JERUSALEM, February 2 (JMCC) - Palestinians seeking treatment at Jerusalem’s six hospitals face unpredictable checkpoint rules that can cause delays or prevent care altogether.

Now, hospital administrators say, a comprehensive protocol is being drafted in order to ensure that Palestinian doctors, hospital staff and patients traveling from the West Bank have unimpeded access to East Jerusalem hospitals.

[The Israeli position is] changing so much. We have documented that they have changed so much. Over the last five or six years, we've been on this rollercoaster relationship with them, said Tawfiq Nasser, chief executive officer of Augusta Victoria Hospital and coordinator of the East Jerusalem Hospital Network.

We hope that we will be able to make a protocol at least for the patients, at this point. There needs to be dignified and easy access of staff and patients [to East Jerusalem], he said.

In early January, hospital patients and staff traveling to East Jerusalem from the southern West Bank area were surprised to find that the Israeli authorities were forcing them to cross through the Rachel Tomb checkpoint on foot.

Since September 2004, a hospital bus system has been in place, whereby an official bus companion accompanies patients and staff on a designated bus through the checkpoints. As of January, the Israelis were no longer issuing the accompanying card.

What this meant is that nobody can be in cars, neither hospital staff nor the patients. The only ones that can come in riding a car are the doctors. We raised a very big advocacy campaign against that, [and the decision] was overturned. So we are back to the old arrangement but they have not issued new cards, Nasser explained.

He said that of the dozen or so requests made to get new accompanying cards, only one or two have been accepted to date, forcing the accompaniers to use expired cards right now.

If you send ten names, they come back with one that has the card. Why? The other nine, when they were two years old, they stole a biscuit in their aunt's house, said Nasser, laughingly, alluding to the fact that most often, the Israelis reject the requests because they say the applicants have criminal records or are a security threat.

COMPROMISING HEALTH

There are six hospitals in East Jerusalem: St. Joseph, St. John, Augusta Victoria, Red Crescent Society, al-Makasset and the Princess Basma Centre. These facilities offer specialized services that are otherwise unavailable in the West Bank or Gaza Strip, including dialysis, oncology, and open-heart surgery, among others.

The Israeli government instated a permit system for Palestinians without Jerusalem identification cards or Israeli citizenship to access East Jerusalem in the early 1990s. Israel’s construction of the Wall – a series of walls, fences and checkpoints running through the West Bank - has only complicated this already timely and costly process.

Still, according to a July 2010 report released by the United Nations Office for the Coordination of Humanitarian Affairs and the World Health Organization, in 2009, over 19,000 patients from the West Bank attended East Jerusalem hospitals for treatment, an average of 365 patients per week.

But vehicles with Palestinian license plates are not allowed through the checkpoints, forcing patients to spend hours waiting to cross on foot, which can be extremely difficult for those with serious illnesses, disabilities or trouble walking.

The report also found that there have been cases where wheelchairs and crutches cause problems for patients waiting in line, crossing revolving gates, or passing through metal detectors at the checkpoints.

Emergency medical services have been impeded, the report outlined, as the Palestine Red Crescent Society recorded 440 delays and denials of ambulances throughout the West Bank in 2009. Two-thirds of these occurred at checkpoints used to access Jerusalem.

Patients can be compromised even up to a life-threatening point when they can't access the hospital, explained Nasser. If a patient needs this surgery, maybe they can be delayed one or two days, but they can't be delayed ten.

Nasser added that he hopes to provide patients whose conditions necessitate regular hospital visits with a special chronic patient stamp on their permits to allow them to remain on the bus or in a car when passing through the checkpoint.

There are chronic patients that need daily chemotherapy or radiotherapy. We really are asking also to have any arrangement be dignified. If you have a patient that is having chemotherapy, vomiting, and then has to line up behind thousands at the checkpoint, you are compromising health, he said.

Ultimately, Nasser said that while the bus accompaniment program helps ensure that patients can get through the checkpoints, it isn't the ideal solution.

What we ask for, I have to be clear, is free access for Palestinian patients into Jerusalem. Having failed in doing that, we have already made the compromise by creating this system, he said.

We, the Palestinians, have to accommodate because we have to survive, but the international community has to deal with the serious issue of ending occupation because ending occupation ends all of this. East Jerusalem has always been a big hub of medical services for the Palestinians and we're not about to give it up now.