Urgent Appeal for Emergency Medical Support

The Issue:

Ramallah, May 31, 2006: In the context of both an impending humanitarian crisis in Palestine and funding shortages facing the organisation, Palestinian Medical Relief Society (PMRS) appeals to the generosity of all its friends throughout the world for support in helping it contribute to averting a public health disaster.

 Background:

Following the results of the January 2006 legislative elections, the Palestinian people are facing an imminent humanitarian crisis as a result of (a) the decision by members of the international community to halt funding to the new Palestinian government; (b) the refusal of Israel to transfer tax monies collected on behalf of the Palestinian Authority (PA); and (c) the refusal of commercial banks to have dealings with the PA. 

These decisions have come in the context of a general deterioration in the conflict, characterized by:

1.    The prolonged closure of the Karni and Erez crossings in the Gaza Strip, which has led to shortages of essential food items including bread, dairy products and fruit and which has brought Gaza’s export market to a grinding halt. [1]  

2.    An increase in Israeli military activity, including frequent incursions by the Israeli military into Palestinian areas [2], extrajudicial assassinations [3], and the firing of more than 5,100 artillery shells in the northern Gaza Strip over a period of just six weeks [4];

3.    The announcement of the so-called ‘Convergence Plan’ by Israeli Prime Minister Ehud Olmert, which aims to set the final borders of the Israeli state by 2009 based on the route of the ‘Separation Wall’, annexing the Jordan Valley and East Jerusalem, and major, illegally built settlement blocs to Israel; and

4.    An intensification of movement restrictions within the West Bank, which OCHA cites as “a primary cause of poverty and the humanitarian crisis in the West Bank and Gaza Strip.” [5]  In January 2006, there were a total of 471 physical obstacles in place by the Israeli military, compared to 376 in August 2005. [6]

Palestinians are already on the edge of survival, with unemployment levels standing at 35 percent, and 64 percent of the Palestinian population currently living below the official poverty line of US$ 2.10 per day. [7]  Many have reduced both the quality and quantity of their food intake, particularly in the Gaza Strip, as ongoing Israeli border closures and movement restrictions have led to shortages of basic foodstuffs and affected access to markets and workplaces.  As a result, up to 40 percent of Palestinians are facing food shortages.

Implications for health:

In such a context, funding cuts are set to have a devastating impact, particularly in the field of health.  In general, PA salaries account for roughly one quarter of Palestinian gross disposable income in 2005, providing vital support to almost one million people, or one in four of the Palestinian population. [8]  The Ministry of Health (MOH) employs 57 percent of all health workers, whose salaries are paid through a combination of MOH contributions (40 percent), funding from international sources (30 percent) and tax monies collected by Israel on the PA’s behalf (30 percent).  [9]

In a recent report, the World Health Organisation (WHO) warned that the acute financial crisis facing the MOH could lead to “a rapid decline of the public health system towards a possible collapse,” and “a shift of control and management of the health service system away from the public sector to NGOs, UN system and the private sector.” [10]  WHO forecasts that this will result in “no access - or limited access - to preventive programs and curative services for an important part of the population, particularly for the poor (1,564,137, 43% of total population),” [11] and already vulnerable population groups, notably women and children.  Patients suffering from cancer and renal complications are already beginning to die due to a lack of essential medicines and medical equipment. [12]

As the ability of the MOH to maintain service provision is weakened, and as people seek out low-cost health care in greater numbers, so the pressure on non-governmental health institutions such as PMRS to fill this gap will become unbearable.  This comes in a context whereby support for non-governmental health service providers to cope with greater number of patients has not increased concurrently, and where such institutions have been facing their own financial crises in recent years as donor funding has been directed away from health. [13]

 Implications for PMRS:

As one of the largest and oldest non-governmental health service providers in Palestine, PMRS has a long history of overcoming challenges in maintaining the regular and affordable provision of basic services, which it achieves through its extensive physical and human network, and through its demonstrated capacity to adapt and respond quickly to needs on the ground.

Yet PMRS has been facing its own funding shortages in recent years which have affected its ability to maintain the provision essential services, particularly primary healthcare services, emergency healthcare services, including the running of many ambulances and mobile clinics, and community-based rehabilitation services, including PMRS lending centres for assistive devices for people with disabilities.  In addition, PMRS is unable to sustain the high cost of providing milk powder and medications to infants with special needs.

