This process started with the development of the “Guideline for Clinical Guideline Development”, in which the model and the methodology of evidence-based clinical guidelines are well explained.
Multidisciplinary teams were formed according to the subject of the guideline. More than 90 health personnel in both West bank and Gaza were trained in the methodology of guideline development. These teams were technically supported by the Quality Health Care Experts at the Quality Improvement Project/ Ministry of Health, throughout the entire period of guideline development.
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Guidelines of Hypertension
Guidelines of Diabetes
A joint report of B'Tselem and Physicians for Human Rights-Israel:
Palestinian Medical Personnel Harmed and Humiliated by Israeli forces
A joint report of B'Tselem and Physicians for Human Rights-Israel, published recently (December 2003), showed that Palestinian Medical Personnel in oPt are being harmed, delayed, abused and humiliated at Israeli checkpoints.
Israel's siege policy that has been implemented in the Occupied Territories over the last three years has unquestionably altered the lives of hundreds of thousands of Palestinians. As of early November 2003, the Israeli army had established fifty-six staffed checkpoints in the West Bank, as well as 607 physical roadblocks that prevent the passage of motor vehicles, 457 dirt piles, 94 concrete blocks and 56 trenches.
These restrictions on movement impede the functioning of an emergency medical system. As a result of the physical roadblocks, ambulances must travel along winding, makeshift roads, and patients must make their own way over mounds of dirt or be carried on stretchers to the other side. The absence of soldiers at these physical roadblocks makes it impossible for the sick to even explain the urgent nature of their medical problem.
Medical personnel frequently experience difficulties in crossing staffed checkpoints. The Israeli army does not have special procedures for ambulances to cross-checkpoints, but have issued only a general procedure relating to Palestinians who seek to cross. The procedures do not provide a proper solution for the severe problems ambulances have in reaching hospitals; in addition, soldiers at times ignore the procedures. Ambulance medical teams have also reported that they are often humiliated by the security force personnel stationed at the checkpoints, and in some cases have been beaten. In a few extreme cases, medical personnel have reported soldiers' use of ambulances for military purposes.
As a result of these difficulties, ambulances are able to reach the sick and wounded only thirty percent of the time. The rest of the time, patients are forced to get to a physical roadblock or checkpoint by themselves. As a result, many Palestinians forgo calling ambulances. This phenomenon is demonstrated by the drastic drop in Palestinian women who give birth in a hospital. The rate of hospital births has dropped from ninety-five percent before the Intifada to less than fifty percent
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Denying access for Union of Health Care Committees (UHCC) Medical Crews’ Work
On the morning of December 28 2003, whhile heading from Nablus to Azoun, Amateen, & Asira Al-Qblya clinics UHCC’s two ambulances were stopped at Howara checkpoint for at least an hour. The Israeli army did not allow them to proceed and forced them to return to Nablus; the same happened to other ambulances present in the area. The Israeli army ignored what the medical teams expressed concerning the necessity of crossing to aid patients. It is worth mentioning that one of the ambulances was carrying a gynecologist and health educator, who were heading to Azoun clinic; while the other ambulance was carrying a GP, health educator and lab technician, who were heading to Amateen & Asira Al-Qblya clinics.
In another incident, the main street at Seelt Al-Daher has been under curfew for more than ten days. This has made it difficult for UHCC medical teams to reach theirCenter, which is situated at the main street. The Israeli army also prohibited patients from reaching the Centre.
PRCS Health Incidents at Checkpoints (December 13-26, 2003)
Nablus, 17 December 2003 (14:00): A PRCS ambulance was shot at by Israeli soldiers while on its way to transport injured people from Balatah Refugee Camp. The bullets penetrated the rear side of the ambulance causing damage to the stretcher.
Bethlehem, 22 December 2003 (19:00): Israeli soldiers at the Container checkpoint stopped a PRCS ambulance team on route to check on colleagues who had previously been detained by Israeli soldiers for 13 hours at the same checkpoint. As one of the PRCS team exited the ambulance and attempted to inquire regarding the detained medical staff, he was attacked by one of the soldiers at the checkpoint.
In addition to the above, the following table lists incidents of denial and delay of access during this reporting period.
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