Socioeconomic situation: In a report on the plight of Palestinians in the Gaza Strip, the Israeli daily Ma’ariv described the living conditions as appalling; these conditions have reached a degree never seen before in the Strip. The report also recounted the widespread dilemma of families forced to sell off their furniture to raise money to buy food. The daily concluded that the Strip has reached a potentially explosive situation.

The commissioner-general of the State of Israel said recently that the conditions “economic [and] social and security [are] worse than ever” in the Occupied Territories.

The current closure of the Occupied Territories is the cause for this situation. Since the beginning of the closure on 28 March, unemployment has reached almost 50 percent in the West Bank and Gaza Strip. And without explanation Gazan laborers crossing into Israel often have their ID cards confiscated and their permits destroyed.

It is estimated that since the beginning of the closure, $750,000 per day, totalling more than $30 million, has been lost from Gaza’s already poor economy.

Violence continues to escalate, with over 80 persons killed in the last six months; compare this to the total of 59 deaths in 1992. Amnesty International in its statement dated 27 May said it “believes that many of these killings are absolutely unjustifiable and that some may amount to extrajudicial executions.” Recently 275 Palestinians have been injured by the authorities, including 80 children.

The consequences and effects of the siege (as the closure is appropriately termed) on the health conditions of Palestinians are devastating; especially for the most vulnerable segments of the society – women, children and the elderly.

The infant mortality rate has soared. UNICEF recently stated that the rate for Gazan children under the age of one year was 41 deaths per 1,000 births, 51 deaths per 1,000 births for children under five.

The number of patients from the West Bank coming to the three major hospitals in East Jerusalem has dropped by more than a third. Permits to cross the green line and permits to enter East Jerusalem are only sparingly given. Local clinics and village health care centers try to absorb the increase, but with difficulty. Those coming to the centers are unable to pay even nominal fees due to unemployment.

Project descriptions: The Gaza Health Project (GHP) is a joint effort by Gazan health care professionals and institutions to address the health care needs of the Gazan population in lieu of any government structure. Below are the components included in the 1994-95 phase.

Family Health Care Centers. When the Near East Council of Churches (NECC) began the Centers six years ago, conditions were bad. Today they are worse. Each center has its own staff including a doctor, a chemist, a lab technician, nurses and midwives. The clinics are open six days a week with the staff concentrating on prenatal, sick-baby and well-baby care. Educational activities and opportunities are also provided for mothers.

“We consider the NECC center in Zeitun [one location] as holy as a mosque or church,” one mother said. “It is essential and vital to every single person in the area.”

Salaries totalling $30,000 for five laboratory technicians are needed. The fact is, laboratory services will stop in January if the salaries are not subsidized.

The Centers have always provided free medicines to children up to six years of age. There are 56,680 children registered, with more than 2,500 added each year. Half the annual cost of these medicines at $37,500 is requested.

Sanitation project: $30,000. For the past 10 years the authorities have prohibited garbage collection and sewage infrastructure. Minimal work has been done in disposal works resulting in uncoordinated efforts and waste.

Private persons may now connect main sewage lines, provided they can afford to do so. The NECC proposes to supervise the Gaza Rehabilitation Committee’s work to connect 40 homes to the sewage mains.

This project would begin to address the horrid sanitary conditions that affect the health of Gazans, especially of children who play in the raw sewage.

Gaza Central Blood Bank: Operational support: $16,000; empty blood bags: $20,000. The Gaza Central Blood Bank has the only donation service in both the West Bank and the Gaza Strip. It cares for 55 hemophiliac children and provides 70 percent of all pregnant women with blood before delivery. Continued operational support is needed.

Empty blood bags are expensive, about $3.50 each. The hospitals have offered to supply used bags, which would then have to be sterilized. This is not acceptable.

Rafah and Jabalya mobile dental clinics: Operational support: $30,000. The clinic in Rafah, a region in southern Gaza, serves more than 60,000 people. Rafah is one of the most underdeveloped areas in the Gaza Strip and in serious need of health care services.

The mobile clinic in Jabalya provides care in the northern camps for another 60,000 people. The most important component of the clinic provides educational materials on dental hygiene with free examinations to children in kindergarten.

Gaza Rehabilitation Committee: Medical supplies: $18,000; hearing aids: $12,000. The Committee was established in 1991 by eight institutions to coordinate the groups serving the disabled. In cooperation with Bethlehem University, the Committee has trained 16 community-based rehabilitation workers. These workers and their supervisors conducted a house-to-house survey in two camps and a village (total population: 80,000) to assess the number of disabled and to evaluate their needs. There are about 3,500 hearing-impaired children and hundreds of young men with spinal cord injuries.

Along with physiotherapy and family counseling, vocational training is offered.

Conclusion: Recently the Israeli housing minister was quoted saying that “preventing Palestinians in the Occupied Territories from entering Israel will be a permanent measure.” With such closures the difficulties and hardships can only increase and the ability of Palestinians to address their medical needs, decrease.