Palestinian Dependence on External Health Services: De-development as a Tool of Dispossession

Abstract

Through multiple mechanisms, armed conflict degrades and destroys health systems, leaving significant gaps in care delivery that lead to worse health outcomes. Civilian populations are often left at the mercy of multiple stakeholders to attain health care. Often, they are unable to meet their needs within their own territory. This has been documented as the case throughout the occupied Palestinian territories for decades. In this paper, I argue that the destruction and de-development of the Palestinian health system is not just a side effect of conflict, but is part of a broader effort of dispossession, disconnecting Palestinians from their land and from each other. I focus on the multiple ways Palestinians are forced to depend on external actors to seek needed care due to the limitations of blockade and occupation, the drivers of these pathways, and the outcomes of this dependence. Lastly, I provide recommendations for refocusing health efforts internally.

A mixed methods study of using wasta in healthcare services in Palestine: predictors, consequences and proposed solutions

“…Enormous disparities exist between the healthcare systems in Israel and Palestine in term of personnel, equipment, expenditure, and resources. For example, Israel’s healthcare expenditure per capita is 10 times higher than Palestine’s ($3,145 vs. $306 respectively) [ 36 ]. Around 3 hospital beds per 1000 population are available in Israel compared to only 1.3 beds per 1000 population in Palestine [ 36 ].…”

“…For example, Israel’s healthcare expenditure per capita is 10 times higher than Palestine’s ($3,145 vs. $306 respectively) [ 36 ]. Around 3 hospital beds per 1000 population are available in Israel compared to only 1.3 beds per 1000 population in Palestine [ 36 ]. There are 5.7 nurses per 1000 people in Israel in contrast to only 1.9 nurses in Palestine and 4.6 physicians per1000 people in Israel as opposed to 2.7 in Palestine [ 36 ].…”

Multidimensional vulnerability and financial risk protection in health in contexts of protracted conflict: Evidence from the Occupied Palestinian Territory

“…4 For multivariate analyses, we include relevant covariates, such as employment status categories, education level of household head, presence of disability or other chronic health conditions, health insurance status and type; and number of household members. 5…”

“…The geopolitical split has led to a fragmented health system between the two regions, with challenges in governance, resource allocation, and health strategy coordination. Decreased tax revenue and foreign aid created financial instability, worsening the ability of the PA to maintain healthcare services [5, 38]. These conditions comprised the baseline of health and social services prior to the Israel-Gaza war beginning in October 2023.…”

Barriers to Elderly Health Care in the Occupied Palestinian Territories

“…The numerous policies and restrictions imposed by Israel impede health care development and therefore negatively impact the health of the people: "The Israeli occupation's policies of road blocks, checkpoints, restrictions on movements, and settlers' colonialism throughout the Palestinian territories are the main cause of fragmentation in the health care system". 23 Physical barriers to health care access are evident in residential areas, with Palestinians in Area C experiencing the worst access. 21 Compounding the issues regarding access, Palestinians from Gaza seeking health care in the West Bank or Jerusalem and residents of the West Bank require permits from the Israeli authorities to access services in Jerusalem.…”