On the December 27th 2008, the Israeli Defence Force (IDF) launched Operation Cast Lead, a three week military assault on Gaza. 1366 Palestinians were killed, 313 of whom were children. International doctors, Mads Gilbert and Erike Fosse, witnessed at first hand, the most horrific war injuries in men, women and children in all ages in numbers almost too large to comprehend’.
However, what we tend to forget is that the 18 month sea and land blockade on Gaza prior to the IDF operation, and the siege which continues to this day helped to precipitate the collapse of Gaza’s healthcare infrastructure. This has manifested itself in a number of ways – the lack of basic medical equipment, such as patient trolleys, ventilators and electronic monitors for vital signs in hospitals like Al-Shifa in Gaza. Infant mortality and growth stunting rates in children (representing reliable indicators of health status) have either stagnated or increased between 2000-2006.
This sad state of affairs for the health of Palestinians is couched within a larger context of a disjointed and inadequate healthcare infrastructure that resulted from continuing neglect, poor management and corruption. Israeli restrictions since 1993 on the free movement of Palestinian goods and labour across borders between the West Bank and Gaza have certainly not helped. The lack of any control by the Palestinian National Authority over water, land, and the environment within the occupied Palestinian territory has made building an effective health system impossible. To compound this further, the reliance on financial assistance from a multiplicity of donors, complete with their different agendas, has resulted in programme fragmentation.
Building an effective healthcare system requires command over resources, self-determination, sovereignty and free movement of people, all absent in the Palestinian territories, particularly in Gaza.
This is the argument put forward by a number of world renowned academics, doctors and surgeons at a conference on health and medical education in the occupied territories organized recently by myself and a number of students at Oxford University. Expert speakers drew on their years of personal experiences in the occupied Palestinian territories (oPt) to expose the devastating effect of crippling economic blockades and military attacks on civilian health and access to medical care, So who are these ‘experts’? Editor of the Lancet – Dr Richard Horton, Sir Iain Chalmers, Sir Terence English, Professor Colin Green and Mr Nick Dudley.
As debate raged on the doom and gloom of a disintegrating healthcare system, the injustices of water distribution, the trauma of women giving birth at Israeli checkpoints, an image of a humiliated people imprinted itself on my mind:“ Going through checkpoints is like going through cattle gate” as Dr Horton pointed out.
I and many others believe that the UK has a special responsibility towards the people of Gaza and the West Bank, due in no part to our historical ties. The Balfour declaration of 1917, which involved Britain giving away a country that didn’t belong to us, to two different national movements, was always bound to end in tears. It is thus our politicians’ responsibility today to clean up this mess, and to uphold the promise made in that same declaration that ‘nothing would be done to harm the civil and religious and rights of existing non-Jewish communities in Palestine’.
I also couldn’t help think during the conference: Why have such distinguished members of the medical elite, with hugely successful careers in their respective fields, invested so much energy in this cause – sometimes putting their jobs on the line as a result? These are people with no political, religious or cultural affiliation to the Palestinian issue, fighting for a cause that is thousands of miles from their doorstep. Because in the end, doctors and surgeons work in the business of helping people – the original Hippocratic Oath clearly states “I will keep them (the sick) from harm and injustice”. That is undoubtedly a political statement. All medics should be championing human rights and waging a war against injustice across the world, wherever it may lie.
While a political solution remains distant, ordinary Palestinians in Gaza and the West Bank continue to suffer. The physical, psychological and social well-being of Gazans remains poor, and as the WHO’s Commission on Social Determinants of Health states:
“The conditions in which people live and work can help to create or destroy their health”.
Although the situation is grave, it is not impossible. Within all the darkness, beacons of light remain bright across both sides of the wall. The Director of the Institute of Community and Public Health at Birzeit University (in the West Bank) wrote in a statement to the audience at Oxford University, that all of us can individually do something to help: by supporting medical education (through scholarships such as that set up recently for Gazan students at Oxford Brookes University), by visiting the region to see at first hand the challenges of daily Palestinian life (Oxford University students are already facilitating the twining of Al Quds University medical school and Oxford), and by advocating for justice and human rights, we can make a difference.
For me the heartfelt passion and commitment of the panel resonated with my core values as a future doctor and reminded me of why I chose medicine in the first place. Inspired by this event, I am taking the first steps on a journey that will take me to see these struggles of a resilient people face to face.
Views expressed in articles are the author’s and do not represent Comment Middle East
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