58th World Health Assembly – Health conditions in the OPT – Israel Ministry of Health report

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Health conditions of, and assistance to, the Arab
population in the occupied Arab territories,
including Palestine

At the request of the Government of Israel, the Director-General has the honour to transmit to the Fifty-eighth World Health Assembly the attached report by the Ministry of Health of Israel.

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ANNEX

Report of the Israeli Ministry of Health
to the Fifty-eighth World Health Assembly
May 2005

On the topic:

THE RELATIONSHIP BETWEEN THE ISRAELI MINISTRY OF HEALTH AND
THE PALESTINIAN HEALTH AUTHORITY

2004-2005

A. Hope for the opening of an era of reconciliation and peace after the disengagement from Gaza and areas in North Samaria

1. We are, hopefully, on the verge of a new era of peace. The disengagement from the Gaza Strip and the northern part of the Samaria Region is to be carried out within the next few months concomitant with the implementation of certain bilateral steps directed towards strengthening mutual  confidence.

2. In the wake of these steps, the improved situation should lead to a warming of relations, and a gradually enhanced cooperation between the Israel Ministry of Health and the Palestinian Health Authority.

B. The Palestinian Health Authority has been independently running, and managing its health and medical services for more than 10 years

3. The Palestinian Health Authority has been fully responsible for the management of the health and medical services in the Palestinian autonomous territories since the transfer of responsibilities from the Israeli civil administration authorities to the Palestinian Authority in 1994. Gaza and Jericho were transferred to the Palestinians on May 18, 1994, while the health systems in the rest of the West Bank were transferred on December 1, 1994.

C. Israeli–Palestinian cooperation from the 1st of December 1994 until the 29th of September 2000 (the date of the outbreak of the “second intifada”)

4. At the time that responsibility for the health systems was transferred to the Palestinian Authority, joint Israeli-Palestinian committees were formed:

• to establish a framework for cooperation between the two parties;

• to discuss professional issues;

• to exchange information, data and views on various health and medical matters;

• and to coordinate common policies.

The six joint committees were given a mandate to develop policies in the following areas:

(1) Public health and epidemiology

(2) Environmental health

(3) Food safety and quality control

(4) Pharmacology and pharmaceuticals

(5) Medical care in Israeli hospitals for Palestinian patients

(6) Training programmes and postgraduate studies for Palestinians in Israeli academic medical centers.

5. Senior Israeli and Palestinian physicians, as well as experts in the relevant fields, were appointed as members of the joint committees. These professionals worked together in a collegial atmosphere, establishing fruitful cooperation, which proved to be beneficial to both parties.

6. Near the end of 1997, the Palestinian Minister of Health made an arbitrary political decision to suspend the operations of two of the committees: those dealing with medical care in Israel, and with training programmes and postgraduate studies for Palestinians in Israel. Despite the suspension of the committees’ activities, Palestinians continued to receive medical care in Israeli hospitals as before, and Palestinian physicians were permitted to continue their residency programmes and other professional activities in Israeli academic centers.

D. The effects of the “second intifada” (the end of September 2000 until the end of the year 2004) in the fields of health care and medicine on the Palestinian and the Israeli civilian populations

7. The Palestinian campaign of terror was launched on 29.9.2000. Concomitantly, the attitude of the Palestinian Authority changed drastically. Regrettably, the Palestinian leadership decided to drag issues of medicine and health care into the arena of political conflict. The Palestinian Minister of Health again made an arbitrary political decision to suspend the meetings and activities of theremaining four joint committees. On the basis of this ruling, the committees in the fields of public health and epidemiology, environmental health, food quality control and pharmacology and pharmaceuticals ceased to operate. In the wake of the IDF revelation in April 2002 that the Palestinian Red Crescent (PRC) ambulances were being used to transport terrorists and weapons, the PRC halted all cooperation with Magen David Adom (The Israeli emergency medical service).

8. In spite of the terrorism, Israel has not modified its humanitarian policies. Israel continues to provide Palestinian patients with hospitalization services and ambulatory medical care at Israeli hospitals. Magen David Adom continues to provide emergency medical assistance to whomsoever requires it. Furthermore, Israel offers public health laboratory services to the Palestinian Health Authority; it provides training programmes and postgraduate studies for physicians and other health professionals and it facilitates the transfer of medical donations and medical equipment to centers in the Palestinian territories.

