The Effect of the Occupation on Access to Healthcare…

June 16, 2009

I just started a new job, working for a medical NGO called Palestinian Medical Relief Society (PMRS).  They were created by a group of doctors in 1979 as a response to the deterioration of the healthcare system and infrastructure in Palestine as a result of the Israeli Occupation. 

One of the main things they do in the West Bank is to provide medical services to isolated villages or cities or villages that are located between the Green Line (the internationally recognized border of the West Bank) and the Separation Wall.  The people who live between the Green Line and the Wall cannot move freely and their access to healthcare is severely limited.  To combat this, PMRS has set up mobile clinics.

Here is an advocacy report about their work in Qalqilia, a town that is COMPLETELY SURROUNDED BY THE WALL, with one Israeli checkpoint controlling all movement in and out.  This has had a severe impact on the economy of Qalqilia as well as their access to medical care.

Map of the Wall, Settlements surrounding Qalqilia

Map of the Wall, Settlements surrounding Qalqilia

Access to healthcare and PMRS’ health services in the Qalqilya district

 Qalqilya district is situated in the North-Western part of the West Bank and inhabited by almost 92,000 people[1], spread throughout 44 communities. Qalqilya district is the most affected by the Separation Wall and Israeli’s closures policies in the West Bank. Indeed, the Wall in Qalqilya goes well beyond the 1967 Green Line, currently reaching around 20 Israeli settlements illegally built on Palestinian land. As shown by the map below, the city of Qalqilya is completely surrounded by the separation barrier and at times randomly closed like a cork in a bottle by an Israeli checkpoint at its entrance, raising major problems in terms of access to healthcare. Despite the 26 primary healthcare clinics dispatched throughout the district, most of health services are concentrated in the city of Qalqilya, and are therefore harder to reach by villagers.

In turn, the economic situation dramatically changed in the district after the beginning of the second Intifada. Qalqilya used to be an economic centre where Palestinians used to come from different cities in the North in order to cross to Israel. Many Israeli Arabs were also coming from Israel to buy merchandise and goods from Qalqilya. With the construction of the Separation Wall and checkpoints, Qalqilya has become an enclave where access is regulated and highly restricted by the Israeli army. Merchandises for more than 600 projects in the city could not anymore be imported due to Israeli’s closure policies.

 Qalqilya is also home to a big water aquifer, now owned by Israeli authorities, who is able to determine the quantity of water available to Palestinians. This allowed quantity is calculated on the basis that it should barely suffice Palestinians’ domestic use, which inevitably has disastrous impacts on agriculture. The disparity in water distribution is very much striking when one drives on the roads of the West Bank and observe how green Israeli settlements are compared to surrounding Palestinian villages. For instance, with the current water shortages, most of citrus trees – for which Qalqilya was famous – had to be cut. Additionally, 30% of Palestinians do not have access to running water and 60% to a proper sewage system, which seriously affects overall health conditions[2]. Digging holes in gardens to store garbage can easily contaminate water sources and provoke diseases, especially affecting most vulnerable groups of society.

 All in all, economic and environmental life in Qalqilya has gravely deteriorated since the beginning of the 2nd Intifada, the construction of the Wall and the stricter movements’ restrictions, which has had an aggravating impact on healthcare in the district that PMRS tries to bridge by providing services both in Qalqilya and its most remote areas.

 PMRS started its activities in the Qalqilya district in 1990. It mainly deals with primary healthcare services as well as preventive and curative programs such as: women’s and child’s health programs, chronic disease centers, laboratory programs, health schools as well as educational and rehabilitation programs. PMRS operates in one clinic in the centre of Qalqilya and provides medical services to isolated communities through its free mobile clinics’ services. PMRS identifies the needs of remote communities and villages through a referral system and coordination meetings with UNRWA and the Ministry of Health. Although they have different policies[3], meetings are held on a regular monthly basis to discuss the health situation and needs of Palestinians in the district, in order to avoid overlaps in the distribution of health services and encourage co-operation between those institutions. Mobile clinics provide services such as: general medicine, women’s health and laboratory analysis. Today, PMRS remains dedicated to provide health services to a larger portion of Palestinians in the Qalqilya district and to improve the overall quality of life of its inhabitants. 



[1] According to the Palestinian Central Bureau of Statistics, 2007 Report, p. 61

[2] See Palestine Monitor 2009 Factbook: www.palestinemonitor.org

[3] The Ministry of Health clinics for instance only treats patients with a health insurance.


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