The life expectancy of Palestinians in the occupied West Bank and Gaza is about ten years lower than that of persons in present-day Israel, according to a new report. Meanwhile, infant mortality and maternal death rates are also four times higher in the West Bank and Gaza Strip.
The data compiled by Physicians for Human Rights-Israel (PHR-I) reveals the disparities in health, which the organization says are direct impacts of the Israeli occupation.
It is important to note that the data used by PHR-I do not include 2014, the year of Israel’s massive assault on Gaza during which more than 2,200 Palestinians were killed. The comparison between Israel and the occupied West Bank and Gaza is also limited by the exclusion of East Jerusalem, which is part of the West Bank.
PHR-I says there is no specific data on East Jerusalem because the Israel’s Ministry of Health considers this occupied territory as being a part of Israel. Israel’s national health insurance applies to East Jerusalem, and local health facilities collect data for the ministry.
PHR-I’s report — titled “Divide and Conquer: Inequality in Health” — says that in the West Bank and Gaza, an average of nineteen babies die per one thousand births, while in Israel, the average is four out of one thousand. While preventable infectious diseases are the main cause of infant mortality among Palestinians, in Israel this is seldom the case.
Twenty-eight out of 100,000 Palestinian mothers living under occupation die during childbirth, contrasted with seven out of 100,000 mothers in Israel.
The incidence of infectious diseases is higher in the occupied Palestinian territories than in Israel. Disturbingly, some vaccinations against life-threatening diseases are not given in the West Bank and Gaza Strip.
Expensive vaccines that prevent Hepatitis A, chickenpox, pneumonia, rotavirus (the common cause of severe diarrhea among infants and young children) and human papillomavirus, which can cause cervical cancer, are not included in the Palestinian Authority’s national vaccination program because of lack of access and cost.
Strangulating Palestinian healthcare
The Palestinian healthcare system is in a state of chronic crisis due to the continuous shortages of funds, medication, medical equipment and a lack in specialist doctors and medical staff in general.
There is less money available for healthcare in the West Bank and Gaza, the report explains. The expenditure per capita is only one-eighth of the expenditure for Israel’s health services.
Israel has further used its control over Palestinian tax funds by delaying the transfer of customs funds to the Palestinian Authority as a punitive measure, making planning of the annual budgets difficult for the ministry of health. Due to these financial difficulties, medical workers are not paid regularly. These restrictions occasionally lead to strikes and reduction of the working week from five to three days.
Israel has eight times more specialist doctors — 1.76 per 1,000 residents — while only .22 per 1,000 residents in the West Bank and Gaza. The number of nurses per 1,000 residents is significantly lower in the occupied territories — 1.9 nurses per 1,000 residents against 4.8 per 1,000 Israelis.
The Palestinian public health system is not able to provide specialized treatments for “complex medical problems in fields such as oncology, cardiology and orthopedics,” PHR-I says.
Many patients needing such care are — at high costs — referred to private Palestinian health facilities in East Jerusalem and, if needed, to hospitals in Israel, Egypt and Jordan. In 2010, the cost of such referrals amounted to about thirty percent of the Palestinian health ministry’s budget. In 2012, more than 5,000 patients were referred to Israel at a total cost of more than one million shekels ($254,670).
These referrals increase the dependency on Israel and are obstacles to the development of an independent healthcare system in the West Bank and Gaza.
Moreover, Palestinians who need to travel for medical treatment outside the occupied territories are subjected to Israel’s restrictive and arbitrary permit system. PHR-I says that Israel makes “the departure of patients from the Gaza Strip for medical treatment conditional upon undergoing GSS (Shabak) security questioning.”
Restricted access to medicine
The Israeli Ministry of Health also controls the import of pharmaceuticals to the West Bank and Gaza Strip. It only allows the import of medicines registered in Israel and blocks imports from neighboring markets which could provide medications at lower costs. Palestinians are not able to benefit from pricing systems used by the pharmaceutical industry which takes the socio-economic status of the target population into account.
The combined customs system with Israel results in Palestinians being required to purchase medications at “first world” prices.
Importing raw materials needed for the local manufacture of medicine is almost impossible due to Israel’s policies, which restrict the transfer of goods and raw materials to the Palestinian territories.
Each import by a Palestinian pharmaceutical manufacturer requires an authorization from the Israeli Ministry of Health. Quite often, Israel prohibits the import of starting materials, declaring that such materials might be used for military operations. In general, manufacturers in Israel do not need such authorizations — and when an authorization is required, it is given on an annual basis.
Physicians for Human Rights-Israel concludes in its report that “two populations live in a single territory, ruled by the same government — with different rights.” One group — the Israelis — enjoys an excess of privileges.
But every person has the human right to access the highest attainable standard of physical and mental health. The right to health includes not only timely and appropriate medical care but also the underlying determinants of health — such as access to clean and potable water, adequate sanitation and safe occupational and environmental conditions.
Israel’s ongoing violence against Palestinians of all ages continues to inflict serious harm and increases the need for healthcare services which the Palestinian system, at present, is struggling to provide.