Osama Tanous & Yara M. Asi
Middle East Eye / July 26, 2022
Biden’s pledge to provide Palestinians with medical aid is merely part of a long history of using humanitarian efforts as a political tool.
On 15 July, US President Joe Biden capped off a trip to Israel and the occupied West Bank with a visit to East Jerusalem, where he pledged $100m in aid to hospitals in the occupied city, which suffered significant cuts in donor funding during the Trump administration.
On its face, this appeared to be a good-faith attempt to provide needed health services. Yet, a Facebook post by Palestinian stand-up comedian Alaa Abu Diab captured much of the cynicism and disillusionment Palestinians felt towards the promised aid package: “We’re the only people in the world whom they don’t want to live nor die! #funding_the_hospitals”.
Abu Diab’s comment reflects the paradox of these types of sporadic funding announcements coupled with the reality of Biden’s visit: tacit approval of a system in Israel that human rights organizations like Human Rights Watch, Amnesty International, and B’Tselem have recently recognized as apartheid, as have Palestinians for decades.
When questioned about the small but growing corner of the Democratic Party that has acknowledged this reality, Biden responded, “I think they’re wrong. I think they’re making a mistake. Israel is a democracy. Israel is our ally. Israel is a friend.”
Humanitarian efforts have long been used as political tools in conflict-affected environments, and the occupied Palestinian territories are among the most representative settings where this has been the case.
Indeed, Palestinian hospitals in Jerusalem are underfunded and in urgent need of support. East Jerusalem has more advanced hospitals, specialized doctors, and updated equipment than any other hospitals in the occupied Palestinian territories. As a result, the city draws patients from the West Bank and Gaza Strip.
But in the larger existing context, this $100m aid, while much needed, will do little to improve Palestinian health.
‘Medical apartheid’
Jerusalem has historically been at the centre of the Palestinian healthcare system. But ongoing Israeli policies that followed the occupation of East Jerusalem in 1967 transformed the city into a colonial frontier, a heavily militarized locale with the declared aim of keeping a Jewish majority in an “undivided capital”.
Discriminatory policies have dismembered the city by limiting land and zoning, promoting de-development, and cutting its historical and natural ties with neighbouring Palestinian cities. The health care system is no exception.
Palestinian patients from the West Bank or Gaza Strip in need of the advanced services available in East Jerusalem cannot merely access the city of their own volition. They require medical permits issued by the Israeli government.
Medical staff that live in the occupied West Bank similarly need work permits to enter the city. These movement restrictions, among other restrictive policies, have greatly damaged the hospitals in the city and slowly marginalized them in the Palestinian healthcare landscape.
Regulations of the pharmaceutical trade with the West Bank have forced Jerusalem hospitals to buy drugs at prices similar to the Israeli market, while lacking the same governmental and financial support.
Further, hospitals in Jerusalem are regularly subjected to Israeli military violence and raids, the most recent example being when the Israeli army raided the French hospital during the funeral of Shireen Abu Akleh, a Palestinian journalist who, as multiple independent sources have found, was killed by Israeli fire.
The disparity in medical care, in particular, among Israelis and Palestinians was highlighted in human rights reports accusing Israel of practising apartheid. Recently, the lack of proper access to vaccinations among Palestinians during the Covid-19 pandemic led analysts to accuse Israel of practising “medical apartheid”.
The root causes
To genuinely improve Palestinian health, the US administration must recognize the root causes of Palestinian suffering: the ongoing Israeli occupation of the West Bank, which has lasted 55 years, and the nearly two-decade long siege of the Gaza Strip, including direct attacks on healthcare facilities and staff, and the restrictions on the movement of people, patients, and medical equipment.
Since the Oslo Accords of the mid-1990s, the response of the international community to this reality has not been to hold Israel accountable, but rather to justify waiting for a supposed two-state solution. Palestinians are treated as victims suffering from a natural disaster in need of temporary support.
It has become acceptable for governments to give financial, diplomatic and military support to Israel while providing intermittent funding to Palestinians to have better access to basic services like water, electricity and healthcare.
In many cases, these donors enable purchasing those services from Israel in a celebrated sign of peaceful cooperation: just one good-willed neighbour helping another.
Palestinians and their health have been reduced to a temporary humanitarian matter that relies on the good intentions of a fragmented donor community.
Biden’s promise of aid to Jerusalem hospitals – while Palestinians in the city are being killed in the streets and expelled from their houses, and Palestinians outside the city remain subject to discriminatory Israeli policies preventing their access to these hospitals – offers a perplexing view of what the international community increasingly recognizes as “peace”.
The social determinants of health – those conditions that create the environment in which people are born, grow, and age – play significant roles in how we live our lives. Merely providing medical aid overlooks this reality completely, and reduces “health” to the medical care that ill people receive.
Wanting to truly improve the health of Palestinians will necessitate tackling the large and oppressive structures under which all Palestinians live, not just the facilities where some of them can be treated.
Osama Tanous is a Palestinian paediatrician based in Haifa and a board member of Physicians for Human Rights – Israel; Currently he is a Hubert H. Humphrey fellow of public health and health policies at Emory University, Atlanta
Yara M. Asi is an Assistant Professor at the University of Central Florida in the School of Global Health Management and Informatics; She is a visiting scholar at the FXB center for health and human rights at Harvard
