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Palestinian health services collapsing - The Lancet


The Lancet, journal of the British Medical Association, has published a report on what passes for health services in Gaza, the West Bank and East Jerusalem: The occupied Palestinian territory: peace, justice and health. The report was written in conjunction with Palestinian public health scientists, the World Health Organisation and other UN agencies.

Among its findings the report says health services are at best 'fragmented and incoherent' and that 10% of children in the territories have stunted growth.

Dr Hanan Abdul Rahim said: "There are gaps in care. There's a low level of post-natal care and often it's not given in a timely manner.

"Mortality rates among infants and under-fives haven't declined much. This is unusual when compared with other Arab countries that used to have similar rates but have managed to bring them down.

"The trend for stunting among children is increasing, and the concern is about the long-term effects. It is caused by chronic malnutrition, and affects cognitive development and physical health.

"There are pockets in northern Gaza where the level of stunted growth reaches 30%.

You can hear the editor of the Lancet, Richard Horton, discussing the work here
You will need to register with The Lancet first.

The report has two over-arching themes:


1 Horton describes the situation in the territories as 'very unusual for several reasons'. The West Bank is under occupation and the siege of Gaza 'feels like you are walking into a prison'. The occupation and siege 'informs the entire health system'.

2. The health system is divided and fragmented: The Ministry of Health is 'very dysfunctional, rife with cronyism and doesn't serve the people well. Then there are Non-governmental organisation providing care, a very small private sector and lastly UNRWA, creating an impossible situation for providing a coherent and effective service.

Horton makes it clear that despite the corruption and fragmentation it is the 'oppressive occupation [that] makes it very hard to organise healthcare'.

Lancet editor Richard Horton first visited the occupied territories in January 2007 and the report is the result of two years' work and in particular thanks the medical professionals and acadmeics of Birzeit University's Institute of Community and Public Health near Ramallah.

Israeli propaganda spokesman Mark Ragev describes the report as 'propaganda'.

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