Health Status in Palestine

1. Health Status in Palestine

2. Palestine - Demographic • From a health perspective OPt consists of two geographical areas- the West Bank (including East Jerusalem) and the Gaza strip . • The West Bank is an area of about 5,800 Km2 with a population of just over 2 million. • The Gaza is a densely populated area of 360Km2 with a population of a little over 1 million

3. Palestine – Demographic, Cont.. • 26% of the population of the West Bank are refugees. • 65% of Gaza population are refugees. • The Palestinian population are young with nearly 20% being under 5 years old, 47% under 15, and only 5% being over 60 years old. • Average household size is just over 6 . • Population growth 3%. • 85% of Palestinians have access to water networks. • 34% of Palestinians in the West Bank and 54% in Gaza are connected to sewage networks • Per capita spend on health ( year 2000) US$ 100 ( 6.5% of per capita GDP).

4. Selected Health Indicators

5. Health Care Services There are four major health care providers operating in Palestine • Ministry of Health • UNRWA • NGOs • Private sector

6. Health Care ServicesDistribution of Health Care Facilities by Provider

7. Impact on Healthsince September 2000 • High number of victims • High number of injured • High number of expected disabilities • Lack of access to health services duo to checkpoints and closures. • performance of health providers and quality of services (next slide) • Budget constrains • Implementation of development of health care system affected badly

8. Cont.. • Health insurance revenues decreased by 60% • Number of food samples and bacteriological water samples for laboratory tests decreased by 33% • Accumulation of garbage in cites and villages causing severe in both health and environment • The immune response of children for measles vaccine was affected duo to disturbance of cold chain. • Discontinuation of vaccination campaigns duo to prevention of medical teams from reaching villages and remote areas • Decrease vaccination of anti-rabies vaccine for animal bites cases by 17%, hepatitis A cases by 16% , hepatitis B for adults by 23% and anti tetanus vaccination by 35%

9. Cont.. • Surveillance of inf. Diseases decreased • Shigelloses outbreak ( 556) was reported in Hebron • 50 cases of infectious diseases were unable to visit the central labs. For diagnosis and follow up, 200 patients of hepatitis B &C could not continue follow up • 1500 contacts to hepatitis B delayed from receiving immunization on time • Patients with chronic diseases could not receive proper follow up and medication

10. Segregation wall

11. General Effect of the wall • Economic effect- poverty- malnutrition • Stress • Destruction of the health and referral systems • Increased costs • Prevention of patients movement • Prevention of health workers movement • Cutting off communities • Blocking ambulances • Blocking vaccines & medical, supplies • Blocking preventive care • Decline in care for chronic patients • Serious effect on Cancer patients

12. Impact of separation wall • The wall will affect 161,700 dunams which is 2.9% of West Bank land area. • It was estimated that the wall will cause direct harm to at least 210,000 Palestinians residing in 67 villages, towns and cities. • The wall will affect all the life aspects of the Palestinians including Health, Education, Employment, farming and social life. • 145 out of 190 Km (stage 1) start operating since July 2003.

13. Implications on the health care system • Creation of 22 vulnerable enclaves (71 clinics) separated from the West Bank. • A change in the geographical distribution of health care facilities. • Isolation of rural communities from urban centers. • Lower quality of health care services. • Reliance on Humanitarian Aid.

14. Complete enclosure • 9 pockets of isolated communities. • These communities are served by a total of 36 clinics. • Ramallah enclaves mostly affected.

15. Time of openings