15. Health conditions in the occupied Palestinian territory, including east Jerusalem, and in the occupied Syrian Golan
The report A64/27 has been submitted by the WHO Secretariat just a day before the scheduled discussion in Committee B. It is accompanied by 4 other reports, released respectively, by Israel, the Syrian Arab Republic, the Palestinian National Authority and the UNRWA (United Nations Relief and Works Agency for Palestine Refugees).
Following, in brief, are the main issues raised in the four reports:
-A ‘politically motivated’ debate and resolution on this item has no place on the agenda of the World Health Assembly.
-Israel has previously provided information on the health conditions of the Palestinians in the West Bank, at the request of the Secretariat. Following this, the Palestinians stopped most of their existing cooperation in health matters, and for this reason Israel will not provide any information on the cooperation in health matters with the Palestinian Authority.
-As regards the Druze population of the Golan Heights, they have access to primary, secondary and tertiary medical facilities throughout Israel, similar to other residents of Israel.
-The health status of residents in the Golan Heights is of a high standard, and the situation does not warrant intervention by WHO.
A health profile of the population is provided, along with a description of the existing medical facilities and of the health system.
-The main determinant of health is the Israeli occupation, especially the limitation of movement imposed by the occupation and the stifling blockade on Gaza. The combined effect is to deprive Palestinians from being part of any long term developmental programmes, and to worsen the crisis of unemployment and poverty (in 2010, 18.3% in the West Bank and 38.0% in the Gaza Strip suffered from poverty). The high levels of poverty seen in the Palestinian regions contributes to the deterioration of health conditions, and its effects include high malnutrition rates among children and anaemia among women.
-There are instances of daily violence against Palestinians by the occupation army and settlers, which undermine life and well-being of Palestinians, weaken local activities and impoverish the population.
-Israel is escalating its attacks against civilians and continues to violate the rights of human rights defenders and activists who resist the occupation through peaceful means.
-There is a continuing campaign of repression and eviction against Palestinians living in East Jerusalem.
-More than 20% of Palestinians, living in Gaza, who require referral treatment outside the Gaza Strip, are deprived of the necessary exit authorizations (Report of the WHO office in Jerusalem).
-Shortage of electricity supply and fuel, restrictions imposed on the imports of building materials and the rationing of medicines and medical equipment have led to a deterioration in both living conditions and health situation of all segments of society in the Gaza Strip; It has a severe impact on the utilization of medical equipment, stoppage of surgical interventions; and treatment of sewage and water.
-The expansion of the apartheid wall in the West Bank and occupied Jerusalem separate the Palestinian population from many medical facilities, and cut them off from the Palestinian-controlled territory.
-The aim of building the wall 35 kilometres deep inside Salfit and Qalqilya – thereby isolating the occupied city of Jerusalem from the West Bank, and expanding the settlements of “Ma’aleh Adumim”, Bethlehem and Hebron - is to create ghettos; there are about 28 ghettos containing 64 Palestinian communities.
-Call for: enforcement of International law (4th Geneva Convention), strengthening of private and public support to Palestinian MoH, protection of physical and mental health of minors exposed to psycho-physical violence; lifting of the unjust siege imposed on the Gaza Strip that prevents the reconstruction of the health institutions destroyed by the Israeli aggression and provision of necessary equipment to those institutions in the Gaza Strip.
-The Arab Syrian population in the occupied Syrian Golan still suffer from many health problems, as they prefer the citizenship of their Syrian homeland and reject the Israeli identity.
-Only those, among the Syrian population in the occupied Syrian Golan, who have an Israeli ID card or have health insurance can receive treatment. They pay high fees for health insurance premiums, medical examinations and hospitalization, which are beyond their limited incomes.
-There is a lack of integrated medical centres to serve the population in the occupied Syrian Golan.
-Syrian prisoners held in Israeli occupation prisons suffer alongside other Arab prisoners from severe physical and psychological torture.
