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Increasing attacks on health care & health worker testimony
In February 2023, there was a significant increase in attacks on health care in the West Bank. Health attacks occurred in the
context of major incursions by Israeli forces into Palestinian towns and refugee camps and a rise in violence carried out by Israeli settler groups. WHO verified 47 health attacks in the first two months of 2023, which included:
• 37 incidents involving obstruction to the delivery of health care, which included closures that happened during incursions on Jenin, Nablus and Huwara,
• 21 incidents involving acts of physical violence towards health care providers, which included exposure to targeting with live ammunition that prevented the provision of first aid and evacuation of injured persons who subsequently died,
• 3 incidents of militarized search of a vehicle.
There was injury to 24 health workers and targeting without injury of at least 12, with three health workers made to undergo strip search and four detained. 44 ambulances were affected, including 42 that were obstructed access to provide health care, six that were damaged, and a further three that were targeted without being damaged.
Two-thirds (68%) of recorded attacks were in the district of Nablus, with other affected areas including Hebron, Jericho, Jenin, Bethlehem, and Jerusalem.
The increased attacks in February echo peaks in health attacks during April and October 2022, see chart 2.
Testimony of Ahmad, a health worker with PRCS
Ahmad has been working for the Palestine Red Crescent Society (PRCS) for 26 years.
“On the 22nd of February during the military raid on Nablus, I was in one of the nine PRCS ambulances that were prevented from entering the Old City to evacuate people who had been severely injured. We were told that there was no coordination [with Israeli forces] for the ambulances to enter, so we decided to continue by foot at our own risk.
“One of the teams went to treat a 2-year-old child who has a heart condition and was suffering from tear gas inhalation. After they reached the patient’s house, they were stuck for two hours inside before they could coordinate to transfer the child to hospital.
“A team of four paramedics had just left their ambulance vehicle to evacuate an injured person when they were directly targeted with rubber coated bullets. The team managed to get the injured person to the ambulance without being directly hit.
“In other attacks on that day, an ambulance was targeted with rubber bullets and another was hit by an Israeli military vehicle causing damage to the body of the ambulance.”
Ahmad describes the difficulties with access and the impact of some of the health attacks in Nablus: “
In normal circumstances, entering the Old City is difficult because of the narrow roads. Entering during a military incursion is even more difficult. The Palestine Red Crescent Society in currently in the final stages of bringing small, specialized vehicles (“tracktorons”) to make entry and transfer of patients easier.
“I am scared for the team. We try to protect ourselves as best we can. It’s so hard to see one of your team injured. Last year, during confrontations in Beita, one of our team was shot while he was in the ambulance. The ambulance was close to a cliff, it could easily have fallen. It was a very intense and difficult situation.
“When a vehicle is damaged it can go out of service for some time. We already have a shortage, especially with the growing needs and the increased number of injuries during the recent violence.
” PRCS has recently started provision of bullet proof vests, helmets, and tear gas masks to its teams, following incidents of direct targeting of health workers. The organization systematically monitors violations against its staff, ambulance and facilities and advocates for enhanced respect and protection of health care across the occupied Palestinian territory.
Ahmad 2nd on the right ©PRCS
Hamzeh, a paramedic, severely injured in a health attack in Nablus
27-year-old Hamzeh Abu Hajar is a volunteer paramedic with the Palestinian Medical Relief Society (PMRS).
Hamzeh first joined PMRS in 2019, participating in courses on first aid and community engagement at their youth centre. In March 2020, after the first cases of COVID-19 were identified in the occupied Palestinian territory, he signed up to join their field teams providing community support and helping sick patients in the Old City of Nablus.
“Helping people during COVID-19 was rewarding. People had no one else to help them, especially older people in our community and those who could not go out of their homes. I used to work night shifts with the other volunteers. We helped with all sorts of tasks, from bringing food to people’s houses to paying for their electricity bills or taking sick patients to doctors and hospitals… I enjoyed the work, and I knew that I wanted to continue to support people in this way.”
In 2022, with increasing escalations across the West Bank, Hamzeh began volunteering as a PMRS first responder.
“Every time the Israeli forces would raid Nablus Old City, I would join the field team. PMRS cars would drive us to different locations where people were injured and needed our help. I always made sure to wear my vest before leaving the house, while PMRS made sure we were all wearing vests by the time we reached a location with injured people… At first, wearing the paramedic vests made us feel protected. However, as the confrontations increased the occupation forces stopped distinguishing between paramedics, journalists and others. We all feel or show fear in different ways. Of course, I was scared when going into the field, but it wasn’t the kind of fear that would prevent me from going to help the people who depended on us.
” At around 8am on the morning of Friday 30th December 2022, Israeli forces raided Nablus Old City. Hamzeh was called to the field to support treating the injured. He left his house wearing his paramedic vest and went towards the Old City with other PMRS volunteers. Around 15 PMRS volunteers were dispersed to different locations to cover the emergency response as effectively as possible. Hamzeh was stationed at the western side of Al Khan neighbourhood.
“I heard calls to help with an injury near my location. I immediately went to respond, and there were another two paramedics behind me. 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 tearing apart from the inside. I was on the ground for several minutes until Al Razi ambulance [a private ambulance] reached me. A sniper had been shooting between the two ambulances on site and me.”
