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WHO event in Gaza to mobilize action on barriers to the Right to Health in the occupied Palestinian territory
6 June 2023, WHO held an event in Gaza to engage partners on mobilizing action to address the key findings and recommendations of two reports on the Right to Health: Barriers to Health Access and Attacks on Health Care 2019 to 2021 and Palestinian Voices 2022 to 2023.
Opening remarks were delivered by Dr Yousef Abu Rish, Deputy Minister of Health, Mr Thomas Jenatsch, Deputy Head of Cooperation for the Swiss Agency for Development and Cooperation, and Dr Richard Peeperkorn, WHO Representative for the occupied Palestinian territory.
The reports outline how fragmentation of the Palestinian people, implementation of a permit regime, physical obstacles to movement, and protection gaps cause health inequities and create substantial barriers to health care provision and health access in the occupied West Bank, including east Jerusalem, and Gaza Strip.
According to the reports, over a third (35%) of patient permit applications and over a half (54%) of companion permit applications were not approved in time for patients to reach their hospital appointments during the period from 2019 to 2021. In the same period, nearly a third (30%) of children were approved permits without either parent approved to accompany them. Overall, referral patients needing exit from the Gaza Strip are among the most vulnerable in society, where WHO documented that nearly one in ten (9% of) patients had died at six months from the date of their first hospital appointment.
The event participants heard from Maysa, mother of five-year-old Ameer, who discussed the experience of successive delays trying to get Ameer access to eye care outside the Gaza Strip. “When Ameer was prevented access to the ophthalmic hospital in Jerusalem, we couldn’t afford to travel to Egypt. It was a very stressful time, we felt lost. I was thankful for the support that we received as a family, and that we were eventually able to reach Jerusalem,” she said.
Mr Isam Younis, Director of Al Mezan Center for Human Rights, discussed the appeals and human rights documentation and advocacy his organization carries out to support Palestinian patients. He stated, “Stringent restrictions on the movement of people and goods from and to the Gaza Strip by Israeli authorities constitutes a policy of collective punishment, prohibited under international law. The arbitrary delay or denial of access for patients represents a direct violation of their right to health.”
Discussions focused on additional findings of the reports: barriers to the sustainable availability of health care and the continued high number of attacks on health care affecting patients, companions, health staff, ambulances, and health facilities in the occupied Palestinian territory.
Dr Peeperkorn concluded, “Health is a fundamental right for every human being. WHO remains committed to sustained documentation and monitoring of barriers to the right to health, as well as to enhancing and mobilizing our collective advocacy towards addressing the structural and root causes of those barriers and promoting respect, protection, and fulfilment of the right to health for Palestinians.”
WHO webpage with the reports and resources for the Right to Health: /opt/information-resources/right-to-health.html
Palestinian Voices 2022 - 2023
Gaza Health Access
Throughout the year, WHO continued to document the impact of barriers to health access on the Palestinian people in Gaza. Below are three of the cases documented from 2022 to 2023:
Khalid
He is a patient and has the same right as any person who wants to get treatment.
Riham, wife of Khalid
Amal
I don’t know why I am prevented. I have been waiting so long! I need to have this test so the doctor can make a clear diagnosis and give me proper treatment. I suffer and worry every day.
Fatma
When I lost my daughter, I felt that there is no life anymore. I am sure my daughter is not the only one killed by this blockade... Why should my little girl have been denied medical treatment?
Fatma’s father
West Bank Health Access
Throughout the year, WHO continued to document the impact of barriers to health access on the Palestinian people in the West Bank. Below are three of the cases documented from 2022 to 2023:
Musaab
This is so inhumane. How can this happen in any place in the world? Why are they blocking me from accompanying my son? I just want to hold his hand when he goes for surgery.
Musaab’s father
Moaayd
These communities face a lot of violations… We should be providing health services at least three times a week, but we cover communities in three districts of the Jordan Valley and there is only so much we can do.
