The Myth of Israel’s ‘Medical Apartheid’

Along with the general attack on Israel as an “apartheid state,” a more specific attack is made on Israel’s supposed practice of “medical apartheid,” where it is claimed that Israeli Arabs and Palestinians deliberately receive substandard care, relative to what Israeli Jews receive. There is no truth to this canard, as is made clear here: “Dissecting the ‘Medical Apartheid’ Myth,” by Akiva Van Koningsveld, Honest Reporting, May 3, 2023:

The “Israel Apartheid” campaign isn’t confined only to mainstream media outlets. It also infects the discourse in medical publications.

In an article published by Global Public Health, a peer-reviewed medical journal specializing in public health policy, Drexel University epidemiologists Yazid Barhoush and Joseph Amon (formerly of Human Rights Watch) falsely claim Israel upholds a “system of medical apartheid” in the West Bank and Gaza Strip that “directly disfavour[s] Arab non-Jewish citizens [sic].”

HonestReporting has repeatedly outlined how the institutionalized racism and segregation that is the very definition of apartheid is absent from Israel’s relations with the Palestinians. Israeli citizens and permanent residents are all afforded the same access to healthcare, regardless of religion, ethnicity or national origin. Meanwhile, since the signing of the Oslo Accords in the 1990s, the vast majority of Palestinians have been governed by either the notoriously corrupt Palestinian Authority (PA) in the West Bank or Hamas, a US-designated terror group, in Gaza.

This must be kept firmly in mind: since the 1994 Oslo Accords, responsibility for the healthcare of the Palestinians rests with the Palestinian Authority in the West Bank and with Hamas in Gaza. It is no longer Israel’s responsibility; nonetheless, Israel continues to help the Palestinian medical personnel, including training them, whenever it can.

Of all the malicious accusations hurled against Israel, the vile charge of “medical apartheid,” reminiscent of ancient blood libels against the Jewish people, is perhaps the easiest to disprove with hard facts and data.

In the five decades following the Jewish state’s victory in the 1967 Six-Day War, which put an end to Jordanian and Egyptian control over the West Bank (including eastern Jerusalem) and Gaza respectively, Palestinians have become healthier than ever, with life expectancy having jumped from 48 to 73.80 years. During that same period [from 1967 to 1994] the estimated infant mortality rate dropped from 150 to 17 per 1,000 live births, and since Jerusalem in the 1970s rolled out an immunization campaign in Arab communities, the prevalence of dangerous childhood diseases like polio has declined significantly.

Think about that: the increase in Palestinian life expectancy from 48 to 74 years, a 60% rise, just between 1967 and 1994. It is doubtful that any other place on the globe has had such a precipitous increase in life expectancy in so short a time, 27 years. And even more impressive is the decline in Palestinian infant mortality from 150 to 17 per 1,000 births, roughly a 90% decrease, during the same period. Is there anywhere in the world where such staggering improvements in health outcomes have been equalled? Yet we are expected to believe that Israel has all along been providing substandard care to the Palestinians. Those who make this charge are assuming that few will bother to actually consult the health data. Let’s hope they are proved wrong.

While there is still progress to be made, the West Bank and Gaza Strip outperform many countries in the region with regard to the United Nations’ health goals. For example, the Palestinian cancer incidence and mortality rates are comparable or even lower than in some Western nations, including Israel. And while correlation does not equal causation, the Jewish state, at least in part, can be credited for some of the initiatives that greatly helped improve the Palestinian health system over the years.

Those initiatives include Israeli doctors training Palestinian health professionals, including nurses and paramedics. And of course, Palestinians have for decades had the opportunity to study in Israel’s first-class medical schools, which are comparable to the best in North America and Western Europe, and far superior to any others in the Middle East.

As Dr. David Stone, emeritus professor of pediatric epidemiology at the University of Glasgow, confirmed in a 2014 paper: “Israel has not damaged Palestinian health. In fact, the opposite is the case. Israeli policies were carefully formulated to improve health conditions in WB/G [West Bank and Gaza] as rapidly as possible. These policies were carried through to implementation on the ground and brought about measurable improvements in Palestinian health and welfare.”

A 60% rise in life expectancy and a 90% decrease in infant mortality among the Palestinians between 1967 and 1994 are the two most telling and astonishing bits of data. But there are others, too, such as the very high percentage of Palestinian children who are now routinely vaccinated against a whole host of diseases; this is due to the Israeli campaign to persuade Palestinians, many of whom had been distrustful of vaccinations, that the vaccines being urged for their children are both safe and efficacious.

