sovereign movement

Palestinian children's health in decline

A two-year international investigation has revealed an increase in the number of stunted children in the occupied Palestinian territories and conditions so extreme that Palestinian women have on occasion been forced to give birth at Israeli military checkpoints.

A series of articles published today by the Lancet concludes that the occupation, the recent conflict in Gaza and inter-Palestinian fighting are undermining the health and development of the population. The best solution to health in the territories is peace and security under a sovereign Palestinian state, argue the authors, who are doctors and academics from Birzeit University in Ramallah and Oxford, with assistance from international health scientists, the World Health Organisation and other UN agencies.

Since 2000, Rita Giacaman from Birzeit University and colleagues say, "life for Palestinians has become much harder, more dangerous and less secure". There is evidence that health gains during the 1990s are being eroded.

A humanitarian crisis had emerged in the Gaza Strip, "intensifying as a result of the Israeli military invasion in December 2008 and January 2009, and because of destruction of homes and infrastructure, the death and injury of civilians and shortages of food, fuel, medicines and other essentials", they say.

Infant mortality dropped between 1967 and 1987, but stalled between 2000 and 2006 at 27 per 1000 live births (the rate in Israel, they note, is 3.9 per 1000).

The rate of stunting - the failure of children under five to grow as they should - has gone up. In 1996, 7.2% of young children had stunted growth, but in 2006, the proportion had risen to 10.2%. "Stunting during childhood is an indicator of chronic malnutrition, and is associated with increased disease burden and death," the authors write. It can also result in damage to a child's mental development and link to obesity and chronic diseases in adulthood. Between 1999 and 2003 rates of tuberculosis have risen by 58% and meningococcal meningitis by 53%.

In spite of substantial funding and efforts, the Palestinian ministry of health has been unable to build up the health systems, the authors say. Restrictions on the movement of goods and labour between the West Bank and Gaza and within the West Bank have been a problem, as has the emergence of two Palestinian authority health ministers, one in the West Bank and one in Gaza. The problems have been compounded by the political divide between Fatah and Hamas. The absence of Palestinian control over water, land and the environment as well as movement has made public health strategies difficult if not impossible. Dysfunctional political systems, corruption and cronyism are among the other factors that "have adversely affected an already fragile health service".

The second article in the series, by Hanan Rahim from Birzeit University, with colleagues from Qatar, Glasgow and Yale universities, finds that the restrictions on movement in the occupied territories have made it harder for women in labour to get to a maternity unit. "Between 2000 and 2006, the ministry of health reported 69 cases of Palestinian women giving birth at Israeli checkpoints," they write. Ten per cent of women in labour were delayed for two to four hours on the road to the maternity facility, whereas the average time without roadblocks was 15-30 minutes.

Yesterday, Hillary Clinton said Israel's demolition of Palestinian houses in East Jerusalem was "unhelpful" and a breach of the roadmap for peace.

The US secretary of state's comments came after she held meetings with the Palestinian president, Mahmoud Abbas, and prime minister, Salam Fayyad, in Ramallah, on the occupied West Bank.