Life under occupation: the health and well-being of Palestinians

This is article no. 1 in a series about global health injustices. Next article: Civil war in Sudan (coming soon).

Introduction

Welcome to the Global Health Injustices Series, which will focus on critically examining the health inequalities and inequities faced by vulnerable populations within different countries and regions worldwide and even put forward actionable steps to improve their health and wellbeing. This series will begin with Palestine, as it has been an enduring crisis that should be addressed to include long-lasting benefits and outcomes for the Palestinians.  

Palestine: from a rich history to current occupation

Palestine is a country in the Middle East (West Asia) mainly bordered by Israel. Palestine is unique in its various cultures and knowledge, moulded by multifaceted events and geopolitical shifts over centuries. The multidimensional cultural landscape of Palestine illustrates the impact of civilisations, such as the Romans, Byzantines, and Ottomans, who each had their religions, languages, and cultures, which still exist in various forms today. The resilience of the Palestinians is evident through their distinct traditions, art, food and environment, which are essential to their identity. 

With these testaments in mind, Palestinians are facing consistent strife because they are under constant occupation, blockade and cutting off of needed supplies carried out by Israel, as noted by several humanitarian and human rights non-governmental organisations (NGOs) like Amnesty International and Save the Children. 

These actions are facilitated by nations, notably the United States and the United Kingdom, through arms and weapons trade. Hence, the struggle for the Palestinians to have autonomy and freedom, among other human rights within their own homeland, is a consistent fight that requires ongoing international cooperation and solidarity. 

Geopolitics: its detrimental impacts on the Palestinians

Given the currently divisive geopolitical landscape, it is essential to bring attention to the health outcomes of the Palestinian population, especially since at least half of them are children. A report from the Global Nutrition Cluster called “Nutrition Vulnerability and Situation Analysis / Gaza” had several key findings and tables (see Tables 1 and 2). Firstly, more than 90% of children less than a year old, along with pregnant and breastfeeding women, encounter high under-nutrition due to poverty. 

Another finding was that approximately 90% of children under five are impacted by at least one infectious disease, and 81% of households in Gaza lack clean and safe water. However, the authors noted limitations in their analysis, such as limited data sources because collecting it is difficult within the context of Gaza, and this was true for screening. 

Another report from the organisation Medical Aid For Palestinians (MAP), titled “Health Under Occupation” from 2017, discussed healthcare access and outcomes more broadly. For example, they noted that in 2016, up to one-third of patients’ permits to exit Gaza for healthcare access were either denied or delayed. Moreover, they stated that 40% of people in Gaza live below the poverty line. 

Given the recent geopolitical shifts in power, these findings from both reports will likely be higher now. This brings forthcoming uncertainty about whether the health outcomes of Palestinians will improve. In a recent qualitative study involving the views of Palestinian physicians in the West Bank, they shared their experiences of violence, threats of violence, issues with healthcare access for themselves and patients, financial difficulties to support their families, struggle to help their patients and limited access to education due to harsher life under occupation. 

Thinking more largely about emergency care in Palestine, one scoping review reported the depletion of healthcare resources such as medical equipment and medications. The authors even related how human rights violations and the destruction of the Palestinian healthcare system, including emergencies, have exacerbated outcomes; the most notable were stroke, myocardial infarction and traumatic injury, among other non-infectious diseases. 

Although the authors included this information from a human rights standpoint, they called for additional interventions and research to fill in and learn gaps within emergency care to enhance health outcomes for Palestinians. This review was published in 2022, and again, many geopolitical shifts in power have taken place within a few years. Therefore, it can be deduced that emergency care is drastically needed for the Palestinians; this is primarily compelled by the blockade in Gaza and occupation in the West Bank.     

Focusing on the mental health outcomes among Palestinians, they have become worse. In another scoping review, researchers focused on trauma among young Palestinian people in Gaza; the authors noted that events, such as exposure to devastation and violence, as well as the death or loss of friends and family, have contributed to mental health outcomes ranging from post-traumatic stress disorder (PTSD) to depression. 

