Palestinian health workers battle the pandemic against a backdrop of violence, obstruction and ongoing impunity

Photo credit: ZUMA Press, Inc. / Alamy Stock Photo

Earlier this year, Medical Aid for Palestinians (MAP) once again joined our partners in the Safeguarding Health in Conflict Coalition (SHCC) to highlight continuing attacks on health workers around the world, including the occupied Palestinian territory.

The Coalition’s annual report charts at least 1,200 incidents of violent threats to health workers, facilities and transports perpetrated across 20 countries in 2019. These incidents follow an alarming and ongoing trend of attacks conducted with impunity, undermining public health and denying civilians access to often life-saving medical services. The report highlights an increase in reported incidents since 2018 (973 across 23 countries).

Coalition founder and chair Leonard Rubenstein reflected on this dire global context:

“Our disturbing findings reveal again that commitments to stopping violence against health care remain thin, more rhetoric than action. It has been four years since the United Nations Security Council committed the international community to take concrete steps toward prevention and accountability, but health workers and patients they serve are still waiting.”

Years of such violence and obstruction to healthcare are a troubling backdrop to the COVID-19 pandemic, having chronically undermined the capacity of affected health systems to respond to needs amid this global crisis.

MAP’s documentation of attacks on Palestinian healthcare

MAP contributed to the report’s documentation of attacks on health in the occupied Palestinian territory (oPt) (p46-49). In 2019, 226 incidents were reported in the West Bank, including East Jerusalem, and Gaza, resulting in 304 injuries to health workers and damage to at least 35 ambulances. The majority of these incidents occurred in the context of Israel’s widespread and systematic use of excessive force – including live ammunition, teargas and rubber-coated steel bullets – against civilian protesters at the “Great March of Return” demonstrations in Gaza, which continued throughout 2019.

Two Palestinian health workers also died after being shot by Israeli forces last year. On March 27, Israeli forces fatally shot Sajed Mizher, a 17-year-old volunteer health worker with the Palestine Medical Relief Society, while he was caring for people injured during clashes at Dheisheh Camp, near Bethlehem in the occupied West Bank. Paramedic Mohammed al-Jedeili, was shot with a rubber-coated steel bullet in the face, causing a skull fracture, while working at the “Great March of Return” protests on May 3. He died on June 10.

The case of paramedic Sabreen Qeshta, who was shot twice while working at the protests in Gaza, is also featured in the report. In June, Sabreen says she received a head injury while evacuating and providing first aid to injured demonstrators, affecting her sight. Then when she was back on duty in September, a bullet entered her hand and abdomen. She now walks with difficulty and needs help with most daily tasks. Sabreen described the circumstances of her second injury to MAP:

“I was providing first aid to a child who was suffering from tear gas inhalation about 70 metres from the fence. Once the child was in the ambulance, I started moving away. With every step I took, an Israeli jeep followed me and opened fire next to my legs and near my face. When I was about 300 meters from the fence, they opened heavy fire. There were three injured people on the ground. As I was leaning down to help one, a bullet hit me.”

A colleague of Sabreen’s, Abdullah Al-Qutati, was also shot dead by Israeli forces in August 2018.

Despite the protected status of health workers and facilities under international law, a culture of impunity surrounds such attacks in the occupied Palestinian territory. In March 2019, the UN independent Commission of Inquiry on the Gaza protests found “reasonable grounds to believe that Israeli snipers intentionally shot health workers,” and that “Israel has consistently failed to meaningfully investigate and prosecute commanders and soldiers for crimes and violations committed against Palestinians.” The health worker casualties that occurred in 2019, as well as the continued impunity for these and previous incidents of violence against health care, underline the importance of accountability to ensuring an end to the violations of international humanitarian law.

In the report, the Coalition make a number of key recommendations on how to improve adherence to international law and protect healthcare (p15-17), including calling on states to: “Take strong diplomatic actions against perpetrators of violence against health care through public condemnations, demarches, and other mechanisms” and “Take actions to ensure respect for international humanitarian law, as set forth in the first article of each of the four Geneva Conventions.”

The SHCC report echoes the findings and recommendations of MAP’s report Chronic Impunity: Gaza’s Health Sector Under Repeated Attack, produced in partnership with Lawyers for Palestinian Human Rights and the Al Mezan Center for Human Rights and released in March 2020, which documented the persistent failure by Israel to conduct genuine investigations into attacks on Palestinian healthcare personnel and facilities perpetrated by its forces, or to provide legal accountability or justice for victims. Chronic, systemic impunity over many years has fuelled recurrence of these attacks.

UN expert describes continued violations against health and healthcare, calls for accountability

In October, the importance of accountability for violations of international law in the oPt was again emphasised by UN Special Rapporteur for human rights in the oPt, Prof Michel Lynk, in his latest report to the UN General Assembly. Prof. Lynk’s report describes how COVID-19 has “significantly strained an already weakened and overstretched health sector, particularly in Gaza”, and that even in the midst of a pandemic Israel’s policies and practices such as movement restrictions and delays to receiving vital medical equipment have “imposed significantly reduced access to Palestinians’ health care and to humanitarian assistance”. His report explains:

“It is imperative that Israel, as the occupying power, and in light of the currently alarming rates of Covid-19, reverse these practices, and allow for the better protection of Palestinians and the improved access to health care services. Absent such measures, health conditions for Palestinians, already suffering the scourge of occupation, are bound to worsen.”

Prof. Lynk further highlights that there is “an enormous gap between promise and performance” when it comes to international law and accountability for violations in the context of the oPt, warning that “without the development and application of comprehensive accountability measures by the international community against the Israeli occupation, it will continue well into the future.” He concludes:

“This occupation will not die of old age. Nor will it crumble from pleas to respect the United Nations which do not promise the inevitability of adverse consequences if disobeyed. Rights under international law are self-evident, but they are not self-executing."

MAP strongly endorses the content of the Safeguarding Health in Conflict Coalition report, and hopes that policymakers in the UK and around the world will carry forward its recommendations, including key actions needed to help protect health workers and uphold Palestinians’ rights to health and dignity. As similarly emphasised by UN Special Rapporteur Michael Lynk, these actions must include urgent steps to end the culture of impunity for violations of international law in the context of Israel’s prolonged occupation, of which attacks on health workers are just one aspect.

You can read the SHCC report in full here. You can also stand in solidarity with Palestinian health workers battling COVID-19 by joining our #IsolatedButTogether campaign.

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