SIXTY-FIFTH WORLD HEALTH ASSEMBLY A65/INF.DOC./4 Provisional agenda item 15 18 May 2012 Health conditions in the occupied Palestinian territory, including east Jerusalem, and in the occupied Syrian Golan At the request of the Permanent Observer of Palestine to the United Nations and Other International Organizations at Geneva, the Director-General has the honour to transmit the attached report to the Sixty-fifth World Health Assembly (see Annex). A65/INF.DOC./4 ANNEX Palestinian National Authority Ministry of Health A REPORT ON THE HEALTH CONDITIONS IN THE OCCUPIED PALESTINIAN TERRITORY To Sixty-fifth World Health Assembly February 2012 3 A65/INF.DOC./4 CONTENTS Page DEMOGRAPHICS ............................................................................................................. 5 Determinants of health ........................................................................................................ 5 The economic situation ....................................................................................................... 6 Health conditions of Palestinians in Israeli jails ................................................................. 6 Israeli attacks on civilians ................................................................................................... SHORTAGE OF FOOD SUPPLIES .................................................................................. 6 SHORTAGE OF FUEL AND ELECTRICITY IN THE GAZA STRIP ............................ 7 Treatment abroad for Gaza Strip patients ........................................................................... 8 THE ANNEXATION, EXPANSION AND APARTHEID WALL IN THE WEST BANK AND OCCUPIED JERUSALEM ................................................................. 9 Providing health services .................................................................................................... 10 Health indicators ................................................................................................................. 13 Conclusion .......................................................................................................................... 14 4 A65/INF.DOC./4 DEMOGRAPHICS Population census 1. In 2011, the population of the occupied Palestinian territories was estimated to be 4 168 860, including 389 298 in occupied Jerusalem. The population distribution was 61.9% in the West Bank and 38.1% in the Gaza Strip. 2. Population distribution according to sex revealed that men accounted for 50.8% of the population and women 49.2%. Crude birth and death rates 3. Data from the Palestinian Central Bureau of Statistics indicate that in 2011, the crude birth rate was 32.8 per 1000 and the crude death rate was 4.0 per 1000. Population distribution 4. Palestinian society is still young. In 2011, children under five years of age constituted 14.7% of the total population living in the occupied Palestinian territories; 40.8% were in the age group (0–14 years) and 2.9% were in the age group 65 years and above. Determinants of health 5. It is obvious that the determinants of health in Palestine are no better than those observed last year. Poverty and unemployment rates in the Gaza Strip have considerably worsened owing to the enduring stranglehold of the Israeli blockade. Besides, the demographic indicators such as high fertility rate, high population growth rate and epidemiological changes exemplified by the prevalence of chronic diseases still constitute formidable challenges facing the Palestinian health system. The presence of the Israeli occupation forces however, is the greatest challenge facing the health sector, not to mention the daily acts of violence perpetrated by the occupying army and the exactions of the hordes of Jewish settlers against Palestinians. Factors such as the presence of hundreds of military barriers, the apartheid wall that dismembers Palestinian territories and isolates them from the rest of the world, in addition to closures of crossings and borders, contribute to making life miserable for all Palestinians. 6. Israel as an occupation force continues its aggression against Palestinian civilians and children for organizing peaceful protest against occupation army and settlers daily acts. Such acts aim at seizing their land and destroying their crops which represent their main source of income especially olive trees. Actually, settlers continue their daily aggression on olive cultivated land by burning or uprooting olive trees. 7. Recently, the Israeli occupation army has been using dogs to terrify and attack peaceful protesters thus causing several injuries. 8. Israel also uses different methods to assassinate resistance figures by aerial bombardment in Gaza where citizens were killed and assassinated and by direct shooting of peaceful protesters in the West Bank and Jerusalem. 5 A65/INF.DOC./4 Annex 9. The blockade imposed on the Gaza Strip since 2005 combined with tightening restrictions on individuals and goods movement via all crossings and borders controlled by Israel, hinder economic growth and exacerbate unemployment and poverty thus throwing its dark shadow on health services. This is quite evident in the deterioration of services provided to mother and child and increase of deliveries at home. This was accompanied with more high risk pregnancies and deaths among mothers and newborn babies, and limit the ability of the ministry of health to achieve the millennium development goals. 10. It has been estimated that the health status of nearly 40% of those suffering from chronic diseases in the Gaza Strip has deteriorated significantly as a result of the reduction in health-care services. Also the ever-increasing transfer for treatment abroad at the expense of the National Palestinian Authority overburdens the Ministry of Health budget and cause Palestinian citizens untold hardships in getting the requested authorizations to exit the Gaza Strip, in addition to the travel and living expenses uncured by the patients and those accompanying them abroad. 11. The concern of the Palestinian National Authority, through the Ministry of Health, for promoting the health of Palestinian citizens as a basic right, and its efforts to provide integrated health services to Palestinian citizens in response to economic, demographic and epidemiological changes has markedly improved health indicators, thus giving national health services an edge over the services provided by some neighbouring countries, taking into account the differences in rates of health expenditure. This is evidence of the resilience of the Palestinian health sector and its ability to cope despite all manner of challenges, and demonstrates concrete results in efforts to achieve the Millennium Development Goals. The economic situation 12. In 2010, the rate of unemployment reached 37.8% in the Gaza Strip compared with 17.2% in the West Bank, and the rate of poverty according to consumption patterns reached 40% in the Gaza Strip and 18.3% in the West Bank. Also 23% of the population in the Gaza Strip and 8.8% in the West Bank suffer poverty as a result of measures taken by Israel and the blockade imposed on the Gaza Strip in particular, and on the Palestinian people in general. The perpetuation of the occupation and the measures taken against the Palestinian people constitute a major obstacle that prevents patients from paying for treatment costs, thereby adding to the burdens that the Ministry of Health is compelled to bear on behalf of the people. Health conditions of Palestinians in Israeli jails 13. More than 4000 Palestinians are still held in occupation jails for combating occupation, some of them have spent several years as administrative detainees without any trial. Palestinian children like adults are subjected daily to arrest and detention without specific charges. They are subjected to all manner of torture and ill treatment as nude inspection which represent a stark insult to human dignity and clear sexual assault. Actually administrative detention for various terms ranging from months to years violates the simplest international norms and laws. Battling against administrative detention, several detainees go on hunger strike for around 66 days amid fears for their lives as their health deteriorates. Yet the Israeli occupation forces still continue its oppressive practice of administrative detention of peaceful administrative Palestinians without trial or release. SHORTAGE OF FOOD SUPPLIES 14. The continuation of the blockade of the Gaza Strip has led to a continued and acute shortage of essential materials, foodstuffs, energy supplies, and other vital necessities. This situation has resulted 6 Annex A65/INF.DOC./4 in the emergence of chronic nutritional diseases, including stunting or excessive underweight. Eleven out of every 100 children under five are chronically or acutely undersized according to the data of the Palestinian Central statistical office in October 2011. Also the nutritional monitoring of the ministry of health, indicated that the prevalence of anaemia in the Gaza Strip is high among children and women, and data show that the prevalence of anaemia has reached 76.2% among children aged 9–12 months, 58.6% among school children aged 6–18 years, and 47.4% among pregnant women. Lack of access to food and high food prices due to the continuing military barriers, restrictions on movement and confiscation of land in the West Bank have resulted in high levels of unemployment and limited purchasing power among a large segment of the population,