Since the 1967 war, the Palestinian population in the occupied territory has been living under military rule, a situation that has been extremely detrimental to the lives of the inhabitants. The exception to this is the population of East Jerusalem, since this part has been annexed by Israel in breach of international law.
In accordance with the dictates of international law, Israel has assumed the responsibility for the occupied territory’s inhabitants and accordingly for providing medical services to the population living in the occupied area. From the outset the provision of medical care was viewed as a limited obligation and Israel maintained two health care systems: one for its citizens within the 1949 Armistice line and to its settlers living beyond the 1949 Armistice line, and another separate health care system for Palestinian people living in the occupied territory.
The differences between the two medical care systems, as well as a lack in an overall plan to develop a health care infrastructure in the occupied Palestinian territory – both a physical and medical personnel infrastructure – has created an unbalanced Palestinian health care system that is dependent on Israel’s medical services. This is the health care system that was transferred to the Palestinians under the Oslo Accords in 1994.
The Oslo Accords also declared that the Gaza Strip and the West Bank would be one territorial unit and that freedom of mobility would be maintained under restrictive conditions determined by Israel. In reality, however, Israel’s control of the Gaza Strip’s land and sea borders were a determinant factor in the isolation of the Strip from the outside world. Since the end of 2002, the Gaza Strip has been closed off to the entry of any medical supplies and the exit of patients and medical personnel has been prohibited, unless granted Israel’s special authorization. During this period, and in light of the Israeli closure on Gaza since June 2007, there has been an ongoing decline in Israel’s permit granting policy to patients requiring medical treatment outside of the Gaza Strip.
It is important to note that these territories have remained under Israel’s effective control, even after the transfer of powers to the Palestinian authority, and since November 2001 these territories have been under Israel’s direct and comprehensive control. Therefore the territories still remain occupied land in which Israel has an unequivocal obligation to provide medical care. Israel’s renunciation of this obligation is a breach of international law. In addition to its renunciation, Israel has also placed obstacles on the Palestinian medical system. The main obstacle is the total restriction of mobility inside the occupied areas themselves, between the West Bank and the Gaza Strip, and from the occupied territory to other countries. In light of the siege policy, entire areas have been isolated from city centers that have traditionally provided them with medical services. As such, the ability to receive medical care is greatly hindered - in secondary medical care, tertiary medical care, and emergency medical care.