Current Issues  
Settlements, Jerusalem, the Security Barrier,
the Right of Return, and more

Occupation: Medical Care

The Occupation
   Taking Control of Land
   Dispossession, Exploitation
   Splitting the West Bank
   Restriction of Movement
      Checkpoints, Closed Rds

   Imposition of Siege
   Beatings & Abuse
   Home Demolitions
   Destruction of olive trees
   Medical Care
   Water Crisis

The Settlements
The Settlements, p2
   Settlers' Violence
   Settlers' Violence, p2

The Separation Wall
Relevant Facts on the Health Care Crisis in Palestine

> Up to 75% of Palestinian health care professionals are unable to report to work regularly, severely affecting all sectors of the health care system.

> Almost 75% of Palestinians live below the UN poverty line of $2 per day.

> 50% of Palestinians require external food assistance to meet their daily caloric intake.  

> More than 70% of Palestinians live in rural areas that do not have hospital services.

> Eighty Palestinians have died due to soldiers and/or closures that prevented access to medical treatment (as of October 9, 2003).

> Fifty-two Palestinian women have given birth at Israeli checkpoints. One thir of the babies died. (as of October 16, 2003).

> 100% increase in home birth deliveries, and 56% increase in still births since September 2000, due to road closures and inability to travel.

> More than 600 reported incidents of Palestinian ambulances denied access at roadblocks by Israeli military.  Fifteen medical personnel killed while on duty, 275 medical personnel injured (as of July 2003).

> 80% of the ambulance fleet of the Palestine Red Crescent Society has been damaged by the IDF; 25 ambulances have been completely destroyed.

> 100% increase in number of Palestinians attending mental health clinics; most of new cases are children.

UN office for the Coordination of Humanitarian Affairs, 2003

Palestinian Central Bureau of Statistics, 2002

USAID, World Bank Report, 2002

The Union of Palestinian Medical Relief Committees:

Health Development and Information Policy Institute

Palestinian Ministry of Health

Palestine Red Crescent Society:

Christian Aid report "Losing Ground: Israel, Poverty and the Palestinians," 2003
The army's severe restrictions on Palestinian movement in the West Bank gravely affect the ability of Palestinians to obtain proper medical treatment.

The hundreds of physical obstructions and dozens of checkpoints result in very limited access to medical treatment, and sometimes none at all. The problem is especially grave among residents of villages and outlying areas who need to get to hospitals in the large cities. For example, persons living in villages around Jerusalem who need to get to hospitals in East Jerusalem for treatment require a permit to enable them to reach their destination. To obtain a permit, patients have to provide medical documents testifying to their illness, as well as confirmation that they have an appointment at the specific hospital and that it is the only facility where the needed treatment is available.

The need for a permit is especially problematic for pregnant women, who need to get to the hospital in time to give birth. Even though the delivery date is uncertain, the permit given to women about to deliver is valid for only one or two days, as is the case for most sick persons. Therefore, women in their ninth month of pregnancy must go to the DCO every few days to renew the permit. As a result, in some instances, the mother gave birth at the checkpoint after her crossing was delayed because she did not have a valid permit. In 2007, at least five women gave birth at a checkpoint, three of them at a checkpoint at the entrance to Jerusalem.

The hardships entailed in obtaining medical treatment involve more than the bureaucracy of the permit regime. In many cases, the way to the hospital is blocked, so the sick and injured have to travel on long, winding, and worn roads. These alternate roads often lead to a staffed checkpoint, where they are forced to wait and undergo checks. In other cases, access to medical treatment is prevented and ill and wounded persons are unable to receive emergency medical treatment when checkpoints are closed at night, and whole Palestinian communities are blocked from entering or leaving by vehicle, including by ambulance. This situation exists primarily in enclaves in the “seam zone” and in a number of isolated areas, among them Beit Furik and Beit Dajan, in the Nablus area. In 2007, there was an increase in the number of persons needing medical treatment who were delayed at checkpoints, and B'Tselem documented five cases in which ill or wounded persons died after being delayed at a checkpoint.

Following a petition that Physicians for Human Rights filed in 1996, the State Attorney's Office announced two procedures instituted by the army regarding the crossing of checkpoints on grounds of medical need. The two procedures were intended to regulate the crossing of Palestinians in case of medical emergency, when a permit would not be needed, and in non-emergency cases. These procedures were supposed to apply at all the checkpoints in the West Bank, but recent testimonies given to B'Tselem indicate that this is not always the case. Frequently, the soldiers, who have no medical training that would enable them to evaluate the medical condition of the person, err in judgment.

The many restrictions on movement have also impaired the ability of West Bank hospitals to function properly. Indeed, the level of service in these hospitals has suffered greatly because of the absence or delay in arrival of doctors and staff as a result of checkpoint delays. Finally, the restrictions on movement also impair the development and expertise of medical professionals in the Palestinian health system: it is almost impossible for physicians and staff to get to in-service training or students to university, and many students are either unable to complete their studies or receive a lower quality of professional training.

International law grants special protection to the sick, wounded, the infirm, and pregnant women, and states that medical teams and sick and wounded persons must be allowed open passage. The many restrictions on Palestinian movement in the West Bank and the extensive period in which these restrictions have been imposed have resulted in a systematic, protracted breach of the law and in grave harm to the health of West Bank Palestinians and to the Palestinian health system.

Articles 16 & 17
Fourth Geneva Convention

The wounded and sick, as well as the infirm and expectant mothers shall be the object of particular protection and respect....The parties to the conflict shall endeavour to conclude local agreements for the removal from besieged and encircled areas of wounded, sick, infirm and aged persons, children, and maternity cases, and for the passage of minister of all religions, medical personnel and medical equipment on their way to such areas.

(Right: Red Crescent Worker helps Palestinian woman in labor down a hill as she tries to reach a hospital near Ramallah, August 2002)

See sources for all topics in this section, The Occupation.