547. The medical facilities in the vicinity of Bedouin villages are fully equipped, Mother and Child Health Clinics are computerized, air conditioned and maintained in good condition.
548. The Ministry of Health operates special health services and Health Clinics for the Bedouin population in the Negev. The service includes an ambulance, run by the Bedouin population that resides in the Negev. The purpose of this service is to ensure an open gateway between the nearest hospital and the Bedouin community. This enables professional workers from nearby residencies to evaluate the living arrangements of patient’s subsequent to their release from hospital. Such personnel can view the patient’s sanitary living conditions prior to their release and provide recommendations accordingly. The cost of a visit to the Health Clinic is identical throughout the State.
549. There are 42,400 Bedouin Israeli children under the age of 6 (53 per cent) who live in Bedouin towns, whereas 47 per cent of Bedouin children live in unauthorized villages. In 2007, the Ministry of Health operated 27 Family Health Centers providing services to the Bedouin population in the Negev, in addition to 51 clinics operated by the various Health Funds.
550. There are 18 Mother and Child Health Clinics located in Bedouin villages. In addition six Mother and Child Health Clinics have been established within the illegal clusters. There are 32 Medical Clinics run by the various Health Funds located in Bedouin communities; nine of which provide services to the unauthorized Bedouin villages.
551. According to a large-scale study conducted by the Myers-JDC-Brookdale Institute during 2003–2005 in association with the Ben-Gurion University, the “Shatil” organization and the Council for Unauthorized Villages in the Negev, approximately 9 per cent of all Bedouin children in the Negev suffer from functional disabilities or chronic illnesses that require ongoing medical treatment and/or monitoring. This percentage is slightly higher than among the general Arab and Jewish populations in Israel (8.3 per cent and 7.6 per cent respectively).
552. For most types of disabilities, the proportion of children in the Bedouin population who suffer from the disability is higher than that among the Jewish population. The number of children in need of continual medical and paramedical treatment is higher in the Bedouin population than in the general Arab and Jewish populations (4.9 per cent, 2.8 per cent, and 2.1 per cent respectively). Furthermore, the percentage of sensory disability among Bedouin and Arab children is twice as great as that found among the Jewish population (2.0 per cent 2.2 per cent and 0.8 per cent respectively).
553. In March 2009, the Israeli NGO, Physicians for Human Rights, published a report regarding the absence of paediatricians in the unauthorized Bedouin villages. Since most of the Bedouin villages are unrecognized by the State, health services are not available to the inhabitants. Although eleven villages were recognized by the State in 1999, it was claimed that they were not yet receiving the services they are entitled to by law. Twelve clinics and eight Mother and Child Health stations are located in unauthorized villages, yet their working hours are limited. However, no paediatrician, gynaecologist or pharmacy was found within a reasonable radius of the area. According to the PHR report, based on data provided by Soroka Hospital, when compared to Jewish children, more Bedouin children approach emergency rooms, are admitted to the hospital and intensive care units, and die from disease. Consequently, many inhabitants turn to private health services or the Health Care clinics available in the large cities.
554. Some of the major improvements in the past decade in the field include improved immunization coverage of Bedouin infants in the Negev. Thus, there has been a significant decrease in vaccine-preventable infectious diseases; with the 2006 figures indicating that 90 per cent–95 per cent of Bedouin children have completed all necessary vaccinations by age three – a sizeable improvement compared to a rate of 27 per cent in 1981. Two mobile immunization teams managed by the Ministry of Health also provide home immunizations to infants in unauthorized Bedouin communities, whose families do not bring the infants to one of the Mother and Child Health Clinics for treatment. A computerized tracking system allows the Ministry of Health to identify infants who are behind on their immunization schedule and to send one of the mobile immunization teams to immunize them.
555. There has also been an important improvement in the growth of Bedouin infants and toddlers over the past two decades, indicating improved nutrition. Moreover, there has been increased compliance with recommendations for supplemental folic acid among Bedouin women in their fertile years, and a decrease in the incidence of open neural tube defects (NTD’s) among Bedouin foetuses and infants. Unfortunately there are still high rates of congenital malformations and inherited diseases among Bedouin infants, due to multiple factors including the tradition of first-cousin marriages, as well as cultural-religious-social barriers to pre-marital and pre-natal screening for inherited diseases.
556. In 2007, the infant mortality rate among Bedouins decreased to 11.5 deaths for every 1,000 live births. The Government is continuing to open Mother and Child Health clinics in unauthorized villages and MCH centres to better serve the population.