9. Organizations such as the Hamas, Islamic Jihad and the Fatah Al-Aksa martyrs Brigade, as well as individuals within the Palestinian police and security forces, have planned and executed terrorist atrocities, including suicide bombings, in Israeli towns and cities. Impressionable Palestinian children and teenagers have been cruelly and cynically exploited by terrorist organizations, and, in many cases, have themselves been encouraged to carry out suicide bombings against the Israeli civilian population.

10. Thousands of Israeli civilians have been killed and wounded in terrorist atrocities. Israeli hospitals have been stretched far beyond their limits in trying to cope with the overwhelming numbers of victims of terrorism including women, children, and the elderly. There is a further enormous burden on the hospitals in Israel in having to maintain a state of constant preparedness for the possibility of yet another terrorist attack, and its consequences, at any time.

11. As a result of warnings of planned terrorist attacks aimed at the entrances to Israeli hospitals, involving the use of Palestinian ambulances or stolen Israeli evacuation vehicles, hospitals have had to exercise extreme caution with regard to the approach of Palestinian and Israeli ambulances to their premises. Stringent security measures must be carried out before an ambulance is permitted to approach the emergency room area, and prior to the entry of patients, escorts and medical teams to the emergency rooms.

12. Finally, the increasing use of ambulances and medical vehicles by terrorist organizations has underscored the need to carry out thorough searches of Palestinian medical and evacuation vehicles at IDF checkpoints, despite the inconvenience and hardship involved. This has to be done to protect our civilian population, by ensuring that ambulances are not being used by those organizations to smuggle terrorists or weapons into Israel.

E. Israeli-Palestinian cooperation in the fields of health and medicine between April 2004 and April 2005.

13. (1) Provision of medical care to Palestinian patients in Israeli hospitals.

Approximately 35,000 patients from the West Bank and Gaza have been treated in Israeli hospitals over the past year. 10,000 have been hospitalized as in-patients, and about 25,000 were referred to ambulatory services, including day-care treatment, radiotherapy, consultations at outpatient clinics, sophisticated diagnostic and investigatory procedures and laboratory tests. In spite of the fact that the Palestinian Authority has halted payments for these services to Israeli hospitals, the Israeli medical centers continue to admit Palestinian patients without any delays or restrictions.

(2) Provision of emergency medical assistance to Palestinians by Magen David Adom (MDA)

(3) Provision of public health laboratory services to the Palestinian Health Authority

Public health laboratories of the Israel Ministry of Health continue to provide assistance to the Palestinian Health Authority, specifically in the realm of laboratory tests for poliomyelitis and other viral diseases.

(4) Facilitating the transfer of medical donations and equipment from abroad to the Palestinian territories.

(5) Provision of training programmes and postgraduate studies for Palestinian physicians and other health professionals in Israeli medical institutions.

In the past year, 53 Palestinians participated in various training programmes in Israel:

• 21 physicians participated in long-term programmes, 8 of them participated either in a full residency programme or in a programme leading to a diploma.

• 6 physicians participated in short-term training programmes.

• 9 physicians participated in various medical activities, once or twice a week, or performed night duties in hospitals.

• 3 physicians participated in research projects in the area of hemato-oncology.

• 1 dental medicine doctor participated in a research project in dentistry.

• 4 pharmacists and chemists participated in research projects at the Faculty of Pharmacy of the Hebrew University of Jerusalem.

• 4 registered nurses participated in a short-term training programme in a department of medical oncology.

• 5 laboratory technicians underwent a one week intensive course in microbiological analysis procedures directed at food microbiological tests.

(6) Several consultative professional meetings in crucial issues of public health and infectious diseases were held during the past year with the participation of Palestinian and Israeli experts in public health.

F. Israel hopes that Palestinian terrorism will completely end, that the dialogue towards peace will resume, and a new era of fruitful cooperation between the Israel Ministry of Health and the Palestinian Health Authority will begin.

14. The Israel Ministry of Health believes that cooperation between the parties in the fields of health and medicine should immediately resume, without reservations, even before the beginning of political negotiations.

15. The Israel Ministry of Health calls on the Palestinian Health Authority to appeal to its political leadership to grant official approval for the resumption of the work of the six joint committees in the fields of health and medicine, for the benefit of both peoples.

16. The Israel Ministry of Health strongly believes that cooperation in the aforementioned fields will lay a cornerstone for the development and strengthening of a foundation for the establishment of a firm, stable, and enduring peace.

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