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Poor quality water is among the WHO's concerns for Palestinians' health

BMJ 2002; 325 doi: https://doi.org/10.1136/bmj.325.7367.735 (Published 05 October 2002) Cite this as: BMJ 2002;325:735
  1. Lynn Eaton
  1. London

    The quality of water and poor standards of sanitation in the Palestinian territories occupied by Israel are a cause of “grave concern,” according to the director general of the World Health Organization.

    In a report published last week Dr Gro Harlem Brundtland said that, despite a resolution passed by the WHO assembly in May calling on her to visit the territories to assess the situation, she has “not been given the opportunity to pay a visit.” According to a spokeswoman the Israeli government had made it clear that it would not let Dr Brundtland visit to carry out her investigation, although discussions were ongoing.

    However, she has based her latest report, which takes account of the escalation of the conflict in the area since March and further border closures and curfews since then, on data from various UN and non-governmental agencies working in the communities.

    According to the Emergency Environmental Health Project, which is sponsored by the US Agency for International Development, the quality of water delivered from water tanks in the Nablus area is below WHO standards for drinking water. And the Palestinian Ministry of Health reported sewage contamination in the water in both Balata and Askar camps, a result of damage to the water and sewage pipe network in these areas. The ministry also reported problems in the distribution of chlorine to clean the water as a result of closures and curfews. More than 600 cases of shigellosis have been reported in the past few weeks in the area.

    Since March 2002 the collection and disposal of solid waste has been problematic, particularly in the Gaza strip, threatening the health of children, says the WHO. Although immunisation rates were high in 2001, Dr Brundtland said that reports indicated they had not been so high this year.

    Vaccination programmes in rural areas were particularly hard hit. In a six month period only limited vaccination programmes were carried out by the mobile teams who normally cover these areas, because of the security situation. Furthermore, vaccines were not always stored as they should be. Some were being held up for more than a day by delays at checkpoints during transportation from central stores to districts, despite being transported in UN registered vehicles.

    There have also been problems storing the vaccines when power cuts occur, which are often lengthy, and maintenance workers report not always being able to reach damaged storage equipment to carry out repairs.

    Closures of hospitals have limited patients' access to services. The UN Relief and Works Agency for Palestine Refugees in the Near East reports that the number of women receiving post natal care has halved this year, while the Ministry of Health reports that the percentage of home deliveries has increased from 5% to 50%.

    Dr Yitzhak Sever, head of the Israeli health ministry's international relations department, said that the Palestinian authority's deputy minister of health, Dr Munzer Sharif, had asked for help about two weeks ago so that immunisation teams could vaccinate children in outlying areas.

    The Israeli defence ministry was, Dr Sever said, currently holding meetings to try to resolve the problem. But he added that the security authorities feared that health vehicles might be used to transport terrorists who would attack Israel. Dr Sever said that there was “no acute health danger” to Palestinian children arising from the delays.

    The Israeli authorities also denied there were any problems with the water supply in the two refugee camps.

    However, Dr Brundtland said the WHO was concerned that people living in the occupied territories would continue to suffer ill health as long as the hostilities continued.

    “It is particularly important that I am enabled to undertake the planned visit as soon as possible so as to assess further the findings from this desk analysis and facilitate an appropriate response,” she said.

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