New report from Physicians for Human Rights and Gisha

New report from Physicians for Human Rights and Gisha: "Realizing Potential" Transitioning from preventing humanitarian crises to developing the Gaza Strip

13.06.2012

Physicians for Human Rights-Israel is pleased to present a new report, "Realizing Potential: Prospects for the Development of the Palestinian Health System and Economy in the Gaza Strip," written jointly with Gisha - Legal Center for Freedom of Movement.

Our new report, whose release marks five years into the closure of the Gaza Strip, since the 14th of June 2007, recommends necessary steps to rehabilitate the health system in the Gaza Strip, promote an independent and progressive health care system, and allow for long-term economic development.

This report suggests that stakeholders engaged in addressing the political, social and economic challenges facing Palestinians in the Gaza Strip utilize a discourse focused on the critical need for development in various sectors of the Palestinian economy, rather than the current discourse, which emphasizes preventing humanitarian crisis and individual humanitarian gestures. The report also illustrates how current use of the language of "humanitarianism" directs public attention to rescue missions and limited acts of compassion, enabling the ongoing postponement of the development of civil infrastructure within the Gaza Strip.

In addition, the report examines changes in the economy and the health care system of the Occupied Palestinian Territories (OPT), specifically that of the Gaza Strip, over the course of the Occupation. In particular, it explains changes in limitations on movement to and from Gaza, reviews the influence of movement and access policies on the economy of Gaza during this period, and explores the potential for economic development in the Gaza Strip, which might be accrued by the free movement of people and goods. In addition, the report addresses the Palestinian health care system and the obstacles which prevent this system from developing, as well as the potential to turn the Palestinian health care system into one which adequately fulfills the needs of the population.

The central recommendations presented in this report touch on the responsibility of Israel for the state of affairs in Gaza, but also on initiatives and actions the Palestinian Authority must take in order to advance the civil systems under its control. The recommendations are based on the opinions of various health and economic experts written especially for this report.

Efraim Kleiman – Professor of Economics, Hebrew University: "The first thing that governments can do for development is to allow business interests access to the markets. If Israel is interested in development of the [Gaza] Strip, it must remove all limitations, since people will not invest in the [Gaza] Strip if they are not assured that their goods will reach the markets on time, that raw materials will reach the factories, and that workers will arrive to work on time. Removing the barriers that prevent investment means, first and foremost, allowing the free movement of people and goods into and out of the area."

Dr. Angelo Stefanini, former World Health Organization Coordinator for the OPT: "International interests must set the development of an improved Palestinian health system as a goal, and dedicate themselves to its achievement, insisting on the one hand that Israel act in accordance with international humanitarian law and on the other hand emphasizing that they will not accord aid which only preserves the situation created by the Occupation."

Dr. Tomer Brody, senior lecturer in the Faculty of Law and the Department of International Relations, Hebrew University: "In order to achieve good economic integration between the Israeli and Palestinian economies, one must enforce an equal standard of public health, environmental quality, etc., on both sides. One of the ways to encourage Israeli-Palestinian cooperation is to procure lower tariffs in external markets, such as the United States and the European Union, for products manufactured cooperatively."

Professor Dani Filc, senior lecturer and Director of the Department of Politics and Government, Ben Gurion University of the Negev, member of the Board of Directors of Physicians for Human Rights-Israel, and Member of the Board of Directors of the Adva Center, recommends acting according to two principles. The first – promotion of the underlying determinants of health: freedom of employment, adequate supply and quality of running water, nutrition and housing. The second – a good health care system must have vertical integration (preventative care, primary care, hospitals) and horizontal integration (among hospitals with different specializations, between community care and hospital care). It is impossible to build a system of this nature without controlling the physical area, without the ability to plan for the future and without freedom of movement and access. The inability of Palestinian stakeholders to engage in planning for the future due to the possibility that Israel will enact new policies that impede development (curtailing funds, for instance) is a central point. Professor Filc emphasizes that a better, more efficient, and more just system, would be one that relies on comprehensive health insurance for the entire population, with strong emphasis on primary care, followed by hospital care. For such a system to exist, the Palestinian Authority must have real autonomy. In addition, universal health insurance requires sources of employment for the majority of the population, since the system is based on taxation of workers. The present conditions of occupation do not allow this. Along with these changes, there is also a need for the development and training of a suitable and sufficient work force, and the development of independent medical specialists in the areas where today the Palestinian Authority is almost entirely dependent on Israel and Jordan, such as oncology, neurosurgery and vascular surgery.

Recommendations of Physicians for Human Rights-Israel and Gisha:

• Israel must remove the limitations on free movement of people and goods in and out of the Gaza Strip in order to enable civil rehabilitation, with emphasis on the underlying determinants of health such as sewage, quality drinking water, nutrition, housing and employment.

• Israel, the Palestinian Authority, Egypt, and international agencies must regulate and coordinate movement through the border passages. All arrangements must assure the residents' right of freedom of movement both between Gaza and the West Bank in both directions and within the Gaza Strip, and must assure security checks in accordance with international law.

• The Palestinian Authority and the Hamas government must make the guarantee of human rights for the residents of Gaza their top priority, and must act responsibility and accountably to further Palestinian civil infrastructure and long-term economic development in Gaza.

• International organizations working within the Gaza Strip must act not only within the humanitarian sphere but also to promote sustainable civil development which can function independently from international intervention.

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