JERUSALEM, July 8 (JMCC) - Lights flashing, sirens blaring, the ambulance sped away from Jenin. Abu Rami thought he had permission to take his sick mother through the Israeli military checkpoint to the nearest hospital.

But the soldiers searched the ambulance and turned it away. Distraught, Abu Rami was finally allowed to take her in his own car. It was too late, however. Abu Rami’s mother died in full view of the checkpoint sniper tower. As he turned around, the soldiers searched his car again, his dead mother in the back seat.

This is an extreme case. But a new joint report by the United Nation’s Office for the Coordination of Humanitarian Affairs (OCHA) and the World Health Organization (WHO) has found that the Wall that snakes through the West Bank is having a grave impact on the health of Palestinians. The hundreds of kilometers of walls, fencing, barbed wire and military checkpoints, combined with a strict permit regime in place since 1993, continue to hinder medical access.

QUEST FOR PERMITS

East Jerusalem is home to six hospitals providing specialized care to Palestinians in the occupied Palestinian territories. Everything from neurosurgery, open heart surgery and dialysis to rehabilitation for handicapped children is provided mainly by these hospitals.

In 2009, over 19,000 people from the West Bank visited East Jerusalem hospitals for treatment. They are, for many, a vital lifeline.

However, for Palestinians without a Jerusalem ID card, gaining access is a complex procedure. To go, a family needs a referral from their West Bank doctor.  They take the referral to the Palestinian ministry of health to get permission. After arranging the hospital appointment, the hospital sends a request to Israeli military authorities to issue a permit for the length of the appointment.

These permits are not always granted. “The Israeli Civil Administration is cooperative and willing but often have orders ‘from above’ that make it difficult,” says William Hadweh, who processes the permit applications from the Augusta Victoria hospital.

“It is a daily struggle,” says Hadweh. “Approximately 20 percent of the permits are rejected in the first application. Eventually, some of these might be granted but it delays their treatment.”

SECURITY NEEDS?

Israel says these procedures are necessary. Often, males between the ages of 15 and 30 have their applications for permits rejected on the grounds of security. Difficulties also arise for the parents of sick children, or family members wishing to escort patients to Jerusalem.

Further, these permits are invalidated on days of “closures.” The new report finds that the occupied Palestinian territories were “closed” for 50 days between April 2009 and March 2010 due to holidays and security alerts.

CROSSING THE WALL

Permission granted, the journey itself is long. Only three of the Wall’s 14 checkpoints are allowed for the use of West Bankers with permits: Qalandiya, Gilo and Zeitoun. Once there, passage is never guaranteed.

“With these papers [permits] they go to the checkpoint, where often they have to have fingerprint checks. Sometimes these do not work and they are turned back,” says Tony Laurance, head of WHO in the West Bank and Gaza Strip.

Vehicles with Palestinian license plates cannot cross into East Jerusalem, and Palestinians with permits must walk through the checkpoints, despite being in poor health.

“Mothers bringing their disabled children to us receive no help,” says Maher Yasmine of Princess Basma hospital. “She has to go through all the hassles. It is hard.”

MEDICAL EMERGENCIES

Permits can be obtained quickly in emergency cases, but delays continue to plague the system. In 2009, cites the report, two-thirds of  440 delays and denials of ambulance passage reported by the Palestinian Red Crescent occurred at checkpoints into Jerusalem.

“If treatment is delayed it can have fatal consequences,” notes Laurance.

“From a medical point of view,” says Hadweh, “urgent is less than half an hour. In this complicated situation, this is impossible to achieve. Often they have to wait and wait.”

Nor are Palestinian ambulances allowed to traverse the checkpoints. Critically-ill patients are removed from the vehicle on one side and loaded on to another vehicle on the other side of the checkpoint.

“This is the sort of process we are requiring people to go through on a daily basis,” says Laurance. “I don’t think it is beyond the ability of the authorities to come up with solutions to these problems.”

Among the report’s recommendations are that hospital staff be allowed to use all Wall checkpoints instead of only three, and that all Palestinians from the West Bank and Gaza Strip be allowed access Jerusalem’s specialized hospitals.