In “Medical apartheid in Palestine,” Barhoush and Amon claim to have identified three alleged Israeli practices that they argue amount to “medical apartheid” (a term that, crucially, has no formal definition in international human rights law). These purported policies include “systematic[ally]” depriving the Palestinian health system of funding, “frequent attacks” on healthcare infrastructure, as well as requiring Palestinians from the West Bank and Gaza to obtain permits to seek treatment in Israel or abroad.

Firstly, the claim that Israel deprives Palestinian health facilities of funding is highly misleading, to say the least. As pointed out by Dr. David Stone, Israel between 1967 and 1994 invested in an “outstanding” child immunization program, developed hospitals, and provided physicians and nurses with “high quality” training. Then, on August 29, 1994, Israel and the Palestine Liberation Organization signed the Agreement on Preparatory Transfer of Powers and Responsibilities, officially transferring responsibility in the health sphere to the newly created Palestinian Authority. Hence, the PA has been in charge for 29 years, whereas Israel’s military government only managed the health system for 27 years (1967-1994).

During the years (1967-1994) when Israel was responsible for the Palestinians’ health care, Israel poured money into transforming their health outcomes. Israel pursued a universal child immunization program, making up for the decades of neglect when Palestinians in Gaza were ruled by an indifferent Egypt and Palestinians in the West Bank by an only slightly less indifferent Jordan. Israel built new, and improved existing, hospitals in the main Palestinian cities in the West Bank. Unfortunately, since 1994, when the PA took over responsibility for the Palestinians’ health care, those hospitals have suffered from a lack of funds. The hospitals in Jericho, Nablus, Beit Jala, and Ramallah all need immediate, major rehabilitation. But the fault belongs to the PA, which has put health far down its list of priorities. Whenever the PA leaders or their family members get sick, they insist on being treated by Jewish doctors, in Israeli hospitals. For example, Mahmoud Abbas, his wife, his brother, and. his brother-in-law have all been treated by Israeli doctors. The doctor who treated Abbas for his heart condition made house calls — most discretely — on his residence in Ramallah.

Aside from the hundreds of millions of dollars that have been siphoned off by Abbas, his sons, and his loyalists in the West Bank, and the five billion dollars stolen from aid money by just two Hamas leaders – Khaled Meshaal and Mousa ibn Marzouk — in Gaza, there is another reason for the spending on health care to have fallen so precipitously after the Palestinians took over that job from the Israelis in 1994. That, of course, is the “Pay-For-Slay” program, on which the PA spends about $350 million USD a year, In addition, Israel withholds precisely that sum from the tax money it collects for the PA, but will no longer transfer in order to discourage “Pay-For-Slay.” This means that adding the money spent directly on “Pay-For-Slay,” and the same sum withheld by Israel, the true cost of “Pay-For-Slay” to the PA amounts to $700 million a year, money that could do a great deal to improve the PA’s health care system.

According to research by Palestinian Media Watch (PMW), however, Ramallah has since prioritized “pay-for-slay” payments to terrorists and their families over improving Palestinian health services. Last year, PMW revealed that the PA spends 33.34 times more per capita paying terror rewards than it spends on health services for the civilian population. As a matter of fact: some terrorists in Israeli jail “earn” more than doctors, and even amid a global pandemic, the PA refused to reallocate terror funds so it could buy coronavirus tests and ventilators.

These figures should infuriate Palestinians, who have felt keenly the decline in their health care ever since the responsibility for it was transferred from Israel to the PA. Only these facts need be remembered: first, the PA “spends 33.34 times more per capita” on paying rewards to imprisoned terrorists than it does on health service for Palestinian civilians; second, these terrorists receive more money in their monthly stipends than Palestinian doctors do; third, the PA refused to cut back on funds for “Pay-For-Slay” during the Covid-19 crisis so that it might buy coronavirus tests and ventilators, thereby condemning thousands of Palestinians to unnecessary sickness and death.

The Palestinians [at least] did acquire millions of COVID-19 vaccines — some of them supplied by Israel — and became among the first in the region to start administering booster shots in August 2021. Yet, in their apparent quest to promote a “blame Israel first” narrative, Barhoush and Amon nevertheless accuse the Jewish state of “vaccine apartheid,” despite there being no clear legal obligation for Jerusalem to inoculate Palestinians who are subjects of the Palestinian Authority government.

After the 1994 Oslo Accords, full responsibility for the health care of the Palestinians was transferred from Israel to the PA. Since then, Israel has had no responsibility for Palestinian health. Despite this, Israel has in fact provided tens of thousands of doses of COVID-19 vaccines to the PA. It also offered 1.4 million doses of the vaccine to the PA, which rejected the offer, claiming that the vaccines were soon approaching their expiration date. Israel replied that the doses were exactly the same as those being given to its own citizens, and were still effective. The PA remained unconvinced.