Ironically, it is at this critical time that PMRS faces a scarcity of essential medicines and medical equipment, and that it may be forced to close a number of its 26 Primary Healthcare Centres, and halt the operation of some of its ambulances and mobile clinics.  Under better circumstances, this would be devastating, yet in the current context, it is nothing short of a disaster.

What You Can Do:

1. PMRS appeals to the generosity of all our friends and supporters throughout the world in helping us face this crisis by sending emergency donations to:

Account Holder: Palestinian Medical Relief Society
Name of Bank: Arab Bank
Account Number: 49-857-9090-667667
Branch: Ramallah # 49-857
Address: Ramallah, West Bank

Alternatively, cheques can be sent to:

Palestinian Medical Relief Society (PMRS)
P. O. Box 51028
Jerusalem

We would like to extend our deepest thanks to all those who continue to support the Palestinian people through PMRS. 

Should you require any further information, please contact:

Bahia Amra
PMRS External Relations Coordinator
bahia@pmrs.ps

Notes:

[1] OCHA.  Humanitarian Update, March 2006, page 3. http://www.humanitarianinfo.org/opt/docs/UN/OCHA/ochaHU0306_En-Final2.pdf.

[2] 4 Palestinians, 3 of them unarmed civilians, were shot dead by Israeli soldiers during an Israeli military incursion into central Ramallah on 24 May 2006.  See PNI Urgent Appeal: 4 Palestinians Killed and 50 Injured During Israeli Military Incursion into Ramallah.  24 May.  http://www.almubadara.org/new/edetails.php?id=1541.

[3] As of 31 January 2006, 418 Palestinians had been killed in assassination operations, including at least 154 bystanders, 44 of whom were children.  Since 5 February alone, a further 23 Palestinians have been killed in this manner.  See PCHR.  http://www.pchrgaza.org/Intifada/Assassinations.conv.htm; ‘Israel's Assassination Policy’.  The Electronic Intifada. http://electronicintifada.net/bytopic/146.shtml.

[4] Amos Harel.  IDF has fired more than 5,100 shells at Gaza in six weeks.  Haaretz, 16 May 2006.  http://www.haaretz.com/hasen/spages/715432.html.

[5] OCHA.  West Bank Closure Count and Analysis.  January 2006.  http://www.humanitarianinfo.org/opt/docs/UN/OCHA/ochaHU0106_En.pdf. 

[6] Ibid: 1.

[7] OCHA Humanitarian Update, January 2006.  Special Focus: Emerging Humanitarian Risks.  http://www.humanitarianinfo.org/opt/docs/UN/OCHA/ochaHU0106_En.pdf.

[8] Ibid. 

[9] Physicians for Human Rights Israel.  Collapse of the Palestinian Health System.  9 May 2006.  Page 2.  http://www.phr.org.il/phr/files/articlefile_1147165735621.doc.

[10] WHO, 6 April 2006.  Possible Consequences on the Health Sector Due to the Reduction of Support to the Public Services.  http://www.healthinforum.net/files/who/consequences.pdf.

[11] Ibid.

[12] See McGreal, C.  Patients Die as Doctors Run Out of Drugs to Treat Them.  The Guardian, 10 May 2006.  http://www.guardian.co.uk/international/story/0,,1771199,00.html; Physicians for Human Rights Israel.  Collapse of the Palestinian Health System.  9 May 2006.  http://www.phr.org.il/phr/files/articlefile_1147165735621.doc;  In February 2006, the MOH launched an emergency appeal calling for help in addressing significant shortfalls in medicines and medical equipment in light of a monthly budget deficit of US$ 4.5 million.  It warned that medicine stocks would be depleted within two months.  See Ministry of Health, 22 February 2006.  Urgent Appeal – Emergency Medical Support: www.moh.gov.ps.

[14] See Mashal, J. & J. Jubran.  2005.  Health and Development Under Uncertainty: The Palestinian Health Care System.  HDIP Policy Papers Series No. 6.  Ramallah: HDIP.

More Background:

"Palestinian medical crisis looms," Boston Globe, May 7, 2006 - http://www.boston.com/news/world/middleeast/articles/2006/05/07/palestinian_medical_crisis_looms/