Disclaimer: The views expressed are that of the individual author. All rights are reserved to the original authors of the materials consulted, which are identified in the footnotes below.
Healthcare in the Occupied Territories has been a contentious issue ever since the beginning of the Israeli-Palestinian conflict over sixty years ago. The conflict has caused huge divides in societies and governments across the world, even though the universal right to adequate healthcare is something that cannot be debated. Israeli military occupation in the Occupied Territories, however, is preventing many Palestinians from receiving this. Considerable amounts of money have been donated in aid, although not all of this has been spent effectively. Whilst money may not be an issue at the moment, long-term sustainability is essential for the development of successful healthcare plans. These can only be delivered with the collaboration of the four main healthcare providers of the areas: the Palestinian Ministry for Health, Palestinian Non-Governmental Organisations (NGOs), the UN Relief and Works Agency (UNRWA) and the private sector[1]. A combination of Israeli military occupation and the inefficiencies of the main healthcare providers are preventing the people of the Occupied Territories obtaining the rights they are entitled to as human beings.
A UN report from November 2001 indicates that healthcare in the area was steadily improving up until occupation[2]. The report offered a comprehensive study of both Gaza and the West Bank, detailing everything from health coordination in the area to infant mortality. For the most part, Gaza and the West Bank fared relatively well in terms of healthcare in comparison to other countries in the Middle East. It was, however, identified that areas such as maternal healthcare needed to be improved. According to the report, the primary cause of death for new mothers was anaemia, which is something that could easily be prevented. The World Health Organisation (WHO) has recommended iron tablets to be prescribed to anyone who has iron levels below 30%, so vulnerable areas of the population such as new mothers should not die of preventable conditions such as this. The question of whether this is a case of neglect or a result of the Israeli military occupation is a vital one.
Furthermore, the WHO have set out these standards, but the responsibility of ensuring they are carried out has been neglected. The report itself has its limitations too. It was, for example, written in 2001 which was before the Israeli medical blockades were imposed and much has changed since then. The strain on medical supplies has also been exacerbated by recent flareups in the conflict. Extensive UN reports such as this are, nonetheless, vital in our understanding of the situation as it stands today.
There are approximately 5 million Palestinian refugees living in the Occupied Territories and 40% of these are children[3].
The conflict has been going on for so long that peace has become a distant memory even for the older generations and children have grown up with violence and warfare on their doorstep.
This has, inevitably had a major impact on their mental health, with many of these children witnessing violence first hand or being the victims of violent acts. Adequate mental health facilities are an invaluable resource in many countries, but for war-torn areas, they are a necessity in order to ensure the children are able to move past the atrocities they have experienced. The complications with regards to the conflict, however, have made this a fantasy. Medical resources are already strained in the area and the main focus is on prioritising primary healthcare. Due to the strain the Palestinian Ministry for Health is experiencing in delivering primary care, it is vital that the UN and UNRWA do more to aid children and adolescents in coping with the trauma they have dealt with. This, however, is becoming a near impossibility with funding cuts to UNRWA by the Trump administration in 2018[4]. Donations from other countries have kept the organisation running despite the cuts[5], but this is a precarious solution, due to the current political climate of the world. In order to sustain a successful mental health programme in the Occupied Territories, long-term solutions are necessary and these can only come about with the successful cooperation between the main healthcare providers.
Although the cooperation between the different health providers of the Occupied Territories has thus far been relatively poor, which is partly due to the corrupt nature of the Palestinian Authority but largely due to Israeli military occupation, there have been attempts from outside parties to rectify this. A May 2019 report from the World Health Organisation (WHO) has detailed efforts made to improve communication between different areas within the health sector, in order to establish a better healthcare system[6]. Areas of focus have included access to better mental health facilities, with online databases containing files for individual patients, as well as improved communication between primary and secondary healthcare providers. The report also details schemes in collaboration with local universities, in order to recruit more people into the medical profession. In theory, this is an ideal solution to the problems detailed thus far in the article. According to the report, these schemes rely on funds from the governments of Switzerland, Austria, Turkey, from the European Union (EU), as well as the United Nations Central Emergency Response Fund. The instability of donations from various governments is always an issue, as withdrawal is always a possibility if one of the countries involved faces economic difficulties.
