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Attacks on health care during the military incursion of Jenin refugee camp
Sabrin is 32 years old and a paramedic from Silat al-Harithiya village, near Jenin in the West Bank. She has worked with the Palestine Red Crescent Society for the past five years.
On Monday 3rd July, Sabrin woke up to news of the military operation on Jenin refugee camp. She tried to reach the PRCS ambulance centre in Jenin for duty but faced difficulties. She stated, “The taxi driver told me it would be difficult to reach Jenin, but I told him I had to reach the ambulance centre to go and help. We agreed to go to the entrance of Jenin, after which I had to find my own way to the ambulance centre.”
Sabrin contacted a private ambulance, who helped her reach. All PRCS ambulances were busy responding to the injuries.
Sabrin accompanied an ambulance team to assist a woman who had gone into delivery inside the camp. The team coordinated for access with the International Committee of the Red Cross (ICRC). However, as the team approached the refugee camp, they encountered difficulties. Sabrin explains, “We came to an intersection, where a military jeep in front of us started ordering us to go backwards. But we could see there were already some military jeeps and a bulldozer behind us.” The driver attempted to negotiate, but discussion began to escalate. “I was worried that the soldiers would shoot towards us. I felt that we could be shot at at any moment. I was scared but I also felt responsibility for the woman who was in delivery. I was worried about her and her baby. The occupation forces insisted that we had to go back, but there was nowhere to reverse as two jeeps were blocking our way from behind. The military jeeps moved and as we began to reverse the military jeep in front of us rammed into our front, pushing us backwards. It was intense, we were all so stressed.”
Another ambulance was sent from the ambulance dispatch centre to respond to the woman in delivery, with coordination through the ICRC. However, this second ambulance was also unable to reach the woman.
On the same day, the same ambulance team was prevented access when trying to evacuate families with children from their homes. Sabrin said, “We wanted to evacuate people suffering with tear gas inhalation. On one occasion I had to get out of the ambulance vehicle to request a military officer to allow us to reach the homes. I told him there were children inside, but he only shouted at me to go back. I tried to talk to another military officer, but he also didn’t allow us.”
The next day, Tuesday, 4th July, Sabrin was unable to reach the PRCS ambulance centre and report on duty due to severe movement restrictions in the area.
“This isn’t the first time we faced difficulties,” she said. “We’ve been shot at and targeted with live ammunition. I get scared every time. I have two daughters and I worry that I would not return to them. But I still feel a strong obligation towards the people. The attacks scare me, but they won’t stop me from continuing my work. In fact, they encourage me to continue because I understand that people depend on us.”
WHO delivers training to improve intrapartum care in the occupied Palestinian territory
14 August 2023 – WHO organized a 3-day training workshop for health workers in the West Bank and Gaza Strip to improve their capacity in providing high-quality, evidence-based intrapartum care.
The training was attended by 24 obstetricians and midwives in the West Bank and 35 in the Gaza Strip, respectively. The training was based on new and existing WHO recommendations that emphasize the importance of women-centred care to optimize the experience of labour and childbirth for women and their babies through a holistic, human rights-based approach.
WHO’s intrapartum care model is based on several components to ensure a positive childbirth experience. It includes respectful maternity care, emotional support during childbirth, effective communication, pain management, continuity of care, regular monitoring during childbirth, skilled and competent and birth attendants, and a well-functioning health system.
The training focused on a few core components of the model, such as the "Labour Care Guide" that aims to improve medical staff practices in labour and deliver, quality diagnosis and management of perineal injuries and how to avoid ineffective or potentially harmful practices. Health workers were also encouraged to consider how women’s individual health can affect delivery.
Throughout the sessions, the trainers provided vital context around maternal and newborn health in the occupied Palestinian territory (oPt). They also recognised the significant steps that have already been taken to reduce maternal and neonatal morbidity and mortality in oPt and highlighted the pivotal role of antenatal and intrapartum care in its prevention.
