassment, detention, assault, and expulsion, to strip them of their most basic political rights.

The economic and social situation has deteriorated even further since the advent of the intifada on 9 December 1987. Israeli occupation authorities, in an attempt to suppress the intifada, have resorted to more vicious measures designed to destroy all parts of the economic and social infrastructure, including health, education, agriculture, industry, public facilities and communications. They daily undertake acts in contravention of basic human rights and international conventions.


II. HEALTH CONDITIONS

Health conditions in the occupied territories have been continuously worsening as a result of the deteriorating socioeconomic conditions and the health policy of the occupation authorities, which can be summarized as follows:

(1) The Israeli occupation authorities have maintained the health institutions and services as they were before the occupation in 1967. Instead of developing and expanding such services, they have closed many hospitals, clinics, health centers and nursing schools and reduced health manpower.

(2) The occupation authorities have prevented the establishment of private health institutions, despite the failure of government institutions to meet Palestinian needs.

(3) The occupation authorities have integrated Palestinian health institutions with Israeli health institutions in order to put them under their direct control.

The consequences of this policy are as follows:

A. Planning

In effect, there is no planning for health institutions that serve the Arab population. Though Arab nationals sometimes participate in expressing opinions, they have no right of decision-making as regards their own health facilities. It is the occupation authorities that take decisions. Because of budgetary cuts, health expenditure for Palestinian nationals does not exceed 20% of that for Israelis.

B. Pharmaceutical industry

Israel is hampering the work of this industry by preventing the importation and provision of requisite raw materials on the pretext that these are strategic chemicals.

C. Health infrastructure in the West Bank

Due to the closure of several hospitals in the cities of Jerusalem and Ramallah, the number of beds dropped from 209 for a population of about 115 000 in 1967 to 116 beds for a population of 140 000 in 1987.

In Jerusalem, the occupation authorities closed the pediatric hospital, the central laboratory, the blood bank, the tuberculosis control center and the only Arab hospital in Jerusalem, the "Hospice".

In the region of Nablus, the occupation authorities closed the old Government hospital and four floors of the new Rafidiya hospital, thus reducing the number of beds because of inadequate medical staff and maintenance.

In the regions of Tulkarem and Jenin, with a population of 82 000, the occupation authorities reduced the number of beds from 140 to 115.

The same picture can be seen in the regions of Bethlehem and the Ghors where a similar reduction of beds took place.

D. Health infrastructure in the Gaza Strip

As a result of the Israeli policy, the number of beds was reduced from 1004 in 1974 to 855 in 1982, while the population of Gaza increased to 665 000 by 1987.

The occupation authorities closed the Tel Al Zabour hospital and the fever hospital and reduced the number of beds to 70 in Al Brige chest disease hospital in 1980, on the grounds that the number of tuberculosis patients had dropped. The hospital could have been utilized to serve, in one way or another, the inhabitants of the central regions who are in urgent need of more services. The orthopedics department of Nasser Hospital in Khan Younes was also closed.

Moreover, the Israeli authorities interfere with the administration of the largest hospital in Gaza, Al-Shifa hospital, which has 336 beds, and have assumed full administration of four other hospitals.

There is only one local (non-government) hospital, with 65 beds of which 40 are reserved for UNRWA and 10 for institutions and trade unions, which means that it is unable to provide services for needy nationals.

E. Medical equipment and supplies in the occupied Arab territories

All hospitals in the occupied Arab territories are suffering from inadequately maintained old equipment and the lack of many items of equipment and supplies necessary for their proper functioning.

F. Health manpower

The occupation authorities prevent new appointments in the health services to replace people who retire or terminate their services for one reason or another. There is a serious lack of medical personnel as a result of the reduction of manpower when hospitals are integrated or closed.

G. Numbers of hospitals and beds

As already mentioned, the number of hospitals has been reduced. Whereas in 1987 there were 14 government hospitals in operation and three others about to come into operation, there are now only nine hospitals. Private hospitals are not permitted. In the Gaza Strip the number of beds was reduced from 1004 in 1974 to 855 in 1982.

In the West Bank, there are 26 hospitals operating with very limited capability. The number of beds in government hospitals was reduced from 1045 in 1979 to 951 in 1984.

H. Primary health care

1. Infant mortality and preventive measures

Preventive activity does not cover all who need it. Infant mortality is very high because of inadequate care. Operational maternal and child health centers cannot meet the urgent needs. Moreover, there is a lack of personnel and prenatal care.

