In 2005 a Memorandum of Understanding (MoU) was signed between Israel's emergency evacuation service, Magen David Adom (MDA), and the Palestine Red Crescent Society (PRCS),paving the way for their joining the International Federation of the Red Cross. The MoU included recognition of PRCS responsibility for medical evacuation within the occupied Palestinian territory, including East Jerusalem, and provisions for enabling access of its ambulances to Jerusalem. Today, five years after the signing of the MoU, PHR-Israel has reexamined the situation regarding emergency evacuation of patients and the operation of PRCS' ambulances in Jerusalem, as well as important aspects of the agreement’s implementation.

In 2007 Physicians for Human Rights-Israel (PHR-Israel) held an initial review of the access of Palestinian ambulances (including PRCS') to Jerusalem, and of the context and implementation of the MoU. The review's conclusion was that the MoU's provisions regarding freedom of movement of Palestinian ambulances were not being respected in most cases, and that serious delays were being caused by an Israeli demand that patients from the West Bank be transferred from a Palestinian to an Israeli ambulance before being granted access to Jerusalem.

Today, five years after the signing of the MoU, PHR-Israel has reexamined the situation regarding emergency evacuation of patients and the operation of PRCS' ambulances in Jerusalem, as well as important aspects of the agreement’s implementation. This examination indicates that:

 

* Provisions designed to enable PRCS ambulances' swift entry to Jerusalem – namely the authorized ambulances – collapsed completely, and in practice almost all the patients from the West Bank are transferred to Jerusalem by the “back-to-back” method [from a Palestinian ambulance to an Israeli ambulance] at checkpoints around the city, causing delays in evacuation..

* New directives reported by MDA, according to which non-medical personnel at checkpoints may not refuse passage to ambulances, are not implemented at all.

* Five PRCS ambulances operate successfully within Jerusalem, but confront significant difficulties in transporting patients from neighborhoods outside the Separation Wall into Jerusalem's medical centers.

* MDA’s undertaking not to operate in the settlements is not fully adhered to, and endangers the achievements resulting from the agreement.