Right to Health: barriers to health access in the occupied Palestinian territory, 2011 and 2012

Report
from World Health Organization
Published on 05 Mar 2013

WHO Launches Report on Health Access Barriers in the oPt

Jerusalem: The WHO oPt released a report today, March 5, 2013, which details the difficulties that thousands of Palestinian patients encounter in obtaining Israeli permits to access specialized health care in East Jerusalem, Jordan and Israel. Restrictions also affect access into Jerusalem for ambulances and health personnel from the West Bank to the East Jerusalem hospitals.
The study used available data from Palestinian Authority ministries and from non-profit health providers to quantify and describe how Israeli movement restrictions in the West Bank and Gaza reduce access to health services for Palestinian patients and health providers, especially to East Jerusalem where the main Palestinian referral centers are located.

  • In the West Bank, one in five patients, companions and visitors who applied through the Palestinian Authority for Israeli permits to enter Jerusalem to access hospitals was denied.
    Data indicates that 81.4% of 175,228 applicants were approved in 2011 and 79.7% of 222,188 applicants in 2012. The remaining applicants were denied or did not receive a response in time for their medical appointment. Approval rates differed widely among the districts. Data disaggregated from 3 of 15 districts in 2012 confirmed that the rate of permit approvals for patients-only was similar to the aggregate data: 82.5%.

  • In Gaza, approval rates were higher. 89.8% of the 10,560 patients who applied for permits were approved to cross Erez checkpoint in 2011 to access hospitals in East Jerusalem, Israel or Jordan; 10.2% were denied permits or did not receive a response in time to access their hospital appointment. 197 (56% were males aged 18-40; 25% were women) were called to attend a security interview as a condition of their permit application. In 2012, 92.5% of Gaza patients were approved, while only 0.9% were denied; 6.6% did not receive a response in time and 206 were called for security interviews.

  • 58% of Ministry of Health referrals within the oPt require permits to access.

  • Ministry of Health referrals in the oPt show a gender gap which narrowed from 2011 to 2012: total referrals: from 46% female/54% male in 2011 to 47% female/53% male in 2012 (in 2012 West Bank: 48% female/52% male; Gaza: 45% female/55% male).

The WHO researchers also used interviews with patients, families, and health personnel and found that permits are difficult to obtain, limit the mode and place of entry of patients and are not always honored at designated checkpoints. Access restrictions can affect health status and well-being. An Abstract of the study based on preliminary findings was published in the UK-based The Lancet in October 2012, one of 32 articles on health in the oPt: http://www.thelancet.com/health-in-theoccupied-palestinian-territory-2012.

Israel separated East Jerusalem from the rest of the West Bank when it unilaterally annexed the city after the 1967 war. Movement into Jerusalem of Palestinians with Gaza or West Bank IDs has become more tightly restricted due to the construction of the separation wall around Jerusalem in recent years.

“We have been monitoring access out of Gaza for several years and the ratio of permits denied or delayed has reduced significantly in this period,” said Mr. Tony Laurance, Head of the WHO oPt office in Jerusalem. “This report marks the first time that we have been able to publish findings on health access for West Bank Palestinians and the data indicates serious restrictions for thousands of patients who are trying to travel to their places of referral.”

“As Occupying Power, Israel is the main duty bearer under international humanitarian law and human rights law to provide humanitarian access at all times for persons needing health care. While recognizing Israel’s legitimate security concerns, we hope that this report will be used to improve health access for Palestinians.”