The health system in occupied Palestinian territory (oPt) is operating under severe pressure due to the effects of the occupation, blockade, rapid population growth, and lack of adequate financial resources and shortages in basic supplies. In the Gaza Strip, years of blockade and movement restrictions on people and materials, including medical resources, compounded by the internal Palestinian divide, have led to a serious deterioration in the availability and quality of health services. The 2014 hostilities added further strain to the health sector. In the West Bank, the key concern is lack of access to quality and affordable health services. Many communities, particularly in Area C, face restricted access to basic health care as a result of insecurity due to the presence and actions of Israeli checkpoints and settler violence. Restrictions on the freedom of movement of patients and ambulances is a particular concern for those seeking specialized treatment in East Jerusalem hospitals.
For Sahar Al Nabaheen, the lack of access to regular, high-quality family planning information and services has all but defined her life. At 31, she lives with her husband and their six children in Al Bureij Camp, Middle Area Gaza. Three of Sahar’s pregnancies were unplanned due to a lack of available contraceptives. With her and her husband unable to find work, her family of eight are living on no income.
An oPt Humanitarian Fund success story: Ahmed Badawi is a 48-year-old farmer, who provides for his wife and nine children. The family owns about two acres of land, located 400 metres from Israel’s perimeter fence with Gaza, in the Ash Shuja’iyeh of the Gaza Strip. For many years, Israel has restricted the access of Palestinians to areas near the fence, undermining farming. In addition, since 30 March 2018, Palestinians have been demonstrating there, on an almost-weekly basis, as part of the ‘Great March of Return’ (GMR), causing damage to crops in the process.
In Gaza, severe limb injuries caused by live ammunition have created a substantial burden on the already overstrained health system. Between 30 March 2018 and 31 July 2019, more than 8,000 Palestinians have been injured by live ammunition by Israeli forces during the “Great March of Return” (GMR) demonstrations along the fence between Gaza and Israel. According to the oPt Health Cluster, 87 per cent of these are limb injuries, with injuries to the abdomen and pelvis accounting for approximately five per cent.
For the past decade, the Gaza Strip has suffered from a chronic electricity deficit that has undermined already fragile living conditions. The situation deteriorated further after April 2017 due to disputes between the de facto authorities in Gaza and the West Bank-based Palestinian Authority (PA), which has been ongoing since the takeover of Gaza by Hamas in 2007. The failure to resolve a longstanding dispute between the two Palestinian authorities on issues related to tax exemption for fuel and revenue collection from electricity consumers resulted in the PA reducing payments for electricity in Gaza. Compounded by a halt in the electricity supply from Egypt due to malfunctioning and inability to repair the feeder lines, this triggered electricity blackouts of 20-22 hours a day. The power shortages had a severe impact on essential services such as health, water and sanitation services, and undermined Gaza’s fragile economy, particularly the manufacturing and agriculture sectors. During this period, the UN coordinated the delivery of donor-funded emergency fuel for generators to ensure the operation of some 250 critical health and WASH facilities.
Years of blockade and other movement restrictions on people and materials, including medical resources, the deepening intra-Palestinian political divide, and a chronic energy crisis, have led to a serious deterioration in the availability and quality of health services in the Gaza Strip. The Gaza health sector suffers from chronic shortages of certain equipment and supplies, including antibiotics and chemotherapy drug stocks. According to the World Health Organization (WHO), there has also been a serious deterioration in the “social determinants of health”, with “water from the aquifer basically unfit for human consumption, sewage flows largely untreated into the Mediterranean and the economy is stifled.”
Najwa Hamad is a 39-year-old resident of Beit Hanoun, in the northern Gaza Strip. Since she and her husband are unemployed, the family does not have a fixed income and relies on financial assistance from various sources, including their extended family.