On July 7, 2009 Physicians for Human Rights and the Regional Council of Unrecognized Villages published a report “The Bare Minimum- Health Services in the Unrecognized Villages in the Negev”.  The report establishes a comparison between primarily health clinics in the unrecognized villages and those at 5 primarily health clinics in peripheral Jewish settlements in the Negev that are similar in geography and demography to the Bedouin villages.  34 unrecognized villages have no medical services whatsoever, including, for example, the village of Al-Fura’a with its 3885 residents.

The report examines four characteristics: service availability, accessibility, compatibility and quality.   The report reveals that health funds and the state have adopted a policy of discrimination in the existing 12 clinics and 8 mother and child health centers in the unrecognized villages in the Negev, and determines that in each of the above characteristics there is a big gap between services offered in the unrecognized villages compared with what is offered in nearby Jewish settlements.  In clinics operated by health organizations in the unrecognized villages there are less doctor-office hours, less labs and less lab-office hours, (one hour vs. three hours per 1000 residents), there are no specialists other than family physicians, there are no pediatricians, gynecologists, pharmacologists or even one pharmacy in any of the villages.  As for compatibility, there is a significant problem due to lack of infrastructure – lack of roads and public transportation and the fact that the majority of clinics are far from most of the villages while most of the residents don’t own a car.

When it comes to nursing services, the gap is very significant:  Ten nurses work in the unrecognized villages amounting to one per 3751 residents while the ratio in nearby Jewish settlements that we checked is 657.  The report reveals that in the unrecognized villages in the Negev there is one doctor per 3116 residents compared to a ratio of one doctor per 892 residents in nearby Jewish villages.  A particularly bad example is the village Tla’Rashid where the ratio is one doctor per 5110 residents.  In addition, more than 50% of the medical staff does not speak Arabic and as a result, there is a language barrier between the medical staff and the patients, particularly when it concerns women and children.  Further, some of the written information and brochures are published only in Hebrew.

The majority of the clinics in the unrecognized villages are in caravans which are located, due to conditions imposed by planning authorities, at the edge of the village, a fact that makes it hard for women and children to visit the clinics.  The clinics are not connected to the national electricity grid and as a result, it is impossible to refrigerate drugs beyond office hours.  Bedouins cannot obtain treatment in nearby Jewish villages.  In some locations such as Beer-Sheva, Yeroham and Dimona there are clinics for “minorities only” which are designed to service the population of the unrecognized villages.  

Problematic office hours:  Even during office hours, Arab-Bedouins are discriminated.  On average a physician has 13 weekly office hours per 1000 residents in the villages and 21 office hours in Jewish settlements.

According to Clalit Health fund the clinics are open five days a week, 8 hours a day.  However, one clinic physician testified that Clalit does not send a replacement physician when a physician is absent due to a disease or a vacation and thus, the clinic remains without a physician for one week or even longer.   Due to the need to rely on organized bussing and lack alternative public transportation to the villages, the medical staff arrives late to the clinics and leaves early.  There is no evening response service in the clinics except, once a week, at Leumit clinic at Al-Sayyid.

Beside the eight mother and child health centers which located near the primarily health clinics, there is a mobile unit.  The truck does not have the means to check the height of a baby or to take urine samples. The mother and child health centers suffers from a severe staff shortage and reduced operating hours and thus, most of the health centers are only open to the public once a week compared to twice a week in the past.  As a result, many women end up not getting necessary medical tests or encounter long lines that force them to return home without getting treated.

The discriminating policy and the lack of recognition by the state prevent the construction of additional clinics in the unrecognized villages and contribute to a failure to close existing gaps.  Lack of extra investment in the villages where health statistics are among the worst in Israel, contributes instead to a gap increase.  In addition, health organizations do not provide equal services in terms of availability, accessibility, compatibility and quality.

The report generated considerable media attention.

For further information, please contact Wasim Abas at
wasim@phr.org.il