The second ambulance had been from the Palestine Red Crescent Society, which was obstructed from reaching Hamzeh. After Al Razi ambulance reached him, they transferred him to hospital. The ambulance tried to exit via the western route to Rafidia Government Hospital but was again obstructed by Israeli forces, which compelled the team to return and take a different route.
“I remember slipping in and out of consciousness. I vaguely remember being in the ambulance. I also remember my brother, doctors, some of my PMRS friends, and many other people surrounding me in the hospital. I was put in an emergency intensive care room when I reached the hospital and ten minutes later I was transferred to the operating room.”
Hamzeh’s surgery took 4.5 hours. He stayed in the intensive care unit for 6 days, after which he was transferred to another ward for a further two days before being discharged home. The bullet had injured Hamzeh’s right lung and diaphragm, torn part of his liver and right kidney, and broken four of his ribs. He also suffered a bladder injury. After being shot, the bullet exited from his back, resulting in a tear of his muscle and an open wound around 20 to 25 centimetres in diameter. As a result of his surgery, Hamzeh had 40 stitches in his abdomen, while his back wound remains open and will require several months to heal.
“When my family first heard I had been injured they didn’t understand the extent of my injuries. When doctors explained to them that I was in a critical condition they were shocked and devastated. They were very worried that – God forbid – I would die. When I woke up after surgery it was difficult for me to understand what had happened to me. I was in shock, and I needed time to process everything… Since I returned home, I have been on many medications, from pain killers to anti-inflammatory medications. I use an inhaler and need oxygen, especially at night. My colleagues from PMRS come on daily basis to help change my dressings. The open wound on my back is the one that hurts me the most. Moving is still very painful for me. I haven’t had a full night’s sleep since I got home. I manage to sleep two hours at most because every place in my body hurts and there is no position I can lie in without pain.”
Hamzeh is still at home undergoing a slow recovery. He moves around the house and goes for follow up visits to the hospital every Tuesday. Because of his broken ribs he faces difficulties moving and sleeping. The injury of his lungs means he gets very tired whenever he tries to move around the house.
“Before my injuries I was very active, I used to go to work and after that I would go out with my friends. Since my injuries I only go out for hospital visits. My friends still visit me at home, but it is not the same! I feel closer to my family now, I sit with them more than I used to before. My family understands my injuries better now and they all try to help me. My brother and mother help me the most.”
Hamzeh is making a slow recovery. He needs close follow up to monitor potential complications of his injuries. Even despite this, he plans to return to the field.
“Before my injury I witnessed some difficult cases working in the first response teams. I helped provide first aid to people who had very severe injuries. I even had to move people who had been killed. One of the hardest experiences was when I had to move a martyr who turned out to be my friend. I had been with him just a few hours before the raid. I was so shocked to see that it was my friend. Even these experiences didn’t prevent me from going back to the field. On the contrary, it gave me a stronger push to go and to support those in need, especially knowing that they depended on our help. I felt it was my duty to help them. After I fully recover, I plan to return. My mother is worried. She keeps telling me that she doesn’t want me to go back. She says the first time I was lucky, but we don’t know what will happen next time. Still, I plan to return.”
West Bank Access 2022
Throughout the year, WHO continued to document the impact of barriers to health access on the Palestinian people in the West Bank.
Below are two of the cases documented during 2022:
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April Communities in the Jordan Valley depend on precarious mobile clinic access Moaayd Daraghmeh is the driver of a mobile clinic for the Palestine Red Crescent Society (PRCS) operating in the Jordan Valley of the West Bank. He has been part of the clinic team for 10 years, working with communities in remote areas reliant on mobile clinics for access to essential primary health care. The communities face obstacles to planning and development, demolition orders that make their lives and livelihoods precarious and uncertain ... Read more |
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| November
21-year-old Musaab repeatedly denied access to cancer care |
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WHO receives trauma and emergency surgical kits to boost medical stocks
8 February 2022 – WHO has received 7 pallets of different modules of lifesaving trauma and emergency surgical kits through the support of the Government of the Russian Federation.
The kits are enough to cover the health needs of up to 250 severely injured patients and 1000 moderate to lightly injured patients.
The kits will boost WHO’s stock of emergency supplies and be deployed, in coordination with the Ministry of Health, during crises to fill critical gaps in need for reducing morbidity and mortality. Availability of the kits will further strengthen WHO’s ongoing efforts to improve the emergency preparedness and response capacity of the West Bank.
“We hope that this contribution will help the Palestinian health care sector cope with the overwhelming difficulties that it faces on a daily basis and provide the necessary services to the population. It's the least we can do to support our brotherly Palestinian people in this most turbulent time,” said Gocha Buachidze, the Representative of the Russian Federation to the Palestinian national authority.
"WHO appreciates the generous support of the Russian Federation, which will help to bolster emergency medical stocks and complements WHO's capacity-building efforts for trauma care at all levels of the health system. This is especially important given the increase in violence in the West Bank, which has led to a surge in casualties that are putting a strain on precious hospital resources," said Dr Rik Peeperkorn, WHO Representative to oPt.
