5-16-08, 9:32 am
Original source:
The health situation in the Gaza Strip has been steadily deteriorating since Israel tightened its siege on the area in June 2007, following Hamas’ forceful takeover. The closure of all entrances and exits from Gaza has barred patients from receiving treatments unavailable within Gaza and has caused a grave dearth of medical supplies, while the sporadic cuts in fuel supply prevent the system from functioning fully. This is exacerbated by the fact that Palestinian internal disputes have led to labor strikes in the Gazan health system.
According to figures of the World Health Organization, in January 2008, 19 percent of necessary medicines and 31 percent of vital medical equipment were lacking in Gaza. There is also a grave shortage of replacement parts for equipment and of disposable items, such as bandages, syringes, and plaster for casts. The cuts in fuel supply have greatly reduced the activity of ambulances, healthcare clinics and infrastructures that ensure maintenance of basic conditions to health, such as clean drinking water and regular removal of solid waste. For example, in early 2008, diagnostic and dental services in 32 of the 56 emergency medical centers run by the Palestinian Ministry of Health stopped due to lack of fuel to operate the generators. In late February, 23 of the Ministry’s 56 ambulances and seven of the 40 Red Crescent ambulances ceased operation because of shortage of fuel.
In addition, Israel has cut back on issuing permits to enter the country for the hundreds of patients each month who need immediate and advanced treatments unavailable in Gaza. Patients are sometimes allowed to cross through Erez Crossing, to go to hospitals inside Israel, and to treatment facilities in the West Bank, Egypt, and Jordan. Since Hamas took over control of the Gaza Strip, however, the number of patients forbidden to leave Gaza “for security reasons” has steadily increased. The WHO reported that in the first three months of 2007, Israel approved 90 percent of the requests; in the last three months of 2007, following the Hamas takeover, the figure dropped to 69 percent.
Rafah Crossing, between Gaza and Egypt, has been closed down since June 2007. In early March and early May 2008 it was opened for several days, following a Hamas-Egyptian agreement for a selected group of Gazan patients to receive treatment in Egypt. The crossing remains closed at the present time.
In June 2007, the High Court of Justice rejected the petition of Physicians for Human Rights, an Israeli organization, against the defense establishment’s improper policy, which distinguishes between persons in immediate life-threatening danger who cannot be treated in Gaza, and patients whom the defense establishment considers “at risk of harm to their quality of life,” such as treatment to prevent amputation. Patients in the latter category generally do not receive permits. The court’s decision, written by Justice Elyakim Rubinstein, denies Gazans the right to health and supports that policy despite its clear breach of medical ethics.
Another petition, which PHR filed in the High Court in December 2007, attacks the legality of a new procedure, whereby every exit permit from Gaza for medical treatment requires a check by the Israel Security Agency. According to PHR, in a number of cases, the ISA exploited its inquiry to pressure patients to provide information in exchange for the permit.
According to the Palestinian Health Ministry and the WHO, a few dozen Palestinians died after Israel delayed or prohibited their exit from Gaza to receive medical treatment. In that some of these patients were suffering from a terminal illness, their deaths cannot necessarily be attributed to delay in granting the permit or to denial of the request. However, it is clear that these patients’ right to optimal and rapid treatment was infringed.
Israel’s responsibility
The scope of Israel’s ongoing control over major aspects of life in Gaza imposes on it responsibility for the safety and welfare of the residents there, in accordance with the laws of occupation specified in the Hague and Geneva Conventions. Regardless of the questions of the legal status of the Gaza Strip, international humanitarian law and international human rights law require Israel to protect civilians in time of armed conflict, safeguard wounded and sick persons, prevent deterioration in the humanitarian situation, and enable the shipment of necessary medicines and provision of an adequate standard of health. In its overall actions relating to the Gaza Strip and its residents, Israel gravely breaches the right of the residents to optimal and available medical care.
B'Tselem urges the State of Israel to carry out its aforesaid legal obligations and enable the residents of the Gaza Strip to exercise their right to health, by preventing the collapse of Gaza’s medical system and allowing patients to leave Gaza to receive appropriate treatment in Israel or elsewhere.
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