Malnutrition on Political Grounds
By Hadas Ziv
Based in Israel, Hadas Ziv works for the organisation Physicians for Human Rights - Israel, and is Project Director for the Occupied Territories.
The last three years have witnessed a severe deterioration in the relationship between Israel and the Palestinians in the Occupied Territories. Civilians in both societies became victims of appalling acts of violence, betrayed by their leaders who are unable to courageously initiate an alternative. While this is true, we believe that Israel, both because it is already a wellestablished and powerful state, and because it is the Occupying Power, bears the responsibility to initiate an end to the hostilities. It is also clear that as long as Israel retains control of the Occupied Palestinian Territories - it is responsible for the well being of all people under its control. Poverty is a direct result of the closures system and therefore Israel is accountable for the impaired welfare of the Palestinian residents of the Occupied Territories. In our clinics in the West Bank we encountered similar situations to those described by Dr. Adnan Al-Wahaidi. We were struck by the high level of bed wetting in the 7-12 year old age group. We also encountered cases of diarrhoea due to bad water, and problems in child development due to malnutrition.
Physicians for Human Rights (PHR) - Israel was established in 1988 as a non-partisan, non-profit organisation. It brings together volunteer health workers and human rights activists who work against abuses of human rights in general, and champion the right to health in particular. Its members and staff attach deep significance to close cooperation with Palestinian civil society, human rights activists and medical organisations and workers. In our medical and human rights work we strive to construct, even if on a small scale, an alternative to that of violence and hostility, thus showing that such an alternative is possible.
PHR-Israel has been prevented from entering the Gaza Strip for three years now, refused by the Israeli security apparatus on the grounds of our staff's personal safety. However, our experience in the West Bank, where we have been conducting mobile clinics every Saturday in cooperation with various Palestinian health NGOs for the past 14 years, shows that our activity is welcomed and appreciated.
Our work in the Gaza Strip is therefore severely restricted. We keep in close contact with human rights and health organisations, campaigning and advocating for the freedom of movement of medical staff and patients both on an individual caseby- case basis, in emergency cases, and also on a collective basis regarding policies of entry and exit. We also monitor the treatment of prisoners and detainees from Gaza who are held in Israel away from their families. We then disseminate the information to our public. Israel has now resumed full control of the Occupied Territories, and exerts total authority over the everyday lives of Palestinian residents. At the same time, the Israeli government prefers to contact foreign and international organisations and ask them to provide humanitarian assistance to the Palestinian residents of the Occupied Territories1.
Israel's regime of severe restrictions imposed on freedom of movement within the West Bank and Gaza Strip - as well as between the two, and between them and the outside world - has severely affected the Palestinian economy, causing deterioration in their standard of living, nutrition and health. According to the World Bank "the second year of Intifada witnessed a further steep decline in all Palestinian economic indicators. By the end of 2002, Real Gross National Income (GNI) had shrunk by 38 percent from its 1999 level. Poverty - defined as those living for less than US$2.1 dollar per day - afflicts approximately 60 percent of the population"2. The effects of these indicators on health are evident: "the health status of the Palestinian population has deteriorated measurably. Real per capita food consumption has dropped by up to a quarter when compared to 1998 levels."3 The effects are especially visible on women and children with higher levels of malnutrition and anaemia. The decline in economic activity leads to a steep fall in tax payment, which in turn causes a growing inability of the Palestinian Authority to supply basic services, let alone develop its infrastructure. Although invaluable to the lives of Palestinians, international assistance is problematic, since it addresses a situation to which the solution can only be political.
"The sine qua non4 of economic stability and recovery is the lifting of closure in its various forms, and in particular internal closure. As long as Palestinian internal economic space remains as fragmented as it is today, and as long as the economy remains subject to extreme unpredictability and burdensome transaction costs, the revival of domestic economic and Palestinian welfare will continue to decay"5.
As long as the occupation continues, the State of Israel's commitment to provide such assistance is both a moral and legal concern.
1The Mission Report 11-19 August, of Ms. Catherine Bertini, UN Personal Humanitarian Envoy of the Secretary-General, states her appointment was in response to- among other things - "a request from Prime Minister Sharon of Israel to the Secretary- General to assist in addressing humanitarian needs arising from the ongoing Israeli-Palestinian Conflict." (p. 1).
2World Bank, Twenty Seven Months - Intifada, Closures and Palestinian Economic Crisis, An Assessment, May 2003, p. xi.
3see footnote 2, p. xiv.
4an essential condition or element
5see footnote 2, p. xvii.
Taken from Field Exchange Issue 20, November 2003