Palestinian territories face huge burden of disability
BMJ 2002; 324 doi: https://doi.org/10.1136/bmj.324.7333.320 (Published 09 February 2002) Cite this as: BMJ 2002;324:320All rapid responses
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For some years now our small Kifaia Foundation has worked in the Gaza
-strip to support and train several organizations of and for disabled
people. Since the start of the new intifada we have witnessed the rise of
new permanently disabled kids, mainly boys in the age between 12 and 18,
who were shot, some while throwing stones, but some just being witnesses
to the clashes or trying to help the wounded. The Gaza Home Care Program,
a new Palestinian initiative takes care of a hundred severely disabled
boys with spinal cord injuries and brain damage due to the bullets. Most
of them have had operations abroad, but they face severe problems when
returning home. There are practically no nursing homes for these cases,
from the only one that is functioning the boys return home with bedsores.
The families of the boys have to be trained to take care of these kids,
and it is a hard job to deal with incontinence, the prevention of bedsores
and infections, to adapt the homes, often without running water and
toilets to the kids wheelchairs and above all that to deal with a severely
traumatized kid who has to face a completely different life, knowing that
he will probably not marry and find a job, and will be a burden to the
family rather than a support.
The Gaza Home Care Program, with a centre in Gaza-City and one in Khan
Yunis is the only one to offer this kind of service: multidisciplinary
support for the boys and their families, training for the parents and
constant supervizing by a multidisciplinary team of physicians, nurses,
fysiotherapists, social workers and psychologists.
The Gaza Home Care Program needs financial support, since the Palestinian
Authorities have been unable to pay the promised salaries. In the
Netherlands several organisations support this program, but more help is
desperately needed.
For more information, see www.xs4all.nl/~kifaia, pictures and small
section in english, or make contact by e-mail, kifaia@xs4all.nl
Anja Meulenbelt, Kifaia Foundation
Competing interests: No competing interests
I find it fascinating that the focus of attention in a British
medical journal should be on the damage done to the Palestinian people as
a result of their declared War against the Jews. Did you feel as much
sympathy for the German people when bombs were falling on German cities in
World War II? Did you worry about the broken bones of the German children
or the eye injuries sustained by the German women and old people? Did you
make a distinction then between the innocents caught in the line of fire
due to proximity to the aggressor and the true innocents that were the
targets of attack (i.e. the British).
The Palestinian leadership has targeted all Jews as the enemy; in
fact, they prefer women and children as victims of their suicide attacks.
The Israeli army, on the other hand, goes to unimaginable lengths to avoid
civilian casualties.
Perhaps a British medical journal would be better served to write
about the effects this one-way war has on the victims, rather than the
relatively few innocents suurounding the aggressors.
Competing interests: No competing interests
In 1987, when the first Palestinian intifada began, there was a
massive international outcry against the use of live ammunition by the
Israeli army against Palestinian, stone weilding, demonstrators. In
response the soldiers changed their policy (to breaking the arms of
protesters) for a while, and when that didn't work they went back to
bullets, creating the first disability epidemic.
Now, 15 years later, the same pattern again, except now there is no
pressure on the Israeli army to show proportionate restraint.
As medical practitioners, it is all very well to treat the
consequences of such state terror, but should we not do better to lobby
for removing the root cause. As the force of a massively powerful state is
weildied against a more or less defenceless population, we should all use
whatever connections we have to condemn this ongoing and escalating
atrocity.
Dr Chris MG Smith
Oxford
Competing interests: No competing interests
Medical Services for Palestinians
Medical Services for Palestinians
Editor,
We feel obliged to comment on the news item 1 and letters 2, 3 which
appeared in the February 9th Edition of the BMJ on disabilities sustained
by Palestinians in the West Bank and Gaza Strip during the current
Intifada.
For O.J.Hartling to suggest that hospitals, clinics and ambulances
are deliberately targeted by the Israeli military 3 is blatantly untrue.
That he can make such a remark implies a complete ignorance of the level
of commitment to the health and wellbeing of the Palestinian people that
the Israeli authorities have demonstrated over the past 35 years. Between
1967 and 1994, the Israel Ministry of Defence and civil administration in
the West Bank and Gaza strip established a high quality primary medical
care system which included many clinics, rural and urban mother and child
care stations and an efficient immunization system. In addition to this,
the standard of existing hospitals was raised by the opening of new
departments and the purchase of additional advanced medical equipment 4.
As regards tertiary centres, in the Samaria region the Israeli civil
administration opened the Rafidia hospital in Nablus in 1976 for surgical
specialties including ophthalmology and vascular surgery. In the same
region the Nablus Watani hospital was established for medical specialty
services including cardiology, haematology, nephrology, and oncology.
Hospitals in Ramallah and Beit-Jalla worked together to provide a similar
range of services for the Judea region 4.
During this period Israel also provided the Palestinians with both in
-patient and out-patient services in Israeli hospitals in all areas of
medicine not fully represented in Palestinian hospitals. Furthermore,
although the Palestinian Authority assumed autonomy over its own health
services in 1994, the State of Israel has continued to provide this
support to the present day, despite the fact that the Palestinian
Authority is witholding payments for various services provided, amounting
to more than NIS 30 million ($6.5M) 4.
The figures quoted by Professor Halileh 2 are not in dispute. The sad
fact is, that since 1994 the Palestinian Authority has had ample
opportunity to improve the quality of its medical services with money
allocated by both Israel and the International Community for this purpose,
but chose instead, to divert hundreds of millions of dollars earmarked for
economic, social and medical development, to buy weapons to support a vast
network of terror.
Jochanan Stessman
Associate Professor and Chairman
Anthony Goldberg
Honorary Clinical Research Associate
Department of Geriatric Medicine,
Hebrew University, Hadassah Medical School,
Jerusalem, Israel
1. Ferriman A. Palestinian territories face huge burden of
disability. BMJ 2002; 324: 320 (9 February)
2. Halileh SO. Need for medical services for Palestinians injured in
West Bank is urgent. BMJ 2002; 324: 361 (9 February)
3. Hartling OJ. Health consequences of Israeli settlements in
occupied lands. BMJ 2002; 324: 361 (9 February)
4. Israel Ministry of Health Report on the promotion and development
of health services in the West Bank and Gaza Strip 1967-1994. Jerusalem,
1994.
The authors have no competing interests.
Competing interests: No competing interests