Sunday, 13 July 2008

"I will keep them from harm and injustice"

Ori Golan meets Israeli doctors treating those who fall between the cracks. The Hippocratic oath in practice.
Early one morning a few months ago, Fatmeh Abed-Rabo from the West Bank village of Walajeh went into labour while in her 7th month. She and her husband, Nasser, sped to hospital in their car. They were stopped on their way by an army checkpoint. For 20 minutes Nasser tried to persuade the soldiers that his wife was in labour, but they would not let them through. In desperation, Nasser took a circuitous route which bypassed the checkpoint. The journey took an hour and a half. On the way, Fatmeh gave birth to a premature baby girl. By the time they arrived at the hospital the baby was in critical condition. The newborn died an hour later.

Fatmeh’s story is just one of a number reported and logged at the office of Physicians for Human Rights-Israel (PHR-Israel), a non-profit association whose mission is to secure and monitor access to medical care to all individuals. "Healthcare is a basic human right which everyone is entitled to, regardless of their legal status, gender, religion or political affiliation." says Michal Rapoport, the organisation’s public outreach manager. "It is a right which in Israel is too often denied to non-Israelis."

PHR-Israel steps into the breach wherever individuals are denied adequate health care. Based in Tel Aviv, the association boasts about 650 volunteers - half of them doctors. They treat migrant workers; Bedouins who live in areas where there aren’t sufficient medical facilities; prisoners who are deprived of humane living conditions; and East-Jerusalem (Arab) residents who are unable to obtain health insurance. However, since the eruption of the second Intifada, it is the Palestinians of the West Bank and Gaza strip who constitute the largest bulk of the association’s work.

"Israel’s occupation has prevented the Palestinians from realising their potential health" says Hadass Ziv, director of the Occupied Territories Project, "but recent events have exacerbated their situation immeasurably: Sweeping restrictions, repetitive curfews, numerous road blocks and reels of red-tape impede on the passage of patients, ambulances and medical personnel to medical treatments."

Once a week PHR-Israel sends a mobile clinic to isolated Palestinian villages in the West Bank (there is currently a ban on entering Gaza) where residents can seek medical treatment. The medical team is made up of Israeli and Palestinian doctors and includes gynaecologists, paediatricians and nurses. They dispense medicine, treat individual patients and supply medical equipment. The residents generally require painkillers, anti-inflammatories, antibiotics, and essential medicine for chronic illnesses such as high blood pressure, asthma and diabetes.
According to Ziv, many of the villages have few, or no, medical facilities – some not even a pharmacist to act as a general health provider. Their visit is announced in advance and people arrive on foot from neighbouring villages as well. "Sometimes we see over 300 patients during one clinic.

Since the start of Israel’s ‘Protective Wall’ PHR-Israel has submitted four High Court appeals involving illegal practices by soldiers at manned checkpoints. "The instructions laid out by the Israeli courts are that residents who need to pass through a checkpoint for urgent medical assistance are allowed through. However, in reality, there are many cases where this does not happen." says Ziv. "I know of at least four cancer patients who died because they could not get their medication or get to hospital for treatment. They call us in desperation. We try to pass on their names and speak on their behalf of them. Sometimes we can facilitate a passage through a checkpoint, but not always."

At times, stresses Ziv, it is simple hard-heartedness which motivates the soldier at the borders. "I once had to deliver a medicine bottle to a cancer patient in Ramallah," recalls Ziv "The officer in charge wanted to know whether the medicine was a donation or a purchase, whether it was intended for one patient or two, and whether it came in a box or a bottle. I had to show medical documents proving that the patient required this specific medicine, Then, I was asked to supply the composition of the drug. This had nothing to do with security; what business is it of the officer’s if the medication doesn’t suit the patient? Or which hospital the patient is referred to: Ramallah or Nablus?"

Volunteers and staff members of PHR-Israel tend to be left-wing supporters. "But not always" cautions Ziv. "We have doctors of all political leaning, even from the Right. What unites them all is the belief that each person is entitled to medical care, in keeping with the Hippocratic Oath.
Asked about morale at PHR-Israel, Ziv nods her head. "During Protective Wall operation we were working round the clock; we were mentally, physically and emotionally drained. I remember one woman who was in labour and had an appointment for a caesarean operation. Suddenly I felt: is it now all my responsibility? Will she live? Will her baby die? Fortunately this woman managed to reach the hospital in time. There are also moments of deep frustrations and despair, after each suicide attack. We live here too; we’re also outraged at the terrorism sweeping across the country."

Dr. Ilan Gull, chairman of PHR-Israel sees the failure to respect human rights as ‘a rampant disease of Israeli society’. It may begin with the Palestinians, but, warns Gull, it does not end there. "Treatment of migrant workers differ from the treatment of Palestinians in degree but not in kind. The level of violence inflicted on the Palestinian population has led to unprecedented levels of violence within Israeli society and families."

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