IRIN 13 August 2006
NABLUS — Five months after an international embargo was imposed on the Palestinian National Authority (PNA), the West Bank is facing a health crisis as pharmaceuticals and medical supplies become increasingly scarce.
“We’re facing severe shortages of 13 important drugs,” said Dr Lou’ay Shaheen, head of the cancer ward at the National Hospital in Nablus. “In the past two weeks, nine of these drugs were made available, but quantities still aren’t sufficient for all the patients.”
The trade embargo followed the democratic election of a Hamas-led government in February. Hamas is considered a terrorist organisation by Australia, Canada, the European Union, Israel, and the United States, and is banned in Jordan.
While the embargo does not prevent the importing of food or medicines, it has delayed supplies from reaching the West Bank as all entry points, which are controlled by Israeli authorities, have been tightened.
‘Palestinian territories’ is a collective name for the West Bank, Gaza Strip and East Jerusalem. The West Bank is a landlocked territory bordered by Israel in the west, north and south, and by Jordan in the east. It was originally Jordanian territory captured by Israel in the 1967 Six-Day War and has since been occupied by Israel. Jordan gave up its claim to the area in 1988.
The West Bank has a population of about 2.8 million people, of which 2.4 million are Palestinians and more than 400,000 are Israeli settlers. Forty percent of the West Bank has been under the limited civilian jurisdiction of the PNA since the Oslo Accords were signed in 1993 , while Israel maintains overall control.
Income and medicines lacking
The major debilitating effect of the embargo, however, is that it is stripping the PNA of much-needed aid and income. The PNA had previously received financial assistance from the European Union (EU) and the United States (US). In 2005, this amounted to about US $1 billion, but the EU and the US suspended all direct aid on 7 April 2006 after the Hamas victory, according to the EU and the US State Department.
In addition, Israel and the Western countries have blocked about US $55million of monthly financial aid that the West Bank had been receiving from Arab donor countries. The embargo has also greatly reduced the PNA’s own revenue stream. Monthly tax collections valued at US $60 million on goods entering the West Bank are no longer being transferred from Israeli authorities to the PNA, according to deputy finance minister Dr Jehad Al Wazeer.
The Israeli government says this money could be used for terrorist activity. “There is no doubt that - from Israel’s point of view - a new situation has been created. The State of Israel will not negotiate with a Palestinian administration if its members include an armed terrorist organization that calls for the destruction of the State of Israel,” read an Israeli government statement after Hamas won Palestinian elections in January.
Israel has said, however, that it would continue to help the Palestinian population meet their basic needs by proposing to reallocate part of the funds due to the PNA to the United Nations and other international relief bodies so that they could offset the human and social consequences of this sanction.
Medecins Sans Frontieres (MSF) is one of the international non-governmental organisations (NGOs) to have rejected Israel’s proposal as unacceptable.
“It is not the role of humanitarian aid agencies to ensure that the basic needs of the civilian populations living in the occupied Territories are covered,” read a statement from MSF issued on 13 April 2006. “This responsibility, in accordance with the fourth Geneva Convention, is that of the occupying power, namely the State of Israel.”
Nevertheless, initiatives by humanitarian agencies to meet the needs of West Bank residents are ongoing.
“We are visiting hospitals, clinics and pharmacies in the West Bank in order to assess their requirements for medicine and medicinal supplies,” said Dr Fathy Abu Mughli, manager of the World Health Organisation (WHO) Health Programme in the West Bank.
“Based on these visits, we will prepare a report and present it in a meeting in Jerusalem with some of the donor countries, international banks, Unicef, UN HABITAT [UN Human Settlements Programme], Care International and MSF,” he added.
Dr Abu Mughli said that the primary purpose of this meeting would be to secure the provision of emergency medicinal supplies, operation room supplies and medicine for cancer and kidney treatment.
‘Catastrophic’ situation
Meanwhile, the ordinary people of the West Bank continue to suffer the brunt of the embargo. According to Deputy Health Minister Dr Anan al-Masri, more than 90 different types of drugs and medical materials are not available because of the blockade, including intravenous solutions, anaesthetics and blood tests for HIV and Hepatitis B. In addition, X-ray films, printing ink and hospital stationery are in short supply.
Doctors at the National Hospital in Nablus, the only hospital in the northern West Bank to offer cancer treatment, were recently forced to cancel chemotherapy programmes due to a severe shortage of drugs. “A number of cancer patients died during the past four months as a result of incomplete treatment,” said one medical specialist, who wished to remain anonymous.
The hospital’s dialysis ward is in no better shape. Visited by 36 patients a day, the department has reduced the number of kidney dialysis operations from three to two times per week due to shortages. “There’s a lack of several essential drugs, like those required to strengthen the blood count during kidney dialysis,” said Abdullah al-Khatib, head of the kidney ward.
Other hospitals in the territory are faring no better. Dr Hussam al-Jawhari, head of the Rafidia Government Hospital in Nablus, was pessimistic: “If the situation continues, we’ll be able to treat emergency cases only.”
Hebron’s Alia Hospital, the second largest surgical hospital in the West Bank, is running solely on donations by civil institutions.
“Our supplies won’t last another month,” said hospital head Dr Saeed al-Sarahneh. “We’re accepting any donation. One charity association donated a bag of flour, a box of lentils and 300 food parcels. We accepted them without hesitation.”
While humanitarian agencies are attempting to alleviate this problem, they warn that on their own they can not meet every need.
“Since this crisis started five months ago, Care International has provided hospital and health care centres with 70 percent of their medicinal requirements for kidney patients,” said Dr Ghassan Shakhshir, operations manager in Care’s Emergency Health Service project, based in the West Bank city of Ramallah. “But we cannot meet all the medicinal needs of the Palestinian Health Ministry.”
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