2. Health insurance

The numbers of participants in the health insurance system dropped to a very low percentage as a result of imbalance between the health services provided and the amounts paid for these services. This is exacerbated by the high cost of living and the low per capita income, particularly as the insurance does not cover children over 18 years of age. The head of the family is therefore too burdened with work to participate.

3. Water supply and sanitation services

Most of the occupied territories in the West Bank and Gaza Strip are in desperate need of drinking-water supply systems and sanitary drainage networks; most sewers are uncovered, which causes environmental pollution and spreads diseases.

4. Epidemiological situation

The above-mentioned conditions have increased the risk of the spread of disease and epidemics in the occupied Arab territories.

PART TWO

DETERIORATION IN THE HEALTH STATUS OF THE PEOPLE AND IN THE HOSPITALS
AND HEALTH CENTERS IN THE OCCUPIED TERRITORIES


A. Israeli oppressive practices and instruments and deterioration of the health status of the citizens

In the face of the defenseless Palestinian people which is fighting for its just and legitimate human rights, the Israeli occupation authorities have recourse to various types and methods of oppression. These methods, which are harmful to the physical and mental health of the human being, range from serious injuries to poisoning, the causation of bodily and mental illness, murder and mutilation of corpses.

In fact the Israeli forces, acting on the explicit orders of the military and political chiefs, are continually and daily inventing worse methods of oppression.

Below will be found a brief summary of the results of these various oppressive methods, based on very precise statistics and eye-witness accounts which show the whole extent of the brutality of the Israeli occupying forces.

1. Use of live ammunition

The statistics attached here show that 460 persons have been killed by live ammunition and that during 17 months 39 764 people were wounded, 8000 of whom risk permanent disability. Well-informed sources inside occupied Palestine have reported that the Israeli occupying forces, in addition to using live ammunition of the conventional type, are using two new kinds of bullet:

In the first place, bullets of very high projective force which cause burns to the body, the danger from them being infinitely greater than from ordinary bullets.

Secondly, bullets which change direction and cause serious in.-Juries and lacerations to various parts of the body before leaving it. In addition, explosive bullets and dum-dum bullets which are internationally prohibited are being used.

2. Tear gas bombs

Composed of chemicals and gases, these have an effect on various parts of the body or on the nervous system and sometimes lead to death and to abortion in pregnant women.

The Zionist occupying forces use these bombs every day against defenseless Palestinian demonstrators in their concentration zones. Up till now 122 people have been killed by these bombs, particularly old persons, diabetics and those who suffer from poor blood circulation, not counting wounds and cases of suffocation.

Abortions due to the use of these bombs number about 500. It goes without saying that nothing is known of the effects of these gases on embryos or about the genetic deformations that they cause.

3. Rubber bullets

This type of bullet contains inside it a pointed piece of metal capable of causing serious injuries, particularly when they are fired at close range. The use of these bullets is as dangerous as the use of ordinary live ammunition, for the serious wounds and fractures that they cause may lead to internal hemorrhage in the stomach and to tearing of the flesh. Several cases of blindness have been recorded, 30 or so of them at the Ophthalmological Hospital in Jerusalem within a period of two months. The number of people injured by rubber bullets so far is 5923.

4. Beating with truncheons, crushing of limbs, fractures

The beating of defenseless citizens and the breaking of their bones and limbs has become common practice by the Israeli occupation authorities in the whole of the occupied territories.

These practices have become more cruel and harsher with the use of metal-edged truncheons and of rifle butts and with the giving of violent kicks intended to break the bones and the use also of large stones and iron bars. The occupying forces take houses by assault and strike all the members of the family including children, or surround the men and subject them to collective bludgeoning in front of the women and children or else they choose passers-by at random and begin to strike them and kick them without mercy. To be noted in particular is the case of a little girl, eight months old, who was injured and had to have four stitches put in her skull.

Files on the victims bear witness to the different types of serious injury proving that the occupation authorities stop at nothing in their efforts to inflict the greatest possible damage to no matter what part of the body, even if it should result in permanent disability. Obviously the conditions of this occupation make it impossible to obtain exact figures for serious cases, and all that can be said is that these oppressive and cruel practices risk creating a whole generation of handicapped people.

5. Curfew

Since mid-December 1987, the occupied Palestinian territories have been subjected to curfews which sometimes last over 20 hours a day for several consecutive days.

