Israel’s protracted occupation of Palestinian territory is back in the news after years of being eclipsed by other crises in the region.
Since the start of the year, President Donald Trump has expressed his support for moving the US embassy in Israel to Jerusalem; the Israeli Knesset voted to approve a law which would allow the expropriation of private Palestinian land in the West Bank for settlements; and the demolition of Palestinian homes has continued to accelerate.
Despite the increased attention to the occupied Palestinian territory in 2017, these developments are just the latest facets of an occupation which, in June, marks its 50 year anniversary.
Everyday life in the West Bank is a story of barriers: to movement, to rights, and to dignity. Since the occupation began in 1967, the West Bank has been cut up by over 500 movement obstacles, including some 70 manned checkpoints and 77 roadblocks, as well as earth mounds, trenches and other barriers. Israel has also erected 406km of separation wall, cutting East Jerusalem off from the rest of the occupied Palestinian territory and bisecting entire communities.
These barriers can turn even the simplest journey into an ordeal; from children going to school to patients reaching hospitals.
Barriers to health
The accessibility of healthcare is a fundamental element of the right to health. Quality of treatment is rendered meaningless if a patient is unable to physically get to the place where it is available.Israel formally – and illegally – annexed East Jerusalem in 1980. The city’s encirclement by the wall and checkpoints now means that Palestinians without an Israeli-issued Jerusalem I.D. must apply for a permit to enter.
Some specialist services, such as radiotherapy and open heart surgery, are unavailable outside the six major hospitals in East Jerusalem. This means that any patient needing these treatments must apply to the Israeli authorities for a permit to reach them, as must any family member wishing to accompany them to provide comfort and support.
This is compounded by the delays caused to ambulances at checkpoints. When patients travelling to East Jerusalem reach one of the checkpoints entering the city, they must endure the ‘back-to-back’ transfer process, moving from a Palestinian-registered ambulance to an Israeli-registered one, even in emergencies.
In an emergency, every second counts when getting to hospital. But checkpoints add more than seconds to these journeys. Between October and December 2015, the Palestine Red Crescent Society recorded that the average delay to emergency patients undergoing this ‘back-to-back’ process was 27 minutes.
A race against time
Burns are a prevalent health risk in the West Bank. Whether caused by industrial accidents, house fires or even arson attacks by settlers, they can cause extreme pain and have serious lifelong effects.
MAP has long recognised these risks and helped to establish the West Bank’s first dedicated Burns Unit at the Rafidia Hospital in Nablus. We continue to provide the unit and its staff with the equipment and training needed to deliver modern and effective care to Palestinians with complex and life-threatening injuries.
But with the imposition of a network of checkpoints and roadblocks, it can take burns victims from elsewhere in the West Bank many hours to reach this unit.
This is particularly true for residents of the southern city of Hebron. The presence of several hundred Israeli settlers in the centre of the city ensures a heavy military presence there. The movement of Palestinians is therefore constrained by the presence of over 100 barriers and checkpoints both inside the city and on the roads leading outside.
This means that a journey of just 50 miles from Hebron to Nablus can sometimes take many hours. A person from Hebron suffering severe burns may therefore be forced to endure an excruciating wait for treatment. Every delay also increases the chance of infection, sepsis and other fatal complications. Improving access to care for those living in the south is therefore critical to saving lives.
Bringing care closer
Recognising this serious gap in care, MAP has partnered with the Welfare Association and the Palestinian Ministry of Health to develop a second Burns Unit at Alia Hospital in Hebron. When it opens, it will be able provide first-class burns care for around one million people living in the southern West Bank.
The unit is now equipped to help burns victims recover safely. Isolation units in the centre have a closed air conditioning system to minimise the risk of airborne bacterial infection, while a specially designed children’s room allows younger patients to play safely as they recover.
Burns treatment is a complex medical specialty, so MAP worked with Interburns to provide training to 29 surgeons, nurses and physiotherapists. The trainees learned the essentials of scar management, burn prevention, reconstructive surgery and assessment.
We have also trained two instructors to teach Essential Burns Care to staff at primary health clinics across the West Bank. This will ensure Palestinians can access basic treatment for burns wherever they are.
Barriers to movement mean barriers to healthcare. Ultimately, the only way to ensure that all Palestinians can access timely treatment is to remove the restrictions they have faced for 50 years, and the occupation of which they are a part.
Until that point, with your support, MAP will continue to work with partners to bring care closer to the people who need it.
This article originally appeared in the Summer 2017 edition of our supporter magazine, Witness.
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Photo credit: Richard Gray