Muhannad
For two days I couldn’t reach work. I would leave my house on foot wearing my paramedic uniform and go to the checkpoint, but the soldiers wouldn’t let me pass.
Health Attacks
Throughout the year, WHO continued to document attacks on health care. Below are four of the cases documented from 2022 to 2023:
Ali
When I responded that I wanted to see what he was doing, the soldier got out of the vehicle and started pushing me and kicking me, hitting me with the back of his gun and causing me to fall to the ground.
Hamzeh
Around five metres before reaching the guy, I was shot in the right side of my upper body. I went back around two meters and fell to the ground. I told the other paramedics that I had been shot. I felt that my body was being torn apart from the inside.
Abed
When they started shooting towards me, I felt helpless. I had the capacity to help – at least to stop his bleeding until we got him to hospital. I knew there were other injuries as well, but I couldn’t reach them.
Shadi
I call on international organizations to give us protection. Doctors, nurses, laboratory technicians and ambulances. We live under occupation, and we are exposed to the violence of occupation every day.
WHO trains paramedics from the West Bank and East Jerusalem in basic pre-hospital trauma care
17 May 2023 - WHO trained 25 Palestine Medical Relief Society paramedics from the West Bank and East Jerusalem in pre-hospital trauma care during a four-day workshop, which aimed to refresh their skills and teach new techniques for stabilizing patients in emergencies and mass-casualty incidents. Participants
The course delivered during the training has been developed by WHO's Emergency Operations Unit and piloted for the first time in the Eastern Mediterranean region. It is designed to provide participants with critical life-saving skills that meet international standards and ensure that health workers speak a shared technical language during emergencies. During the training, participants particularly benefited from learning about handling patients with major injuries from gunshots and blasts.
"This training is part of a larger roadmap WHO has developed in collaboration with the Ministry of Health to improve the emergency preparedness and response capacity in the West Bank and East Jerusalem. Since 2022, efforts have been ongoing to identify and address gaps in the trauma care pathway at the pre-hospital, hospital, and post-hospital levels, aiming to reduce morbidity and mortality during emergencies," said Dr. Athanasios Gargavanis, WHO Emergency Care Technical Officer.
Since December 2021, WHO has trained 195 health workers in the West Bank and East Jerusalem in mass-casualty management protocols and supported seven main hospitals in the West Bank to update their emergency plans.
The basic pre-hospital trauma care training was delivered through WHO's Contingency Fund for Emergencies (CFE), which provides resources for rapid emergency responses, often within 24 hours.
"CFE has been vital in supporting WHO scale-up efforts to improve the trauma care pathway, which is extremely important in the current context given the increased violence in the West Bank," said Dr. Gargavanis.
WHO is developing plans to expand the basic pre-hospital trauma care training across the West Bank, after analysis of feedback received from participants of the recent training.
Khalid “He is a patient and has the same right as any person who wants to get treatment.”Khaled Riham, wife of Khalid
Khalid, 36 years old from Gaza city, has end stage kidney failure. For 16 years, he has been dependent on weekly haemodialysis
(a procedure to remove waste and water from the blood, to perform the function of healthy kidneys).
In late 2022, Khalid required referral out of Gaza for vascular surgery so that he would be able to keep having lifesaving haemodialysis. Despite repeated surgeries in Gaza, doctors were unable to establish the vascular access needed for the procedure. At Makassed Hospital in east Jerusalem, Khalid was to receive an artificial blood vessel graft.
In total, Khalid made six permit applications to Israeli authorities. He was never approved a permit to reach Makassed Hospital but was instructed to change the destination and arrange a hospital appointment in Jordan after several appeals through human rights organizations and advocacy by the UN and partners. As of April 2023, Khalid was awaiting financial coverage from the Palestinian Ministry of Health for an appointment at a hospital in Jordan.
Table 1: Khalid’s hospital appointments, intended hospital destination, and permit outcomes