6. Closure of access roads and establishment of check-points

The occupation authorities have closed the access roads to towns, villages and camps, and set up military check-points on these roads. They are prohibiting citizens from leaving these areas and citizens from outside the areas from entering them. They prohibit the entry of journalists, provisions, relief supplies and ambulances, and confiscate all water brought in by women from wells and water sources nearby. They also impound provisions brought in by citizens during the brief periods when the curfew is lifted.

7. Restrictions on provisions and medical supplies

The siege imposed by the occupation authorities involving prohibition of the entry of provisions and medical supplies was part of the policy of collective punishment practiced by the Israeli authorities. In addition to this, water and electricity were cut off and emergency food supplies were impounded. Fuel was also withheld from the population in the occupied territories and although there are few official reports and little information concerning food and provision shortages and the hunger suffered by the citizens, there is clear evidence that there were these problems, as a result of the long duration of the siege and curfew.

8. Violation of holy places and aggression against the clergy

Occupation soldiers daily violate the sanctity of Islamic and Christian holy places and attack members of the clergy and have done so since the beginning of the uprising. Approximate statistics show that more than 350 to 500 assaults are made every year against religious places and clergy, and information received from occupied Palestine indicates that most mosques in the West Bank and the Gaza Strip have been exposed to attack and that members of the clergy have been assaulted inside these mosques. Such violations take different forms:

9. Aggression and oppressive practices by settlers

Aggression against Palestinians by settlers is part of official Israeli policy aimed at creating an atmosphere of fear and terror to force citizens to leave their lands. This has taken the form of numerous acts of terrorism, such as abducting and killing citizens (including women and children), setting fire to fields, shops, cars, petrol stations and entire markets, beating up citizens, shooting at them and looting from houses and stores, attacking mosques, churches, schools, institutes, universities and institutions, and breaking up any furniture and equipment to be found there. In addition, fruit trees are uprooted with bulldozers or felled with electric saws.

10. Demolition of houses and other measures

The occupation authorities demolish houses systematically or seal them with red wax on the grounds that a member of the household is accused of activities against the security of the State. This means that any building occupied by several families unrelated to one another could be demolished if one of the people living in it happened to be the subject of such charges. The situation has become worse in recent months, when any Israeli officer or soldier can take the decision to demolish a house without giving sufficient notice to those who live in it. The number of houses demolished or closed by mid-April was 760.

11. Detention

The occupation authorities have recourse to individual or collective detention of Palestinian citizens under the terms of military orders that are contrary to international laws and customs. Detention takes place in accordance with the following practices:

The detainees are subjected to ill treatment of every kind. Women and children under 15 years of age are not spared.

12. Expulsion

The Israeli occupation authorities resort to expulsion of Palestinian citizens by decision of the military governor. The people expelled have no legal redress except to petition the Israeli Supreme Court of Israel which always finds in favor of the expulsion orders. Seventy Palestinians have been expelled so far.

B. Deterioration of the health infrastructure in the occupied Arab territories

The practices already mentioned and the Israeli policy of repression have resulted in a deterioration of the health infrastructure in the occupied territories. The main reasons for this are laying siege to hospitals, taking them by assault and stopping them working; acts of aggression against medical teams and the destruction or damaging of basic health structures together; and the decrease in the expenditure on the medical sector.

1. Storming of hospitals and destruction of their equipment

On 9 December 1987, the first day of the rising, the Israeli occupation authorities laid siege to El-Shefaa Hospital in the Gaza Strip. Tear gas grenades were dropped from helicopters and Israeli soldiers burst into the hospital, firing live ammunition at citizens who were there to give blood. They threw tear gas grenades into various departments, struck patients and doctors and nursing personnel before arresting a certain number of the wounded.

These acts of aggression were repeated with increased brutality in the days that followed. On 11 December 1987, the Israeli forces laid siege to the Women's Union Hospital in Nablus, stormed it and committed the same acts. A journalist was struck, his cameras and those of other journalists were confiscated, and several doors and windows of the hospital and the neighboring nursing school were smashed.

2. Attacks on doctors and health workers

The Israeli forces attack doctors and health workers in the places where they give their services: inside hospitals, in ambulances, or inside besieged camps and villages. Furthermore, health personnel are prevented from carrying out their humanitarian duties of helping and caring for the wounded. Ten doctors have been arrested so far.

