A R C H I V E S
Madinat al-Muslimeen Islamic Message Board
| letter &then background health in Palestine |
|---|
| amatullah |
| 08/01/02 at 18:48:53 |
| To Whom it May Concern, I am an MD/PhD student at the University of British Columbia, in Vancouver. As a medical student I am committed to the concept that access to health care is a human right. Additionally I believe that health care professionals have a particular duty to draw attention to the impacts of war and violence on the physical and mental health of individuals and whole communities. I am deeply troubled by the escalating violence in Palestine and Israel. Thus I have decided to travel to Palestine during the month of August 2002 as part of an International Solidarity Movement delegation. The delegation is being organized by, The Center for Rapprochement, and the Palestinian Center for Human Rights in Palestine, Internationals for Justice in Palestine, and the Palestinian Solidarity Group (based in Vancouver). As part of the delegation, my specific focus will be on understanding and documenting health effects of Israeli occupation in the West Bank and in helping to lay the foundation for a subsequent North American tour by Palestinian physicians and other healthcare workers from the Union of Health Workers at Al-Awda in Gaza. The Palestinian Solidarity Group in Vancouver is the key sponsor for the Palestinian delegation. We are currently exploring collaboration on this project with organizations such as Medecins Sans Frontieres Canada (West Region), Washington Physicians for Global Survival, and Friends of Union of Palestinian Medical Relief Committees in the USA. We are also seeking to collaborate with progressive physician's groups and community groups across North America, who may be interested in hosting the physicians and health care workers in their own cities. It is important that we work together with progressive groups in the health care sector, as well as with community organizations already actively opposing the occupation. The Arab community in Vancouver will cover costs associated with air travel to Vancouver. Collaborating organizations can: · assist with funding to bring the Palestinian delegation to their own cities · assist in securing US visas for the delegation - through provision of formal letters of invitation · organize and publicize meeting with delegation members In Palestine I will work closely with Dr. Majid Nassar, director of the Beit Sahour Medical Committee and Nehal and Rabah Muhanna of the Union of Health Workers at Al-Awda Hospital in Gaza. I have a Master's degree in Public Health from Columbia University in New York, and three years of work experience as a refugee rights advocate at the national level. This educational and professional experience means that I have developed many skills that will assist me in successfully fulfilling my objectives. I am requesting that progressive physicians consider donating $50-$100 to help me defray the costs of travel to Palestine. I am seeking to cover half the cost of my trip through donations. In order to do this I need to raise 900.00 Cdn (Approximately 600.00 USD). Thank you for taking the time to read this letter and consider my request. I firmly believe that small groups of committed people can help to solve problems that may seem intractable. Specifically, I think it is extremely important that we in North America develop a better understanding of the lived reality of Palestinians in the occupied territories. Please feel free to circulate this letter to any physicians or organizatiojs you feel might be interested in supporting this endeavor. I can be contacted via email suve@interchange.ubc.ca and by telephone at 604 734 5095. My mailing address is Suvendrini Lena, Suite A 2395 West 7th Ave Vancouver, BC V6K 1Y4. In Solidarity, Tanya Suvendrini Lena MPH MD/PhD Candidate University of British Columbia, Vancouver. Canada *** Background on the Health Crisis in the Occupied Territories Since September 28, 2000 Israeli defense forces have killed more than 1570 Palestinians and injured more than 20,000. Children make up one-third of the injured. During this same period seventeen medical officers of the Palestinian Red Crescent Society PRCS (the equivalent of the Red Cross) have been killed. One hundred and sixty two medical staff workers have been injured and there have been 188 attacks on ambulances resulting in damage to 80% of the PRCS fleet (Source: PCHR). Palestinian civilian casualties are mounting and at the same time the Israeli war on civilian infrastructure has created an unprecedented crisis in the health care system. According to the WHO, as of April 2002, health services in the West Bank and Gaza Strip were "in danger of collapse". In a press release dated April 4, the WHO describes the crisis as follows: "The crisis is reflected in a shortage of medicine/antibiotics used to treat injuries encountered, the inability of health personnel and patients to access health facilities, the lack of food, water, electricity, access to services and access to dead bodies" The capacity to develop and sustain an autonomous and comprehensive health care system, accessible to all people, is an essential element of the infrastructure of a self-governing community. The human right to health and well-being is not only an individual right to access health care when needed. Rather, it involves the rights of communities to elaborate and maintain a health care system responsive to their particular and self-defined needs. The recent re-occupation has violated Palestinian rights to health in three important ways. First, over the last several months critical basic public health infrastructure has been destroyed. Second, health care providers have been directly targeted in military actions. Third, prolonged occupation, with associated daily exposure to brutal violence, fear, curfews, mobility restrictions and severe food shortages, has profound impact on chronic disease morbidity, mental health, and the nutritional status of Palestinian civilians. The destruction of basic public health infrastructure Rita Giacaman and Abdullatif Husseini of the Institute of Community and Public Health at Birzeit University have conducted household surveys of several West Bank towns. They report that during the months of March and April homes in many villages in the West Bank and Gaza were without water supply most or all of the time (e.g Tulkaram 23% of homes, Ramallah 37%, 39% Nablus, Jenin 92%). Eighty five percent of Ramallah households experienced problems with sewage disposal. Several families reported that as a result of the curfews they were unable even to transport garbage to street refuse container resulting ing "garbage piling up inside homes." Sewage systems in many towns were destroyed during the invasion and have yet to be repaired. For example, Israeli soldiers have blocked attempts to repair the partially destroyed sewage system in the Rafah refugee camp by shooting at municipal workers as they try to repair the damage. As a result wastewater is now flooding the streets of the camp and flowing towards homes. Five thousand Palestinians live in the Rafah camp (PCHR