Arab child’s sickbed is part of the battleground

ARON HELLER AND DALIA NAMMARI THE ASSOCIATED PRESS
Published: April 4, 2009

WADI FUQEEN, West Bank -- Asil Manasra, a 6-year-old Palestinian girl, was in her eighth month of intensive treatment at an Israeli hospital for complications arising from a long bout of tuberculosis when she was abruptly forced to stop the visits.

A week after she was discharged, she died.

It's impossible to know how much longer Asil might have lived, but her family is convinced she is the first victim of a Palestinian decision that has cut hundreds of people off from proper medical care and has led Israeli hospitals to turn away those in need.

It's another painful byproduct of a conflict that recently exploded into a month of open warfare, and has left both sides on the defensive against charges they have left the weakest and most desperate to pay the price.

"I blame everyone. Should children die because of political decisions?" asked Asil's father, Jamal Manasra. "How can you stop treatment? When a child is so sick that she is going to die, is there something more important than that?"

The family was forced to stop her treatments after the Palestinian government, angered by Israel's offensive against Gaza militants, decided in January to stop paying Israeli hospitals to treat Palestinian patients. With no coverage, Asil's parents could no longer afford to pay for her expensive tests, CT scans and medication.

For years, Palestinians and patients from the wider Arab world have regularly been referred to hospitals across Israel for diseases their own hospitals could not treat. Israel boasts an advanced medical system and promotes its treatment of Palestinians and employment of Arab doctors as a small beacon of coexistence amid the Israeli-Palestinian conflict.

Fathi Abu Moughli, the Palestinian minister of health, abruptly halted the arrangement after Israel's assault on Hamas militants in Gaza, which Palestinian officials say killed some 1,300 Palestinians and wounded thousands more.

Initially, Abu Moughli insisted the ruling was limited to those wounded in the war. He said more than 1,000 injured Gazans were transferred to Egypt, Saudi Arabia, Libya, Morocco and other Arab countries so that they would not have to be treated by the same country that harmed them.

But in an interview with The Associated Press, he acknowledged that the edict was far more comprehensive, aiming to cut costs, rid Palestinians of their need for Israeli medicine and deny the Jewish state a "propaganda" campaign that improves its world image while the cash-strapped Palestinian Authority foots the bill.

"We are trying to free our health system from dependence," he said.

But Palestinian patients and their Israeli doctors say the measure is too drastic and now puts hundreds at risk. Strokes have gone untreated. Cancer patients in need of chemotherapy, radiotherapy and bone marrow transplants have had their treatments interrupted.

The Sheba Medical Center, near Tel Aviv, reported a drop of about 60 percent in referrals of Palestinian patients since the war ended Jan. 18. Jerusalem's Hadassah Hospital said it received just a few dozen referrals in February, down from 1,600 a month on average last year.

Israeli hospitals have also come under criticism for refusing to accept the patients without the financial commitment of President Mahmoud Abbas' Western-backed government. Many patients simply stopped coming, either lacking permits to cross Israeli roadblocks or fearful that they will be turned away by hospitals.

Physicians for Human Rights-Israel, along with three other rights groups, has criticized both sides. It has called on the Palestinian government to restore coverage for Palestinians until an alternative is found, and urged Israel to provide health care regardless of Palestinians' financial means.

"The Palestinian Authority has the right to decide where it will refer its patients," said Ran Yaron, from Physicians for Human Rights. "But it bears responsibility for those already referred. . . . This political move cannot be on the backs of the patients."

AHadassah official said the hospital has treated some "special cases" at no cost but cannot afford to give sweeping free medical services. "You can't run a hospital if you treat everyone for free," said the official, speaking on condition of anonymity because he was not permitted to discuss the policy publicly.

Abu Moughli, the health minister, said costs of Israeli hospitals are three to four times higher than in the West Bank. He insisted the Palestinian health system has greatly improved and can treat more diseases than ever before. Those it cannot are now referred to Egypt, Jordan and elsewhere.

The Palestinian Authority, whose budget is largely filled by international donations, says it is saving $17 million by stopping the transfers to Israeli hospitals.

When the Palestinian government cut off her payments in February, Asil had to stop going to her treatments. She spent the last week of her life in a hospital in the West Bank town of Bethlehem, taking medication advised by a Hadassah doctor.

"If we wouldn't have left Hadassah she would have been under supervision," Manasra said. "There still would have been hope."