3. Obstacles to transport of the wounded by ambulance

The occupation authorities prevent ambulances from carrying the wounded to hospital. This has become everyday practice and is all the more serious in that the emergency services in the occupied territories suffer from a chronic shortage of ambulances.

4. Making the work of hospitals impossible

On 20 December 1987 the military governor issued an order warning all health centers and hospitals in the West Bank and the Gaza Strip not to receive casualties injured during the uprising and prohibiting all physicians and health workers in hospitals from giving any information or making any statements to the local or international press.

It is to be noted that these atrocities practiced by the Israeli authorities against medical teams, hospitals and health centers are in direct contravention of the rules of international law, the Geneva Conventions and all humanitarian customs and traditions. Such practices have forced physicians in the Gaza Strip and the West Bank to go on strike and to issue a number of calls and statements urging international action and demanding that international organizations attempt to put an end to such inhuman practices.

5. Deterioration of health infrastructure in the occupied territories

The health infrastructure is continuously deteriorating as the policy of the occupation authorities ignores planning for its development. Health institutions and services remain as they were before occupation in 1967. The occupation authorities have even closed a great number of hospitals, clinics and medical centers, in addition to reducing medical manpower. They also oppose the establishment or development of private or charitable health institutions.

The occupation authorities have endeavored to link the Palestinian health institutions and citizens with Israeli institutions, with the aim of dissolving the independent Arab entity.

The occupation authorities do everything possible to hinder the development of pharmaceutical industries in the occupied territories, by interfering with the work of existing factories and by preventing the import of essential raw materials on a variety of pretexts. They oppose the establishment of new pharmaceutical factories. As regards health infrastructure in the West Bank and the Gaza Strip, the occupation authorities have declared Jerusalem part of Israeli territory, destroyed its health institutions, and prevented Palestinians from Jerusalem from joining the health insurance scheme in the West Bank. They have also closed several centers, including the pediatric hospital, health department, central laboratory, blood bank, etc. These arbitrary measures were also applied in the areas of Ramallah, Nablus, Tulkarem, Jenin and Bethlehem.

In the Gaza Strip, the arbitrary policy resulted in the closure of Tel Al Zohour Hospital and the Fever Hospital, and the conversion of their facilities into military offices. The number of beds in the Hospital for Chest Diseases was reduced to 70 in 1980, although it is the only hospital in the region. The occupation authorities have also closed the bone surgery department in the Nasser Hospital at Khan Younes, despite its utmost importance under the prevailing conditions.

As a result of this barbaric policy, all hospitals of the occupied Arab territories have become inadequate because of their aging, shortage of medical and professional staff, and deterioration of their servicing facilities.

Primary health care is also suffering a serious decline in its level and its potential to deliver essential services; maternal and child health centers, which cannot meet the minimum needs of the citizens, are suffering from severe shortages of equipment and staff.

All this has led to a rise in mortality rates among children, who constitute 48.7% of the population, with infant mortality ranging from 80 to 159 per 1000 live births in different occupied areas.

Citizens also have to face the problem of the government medical insurance scheme. Their difficult living and economic conditions have resulted in a decrease in the number of participants. The health services provided do not correspond to the amounts paid by the citizens.

6. Reduction of expenditure on the health sector

It is obvious that the funds allocated to the health sector are very low compared with the enormous sums accruing to the occupation authorities from the occupied territories, whether by means of economic exploitation or through taxes and various other levies.

The gap seems unbridgeable between funds allocated to the health sector in the occupied territories and those allocated to Israeli citizens, or even compared with expenditure in the neighboring Arab countries.

The reduction in expenditure has had adverse effects on the health sector, as follows:

(a) Reduction in the numbers of hospitals and beds

The numbers of hospitals and beds have been reduced both on the West Bank and in the Gaza Strip. On the West Bank there are 26 hospitals that operate under great pressure with almost no facilities. They have 2100 beds, supposedly to serve one million people. In the Gaza Strip there are only 9 government hospitals serving more than half a million people.

The number of beds in government hospitals on the West Bank declined from 1045 in 1979 to 951 in 1984. In the Gaza Strip it declined from 1004 in 1974 to 855 in 1982. Reliable information indicates that there are only 1.8 beds per 1000 population in the occupied territories whereas there are more than 6.9 in Israel.

(b) Number of health workers

The number of health workers in the occupied territories declined by 25% because of non-recruitment, despite the need for personnel, not to mention the dismissal and harassment of health workers. The number of physicians out of work amounts to more than 100 or 30%.