Press Release 25 June 2002). Without proper sewage treatment and a clean water supply Palestinian communities are extremely vulnerable to outbreaks of waterborne infectious disease. Palestinian children are likely to be particularly susceptible. It is important to document the effects of occupation on public health infrastructure (i.e water supply, sewage treatment, primary health care networks and infectious disease surveillance systems). It is also necessary to document the effects of this infrastructure breakdown on the health of vulnerable groups such as children and the elderly. The direct targeting of health care providers by the IDF Medical committees in most Palestinian towns report severe understaffing of primary care clinics and emergency medical services. These shortages occur because roadblocks, checkpoints, and curfews prevent staff from reaching workplaces. The International Committee of the Red Cross (ICRC) has expressed "increasing alarm" at restrictions imposed by the IDF on both the PRCS medical services and its own humanitarian mission in the occupied Palestinian territory. The ICRC has expressed concern that closures and curfews in towns have specifically restricted women's access to emergency obstetric care. (Source: Report of the UN High Commissioner for Human Rights (58th session Agenda item No.4) 24 April 2002 Submitted pursuant to decision 2002/103 of 16 April 2002 - Subsection I 30-42) The Palestinian Red Crescent Society(PRCS) has reported systematic interference in its functions by the Israeli authorities. According to the PRCS, this interference has included denial of access to ambulances, delaying of ambulance services, the denial of access to medical services, medicines, and vaccinations for the civilian population, the arrest of patients from ambulances, the targeting of emergency and humanitarian workers, shooting at PRCS emergency response teams, and the deliberate abuse and torture of Red Crescent emergency workers. Since September 28 2001, PRCS reports 600 specific incidents of denial of access to PRCS ambulances. For its part, the IDF explains that incidents involving ambulances are due to the increasing use of ambulances and medical vehicles by terrorist organizations. The IDF alleges that Palestinian fighters are working on the premise that these vehicles do not undergo thorough examinations when they pass through IDF roadblocks and checkpoints. Current internal closures (via atleast 120 checkpoints), road blocks and physical barriers enable the Israeli army to completely control and restrict the movement of people and goods within the West Bank and Gaza Strip. The occupied Palestinian territories are still predominantly rural. Seventy percent of Palestinians live in rural areas without local hospital services. In this context the curfews, roadblocks and checkpoints deliberately and completely isolate civilians from access to health care. Inability to reach hospital has effected pregnant women. Over the last two years there have been 39 cases of births at checkpoints and a stunning 100% increase in home deliveries. UNRWA reports 58% increase in number of still births (data from Jenin and Hebron areas) and a 52% decrease in women attending prenatal care. Long term impact of prolonged occupation on chronic disease, mental health and the nutritional status of children Rita Giacaman and Abdullatif Husseini have begun to document the impacts of occupation on mental health, nutritional status and chronic disease outcomes. Their data derives from household surveys conducted in the towns of Tulkaram, Ramallah, Nablus and Jenin between 28 March 2002 and 22 April 2002. Food shortages were reported in over 1/3 of households in all cities. Persistent food shortages, such as currently experienced by Palestinian civilians result both from lack of supply and disruption of the fundamental economic processes of society. In Ramallah 20% of families substituted tea for children's milk. Tea not only lacks calcium, but it chelates iron, blocking its absorption. This disturbing finding underlines the need for clinical exams focusing on nutritional status of children. Between one to two thirds of homes (rates vary by community) report direct exposure to bombing, shooting or destruction. Ninety percent of households across communities reported mental health problems resulting from the invasion. Specific sequelae among children include crying, screaming, fear, enuresis, fever and nightmares. Adults suffered headaches, stomach aches, diarrhea, heartache, diabetic exacerbation, fainting, and pain related to fear. Between 22% and 49% of households (again varying by community) reported medication shortages. One tenth of Tulkaram households reported deterioration in people with chronic illness such as diabetes and hypertension. In Jenin specifically, 91% of residents reported living with the sounds of shooting explosions and destruction most or all of the time. In response to these attacks, 36% of households hid in fear, and suffered lack of sleep and mental distress, 28% reported the family hiding in one room quietly so as not to draw the attention of the army. Fourteen percent of respondents specified children's fear and crying and unrinating on themselves. The remaining households gave answers such as "did nothing", "this is normal", "no fear", "escaping to the neighbours", "and taking sedatives." Forty-five percent of Tulkaram households reported that their home had been searched. Giacaman and Husseini describe the experience of house searches as follows: "Searching homes is quite a terrifying experience, not only because of the usual destruction of property that ensues, but also because usually families are all placed in one room and locked up, as the army searches, while families experience worry and fear, not only in relation to their property but also in relation to the potential arrest of a family member". The authors conclude that trauma evaluation and management should be a priority health care providers and institutions: "We are witnessing a situation where the majority of households in all towns report mental health problems that require immediate inpervention in the hope of minimizing the longer term effects on people and especially on children?Jenin may very well be a case in point demonstrating the need to not only pay attention to the damages that took place during the re-invasion of the West Bank by the Israeli Army in terms of physical infrastructure or loss of income or both but also in terms of the social, medical, and humanitarian costs to households and people. Sources: Palestine Monitor 27 May 2002 On behalf of the Palestine NGO Network (PNGO) Report of the UN High Commissioner for Human Rights (58th session Agenda item No.4) 24 April 2002 Submitted pursuant to decision 2002/103 of 16 April 2002 - Subsection I 30-42) PCHR Press Releases 01 April 2002 - 25 June 2002 www.pchrgaza.org Giacaman and Husseini, Life and Health During the Israeli Invasion of the West Bank. Institute of Community and Public Health, Birzeit University 25 May 2002. HDIP Report: Health Care Under Siege, May 2001 www.hdip.org |
Madinat al-Muslimeen Islamic Message Board |