Doctors in the Palestinian territories are deeply concerned at the level of disability that will result from the present conflict with Israel and the restricted facilities that are available to deal with it.
Research carried out by the Institute of Community and Public Health at Birzeit University, near Ramallah, shows that about 13% of the injuries sustained by Palestinians during the conflict so far are likely to result in permanent disability. A total of 33 000 injuries have been sustained up to now, so the number of people left disabled will be substantial.
Yet the Palestinian territories have only four centres to deal with such problems. All are situated in the West Bank, except for one in the Gaza strip, and their bed occupancy is more than 100% most days.
One centre has managed to increase its beds from 22 to 30, but the others, which between them have 41 beds, have not been able to do so. All the centres are non-government centres run by charitable organisations.
Many of the people injured in the conflict are children or young people. An analysis of the 6071 injuries sustained during the first three months of the current intifada (Palestinian uprising) in the West Bank (from 28 September 2000 to the end of December 2000), carried out by Dr Samia Halileh and her fellow researchers, show that 25% were schoolchildren and 60% were aged 18-34.
Dr Halileh said that the injuries most likely to lead to permanent disability were those inflicted by the fragmented bullets fired by Israeli M-16s, a US lightweight field rifle. The bullet often breaks into tiny pieces after penetration, ripping up muscle and nerve and causing multiple internal injuries, much like the internationally banned dumdum bullet.
Dr Robert Kirschner, a physician and forensic expert with the University of Chicago Medical School, who visited the area with Physicians for Human Rights, noted the same thing: “By inflicting these leg wounds, it's a form of summary punishment. It causes a permanent disability.” (Washington Post Foreign Service, 2000 Nov 30.)
The mortality and morbidity data used by Halileh and colleagues were original, raw data collected retrospectively from the Red Crescent and the Ministry of Health, checked, and analysed. (See p 361.)
Figure.
ROBERT BELL
Two Palestinian children wounded in West Bank clashes wait to travel to Germany for treatment