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The Labyrinths to Health in Gaza (December 2019)

Countries
oPt
Sources
MDM
Publication date

Introduction

Gaza: a 365-square-kilometre strip of land containing dozens of governmental, NGO and private institutions focused at providing health services to two million Palestinians. After several years of wars, political division and siege, the access to health for this population has witnessed almost a reversal. The availability of services is questionable. New departments open, but the essential components required to make them run are missing: drugs, equipment, and human resources. When these services are not available inside the Strip, patients have to seek them elsewhere. The ambition of attaining the essential right to health can take a Palestinian through an almost endless maze of obstacles imposed within and outside the Gaza strip.

Among the complex pathways to health, one of the most remarkable obstacles Palestinians from Gaza have to face is the Israeli controlled permit regime. In February 2018, Al Mezan Center for Human Rights, Amnesty International, Human Rights Watch, Medical Aid for Palestinians (MAP) and Physicians for Human Rights Israel (PHRI) published a joint statement highlighting the consequences of the permit restrictions Gaza patients regularly suffer. It made the case that the permit regime has negatively affected the life of thousands of people, even condemning some to death. Moreover, scientific research has shown that populations barred from travel for medical care are at increased risk of poor health in the long run, suffering the consequences up to 25 years later. The permit regime is an obvious expression of the implications of the blockade; but more importantly, it also implies that the structural cause for needing these exit permits is the lack of advanced medical services capable of responding to complex and specialised cases within Gaza.

Up until now, the health community has focused its advocacy on the permit regime for patients who seek services outside the Strip, but not enough interest has been given to understanding why these tertiary-level care services are not available inside Gaza. This study thus aims to bridge the current narrative with the concepts of sustainable access and proper development of the tertiary-level care services sector within the Strip.

Uncovering the multiple challenges of the specialised health services in Gaza and their nexus with the harsh reality of the exit permit regime is easier when it is seen through the eyes of Palestinians and from thereon explore the world that lies behind those experiences. Inspired from real life stories, MdM offers to accompany the AlGazaoui family on its journey seeking treatment for their different health problems. The report therefore does not follow a traditional structure deconstructing the technical components by thematic clusters, but aims to provide a more human experience for understanding the current challenges patients and the health system suffer in Gaza. The report focuses mostly on three medical specialisations: paediatrics, orthopaedics and oncology, as these represented almost 50% of all referrals between 2017 and 2018 and portray both general and specific challenges of Gaza’s health care system.