While the report noted that some Israeli measures have reduced movement restrictions in the West Bank, with “the removal of dozens of obstacles” around Qalqilya and Nablus, they are tightening in East Jerusalem. This has been most problematic in terms of access to the six hospitals located there, which provide specialist services not available elsewhere in the West Bank and Gaza, including dialysis and oncology, open-heart surgery, neurosurgery and eye surgery.
At present patients are required to pass through three checkpoints on foot, a policy WHO representatives described as “undignified and often unsafe” when applied to severely ill patients. A further problem has been the lack of access for hospital staff, who until 2008 had been given special dispensation to pass East Jerusalem checkpoints. That ‘privilege’ was then suspended before protests led to it being restored for doctors, but not nurses or support staff, who now face lengthy delays and periodic refusals in attempting to access their workplace. WHO officials say Israeli authorities have given “no clear reason” for this damaging policy which severely impacts on the maintenance of hospital services, and that they are continuing to press for full, unrestricted access.
The problem is more severe for patients. In 2009, almost 50% of patient referrals for specialised care were to East Jerusalem hospitals, which treat around 19,000 patients a year. Since 1993, Palestinians without Jerusalem ID cards are forced to apply for permits in order to receive treatment, a time consuming, unreliable process that leads to costly delays in dealing with urgent health problems. Emergencies are not treated as such. In 2009, the Palestinian Red Crescent Society reported 440 “denials and delays” of ambulances in the Occupied Territories, “two thirds of which occurred at Barrier checkpoints accessing Jerusalem”. The permit applications department from Augusta Victoria Hospital estimates 20% of patients are refused.
Al-Quds University in Abu Dis is the main training centre for medical students, but the 90% of students from the West Bank require permits to attend their courses. In the last month Al Quds medical school announced 11 students were forced to end their training as they were not given permission.
The report’s other main concern was the increasing difficulty for West Bank farmers in the ‘seam zone’ in accessing their land. Farmers must apply for an Israeli permit proving ‘connection to the land’ and satisfy security criteria. This, coupled with a gate system that only allows workers through at certain times of the day and never at night, has led to a steep decline in production and the abandonment of large tracts of land. UN studies show farmers are wary of submitting personal documents to Israeli security services “for fear they will be used against them” and others refuse to apply out of principle. As a consequence, only 207 of 1,000 farmers in Habla, Qalqilya were issued permits last year, 73 of 1,400 in in Zeita, Tulkarm and 70 of 1,750 in Anin, Jenin.
The presence of barrier gates in the seam zone represents a serious health concern. If an injury, common in rural areas, takes place outside the designated opening hours, the victim cannot receive treatment until the next opening.
Along with the report, OCHA and WHO have issued a short list of demands to the Israeli authorities; 24 hour access through gates around the seam zone to facilitate medical treatment, as well as unhindered access for medical personnel, students and patients to East Jerusalem hospitals. OCHA representatives have as yet received no response.
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