“Ensuring the mother’s health after childbirth is a key priority. Today’s training provided health workers with knowledge and tools to accurately diagnose and timely treat internal injuries and lacerations to prevent future complications. We also trained them in surgical suturing so they can stop internal bleeding that can occur during birth”, said Dr Hadeel Al-Masry, one of the trainers.
Feedback from participants following the training was very positive. Dr Ahmad, from Yatta Government Hospital in the West Bank, found the training useful for his daily work in the maternity ward. “Every day we deal with patients suffering from internal injuries due to childbirth. This training will help us effectively diagnose the extent of perineal injuries and treat them”.
Dr Alaa, an obstetrician and gynaecologist at Nasser Medical Complex in Gaza Strip, said that in addition to the theoretical and practical skills they acquired during the training, participants also learned the importance of communicating with patients. “Open communication with women during labour and delivery can improve diagnosis of internal injuries and prevent irreversible complications and health problems.”
Following the training, health workers were keen to influence and support more dignified, responsive and respectful maternity care in their hospitals, as well as pass on the knowledge to their colleagues. Post-training supervision visits will now be conducted to assess the knowledge and skills of health care providers.
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Palestine Social Medicine Course Launched
11 July 2023 - The Institute of Community and Public Health (ICPH) at Birzeit University, the François-Xavier Bagnoud (FXB) Center for Health and Human Rights, and the World Health Organization in the occupied Palestinian territory have launched the Palestine Social Medicine course. This intensive course is part of the activities of the Palestine Program for Health and Human Rights, a partnership between ICPH at Birzeit University and the FXB Center for Health and Human Rights at Harvard University, United States. The course is supported through Swiss Agency for Development and Cooperation funding to WHO occupied Palestinian territory Right to Health programme.
Course participants comprise a group of 30 medical and health sciences students from Palestinian universities across the West Bank and Gaza Strip, as well as universities in the United States.
The course aims to educate students about the social, structural, and political determinants of health globally and in Palestine, providing practical and real-life examples of the obstacles that hinder reaching optimal levels of health and healthcare delivery and exploring strategies to mitigate these obstacles. The course combines theoretical lectures with interactive group activities and field visits, offering a comprehensive and dynamic learning experience. The three-week course equips students with the theoretical foundations and tools to understand and analyze the social and structural determinants of health; the applicability of those foundations and tools in the Palestinian historical and geographic context; and the skills to use these tools towards structural change and improved health.
Strengthening protection of health care in the occupied Palestinian territory
23 June 2023 – WHO conducted two workshops in Ramallah, West Bank, and Gaza City on strengthening protection of health care against attacks and barriers to access in the context of occupation.
WHO has documented increased attacks on health care in the West Bank, with the surge in incursions and violence in 2023. From January to the end of May 2023, there have been at least 124 health attacks, resulting in 39 health worker injuries and the arrest and/or detention of 9 health workers, 1 patient and 1 companion. At least 117 ambulances were affected in attacks, including 104 obstructed access, 15 damaged, 3 used as a shield, 4 searched and 4 directly targeted without causing damage to vehicle body. Meanwhile, 12 attacks involved damage to health facilities. In Ramallah, 35 participants attended the workshop, which focused on improving and aligning monitoring and documentation of health attacks, and identifying measures to better protect patients, health workers, ambulances, and facilities against acts of violence and interference with care provision.
In the Gaza Strip, ongoing blockade and closure has resulted in systematic obstruction to accessing health care. Patients, companions, and health workers are required to obtain Israeli-issued permits to reach health facilities in the West Bank, including east Jerusalem, as well as in Israel and Jordan. In May 2023, 22% of patients were not approved permits in time to reach needed health care, while 53% of companions were not approved in time to accompany patients including children, persons with disabilities, the elderly, and those incapacitated by their illness. A total of 31 participants joined the workshop in Gaza, which sought to enhance protection for individuals encountering arbitrary delay and denial of health access, and to bolster collective advocacy.
