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World Health

Organization WHO occupied Palestinian territory May 2011 © Patrick Zoll, WHO WHO provides technical guidance for national health policies and programmes in the occupied Palestinian territory – such as the Global School Health Survey.

Who we are The World Health Organization (WHO) The WHO office in the occupied Pa- is the specialized body for health within lestinian territory (oPt) is the principal the (UN) system. WHO technical advisor to the Palestinian Mi- produces health guidelines and stan- nistry of Health (MoH) providing trai- dards, provides technical support to ning and technical advice on a wide countries to address public health is- range of health issues. In the humani- sues and monitors and assesses health tarian field, WHO leads the Health and trends. Nutrition Cluster for the coordination WHO works with governments and of assistance by international and local partners to tackle global health prob- partners to the health sector in oPt. lems and improve people’s well-being. WHO employs 45 staff at its offices in Over 8000 public health experts work and and is sup- for WHO in 147 country offices, six re- ported by the Regional Office for the gional offices and at the headquarters Eastern Mediterranean Region (EMRO) in , Switzerland. in Cairo and WHO headquarters.

The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition. Preamble of the 1946 WHO

P. O. Box 54812, Jerusalem 95147 phone: +972 2 540 0595 [email protected] What we do

The mission of the WHO office for the oPt is to promote the health of the Palestinian population, the develop- ment of the health system and ensure that emergency health needs are met. WHO works closely with the Palesti- nian MoH in carrying out this mission and is the technical adviser for the Health Sector Working Group (which coordinates aid for the health sector).

WHO follows a strategic framework of © Ahed Izhiman, WHO assistance with the MoH (the Count- WHO supports the coordination of ry Cooperation Strategy) to develop emergency preparedness. national capacity. Every two years, a more detailed programme of technical which coordinates the work of the hos- support, training and consultancy is pitals on issues of common concern, agreed and implemented jointly with such as access. MoH covering areas such as emergen- cy health preparedness, health system HIV/AIDS and Tuberculosis and human resource development, me- Donor: Global Fund through UNDP dical technology and pharmacy. As a sub-recipient of the Global Fund In addition, WHO implements a num- programme on HIV/AIDS and tubercu- ber of development and humanitarian losis (TB), WHO works with other UN programmes in the health sector fun- agencies, MoH and the National AIDS ded by different donors. Committee in order to keep preva- lence of HIV/AIDS and TB low. WHO has contributed to research, the deve- Main Development Programmes lopment of national strategies and the introduction of guidelines. In the field Hospitals of TB, WHO supports development of Donor: European Commission national treatment guidelines and trai- The six East Jerusalem Hospitals (EJH) ning modules. With HIV/AIDS, actions are the main providers of tertiary care are focused on counselling and testing, in oPt. They serve as referral centres anti-retroviral treatment, blood safety for in need of specialized and surveillance. care from the and the . WHO is supporting the hospitals Public Health Institute to achieve international accreditation. Donor: Norway This requires the hospitals to comply WHO, with the support of the MoH with clinical and non-clinical standards and the Norwegian Government, is and continuously improve the quality of exploring the case for establishing a care and safety for patients and staff. National Public Health Institute in oPt WHO is also supporting the develop- to strengthen core public health func- ment and activities of the EJH network, tions such as evaluation and analysis of

2 World Health Organization health status, public health surveillance, years, WHO has assisted the MoH in quality assurance and public health re- establishing mental health units to lead search. The National Institute would be reforms in the integration of mental an independent body providing reliable health into primary health care and has health information and advice to the supported the introduction of postgra- MoH, other decision makers and the duate mental health programmes in general public. Palestinian universities. WHO has also supported the establishment of family Non-Communicable Diseases and user associations, a rehabilitation With a rise in life expectancy and a programme in Mental Hospi- change in life style, non-communicable tal and has conducted public education diseases (NCDs) are on the rise in oPt campaigns. as in other countries. Around 50% of deaths are attributable to cardiovas- cular diseases, cancer, diabetes and Main Humanitarian Programmes chronic respiratory diseases. WHO is supporting the MoH in fundamentally Health & Nutrition Cluster Coordination changing the approach to NCDs from Donor: Spain, Norway purely curative care to prevention and WHO leads the oPt Health and Nutrition control. Modifiable risk factors – tobac- Cluster: the joint coordination forum for co and harmful alcohol consumption, 55 UN agencies and international/local unhealthy diet and physical inactivity – NGOs providing humanitarian health are the main causes of the four major and nutrition services in oPt. The clus- NCDs. ter is co-chaired by the Palestinian MoH to ensure alignment with national struc- Mental Health tures. The cluster conducts common Donor: European Commission needs assessments in order to fill gaps WHO has supported the development and prevent duplications in aid delivery. of community-based mental health ser- It is also the forum for emergency pre- vices in oPt since 2003, when the stra- paredness, both for armed conflict and tegic operational plan for mental health natural disasters. In addition, WHO re- services was developed jointly with the presents the health sector in intra-sec- MoH and WHO HQ. Over the past three toral and donor coordination meetings, plays a key role in facilitating the work of health partners in Gaza, and liaises with the MoH in , the de facto authorities in Gaza and the Israeli au- thorities on humanitarian health issues.

