{"id":199349,"date":"2012-07-19T00:00:00","date_gmt":"2019-03-12T17:46:10","guid":{"rendered":"https:\/\/www.un.org\/unispal\/?p=199349"},"modified":"2019-03-12T17:46:10","modified_gmt":"2019-03-12T17:46:10","slug":"auto-insert-199349","status":"publish","type":"document","link":"https:\/\/www.un.org\/unispal\/document\/auto-insert-199349\/","title":{"rendered":"Referral of patients from the Gaza Strip &#8211; WHO monthly report (June 2012)"},"content":{"rendered":"<div>\n<div>\n<p style=\"margin-top:0px;margin-bottom:0px;\">\n<hr height=\"7px\" \/>\n<\/p><\/div>\n<div style=\"text-align:center;\">\n<p style=\"margin-top:0px;margin-bottom:0px;\"><img class=\"lazyload\" decoding=\"async\" src=\"data:image\/svg+xml,%3Csvg%20xmlns%3D%27http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg%27%20width%3D%27743%27%20height%3D%27169%27%20viewBox%3D%270%200%20743%20169%27%3E%3Crect%20width%3D%27743%27%20height%3D%27169%27%20fill-opacity%3D%220%22%2F%3E%3C%2Fsvg%3E\" data-orig-src=\"https:\/\/www.un.org\/unispal\/wp-content\/uploads\/images\/ad7018ff54c03f2d85257a40004bdfd7_image0.GIF\" border=\"0\" height=\"169px\" width=\"743px\" \/><\/p><\/div>\n<div style=\"text-align:left;padding-bottom:5px;\">\n<p style=\"margin-top:0px;margin-bottom:0px;\">\n<hr height=\"7px\" \/><span style=\"color:#424282;font-size:9pt;font-family:Times New Roman, serif;\"><strong>Referrals from Gaza: Summary for June 2012<\/strong><\/span><\/p><\/div>\n<ul type=\"disc\" style=\"margin-left:-20px;margin-top:0px;margin-bottom:0px;\">\n<li style=\"color:#000000;text-align:left;padding-bottom:4.5px;font-size:9pt;font-family:Times New Roman, serif;\"><strong>MoH referrals of Gaza patients to Jordan and Israel were significantly reduced in June, reflecting the financial crisis of the Palestinian Authority and cost-cutting measures. Only 5 MoH referrals were made to Jordan, compared to a 2012 monthly average of 38 after Jordanian hospitals limited admitting MoH referral patients because of the Palestinian Authority&#8217;s accrued debt for patient care over the past year. Referrals to Israel fell by one-third from the monthly average.<\/strong><\/li>\n<li style=\"color:#000000;text-align:left;padding-bottom:4.5px;font-size:9pt;font-family:Times New Roman, serif;\"><strong>Three patients were denied Israeli permits to cross Erez checkpoint for medical treatment, while 48 patients, including 9 children, did not receive a response to their applications and missed their medical appointments.<\/strong><\/li>\n<li style=\"color:#000000;text-align:left;padding-bottom:4.5px;font-size:9pt;font-family:Times New Roman, serif;\"><strong>Patients were referred during June for treatment primarily for the following subspecialties: cardiovascular (20%), oncology (16%), ophthalmology (8%), nuclear medicine (7%), orthopedics (6%), hematology (4%), and neurosurgery (4%). These categories represented 65.5% of total referrals, and 72.7% of the estimated total cost of referrals in June of NIS 13 M ($ 3.3 M).<\/strong><\/li>\n<\/ul>\n<div style=\"color:#000000;text-align:left;padding-bottom:4.5px;font-size:9pt;font-family:Times New Roman, serif;\">\n<p style=\"margin-top:0px;margin-bottom:0px;\">During June 2012, the Referral Abroad Department (RAD) of the Palestinian Ministry of Health (MoH) referred 1,336 patients (733 males and 603 females; 54% and 45%, respectively) to health facilities for specialized treatment not available in MoH facilities in Gaza. 21.7% (290 patients) were referred to NGO or private facilities within the Gaza Strip and 78.3% <strong>(1,046 patients) were referred outside of Gaza <\/strong>to hospitals in East Jerusalem (40.2%), Egypt (31.4%), Israel (16.5%), the West Bank (11.5%) and Jordan (0.5%). 736 of these patients required Israeli-issued permits to access through Erez crossing, while 328 required an Israeli-issued ID and Egyptian approval to enter Egypt through Rafah border crossing (see Table 1, below).<\/p><\/div>\n<div style=\"color:#000000;text-align:left;padding-bottom:9px;font-size:9pt;font-family:Times New Roman, serif;\">\n<p style=\"margin-top:0px;margin-bottom:0px;\">According to the Director of Gaza RAD, Jordanian hospitals have limited admissions of recent MoH referrals since early May 2012, due to the failure of PA to cover costs of treatment for Palestinian patients referred over the last few years: only 5 MoH referrals were made during June, compared to a monthly average of 38 in 2012.