-Lack of medical human resources: As a result of the Israeli occupation students are not allowed to attend the university or enrol in disciplines such as medicine, dentistry and pharmacology unless they approve of the occupation and hold Israeli nationality.
-The occupation forces of Israel use land in the occupied Syrian Golan as landfills for radioactive nuclear waste, which are not subject to any form of external control.
-Deprivation of water resources: Israel diverts water from Golan Heights to nearby Israeli settlements, thus depriving the local population
-The WHO and other international organizations are requested to intervene by setting up and running medical facilities in the occupied Syrian Golan and, furthermore, provide help to the population in accordance with the relevant international treaties.
United Nations Relief and Works Agency - UNRWA
Detailed report on health services manned by UNRWA is provided.
-Restrictions on the movement of people and goods remain a major obstacle to socioeconomic development and health-care provision and, in particular, affects access to specialized care.
-Among Palestine refugees, children and adolescents are particularly vulnerable. Post-traumatic stress and other psychological and behavioural disorders is emerging as a health priority.
-Continued food insecurity is also affecting health conditions; the nutritional status of pregnant women and children remains a major concern.
-The health status of Palestinian refugees has deteriorated as a consequence of the prevailing adverse social and economic conditions and insecurity. In addition, UNRWA faces increasing challenges in delivering health services. The quality of care, particularly curative care, is at stake.
-Palestine refugees are victims of compromised access to health care and the adverse impact of conflict, violence, occupation, political instability, poverty, social discrimination and hardship. These are impacting negatively on their right to achieve the highest attainable standards of health. UNRWA aims to address these socioeconomic disparities and to mitigate their effects on health through the provision of the best possible comprehensive primary health care services.
PHM’s comment on “REPORT BY THE SECRETARIAT”:
We recognize the historical pledge by the WHO regarding the health of Palestinians, as well as the current commitment to strengthening the health system and supporting the MoH in capacity building, assessment of health needs, identification of priorities, evaluation of programmes, monitor of referrals, and setting up a wide alliance among diverse actors of civil society.
However, in the context of an occupation that has now lasted 44 years, a technical approach that aims only to strengthen the health system, is not enough. The structural determinant of health, represented by the Israeli occupation, has to be addressed, despite the obvious attempt by the Israeli government to deny the WHO a legitimate role on this issue.
The health conditions in the West Bank have to be viewed in the context of the large variation of the geo-political structure of the area. The report by the secretariat hints at the difference between Area C (according to the Oslo Agreement) and the others in terms of access to medical services, but does not mention the role of settlements and closures in affecting every single social determinant of health. The impact of the illegal colonization of the West Bank has been extensively addressed by the UN OCHA report “The Humanitarian Impact on Palestinians of Israeli Settlements and Other Infrastructure in the West Bank, July 2007”. It is unacceptable to gloss over the findings of this report.
With regards to the health situation in Gaza, we strongly support the Secretariat report that “the closure of the Gaza Strip is undermining the functioning of the health-care system, hampering the provision of medical supplies and the training of health staff and preventing patients with serious medical conditions receiving timely specialized treatment outside the Gaza Strip”. The PHM, appeals to the WHO and member states to take a clear and unambiguous position against this gross injustice and human rights violation.
The WHO should not be timorous in opposing the manner in which the occupation has a gross structural impact in preventing Palestinians from meeting their health needs. The mere mention of poverty, stagnation of development, difficulties with accessing medical services, lack of water for human and agricultural use, without clearly drawing the connection between these and their root cause - the Israeli occupation and the presence of settlements - cannot contribute to finding effective solutions to the health crisis faced by Palestinians.
As regards Jerusalem, the WHO should report whether the call on Israel “to ensure access to all Palestinians from the West Bank and the Gaza Strip to the six hospitals in east Jerusalem”, made by the joint report with the United Nations Office for the Coordination of Humanitarian Affairs (UN OCHA), has been respected.
We express great concern with the uncontrolled landfills for radioactive nuclear waste which are denounced by the Syrian Arab Republic, and ask to WHO to investigate and report over it.
Global Health Watch 4
Global Health Watch 3
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