The accusation that the Israel Defense Forces target Palestinian medics is a particularly grave one. After all, the law of armed conflict grants medical personnel and facilities special protection against military attacks, and the IDF’s Code of Ethics explicitly forbids troops from “employ[ing] weaponry and power in order to harm non-combatants.”

But the Palestinians don’t play by the same rulebook. Barhoush and Amon omit altogether that Hamas, Islamic Jihad, and other terrorist organizations stand accused of violating international humanitarian law by using ambulances and medical facilities to attack Israelis. The International Committee of the Red Cross, which monitors compliance with the Geneva Conventions, stresses that medical units and transports lose their protected status under international law if they commit, “outside their humanitarian function,” acts that are harmful to the enemy.

In other words, if a medical facility stops being used as a medical facility, then it loses the special protection it would otherwise deserve. When a hospital has been taken over by Palestinian gunmen, who use it as a base from which to launch rockets at Israel, or a Red Crescent ambulance is ferrying gunmen to or from the scenes of battles, both the hospital and the ambulance lose their protected status because they are no longer exercising their humanitarian function, but are furthering the Palestinians in their war-making.

For instance, on October 14, 2022, armed terror operatives sought cover behind a Palestinian Red Crescent ambulance as they fired at Israeli servicemen during a terrorism counter-raid in Jenin. After the exchange of fire was over, the PA Ministry of Health announced that a local doctor had been killed in the fighting. However, soon after this official announcement, the Al-Aqsa Martyrs’ Brigades, an internationally recognized terror group loosely affiliated with the ruling Fatah party, declared that the doctor was a member of the organization and had “died in an armed clash.”

The ambulance was being used to provide cover for Palestinian gunmen; there were no patients inside; thus, it was no longer a “humanitarian” vehicle transporting the wounded to hospitals. The doctor who was killed was not engaged in treating the wounded; he turned out to be a member of the Al-Aqsa Martyrs’ Brigade, a terrorist group, and was engaged in combat when he was killed. The terror group admitted this when it noted that the doctor had “died in an armed clash,” not “while treating the wounded.”

Finally, Barhoush and Amon assert that the travel permit system, which requires West Bank and Gaza Palestinians to apply for permission before seeking treatment at facilities in pre-1967 Israel and other countries, “deprive[s] Palestinians of the full realisation of their right to health.” This reasoning likewise fails, as Israel is simply under no obligation to treat PA residents.

Israel is no more obligated to medically treat the Palestinians ruled by the PA than it is obligated to treat Mexicans, or Chinese, or Swedes. Nonetheless, Israel has treated many Palestinians — often for free — and Arabs from a dozen countries, who have come hoping to be healed by Israel’s first-rate doctors, in its first-rate hospitals. But Jerusalem requires that these patients first apply for, and receive, a permit for such treatment. That is no different from what some other countries demand when their medical care is being sought by foreigners: those foreigners need first to apply and obtain permission for such treatment.

Still, despite ongoing attempts to exploit Israel’s humanitarian policies, some 100,000 Palestinians receive clearance to enter the country for treatment every year. Ten years ago, the Palestinian Authority’s official newspaper quoted its then minister of health as saying that 30 percent of the child patients in Israel’s Hadassah Medical Center are Palestinian, and that the Jerusalem hospital is training “60 Palestinian medical interns and specialist physicians who will be returning to the [Palestinian] Authority areas to carry out their work.”

Indeed, in Israeli hospitals, Israeli Jews and Palestinian Arabs are treated equally by both Jewish and Arab medical staff, based solely on medical and not political concerns, putting all accusations of apartheid to bed once and for all….

The biggest obstacle to Palestinians receiving better medical treatment is the PA itself, which instead of investing more in the training of doctors, nurses, and other medical personnel, or in improving rundown hospital facilities, or in buying more advanced medical equipment, chooses instead to spend hundreds of millions of dollars on the “Pay-For-Slay” program that rewards past, and incentivizes future, terrorism. Meanwhile, when Israel was responsible for the Palestinians’ healthcare between 1967 and 1994, infant mortality sank from 150 to 17 per 100,000, and life expectancy rose from 48 to 74 years. Both are spectacular achievements. And pediatric immunization campaigns carried out by Israeli medical authorities were a great success in changing the minds of a formerly ignorant and distrustful population.

Now, can we please have no more of that idiotic talk about Israel’s “medical apartheid”?