<\/p><\/div>\n<div style=\"text-align:center;\">\n<p style=\"margin-top:0px;margin-bottom:0px;\"><img class=\"lazyload\" decoding=\"async\" src=\"data:image\/svg+xml,%3Csvg%20xmlns%3D%27http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg%27%20width%3D%27676%27%20height%3D%27213%27%20viewBox%3D%270%200%20676%20213%27%3E%3Crect%20width%3D%27676%27%20height%3D%27213%27%20fill-opacity%3D%220%22%2F%3E%3C%2Fsvg%3E\" data-orig-src=\"https:\/\/www.un.org\/unispal\/wp-content\/uploads\/images\/ad7018ff54c03f2d85257a40004bdfd7_image1.GIF\" border=\"0\" height=\"213px\" width=\"676px\" \/><\/p><\/div>\n<div style=\"padding-top:9px;font-size:9pt;font-family:Times New Roman, serif;color:#000000;padding-bottom:4.5px;text-align:left;\">\n<p style=\"margin-top:0px;margin-bottom:0px;\">Patients were referred during June primarily for treatment in the following subspecialties: cardiovascular (20%), oncology (16%), ophthalmology (8%), nuclear medicine (7%), orthopedics (6%), hematology (4%), and neurosurgery (4%). These cases represented 65.5% of total referrals, and 72.7% of estimated total cost of referrals in June of NIS 13 million ($ 3.3 million). A total of 218 patients were referred for either cardiac surgery (82) or cardiac catheterization (136), which represented almost one third (27.2%) of the total referral cost in June 2012; cases were referred to hospitals in the oPt (192 cases), Israel (18) Egypt (7) and Jordan (1). <\/p><\/div>\n<div style=\"color:#000000;text-align:left;padding-bottom:4.5px;font-size:9pt;font-family:Times New Roman, serif;\">\n<p style=\"margin-top:0px;margin-bottom:0px;\"><strong>Permit applications for patient referrals through Erez <\/strong><\/p><\/div>\n<div style=\"color:#000000;text-align:left;padding-bottom:4.5px;font-size:9pt;font-family:Times New Roman, serif;\">\n<p style=\"margin-top:0px;margin-bottom:0px;\">In June 2012, 784 patient applications were submitted to the Israeli District Liaison Office (DCL) for permits to cross Erez to access hospitals in the West Bank including East Jerusalem, Israel and Jordan (see Table 2) compared with 883 in May, 764 in April and 768 in March 2012. <\/p><\/div>\n<div style=\"color:#000000;text-align:left;padding-bottom:9px;font-size:9pt;font-family:Times New Roman, serif;\">\n<p style=\"margin-top:0px;margin-bottom:0px;\">During this month 91% of applications (715) were for patient referrals submitted and financially covered by the MoH, 3.1% (25) were self-funded, 2% (16) by Physicians for Human Rights &#8211; Israel, 1.5% (12) by Nour ala al Alam Foundation, 0.6% (5) by Peres Peace Center and the remaining 1% (9) cases by other funds.<\/p><\/div>\n<div style=\"text-align:center;padding-bottom:5px;\">\n<p style=\"margin-top:0px;margin-bottom:0px;\"><img class=\"lazyload\" decoding=\"async\" src=\"data:image\/svg+xml,%3Csvg%20xmlns%3D%27http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg%27%20width%3D%27691%27%20height%3D%27219%27%20viewBox%3D%270%200%20691%20219%27%3E%3Crect%20width%3D%27691%27%20height%3D%27219%27%20fill-opacity%3D%220%22%2F%3E%3C%2Fsvg%3E\" data-orig-src=\"https:\/\/www.un.org\/unispal\/wp-content\/uploads\/images\/ad7018ff54c03f2d85257a40004bdfd7_image2.GIF\" border=\"0\" height=\"219px\" width=\"691px\" \/><\/p><\/div>\n<div style=\"text-align:left;margin-left:100px;\">\n\t\t\t\t<span style=\"color:#000000;font-size:4pt;font-family:Times New Roman, serif;\"><sup>1<\/sup><\/span><span style=\"color:#000000;font-size:7pt;font-family:Times New Roman, serif;\">Approvals are typically communicated to the patient less than 24 hours in advance of their scheduled appointments. <\/span>\n\t\t\t\t<\/div>\n<div style=\"text-align:left;margin-left:100px;\">\n\t\t\t\t<span style=\"color:#000000;font-size:4pt;font-family:Times New Roman, serif;\"><sup>2 <\/sup><\/span><span style=\"color:#000000;font-size:7pt;font-family:Times New Roman, serif;\">Permit applications for patient access through Erez can only be submitted within 10 days of hospital appointments. When there is no timely response from the Israeli Liaison Office, the applications are registered here as &#8220;delayed&#8221;, meaning