Protecting Right to Health in oPt through Advocacy Over the past seven years, WHO has worked with government and non government partners to improve documentation and reporting of health rights in Palestine and to advocate on access with the UN and with legal duty bearers, including Israel, the Palestinian Authority and the de facto authorities in Gaza. Movement restrictions directly impact on access to health and health outcomes for patients, and hinder health workers and emergency services. 

WHO has made every effort to mobilize funds to maintain this important work, but due to a funding shortfall after May 2017 there is risk of an abrupt halt to its health access reporting and advocacy activities. This comes at a time of high demand for advocacy due to the lowest levels of health access since 2009.

The policies of occupation expose Palestinians to violence and risk of death and injury at checkpoints, in demonstrations and in public spaces. Severe restrictions on the movement of goods and people into and out of Gaza, and the economic impact of limited access to Area C in the West Bank (which comprises over 60% of the West Bank), have had a detrimental effect on the broader social determinants of health, negatively affecting both physical and mental health. The violence and frustrations of occupation exacerbate the risk of gender based violence (GBV). . 

In Gaza there are 2 million Palestinians of whom 70% are refugees a quarter are adult women and half are children.  Since the tightening of movement restrictions in 2007, Gaza has  experienced a chronic shortage of drugs, with 30% of essential medicines unavailable in April 2017.  In the same month, 38% of needed medical disposables were not allowed to pass into Gaza and electricity supply remained limited to 8 hours per day for most.  Many patients must travel outside of Gaza for specialized health care, including cancer patients for radiotherapy and chemotherapy. In Gaza in 2016 four of every ten patients and half of their companions were not approved permits to exit Gaza in time for their hospital appointments. WHO collects and analyses data on referrals, which showed declining health access for patients needing to exit Gaza for medical investigations and treatment. In December 2016,  six in ten patients’ requests to travel  were not approved, the lowest level since 2009.  

In the West Bank, patients in 231 vulnerable communities in Area C, and communities in the Seam Zone and East Jerusalem peripheries are hindered from accessing essential primary healthcare services by the system of checkpoints, the separation barrier and a lack of finances and adequate transport infrastructure in remote areas. Access to referral health facilities (secondary or tertiary health care) in the West Bank, including in East Jerusalem, and for specialist care in Israel or elsewhere, depends on obtaining a permit for travelin advance. In 2016, one in five permit requests to travel to hospitals was rejected. Delays in medical care cause anxiety, poorer health outcomes and risk loss of life. 

In East Jerusalem, the project will carry out a study into the social determinants of health and the specific barriers to accessing healthcare for residents.

Direct beneficiaries of the project were estimated on the basis of numbers denied or delayed permits to access healthcare in 2016, and divided by two for the six month period. The figure is conservative, but accounts for the fact that a proportion of those receiving permits do not subsequently seek care.  Refugee estimates on the basis of an overall figure of 35% (Palestinian Return Centre). The project also supports patient rights groups. 

Additional staff on the project, including the project manager, are supported by the additional donors listed under 'other funding'.

The project aims to promote the right to health for Palestinians through continued documenting of barriers to health care and ongoing advocacy efforts with partners