In addition, the situation in the Occupied Territories is so volatile that it is difficult to say whether any schemes implemented by WHO will be successful in the next few years. This highlights the importance of establishing an autonomous healthcare system that is able to adapt to any deteriorations in a situation. At the moment, the scheme in place by WHO has been the best solution to healthcare problems, as they have been able to recognise the problems in the area and establish long-term methods in an attempt to combat them.
Healthcare is an incredibly important part of creating a sustainable future for Palestine. It is vital that world governments and the United Nations work together in order to make this an achievable goal.
The Trump administration’s cuts to UNWRA funding is evidence of the danger on relying on outside donations. A long-term healthcare plan needs to be put in place, with emphasis on training doctors and giving them incentives to stay in Palestine. Identifying the problems of the current healthcare system in a reliable and comprehensive way is an imperative step in the development of a new and improved system.
Collaboration between the various sectors responsible for the deliverance of healthcare is vital in ensuring this. One of the major factors preventing development in this sector is Israeli military occupation. This is something that world governments have been attempting to combat with little success and there are no signs of it ceasing in the near future. The best immediate option is, therefore, to work around the occupation until the Israeli government withdraws its troops from the Occupied Territories. This could be done by negotiations from neutral parties, as agreements such as the Oslo Accords and the Camp David Agreement have shown that the Israeli government can be willing to negotiate. The current political climate of the region, on the other hand, indicates that Israel will not be as willing to negotiate as it was in the past. It is, nonetheless, an established fact that healthcare is a universal human right and should not be denied in any circumstance. This is why it is so important to implement a sustainable healthcare plan for the Palestinians as soon as possible.
It cannot be said that the rest of the world are sitting back and watching whilst the Palestinians are suffering under Israeli occupation.
The question of whether an end to the Israeli-Palestine conflict in the foreseeable future is undoubtedly negative, but this does not mean there is a chance to improve the lives of those living in the Occupied Territories. The UN and WHO are putting efforts into establishing sustainable healthcare in the areas, but the reliance on outside donors makes for an unstable development programme. It is optimistic to say there can be a focus on aiding the Palestinian healthcare system in functioning autonomously, due to the volatile nature of the conflict, but this is the only way a long-term healthcare plan will be able to work.
Recent developments in the US government’s attitude towards the conflict may have negative implications for the Palestinians, but this does not negate the responsibilities of other major world governments to initiate a peace process for the sake of both Palestinians and Israelis. It will inevitably be a long and arduous process but without the goal of peace in the area, a sustainable long-term healthcare plan will be meaningless.
Amirah Mannan (Middle East)
SOURCES
[1] Awad Mataria and others, 'Health in the Occupied Palestinian Territory: The health-care system: an assessment and reform agenda' [2009] 373(9670) The Lancet 1207-1217
[2] Ibid
[3] Tony Waterston and Dina Nasser, 'Access to healthcare for children in Palestine' [2017] 1(1) British Medical Journal Paediatrics 1-6
[4] Jane Ferguson, 'How Palestinians in the West Bank Are Reacting to Trump's Peace Plan' (PBS, 2019) <https://www.pbs.org/newshour/show/how-palestinians-in-the-west-bank-are-reacting-to-trumps-peace-plan> accessed 29th November 2019
[5] Health conditions in the occupied Palestinian territory, including east Jerusalem, and in the occupied Syrian Golan. (2019). [online] World Health Organisation, pp.1-14. Available at: https://apps.who.int/gb/ebwha/pdf_files/WHA72/A72_33-en.pdf [Accessed 29 Nov. 2019].
[6] Ibid
Comments