Healthcare crisis in Gaza: the BMA responds

Editor—The BMA shares the grave concern that has been expressed about the apparent collapse of the health system in Gaza.¹ It recognises that the freeze on aid and other funds to the Palestinian territories is having a profoundly damaging effect on hospitals and health care in Gaza, where reports have indicated that child malnutrition is also at a worrying level. However, contrary to the assertion that it is ignoring this crisis, the BMA has been active in collecting information and liaising with medical human rights groups, such as the International Federation for Health and Human Rights (IFHHRO) to see how best help might be provided.

The BMA has its own way of approaching such issues. In 1997, the BMA adopted a policy at its annual meeting, strongly opposing all economic sanctions that damage health care, and BMA Council was instructed to call on states to respect the agreed exemptions for medicines, medical supplies, and basic food items. The association has attempted to implement this policy in as fair a fashion as possible. For example, it lobbied strongly over many years against the blockade of medicines to Iraq and had repeated meetings with ministers to focus attention on the very serious health effects of those sanctions. This was a well planned and continued lobby led by the BMA's International Committee.

The damage to the health system in Gaza is no less, but there has been less time to organise a well thought through response that also takes account of the political difficulties, following the Hamas elections and the consequent instabilities.

As initial steps, however, the BMA has indeed called on the World Medical Association to issue a statement about the unacceptable damage being done to the Palestinian health system and is in close contact with colleagues in both Israel and Palestine who are highlighting the problems and organising appeals for donations of medicines.

Through its Brussels office, the BMA has been closely monitoring the EU discussions which are now hopefully leading towards the unblocking of some (albeit) limited aid into Gaza.

Clearly any delay is worrying, but we welcome the fact that the EU has now drawn up plans to provide some funding for Palestinian doctors, teachers, and pensioners in an effort to diminish the humanitarian and political crisis in the occupied territories. Our understanding is that three channels of funding are being proposed: one to provide $6m a month to an existing EU initiative to pay Palestinian utility bills; another to provide $7m a month to meet non-salary costs of essential health, education, and social services; and the third channel could directly pay allowances to employees in some key sectors. Under the plan, we understand that allowances for doctors and nurses are proposed to a level of about $8m a month.

What is needed now is practical help in releasing the aid that is available but has been blocked. The BMA cannot involve itself in political questions but will certainly be encouraging the UK government to influence its EU partners to try and reduce damage to this already fragile health system.