July 18, 2017
IFHHRO member Physicians for Human Rights – Israel (PHRI) recently published a short report on the right to health in the Occupied Palestinian Territories and in the Israelian prison system. The report will serve as PHRI’s submission to the United Nations Universal Periodic Review system.
According to PHRI, the report illuminates Israel’s failure to protect the right to health, under international human rights law and international humanitarian law, to all persons under its responsibility. The four key ways in which the right to health has been impacted are:
- Denials of medical exit permits to Palestinians in the Occupied Territories
- Prolonged use of solitary confinement
- Attacks on Palestinian medical teams
- The mistreatment of Palestinian hunger strikers and the enactment of Israel’s force-feeding legislation.
The purpose of this report is to draw attention to and provide recommendations regarding the right to health for people in the Occupied Palestinian Territory and prisoners/detainees.
1. Inhibited access to healthcare through denial of medical exit permits
One of the most critical human rights issues facing Palestinians in the Occupied Palestinian Territory (OPT) is the restrictions placed on freedom of movement and the denial of the right to health that ensues. When the healthcare needs of Palestinian patients extend beyond that which local institutions can provide, Palestinians cannot transfer to an external medical institution without receiving a medical referral and a financial coverage from the Palestinian Ministry of Health. Palestinian patients then have to receive a timely permit to enter or cross Israel. The majority of those seeking PHRI intervention come from Gaza.
PHRI provides assistance to Palestinians seeking these permits and transfers whose requests are either delayed or denied outright. It also collects data documenting trends regarding these requests for assistance. “PHRI observations from recent years reflect troubling trends regarding the denial of exit permits to receive medical care in hospitals with necessary treatment and expertise available.” In 2013, 88.7% of requests to travel outside the Gaza Strip due to medical needs were approved, however in 2016, the approval rate dropped to 62%.
2. Prolonged solitary confinement of prisoners and detainees, including those with mental illness and minors.
Solitary confinement is a form of incarceration that is seriously detrimental to prisoners’ short and long-term mental and physical health. It involves the distancing of one or two prisoners from the other inmates, for 22 or more hours a day, indefinitely at times, cutting him off from virtually any meaningful human contact and social interaction. It is a cruel practice that runs fundamentally counter to any attempt to rehabilitate and treat prisoners.
In recent years, the use of solitary confinement by the Israel Prison Service (IPS) has nearly doubled. In 2012, 390 placements in solitary confinement were recorded. That number jumped to 570 in 2013 and 755 in 2014. Solitary confinement exacerbates existing mental/physical illness and may cause irreversible damage. Nonetheless, the IPS isolates prisoners with mental health issues as a way of dealing with their mental condition or as punishment for behavior they cannot control. “The IPS is responsible for ensuring conditions that do not harm a prisoner’s health or dignity.”
3. Attacks on Palestinian medical teams
Since October 2015, there has been a rise in attacks against Palestinian medical teams by Israeli security forces. These attacks have largely remained uninvestigated by the authorities. The Palestinian Red Crescent Society has documented 421 attacks against team members alone between October 3, 2015 and February 28, 2017. Over 160 staff and volunteers were injured and 108 ambulances sustained various types of damage. PHRI has investigated complaints concerning 31 incidents where Israeli security forces harmed or hindered medical teams while carrying out their activities. Incidents include: use of bullets and tear gas on ambulances, removal of injured people from within ambulances, and interference with the work of emergency teams that resulted in grave consequences for patients.
“The barriers placed on medical teams by security forces and the pattern of denial and delay of medical treatment to Palestinians suspected of carrying out attacks or taking part in protests are in contravention to international law and human rights standards, including the Geneva Convention provisions, UN Resolutions, and standards by the World Health Organization. According to these standards, the wounded and sick must be cared for and the operations of the relief societies must be facilitated.”
4. Israel’s policies and practices towards hunger-striking Palestinians
The IPS attempts to forcefully subdue hunger strikers and silence their protest through a number measures, including but not limited to: (1) shackling during hospitalization and (2) denying entry of independent physicians. With regards to the second topic, the IPS usually denies the requests of hunger-striking Palestinians for an independent physician visit, which is in contradiction of one of its own directives. “Such physician visits are necessary, in part, due to the structure of healthcare services in Israeli prisons. Decisions about patient health are made by medical personnel from the IPS, which is subordinate to the security system and thus subject to political and security considerations. A problem of dual loyalty exists, whereby IPS doctors, being directly employed by the prison services, are often in a state of conflict between the interests of their employers and their professional and ethical obligations toward their patients.”
Finally, the Force Feeding bill, which was passed in July 2015 by the Knesset, authorizes a district court to permit the administration of forced medical treatment—including force feeding—to a hunger-striking prisoner. This places hunger strikers at risk of cruel, inhuman or degrading treatment.