Medical Equipment and Drugs for Gaza Donor: Islamic Development Bank In the Gaza Strip, WHO provides support to fill gaps in the supply of pharmaceuticals and medical equip- © Patrick Zoll, WHO ment, and helps in handling the large WHO supports the Palestinian Ministry of volume of medical supplies donated Health in providing drugs to Gaza. to the Gaza Strip. This entails provi-

occupied Palestinian territory 3 ding urgently needed drugs, medical about 90% of births in the Gaza Strip. equipment and spare parts required The goal is to raise standards of clinical for maintaining medical equipment and care and reduce risks from over-medi- electricity generators for hospitals. In calised management of normal labour, addition, WHO is involved in logistics high-risk pregnancies, postnatal compli- and supply management helping to cations and the premature discharge of sort, register, store and deliver medical mother and babies after birth. Another supplies. objective is to improve infection control and provide more dignified and sensi- Maternal and Child Health tive care for women in childbirth. Key Donor: Australia improvements in childbirth care routi- WHO is working with maternity and nes and delivery settings have already neonatal units in the seven main public been introduced. hospitals in Gaza to improve the qua- lity and safety of care before, during Advocacy and after childbirth. The project covers Donor: Swiss Development Cooperation The WHO advocacy programme focu-

UNITED NATIONS WORLD HEALTH ORGANIZATION FATENAH MOVIE Ofce for the Coordination of Humanitarian Affairs West Bank & Gaza Ofce Background Information on Health in Gaza occupied Palestinian territory occupied Palestinian territory March 2011 occupied Palestinian territory ses on Palestinians’ right to health, in

SPECIAL FOCUS July 2010 Gaza 2011 – the reality behind “Fatenah” particular access to health. Through re- Based on a true story, which took place in 2005-2006, the movie “Fatenah” shows how ’s continued blockade of the Gaza Strip impacts the Palestinian population ’s right to health. The Gaza Strip is home to 1.6 million people living in a 360km area. Gaza’s population density is only surpassed by Macau, Monaco, search, monitoring and reporting, WHO Singapore, Hong Kong and Gibraltar. After years of conflict and a blockade imposed by Israel, Gaza’s economy has come to a standstill: official unemployment is at 40% and more than two out of three people live below the poverty threshold. In the movie, Fatenah’s family struggles to raise 200 Jordanian dinar – less than 300 US dollars at today’s rate – for her cancer treatment; the scenario is highlights the impact on health care of symptomatic of widespread poverty in Gaza. The health system in Gaza is stretched to its limits. Essential drugs are often unavailable. For example, cancer patients like Fatenah who are undergoing chemotherapy, which involves a combination of medications, are particularly vulnerable to drug shortages. Up to one the Israeli occupation and the on-going third of essential drugs and one fifth of medical supplies were out of stock in Gaza in 2010. Furthermore, recurrent power cuts and an unstable power supply severely affect medical care: treatments are interrupted or have to be postponed, specialized medical equipment is damaged or supportive services, such as laundry or sterilization, have to be suspended. In 2010, almost 13,000 patients had to leave the Gaza Strip because the medical care they needed was unavailable locally. The majority needed a permit from Israel to pass through Erez checkpoint – one of only conflict in oPt. To improve the fulfil- two crossing points out of the Gaza Strip. In the movie, Fatenah lives through the ordeal of trying to obtain a permit from the Israeli authorities and the agony of waiting for an answer. In 2010, nearly one out of five patients had their permit application Photo by Ahed Izhiman, WHO Ahed Izhiman, Photo by refused or did not receive a response from the Israeli authorities on time. These patients missed their hospital appointment. Six patients died in 2010 while waiting for a permit to leave Gaza: four were children, ment of the right to health, it uses pu- Ambulance waiting at a Barrier checkpoint for a patient from the West Bank. the youngest of them a 22-day-old baby. Israel’s blockade has a direct negative impact on the state of the health system in the Gaza Strip:

o Importation restrictions complicate the import of medical equipment and spare parts. Technicians from SIX YEARS AFTER THE INTERNATIONAL COURT OF JUSTICE ADVISORY OPINION ON THE BARRIER manufacturing companies cannot enter the Gaza Strip to service equipment. Around one fifth of all medical equipment in Gaza was either broken or not used in late 2010. blic advocacy and quiet diplomacy with THE IMPACT OF THE BARRIER ON HEALTH o Travel restrictions render it nearly impossible for doctors and medical staff to attend training courses and conferences abroad. Medical staff are, thus, precluded from acquiring the latest knowledge, which might result in late or false diagnosis – as is the case for Fatenah. Because of the extensive humanitarian impact of the fth anniversary of the ICJ opinion in July 2009. o Limitations on the import of construction material make it impossible to build the extensions to hospitals Barrier, OCHA has been monitoring and reporting This year, in conjunction with the World Health that are needed to keep up with population growth. stakeholders. The programme strives on affected Palestinian communities in the West Organization (WHO), the update will focus on the The United Nations has repeatedly called on Israel to lift the blockade on Gaza to allow the Palestinians Bank, including East Jerusalem, since 2003. The impact of the Barrier on health, in particular patient there to live their lives with dignity. current update summarises the main ndings of and staff access to the specialized medical facilities this research, while outlining developments since only available in East Jerusalem. the last Barrier report, issued on the occasion of the to increase knowledge of health and

Fatenah Movie – Background Information on Health in Gaza 1 human rights within MoH and the aca- WHO collects and disseminates informa- demic community in oPt by organising tion on the health status of Palestinians. seminars and trainings.

How to contact us

Main WHO Office in Jerusalem WHO Sub-office in Gaza

Abu Obaida Ibn El Jarrah Street, 10 Al Nasser Street, Al- P.O. Box 54812 P.O. Box: 5309 Jerusalem UNDP Building, Gaza City E-mail: [email protected] E-mail: [email protected] Telephone: +972 2 540 0595 Telephone: +972 8 282 2033 Fax: +972 2 581 0193 Fax: +972 8 284 5409

Website: On-line publications: www.emro.who.int/ www.issuu.com/who-opt/docs

4 World Health Organization