Nevertheless, the authors stated that further qualitative research is vital to addressing gaps in knowledge and enhancing mental health outcomes among the Palestinian youth and the wider population. Connecting back to how the modern geopolitical landscape is very dynamic, the poorer mental health outcomes among Palestinians have conceivably increased. 

Urgent calls to action: recommendations from NGOs to upholding human rights

Given all of these detrimental impacts on the health and wellbeing of Palestinians, there are recommendations from organisations, notably the United Nations (UN), for ways forward towards upholding the human rights of Palestinians:

These recommendations, among others mentioned in the report from the United Nations (UN) High Commissioner for Human Rights, were divulged in 2024; the year had been a challenging time, particularly in Gaza, due to the complete blockade of food, water and essentials like medical supplies; in addition to this, many explosives were dropped on Gaza, killing thousands of men, women and children. Finally, buildings, such as hospitals and homes, were destroyed.  

Conclusion: moving forward towards a equitable and equal future for Palestinians

Reflecting on everything discussed in this article, the numerous injustices happening to Palestinians must not go on; they have been suppressed for nearly 75 years by governments and the mainstream media before receiving closer attention, examination and debate within Western society recently. Therefore, we need to take actionable steps by initiating more open discussions of justice and advocacy involving the voices of Palestinians, such as myself and others. 

Furthermore, it is crucial always to nudge those in positions of power worldwide to fulfil their responsibilities as civil servants and defend human rights for everyone. Both of these actions uphold the health and wellbeing of Palestinians living in Gaza and the West Bank, especially as enabling the recommendations from the UN and other NGOs. As for the wider international community, we must continue upholding human rights to maintain our health and wellbeing.

In my next article, I will discuss Sudan because this population has also encountered many injustices, primarily the civil war that has been occurring since 2023. This has impacted the health and wellbeing of the Sudanese population, which requires thorough attention and discussion.   

Written by Sam Jarada

Related articles: A perspective on well-being / Gentrification and well-being

REFERENCES

Human rights in Israel and the Occupied Palestinian Territory. Amnesty International. 2022. Available from: https://www.amnesty.org/en/location/middle-east-and-north-africa/middle-east/israel-and-the-occupied-palestinian-territory/report-israel-and-the-occupied-palestinian-territory/ 

‌Occupied Palestinian Territory. Save the Children International. 2024. Available from: https://www.savethechildren.net/occupied-palestinian-territory 

‌Nutrition Vulnerability and Situation Analysis / Gaza. 2024. Available from: https://www.nutritioncluster.net/sites/nutritioncluster.com/files/2024-02/GAZA-Nutrition-vulnerability-and-SitAn-v7.pdf 

‌HEALTH UNDER OCCUPATION. Medical Aid For Palestinians. 2017. Available from: https://www.map.org.uk/downloads/health-under-occupation---map-report-2017.pdf 

Husam Dweik, Hadwan AA, Beesan Maraqa, Taher A, Zink T. Perspectives of Palestinian physicians on the impact of the Gaza War in the West Bank. SSM - Qualitative Research in Health. 2024 Nov 14;6:100504–4. Available from: https://www.sciencedirect.com/science/article/pii/S2667321524001136 

‌‌Rosenbloom R, Leff R. Emergency Care in the Occupied Palestinian Territory: A Scoping Review. Health and Human Rights. 2022 Dec;24(2):255. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC9790939/ 

‌Abdallah Abudayya, Fugleberg T, Nyhus HB, Radwan Aburukba, Tofthagen R. Consequences of war-related traumatic stress among Palestinian young people in the Gaza Strip: A scoping review. Mental Health & Prevention. 2023 Nov 25;32:200305–5. Available from: https://www.sciencedirect.com/science/article/pii/S2212657023000478 

M.I. Human rights situation in the Occupied Palestinian Territory, including East Jerusalem, and the obligation to ensure accountability and justice - Report of the United Nations High Commissioner for Human Rights - Advance unedited version (A/HRC/55/28) - Question of Palestine. United Nations. Available from: https://www.un.org/unispal/document/human-rights-situation-in-opt-unohchr-23feb-2024/