(c) Disease prevalence

Diseases and epidemics such as hepatitis have spread because of reductions in water and sanitation services. Environment conservation facilities are lacking, leading to pollution. in the Central Region camps in Gaza, for example, on account of the lack of appropriate drinking-water arid sanitation facilities and the lack of the necessary maintenance, drinking-water often mixes with sewage water. The same thing happens in several areas on the West Bank.

Diseases due to psychological factors, such as heart diseases, hypertension, diabetes and ulcers, have increased.

Because of difficult economic conditions and blockades, 7% of infants suffer from malnutrition.

Mental diseases greatly increased because of psychological stress and the humiliations inflicted upon Arab citizens.


C. Results of oppressive practices and of the deterioration of health and social conditions in the occupied territories

1. Martyrs

The number of heroic martyrs who have given their lives during the intifada, from its inception up to mid-April, is 670 persons, that is 38 martyrs per month. Of this total, 460 died from gunshot wounds, 122 from suffocation by toxic gases, 39 from beatings, and 49 from other causes.

The figures given by the occupying authorities show 300 martyrs, a number inconsistent with that documented by names and shown on the computer of the PLO Institution for Social Welfare and Care of-Martyrs' Families. The occupying authorities try to obscure facts in order to hide the huge extent of the results of their savage practices. They only acknowledge the number of martyrs killed by soldiers, ignoring the statistics showing the number of martyrs killed by settlers or during investigation and torture, for they register these as natural deaths or suicides.

Moreover, there are the abortion cases resulting from the breathing of toxic gases. There were 500 such cases up to mid-April.

As for the breakdown of the number of martyrs according to age, the statistics show that young people predominate.

2. Injuries

According to the figures given by the PLO Institution for Social Welfare and Care of Martyrs' Families, the number of injuries caused during the 17 months since the start of the intifada is 39 764. This figure is based on the cases notified by the news agencies, the International Red Cross and the press. It does not include the very many cases which people refrained from reporting for fear of detention, and which were treated secretly at home.

It is worth mentioning that injuries outnumber the injured persons, since many people received more than one injury each. The actual number of injuries is about 120 000. To be more objective, a person who has received more than one injury is here considered to have only two injuries. It has been established that 60% of injured persons sustained more than one injury, so the actual number of injuries should be 63 622. The average number of injured persons is about 2309 per month, or about 78 per day.

The predominant category here is again young people. Breakdown by sex shows that male casualties up to mid-April numbered 31 254, accounting for 78.6% of the total. The number of female casualties is 8409, or 21.4% of the total. According to statistics, the
causes of injuries are as follows:
The breakdown by type of physical injury is as follows:

    6759 Upper limbs
    6441 Lower limbs
    4970 Abdomen
    4732 Chest
    4215 Head
    3499 Eyes
    3141 Spinal column
    2823 Face
    2704 Pelvis
    398 Other parts
(17.2%)
(16.2%)
(12.5%)
(11.9%)
(10.6%)
(8.8%)
(7.9%)
(7.1%)
(6.8%)
(1%)

3. Psychological effects

The long years of suppression and oppression, reaching their maximum height during the intifada, have led to adverse psychological effects on the Palestinians in the occupied territories, particularly children. The difficult economic and living conditions resulting from the non-existence or shortage of material resources, the lack of suitable housing, the constant anxiety about food, clothes and the whereabouts of the family, the lack of work opportunities, the loss of children, relatives or friends, the disabilities resulting from injuries, the prevailing atmosphere of terror, the feeling of instability and insecurity - all these are factors producing uninterrupted psychological pressure under which it is quite natural for cases of depression, psychological anxiety and hysteria to spread, especially among women. It is not surprising that more complex psychological disorders become prevalent, most serious of which are the adverse effects an children that in some cases leave them beyond cure. The Palestinian child is no longer a normal child. The occupation conditions have forced him to resist, as elders do. He has been deprived of innocent play, entertainment, rest and education. These little ones have experienced bitterness, pain and sorrow at losing a beloved parent, brother or sister or all of them together.

The responsibility for the care of children and their psychological stability is no longer ours alone; it is the responsibility of the whole world, its nations and its international organizations concerned with child matters.

We are now undertaking some in-depth studies in this regard, since we consider psychological disability as more harmful to mankind than physical disability.

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