557. Furthermore, the Government has been funding several special projects to improve the health and expand the health-care services provided to Bedouins living in unauthorized villages. One of these programmes is a special long-term intervention programme aimed at decreasing infant mortality among Bedouins. The programme is community-based and boasts a wide-consortium of participants, including representatives from the Bedouin community leadership and the educational system, along with providers of curative and preventative health care services, the Department of Health in the Community and the Department of Epidemiology in the Faculty of Health Sciences at Ben-Gurion University of the Negev.
558. The Government funds genetic testing and counselling for members of tribes which have a prevalence of serious inherited diseases. The diseases included in the funding scatter among the population in a 1:1000 relation.
559. There has been a sustainable decline in the incidence of infectious disease among Bedouin infants over the past decades. There is, however, generally a higher rate of infectious disease among Bedouin infants than among Jewish infants of the same age. Bedouin infants and children have lower rates of Pertussis, Tuberculosis and HIV infection. Furthermore, due to high immunization coverage among Bedouin infants, indicating improved access and utilization of preventive health care services, there have been no cases of measles since 1994 and no cases of poliomyelitis, diphtheria, congenital rubella, neonatal tetanus or tetanus in Bedouin children in the Negev since 1990. During the period 2000–2003, no cases of mumps were reported. Additionally only one to two cases of Homophiles influenza disease was reported in 2000–2002, and none in 2003.
560. Specialty physician services are provided to the Bedouin community in the Negev, including: Paediatrics, General Internal Medicine, Neurology, Family Medicine, Dermatology, Gynaecology and Obstetrics, Ear, Nose and Throat, Ophthalmology, Orthopaedics, Gastroenterology, Cardiology, Surgery and Trauma, Paediatric Surgery and Paediatric Pulmonary Medicine. In addition, every resident has equal access to all the specialty clinics at the Soroka University Medical Center, with no discrimination made between Bedouin or Jewish patients.
561. The Government, as well as the main HMO serving the Bedouin population, has made substantial efforts to train and recruit Bedouin physicians and nurses. The Government provided all the funding required for three classes of Bedouin students to complete their training as registered nurses, including funding their transportation to nursing school, a meal allowance during their studies, and special remedial lessons to assist those who needed it. The Government has similarly provided special funding to hire Arab physicians and nurses.
562. A course for qualified Bedouin nurses opened in 1994. It should be noted that students who participate in the course are committed to serving their first three years of practice after graduation wherever the Ministry of Health decides their services are needed. This will guarantee that the trained nurses serve the target population: the Bedouins. In addition, the first female Bedouin physician in Israel, Rania al-Oqbi, recently completed her degree. She was part of the special “Cultivating Medicine in the Desert” programme, which is aimed at incorporating more Bedouin into the health services. Currently, six Bedouin women are studying medicine; 35 Bedouin women have completed degrees in various health professions; and 45 additional women are studying health sciences.
563. Seventy per cent of Bedouins live in planned, urban towns, with municipal infrastructure, including running water in every home (with the water in question meeting the Israeli standards for drinking water quality). The percentage of bacterially contaminated drinking water samples followed previous downward trends reaching 0.25 per cent in 2007 (7.6 per cent in 1990 and 1.9 in 2001).
564. Nearly 62,000 Bedouin live in illegal clusters throughout the Negev; these villages cause difficulties in terms of supplying the residents with necessary services, especially the provision of water. While the Government does not question its duty to supply its inhabitants with services such as water, it is practically impossible to supply it to sporadic destinations which disregard the national construction and planning programmes.
565. Nevertheless, until the completion of the establishment of permanent Bedouin towns and the regulation of water supply systems, the Ministerial Committee for the Arab Population has decided to build “Water Centers”.
566. Following this decision, instructions were given concerning the planning of water supply systems to several “Water Centers”. The Water Centers are part of the Government’s understanding of the needs and current realities of the Bedouin population and its efforts to improve their living conditions. The planning of the centres takes into account an amount of water suitable for the magnitude of the population expected in 2020, and the establishment of the centres is very costly.
567. These systems will enable the supply of water to a significantly larger portion of the Bedouin population, than the portion receiving a water supply today through individual connections. There are currently 5 Water Centers, which are located in the most populated areas of the Bedouin Diaspora, compatible with the Government’s plans for the establishment of permanent towns.
568. An additional method employed, is through direct water connections to the main water pipeline, granted to a minimum of ten families. Due to the problematic nature of these connections, which require the transfer of water to unauthorized villages, this method is less frequently used than in the past. The Water Committee, which evaluates requests for connections to pipelines, approves the connection to such a pipeline, as well as negotiates agreements in cases of disputes between residents of the Diaspora over ownership of such connections.
569. In addition, according to “Mekorot,” the Israel National Water Corporation, numerous pirated connections to pipelines are being made without the authorization of the Water Committee.