that the Palestinian Liaison Office received no response to the permit application prior to the patient&#8217;s hospital appointment date. Some patients in this category may eventually receive permit approval, but after their hospital appointment has passed. They must then reschedule their appointment. Other patients in this category may eventually receive denials or may fail to receive a response. <\/span>\n\t\t\t\t<\/div>\n<div style=\"text-align:left;padding-bottom:3.5px;margin-left:100px;\">\n\t\t\t\t<span style=\"color:#000000;font-size:4pt;font-family:Times New Roman, serif;\"><sup>3<\/sup><\/span><span style=\"color:#000000;font-size:7pt;font-family:Times New Roman, serif;\">These are requests for interrogation as communicated by Israeli authorities through the Palestinian Liaison Office. This may be underreported since Israeli authorities sometimes contact patients directly for interrogation.<\/span>\n\t\t\t\t<\/div>\n<div style=\"color:#000000;text-align:left;padding-bottom:4.5px;font-size:9pt;font-family:Times New Roman, serif;\">\n<p style=\"margin-top:0px;margin-bottom:0px;\">Throughout June, <strong>93.5% (733 patients) of all patient applications for permits were approved, <\/strong>higher than the 2011 average approval rate of 89.7%. Three patients (0.4%) were denied permits to cross Erez checkpoint (2 males for orthopedic treatment, and one female for gynecologic treatment); 2 of the denied patients (1 male and&nbsp;&nbsp;1 female) were in the 18-40 years age group, and the third was a male patient in the 41-60 years age group.<\/p><\/div>\n<div style=\"color:#000000;text-align:left;padding-bottom:4.5px;font-size:9pt;font-family:Times New Roman, serif;\">\n<p style=\"margin-top:0px;margin-bottom:0px;\">6.1% (48 patients, including 9 children) receive no answer to their applications before their hospital appointment date; 14 patients were waiting for ophthalmic treatment, 7 for orthopedic, 8 for cardiac, 6 for oncology, 4 for neurosurgery and the remaining for other specialties. <strong>15 patients (4 females and 11 males) were called for interrogation by the Israeli General Security Services (GSS) as a condition of their permit application.<\/strong><\/p><\/div>\n<div style=\"color:#000000;text-align:left;padding-bottom:4.5px;font-size:9pt;font-family:Times New Roman, serif;\">\n<p style=\"margin-top:0px;margin-bottom:0px;\">Following their interrogation, 10 patients received no response from the GSS about their permit application, 3 were approved, one was asked to resubmit the request, and one was asked to change their companion.<\/p><\/div>\n<div style=\"color:#424282;text-align:left;padding-bottom:4.5px;font-size:9pt;font-family:Times New Roman, serif;\">\n<p style=\"margin-top:0px;margin-bottom:0px;\"><strong>Delays in Medical Treatment<\/strong><\/p><\/div>\n<div style=\"color:#000000;text-align:left;padding-bottom:9px;font-size:9pt;font-family:Times New Roman, serif;\">\n<p style=\"margin-top:0px;margin-bottom:0px;\">Delays in processing applications and non response to applications can be critical for patients who are waiting for urgent medical treatment. In 2011, WHO documented three cases of patients who died while waiting to receive permits to travel through Erez crossing to access their referral treatment, but this figure is considered underreported due to the lack of systematic follow up of the health status of patients denied health access.<\/p><\/div>\n<div style=\"text-align:center;padding-bottom:4.5px;\">\n<p style=\"margin-top:0px;margin-bottom:0px;\"><img class=\"lazyload\" decoding=\"async\" src=\"data:image\/svg+xml,%3Csvg%20xmlns%3D%27http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg%27%20width%3D%27713%27%20height%3D%27187%27%20viewBox%3D%270%200%20713%20187%27%3E%3Crect%20width%3D%27713%27%20height%3D%27187%27%20fill-opacity%3D%220%22%2F%3E%3C%2Fsvg%3E\" data-orig-src=\"https:\/\/www.un.org\/unispal\/wp-content\/uploads\/images\/ad7018ff54c03f2d85257a40004bdfd7_image3.GIF\" border=\"0\" height=\"187px\" width=\"713px\" \/><span style=\"color:#ffffff;font-size:9pt;font-family:Times New Roman, serif;\"><strong>T<\/strong><\/span><\/p><\/div>\n<div style=\"text-align:center;padding-bottom:4.5px;\">\n<p style=\"margin-top:0px;margin-bottom:0px;\"><img