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Migrant & Undocumented People Dept Update 31.3.08

Migrant and Undocumented People Department Update 31.3.08

Open Clinic Campaign, Demanding Ministry of Health take Responsibility: Week 1

After a week of closure of the Open Clinic for refugees, preliminary responses from the Israeli Parliament are positive, and the Ministry of Health shows willingness to recognize responsibility for healthcare of refugees. Action triggers widespread public debate in Israel.

23 March 2008 - PHR-Israel transfers responsibility for the health of refugees and asylum seekers in Israel to the Ministry of Health: In an unusual move, PHR-Israel announced that it was transferring the responsibility for providing medical treatment for asylum seekers and refugees to the Israeli Ministry of Health, and closed its Open Clinic. The action was taken due to intense pressure on the Open Clinic in recent months, and after repeated requests to the Ministry of Health went unanswered.


Over the course of 2007 the number of patients treated at the Clinic rose by 70 percent. The monthly average of patients seen at the Clinic in 2007 was 504, compared to 301 in 2006. Toward the end of 2007, and after the beginning of 2008, the number of patients continued to rise, and approximately 100 patients were coming to the Clinic every evening.
In recent months the intense pressure forced us to ask paramedical staff to undertake initial screening (triage); many patients were asked to return on another date to see a physician. Staff members responsible for referring patients for ongoing monitoring were also unable to cope with the overwhelming amounts, and were unable to provide solutions in complex cases requiring expensive and/or protracted treatment.
Given this reality, we came to believe that continuing in this manner was a disservice to patients, staff and voluneers alike. For further details, see the Report on the Open Clinic - 2007 and our previous Update (Update and Report)

In a letter to the Minister of Health warning that we would be obliged to close the Open Clinic, we wrote:"A low-budget volunteer-run clinic cannot, will not and should not constitute a replacement for appropriate State policy."
"We do not have the ability to provide adequate diagnosis and care, and cannot provide care that is only available in hospitals. Beyond the issue of public responsibility on the part of the State, continuing to operate the Open Clinic in the current circumstances, in which hundreds of refugees and asylum seekers approach us daily, would be irresponsible on our part."


Patient-care during the action: Over the past week, PHR-Israel has stopped seeing patients at its Open Clinic, and used volunteers to accompany refugees to hospitals, where we have asked that medical treatment be provided in the emergency rooms . Patients were taken by minibus to Ichilov Hospital in Tel Aviv, which has supported the work of the Open Clinic on a voluntary basis for many years, as well as to Sheba Medical Center at Tel HaShomer and Wolfson Hospital in Holon Although this added pressure to the already busy ERs, and some minor mishaps occurred, the patients were admitted to the emergency rooms and received care.

On 23 March, 33 patients were referred to Ichilov Hospital.
On 24 March, 12 patients were referred to Wolfson Hospital.
On 25 March, 25 patients were referred to Sheba Medical Center.
On 26 March, 8 patients were referred to Ichilov Hospital.
On 30 March, 19 patients were referred to Beilinson (Rabin) Hospital.

Israeli hospitals are required to accept the patients under the terms of the Patient's Rights Law. However, the hospitals do not receive any payment for treatment in these cases, since the patients themselves have no possibility to pay, and the Ministry of Health and Ministry of Finance do not provide financing for this law. Accordingly, the response by the hospitals is admirable, as is the fact that they have joined our advocacy efforts in the Israeli parliament, the Knesset (see below).

In addition to taking the patients to hospital emergency rooms, we have also distributed information sheets in various languages over the week to hundreds of refugees and asylum seekers. The information sheets include useful information about referral to emergency rooms, as well as the addresses and telephone numbers of the hospitals, and the telephone numbers of the Ministry of Health itself.

Raising the issue on the public agenda: During the week before the closing of the clinic, and during the first week of its closure, extensive media outreach was initiated by PHR-Israel, resulting in unprecedented media coverage in Israel, and placing the subject on the public agenda. Our goal is to promote meaningful public discussion of refugees' right to health, and of the balance of responsibility between the government and NGOs.
For examples of media coverage, see:

News report: Haaretz On-Line: Illegal immigrants' clinic closes in protest of state's inactivity
PHR-Israel sponsored article, Ynet: When the state shirks its responsibility, we must have the courage to refuse. (Hebrew Only)
News report: Jerusalem Post: TA clinic for illegal workers, refugees to close
Video clip: Report on Channel One News about the closure of the PHR-Israel Open Clinic (Hebrew Only)


The Minister of Health responds: On the same day that the Open Clinic was closed, the Minister of Health took the first step toward accepting responsibility:
"Minister of Health Yaacov Ben-Yizri asked the government to approve a budget of NIS 7 million in order to provide medical treatment and inoculations for refugees present in Israel without authorizations. The request follows the announcement by Physicians for Human Rights-Israel that it is today closing the clinic intended for refugees and asylum seekers in Israel."
Ben-Yizri presented the request in writing to Director-General Ra'anan Dinor of the Prime Minister's Office." (Meital Yasur, 23 March 2008, Ynet).

We see this request for funding by the Minister of Health as an admission of responsibility by the Ministry, for implementing the right to health of asylum seekers; this report is therefore encouraging.

Discussion held in the Parliamentary Committee for the Problem of Migrant Workers, titled "The Closure of the PHR-Israel Clinic". On 26 March 2008, as a result of PHR-Israel intensive advocacy and lobby work as well as extensive media coverage, a parliamentary (Knesset) committee convened an urgent meeting in order to discuss the transfer to the government of responsibility for medical treatment of refugees and asylum seekers, following our announcement that we would no longer be able to accept responsibility for this task. In preparation for the meeting, the Knesset Information and Research Department prepared a report entitled "The Closure of the PHR-Israel Clinic and Medical Treatment for Asylum Seekers," that was presented to the participants of the meeting, including PHR-Israel (26.3.08, Hebrew only - Knesset Report).

The Ministry of Health representative at the meeting raised a funding demand totaling NIS 42 million in order to provide medical treatment for refugees and asylum seekers. According to the Ministry of Health's request, the treatment provided will be similar to that provided through the national public health insurance program.

MKs Ran Cohen and Dov Hanin, who had visited the Open Clinic on 10 February 2008 during one of its busiest periods, participated in the discussion, as did MKs Avishai Braverman and Sarah Merom-Shalev. Participants also included representatives of the Ministry of Health and the Tel Aviv Municipality, Head of UNHCR -Israel, the director of Wolfson Hospital and the deputy director of Ichilov Hospital.

The committee decided to request that the Prime Minister and the Finance Minister forward the necessary budget to the Ministry of Health in order to finance treatment of asylum seekers and refugees. Announcement of the committee on the Knesset website (Hebrew only).

It was also decided that a further parliamentary discussion will be held on 8 April 2008 in the format of a joint session of the Labor, Social Affairs, and Health Committee and the Migrant Workers Committee.

PHR-Israel welcomes the demand by the Minister of Health that a budget be provided for the treatment of refugees and asylum seekers. We will continue to act to implement this demand, and we will provide further updates on future developments.


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