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. 2002 Feb 9;324(7333):361.

Israeli-Palestinian conflict

PMCID: PMC1122280
BMJ. 2002 Feb 9;324(7333):361.

Need for medical services for Palestinians injured in West Bank is urgent

Samia O Halileh 1

Editor—The most recent toll of injuries among Palestinians in the West Bank and Gaza Strip during the current Al-Aqsa Intifada is 32 849, or 9.9 per 1000 population.1-1 Data from just over a year ago show that of the 6071 injured from 28 September till the end of December 2000, 789 were expected to have permanent disability, a rate of 263 per month, or 13%. Similar rates have been noted by other sources.1-2,1-3 This is equivalent to 7890 people becoming disabled every month in the United Kingdom.

Analysis of the pattern of injuries in last year's data shows why the rate of disability is so high. People under 35 were most likely to be injured. Of the 6071 injured, 226 were aged 0-11 years, 1297 were aged 12-17, and 3535 were aged 18-34 compared with 414 aged 35-49 and 599 aged 50 or over. In addition, both the type of weapon used and the site of injury show the potential for a high rate of disability.1-4,1-5 In all, 1418 people were hit by live, mainly American-made, M-16 bullets, which often break into tiny pieces and cause multiple internal injuries, and 1936 were hit by rubber coated metal bullets, which can cause extensive damage when fired at short range. Half of the injuries (3032) were to the upper part of the body, including the head, and nearly a quarter (1403) to the lower part, including the pelvis.

The long term needs of disabled people are great in all health systems. In the West Bank only the largest of the three non-governmental rehabilitation centres has been able to increase its beds from 22 to 30. Community based rehabilitation is constrained by the overwhelming medical needs of those injured and by the isolation and separation of cities and villages imposed by the Israeli army as a form of collective punishment.

The international community needs to call for an immediate end to the occupation of the West Bank and Gaza Strip. Local and international policymakers need also to develop urgently the service for and care of disabled people, both qualitatively and quantitatively, to deal with this pressing humanitarian problem.

Footnotes

I acknowledge the work of Amal R Daoud, Rana A Khatib, and Nahed S Mikki for their contribution to the original article that led to this letter.

References

  • 1-1.Palestinian Central Bureau of Statistics. Population in the Palestinian Territory, 1997-2025. Ramallah: PCBS, 1999. Also Ministry of Health website www.moh.gov.ps/update/totalmartyr.html (accessed 28 Jan 2002).
  • 1-2.HDIP. Health care under siege II: The health situation of Palestinians during the first two months of the Intifada.: HDIP; 2000. [Google Scholar]
  • 1-3.Ministry of Health. Cumulative data analysis until 8 January 2001. Available at http://www.pna.org/moh/alaqsa_stat0801.htm (accessed 2 Mar 2001).
  • 1-4.Richburg K. Young Palestinians suffer bone-shattering experience. Washington Post Foreign Service 2000; 30 Nov.
  • 1-5.Goldenberg S. Israel shifts to live bullets: assassinations and gunfire into mobs take rising Arab toll. Guardian 2000; 28 Nov.
BMJ. 2002 Feb 9;324(7333):361.

Health consequences of Israeli settlements in occupied lands

Ole J Hartling 1

Editor—Can people believe in the olive branch, the symbol of peace, in the Middle East? So many olive trees have been felled to make room for Israeli settlements in the occupied territories, West Bank, and Gaza Strip. These settlements seem increasingly to be a root cause of the terrorist activities practised by both sides. Whereas terrorism quickly makes headlines in the media, the idea of settlements is innocuous to many people. The settlements are, however, far more destructive to the peace process and have much more serious and long term consequences than the loss of life through terrorism.

The settlements are a clear breach of the Fourth Geneva Convention, which states that an occupying power must not transfer parts of its own civilian population to occupied areas.2-1 Nevertheless, the Israeli settlements were established soon after the war in 1967 and have grown ever since.

The settlers' houses are built mainly on the hilltops. Water and electricity are installed and a sewage system is established, often with an outlet for draining untreated sewage into the valleys. Nearly 400 000 settlers use the same amount of water as 3 million Palestinians. In Gaza around 6500 settlers surrounded by security zones use more than 40% of the area while the 1.1 million Palestinians are crowded into the remaining 55-60%.

The fast growing settlements gradually encroach on the Palestinian villages, often isolating them from their surroundings. Palestinians require special permits to travel between the Palestinian administered areas, and Israeli soldiers check the permits at the many control posts.

Figure.

Figure

KHALED ZIGHARI/AP PHOTO

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A bedouin shack is removed from the outskirts of the Jewish settlement of Maale Adumim, near Jerusalem

Health services are affected. Passage has been denied several times to ambulances in times of great need—sometimes with fatal consequences.2-2,2-3 Hospitals, clinics, and ambulances are targets for the Israeli military forces and for settlers, many of whom carry arms.

The occupation has several indirect health consequences.2-3,2-4 For example, the incidence of psychiatric conditions has doubled, mainly in children. Difficult road conditions mean that neither health staff nor patients can reach hospitals, maternity wards, or clinics. Distribution of drugs is difficult. Vaccination programmes cannot be carried out satisfactorily. United Nations supply trucks cannot circulate unhindered. Some villages are so effectively cut off from the outside world that food is limited.

Footnotes

OJH is a member of Physicians for Human Rights/Denmark, the Danish Medical Group of Amnesty International, and the Danish parliament's ethical committee.

References

  • 2-1.United Nations Security Council. Resolution 1322. Adopted by the Security Council at its 4205th meeting on 7 October 2000. New York: UN, 2000. (S/RES/1322.)
  • 2-2.B'Tselem. Information sheet June 2001. Jerusalem: Israeli Information Centre for Human Rights in the Occupied Territories, 2001:8-9.
  • 2-3.Commission on Human Rights. Report of the United Nations High Commissioner for Human Rights and follow-up to the world conference on human rights. Question on the violation of human rights in the occupied Arab territories, including Palestine. New York: United Nations Economic and Social Council; 2001. pp. 1–28. . (E/CN.4/2001/114.) [Google Scholar]
  • 2-4.World Health Organization. Health conditions of, and assistance to, the Arab population in the occupied Arab territories, including Palestine. Geneva: WHO; 2001. [Google Scholar]

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