class=\"lazyload\" decoding=\"async\" src=\"data:image\/svg+xml,%3Csvg%20xmlns%3D%27http%3A%2F%2Fwww.w3.org%2F2000%2Fsvg%27%20width%3D%27726%27%20height%3D%27417%27%20viewBox%3D%270%200%20726%20417%27%3E%3Crect%20width%3D%27726%27%20height%3D%27417%27%20fill-opacity%3D%220%22%2F%3E%3C%2Fsvg%3E\" data-orig-src=\"https:\/\/www.un.org\/unispal\/wp-content\/uploads\/images\/ad7018ff54c03f2d85257a40004bdfd7_image4.GIF\" border=\"0\" height=\"417px\" width=\"726px\" \/><\/p><\/div>\n<p style=\"margin-top:0px;margin-bottom:0px;\">\n<table cellspacing=\"0\" background=\"#000000\" width=\"100%\" style=\"text-align:left;margin-left:initial;margin-right:auto;\">\n<tr>\n<td width=\"50%\" valign=\"top\" style=\"text-align:left;padding-top:12px;border-color:#000000;border-style:solid;border-top-width:0px;border-bottom-width:0px;border-left-width:0px;border-right-width:0px;\">\n<p style=\"margin-top:0px;margin-bottom:0px;\"><a href=\"http:\/\/www.emro.who.int\/countries\/pse\" style=\"color:#0000ff;text-align:left;padding-top:12px;font-size:12pt;font-family:Times New Roman, serif;\"><strong>www.emro.who.int\/countries\/pse<\/strong><\/a><span style=\"color:#0000ff;font-size:12pt;font-family:Times New Roman, serif;\"><strong>&nbsp;<\/strong><\/span><\/p>\n<\/td>\n<td width=\"50%\" valign=\"top\" style=\"color:#004080;text-align:right;padding-top:12px;font-size:12pt;font-family:Times New Roman, serif;border-color:#000000;border-style:solid;border-top-width:0px;border-bottom-width:0px;border-left-width:0px;border-right-width:0px;\">\n<p style=\"margin-top:0px;margin-bottom:0px;\"><strong>advocacy@who-health.org<\/strong><\/p>\n<\/td>\n<\/tr>\n<\/table>\n<p>\n\t\t\t\t<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Referrals from Gaza: Summary for June 2012 MoH referrals of Gaza patients to Jordan and Israel were significantly reduced in June, reflecting the financial crisis of the Palestinian Authority and cost-cutting measures. Only 5 MoH referrals were made to Jordan, compared to a 2012 monthly average of 38 after Jordanian hospitals limited admitting MoH referral <a href=\"https:\/\/www.un.org\/unispal\/document\/auto-insert-199349\/\"> [&#8230;]<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"template":"","meta":{"footnotes":""},"country":[],"document-category":[1323],"document-source":[2529],"committee-meeting":[],"document-subject":[2517,1945,2005,2533,5200],"entity":[1729],"document-language":[6542],"class_list":["post-199349","document","type-document","status-publish","hentry","document-category-report","document-source-world-health-organization-who","document-subject-access-and-movement","document-subject-assistance","document-subject-gaza-strip","document-subject-health","document-subject-humanitarian-relief","entity-united-nations-system","document-language-english"],"_links":{"self":[{"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/document\/199349","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/document"}],"about":[{"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/types\/document"}],"author":[{"embeddable":true,"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/users\/1"}],"version-history":[{"count":0,"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/document\/199349\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/media?parent=199349"}],"wp:term":[{"taxonomy":"country","embeddable":true,"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/country?post=199349"},{"taxonomy":"document-category","embeddable":true,"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/document-category?post=199349"},{"taxonomy":"document-source","embeddable":true,"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/document-source?post=199349"},{"taxonomy":"committee-meeting","embeddable":true,"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/committee-meeting?post=199349"},{"taxonomy":"document-subject","embeddable":true,"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/document-subject?post=199349"},{"taxonomy":"entity","embeddable":true,"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/entity?post=199349"},{"taxonomy":"document-language","embeddable":true,"href":"https:\/\/www.un.org\/unispal\/wp-json\/wp\/v2\/document-language?post=199349"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}