PA health care teeters on total collapse

Aid groups say they can't replace PA; more Palestinian kids beg in Israel.

By RAFAEL D. FRANKEL
pals guns and kids in ga (photo credit: AP)
pals guns and kids in ga
(photo credit: AP)
Israel must immediately lift its economic siege of the Hamas-led Palestinian Authority if a total collapse of the Palestinian health care system is to be avoided, according to a position paper released by Physicians for Human Rights Tuesday. Thousands of people are likely to die in the short term if funds are not transferred to the PA Ministry of Health to pay for medicine and other supplies, as well as the salaries of doctors and nurses, according to the paper. The paper comes on the heels of a string of reports of rapidly deteriorating conditions in hospitals throughout the Palestinian territories, particularly in the Gaza Strip. Hospitals there say they are running dangerously low on basic medical supplies and that as a result they are unable to provide patients with important treatments like kidney dialysis. Their warning comes as reports of Palestinian children being sent by their parents to beg in Israel have increased substantially in the last two weeks. Though the phenomenon has been observed for the last two-and-a-half years, said Yitzhak Kadman, the executive director for National Council for the Child, his organization has been "flooded with phone calls and e-mails more recently, indicating it is on the rise." The declining quality of health care in Gaza comes despite what a Civil Administration spokesman said were at least eight truck loads of humanitarian supplies delivered through the Karnei crossing in the last three days. The spokesman said that at least 20 truck loads of medicine passed through Karnei in April, despite an attack on the crossing and many security warnings. Foreign Ministry spokesman Mark Regev said Israel had no interest in seeing the Palestinian health care system collapse and was trying to prevent this while at the same time working to prevent funds from reaching the Hamas-led PA. "We are encouraging donations and transfers of medicines and other vitally needed products [to Palestinian health facilities,]" Regev said, adding that the shortages of supplies were probably the result of the PA's empty coffers. "It is a challenge that we have to deal with." Nearly all of the PA's non-salary medical costs, totaling around $7.7 million per month, were previously funded by foreign donors. Since Hamas took over the Palestinian Legislative Council and government, that money has completely dried up. Israel and the international community, Regev said, were considering buying medical supplies directly and delivering them to the PA, rather than giving money to the PA to make the purchases itself. "We will do everything we can to make sure medicines expeditiously reach the relevant health facilities in the PA," he said. Israel is less inclined to help where the salaries of PA health workers are concerned. They total around $5.8m. per month. That funding previously came from international donors (30%), taxes collected by Israel on the PA's behalf (50%), and PA collected tax revenue (20%). "Israel and the Quartet don't want to do anything that will require contact with a Hamas-controlled PA government, that will require giving legitimacy to a Hamas-controlled PA government, or that will require strengthening a Hamas-controlled PA government," Regev said. Physicians for Human Rights said in its paper that this policy would eventually cause the collapse of the PA health system and that, under international law, Israel would then be directly responsible for providing care to the Palestinians. "In this situation, the State of Israel will be required to finance the health needs of 3.5m. Palestinians living under its control. Although it continues to bear such responsibility every day in the occupied territories, and although it denies this responsibility, Israel will no longer be able to stand back as a humanitarian disaster occurs," the report reads. The drafters of the report rejected proposals by Israel and the international community to transfer responsibility for the PA health system to the World Health Organization or other non-governmental bodies, saying it was "unfeasible in the short term." That same message was delivered by a group of 36 NGOs operating in Gaza in a joint report on the conditions there eight months after disengagement. According to their report, 78% of Gazans live below the poverty line and 10% of children under the age of five suffer from chronic malnutrition. Despite efforts by Israel and the international community to use NGOs to provide direct humanitarian aid to the Palestinians, bypassing the PA, the humanitarian situation there will worsen significantly as it is impossible to provide a substitute for the services that were provided by the PA, the report said. "All the international aid agencies put together will not be able to replace the services that the Palestinian Authority provides to the people in the Gaza Strip," said David Shearer, head of the United Nations Office for Humanitarian Affairs.