Israel is fueling the collapse of the Palestinian healthcare system

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As Palestinians across the occupied West Bank face unprecedented violence at the hands of Israeli settlers and soldiers, the healthcare system they rely on for lifesaving medical treatment and primary care is on life support. This is a result of a financial crisis engineered by Israel.

For many Palestinians with serious health conditions, this crisis is a death sentence. Without urgent international pressure on Israel, the healthcare system will soon collapse completely.

Under the supposedly temporary Oslo Accords that created the Palestinian Authority in the 1990s, Israel collects taxes and customs from Palestinians and is obligated to transfer them to the Palestinian Authority. But since 2019, Israel has been withholding an increasing portion of those funds to punish the authority for pushing for international recognition of Palestinian statehood and accountability for Israel’s violations of international law.

A year ago, Israel stopped transferring all funds, depriving the Palestinian Authority of $6 billion, or nearly 70 percent of its public income. As a result, it has been unable to pay the salaries of doctors and other medical staff in the public health system, bills from pharmaceutical suppliers or private healthcare providers or maintain medical equipment and infrastructure.

Government-run hospitals are currently able to provide only lifesaving treatment, and at reduced quality. There is an acute shortage of medication, endangering the lives of 4,000 cancer patients and thousands of dialysis patients. Even if medications were available, most people cannot afford them on the private market due to Israel’s strangulation of the Palestinian economy. There are also severe shortages of critical medical equipment and supplies, including surgical sutures, dialysis filters, stents and catheters.

With the Palestinian Authority unable to pay doctors and other staff more than 30 to 50 percent of their salaries for the last three years, many are working reduced hours. Along with the shortage of supplies, this has caused more than 11,000 surgeries to be postponed so far this year.

Compounding matters, Israeli restrictions on Palestinian movement make it difficult for people to travel to access medical care or for ambulances and medical teams to reach them in their homes. And attacks by Israeli settlers, which have skyrocketed over the past year, often make it too dangerous for patients or medical workers to move about.

The Palestinian Medical Relief Society, which I co-founded, operates 123 mobile clinics and teams serving nearly 300 communities in the West Bank and Gaza that have no other source of medical care. In recent months, our staff have found themselves in increasing danger, in one instance having to run for their lives from settlers in the Southern West Bank.

My own family is among those that have been touched by this crisis. My wife, like many other Palestinians who have cancer, has been unable to get her medication, forcing us to buy it directly from the manufacturer at great cost. My wife introduced public health to Palestine as a founder of the community and public health institute at Bir Zeit University. She trained many doctors and nurses to provide community and primary care.

We have helped millions of people alleviate their suffering. And now we find ourselves unable to access public healthcare when we need it.

The situation is far worse in Gaza, where the health, water and sanitation systems have been decimated by the ongoing blockade and by Israel’s military attacks, which have killed more than 1,700 health workers since October. Our teams there are having great difficulty getting the medications their patients need, and what supplies they do have are quickly running out. There is only one barely functioning MRI machine in Gaza along with a lack of CT scans, ultrasounds and many other pieces of basic medical, lab and surgical equipment.

Just as Gaza’s health system was systematically targeted by the Israeli military, the healthcare crisis in the West Bank is a result of deliberate Israeli policies that are designed to make life unbearable for Palestinians to pressure us to leave our homes and land.

Another component of this effort has been Israel’s campaign to shut down nongovernmental organizations like Doctors Without Borders and Oxfam, as well as the U.N. Relief and Works Agency for Palestine Refugees in the Near East. Fully 934,000 Palestinians — around 30 percent of the population in the West Bank — rely on the latter for healthcare.

Many of these policies are being spearheaded by Israel Finance Minister Bezalel Smotrich, himself an illegal settler. Smotrich, who is in charge of Israel’s settlement enterprise, openly declares his intent to “collapse” the Palestinian Authority, “encourage” Palestinians to “migrate,” and annex the West Bank and Gaza in violation of international law.

The U.S. and Israel’s other Western backers must act immediately to guarantee provision of essential medicines and supplies and to apply pressure on Israel to release the funds it owes the Palestinian Authority, allow us freedom of movement, stop settler terrorism and allow the U.N. Relief and Works Agency and non-governmental organizations to operate unimpeded.

Failure to do so will result in the total collapse of the Palestinian healthcare system and further needless death and suffering and will mark the latest chapter in the international community’s complicity in Israel’s trampling of the fundamental principles of international humanitarian law.

Dr. Mustafa Barghouti, MD, MP, is president of the Palestinian Medical Relief Society.

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