The Association of Israeli and Palestinian Physicians for Human Rights was established during the first months of the uprising, against the background of a severe situation in which people were killed and wounded daily. AIPPHR works for the protection of human dignity and human life; defending physicians and patients in a state of political conflict out of loyalty to the principles of universal morality which constitute an inseparable part of the medical profession. This report, which is the result of months of research and investigation, is aimed, among other purposes, at bringing reliable information to the knowledge of the medical community in Israel and the Israeli Medical Association (IMA)--the body which organizes them. The silence of the medical community in the face of the phenomena described above is foreign to the spirit of doctors and medicine. The association's activity is aimed at creating a change in this situation out of the belief that the silence on the part of a large section of the medical community in Israel stems from a lack of regular and reliable information. In order to describe the situation of the medical services in the Gaza Strip, one must note two contrasting trends: on one hand, there is advancement in the population's health conditions, which is expressed by a decline in the infant mortality rate (from 86/1000 in 1970 to 28.1/1000 in 1988); a decline in the number of cases of whooping cough among children (30.1 in 1970 in contrast to 0 in 1988); and a decline in the number of cases of polio (14.3 in 1970 in contrast to 1 in 1980). On the other hand, the tendency of stagnation must be noted, especially in the development of independent local health services. Medicine in the Gaza Strip has been during the entire period of the occupation, and remains, completely dependent on Israeli medicine. Modern equipment and modern medical technology have been at the service of the residents of the Gaza Strip in Israeli hospitals, but they were not given the chance to develop high-standard medicine in their own hospitals. The Gaza Strip population has no representation at the decision-making level on issues of budget, development and distribution of resources--which are completely in the hands of the Civil Administration and the Israeli authorities. During the uprising there was a steep rise in medical needs. Residents in need of medical services are completely dependent on the decisions of the military government and the state leadership and the giving of these services is tied to political, not medical/professional policy. Since the beginning of the uprising in the Occupied Territories, a new tendency has appeared; the use of medicine as an additional means of repression against the population. This means that medicine has been removed from the status of a basic human right and recruited as a means of punishment. This is a phenomenon which no physician or person of conscience can accept.
PIP: The Association of Israeli and Palestinian Physicians for Human Rights (AIPPHR) is concerned about the use of medicine as a means of political repression in the Gaza Strip as well as a general lack of access to adequate medical care. These concerns emerged from a fact-finding mission to the Gaza Strip by AIPPHR representatives in 1989. There are 650,000 residents of the Gaza Strip (227,000 of whom are in refugee camps), and the population density of 1857/sq km. Most of the 500 physicians (a 1/1300 doctor-population ratio compared to 1/400 in Israel) are employed in government hospitals. These hospitals were found to lack the most basic equipment and conditions are filthy. Only 40% of the population can afford the cost (about US$320/family/year) of medical insurance, and the number of hospital beds in Israel set aside for Gaza Strip residents has been reduced--apparently for political reasons--from 2800/month in 1987 to 800 days/month. The United National Relief and Works Agency for Palestinian Refugees has been offering emergency medical services to refugee camp residents since the uprising, but authorities have undermined this work by delaying permits for ambulances and necessary equipment and detaining medical workers for interrogation. Between December 1987 and April 1989, there were 19,255 politically related injuries and deaths in the Gaza Strip. Many of those wounded in the uprising avoid going to hospitals due to the Army's Prominent presence, the fear of being detained in the course of medical treatment, and the Army's attacks on patients and staff. 4 physicians have been detained with no charges filed, and Gaza Strip physicians are frequently denied the right to leave the area to attend medical conferences. AIPPHR is appealing to Israel's medical community to ensure that policies in the Gaza Strip are based on medical needs rather than political factors.