The army's severe restrictions on Palestinian movement in the West Bank gravely affect the ability of Palestinians to obtain proper medical treatment.
The hundreds of physical obstructions and dozens of checkpoints result in very limited access to medical treatment, and sometimes none at all. The problem is especially grave among residents of villages and outlying areas who need to get to hospitals in the large cities. For example, persons living in villages around Jerusalem who need to get to hospitals in East Jerusalem for treatment require a permit to enable them to reach their destination. To obtain a permit, patients have to provide medical documents testifying to their illness, as well as confirmation that they have an appointment at the specific hospital and that it is the only facility where the needed treatment is available.
The need for a permit is especially problematic for pregnant women, who need to get to the hospital in time to give birth. Even though the delivery date is uncertain, the permit given to women about to deliver is valid for only one or two days, as is the case for most sick persons. Therefore, women in their ninth month of pregnancy must go to the DCO every few days to renew the permit. As a result, in some instances, the mother gave birth at the checkpoint after her crossing was delayed because she did not have a valid permit. In 2007, at least five women gave birth at a checkpoint, three of them at a checkpoint at the entrance to Jerusalem.
The hardships entailed in obtaining medical treatment involve more than the bureaucracy of the permit regime. In many cases, the way to the hospital is blocked, so the sick and injured have to travel on long, winding, and worn roads. These alternate roads often lead to a staffed checkpoint, where they are forced to wait and undergo checks. In other cases, access to medical treatment is prevented and ill and wounded persons are unable to receive emergency medical treatment when checkpoints are closed at night, and whole Palestinian communities are blocked from entering or leaving by vehicle, including by ambulance. This situation exists primarily in enclaves in the “seam zone” and in a number of isolated areas, among them Beit Furik and Beit Dajan, in the Nablus area. In 2007, there was an increase in the number of persons needing medical treatment who were delayed at checkpoints, and B'Tselem documented five cases in which ill or wounded persons died after being delayed at a checkpoint.
Following a petition that Physicians for Human Rights filed in 1996, the State Attorney's Office announced two procedures instituted by the army regarding the crossing of checkpoints on grounds of medical need. The two procedures were intended to regulate the crossing of Palestinians in case of medical emergency, when a permit would not be needed, and in non-emergency cases. These procedures were supposed to apply at all the checkpoints in the West Bank, but recent testimonies given to B'Tselem indicate that this is not always the case. Frequently, the soldiers, who have no medical training that would enable them to evaluate the medical condition of the person, err in judgment.
The many restrictions on movement have also impaired the ability of West Bank hospitals to function properly. Indeed, the level of service in these hospitals has suffered greatly because of the absence or delay in arrival of doctors and staff as a result of checkpoint delays. Finally, the restrictions on movement also impair the development and expertise of medical professionals in the Palestinian health system: it is almost impossible for physicians and staff to get to in-service training or students to university, and many students are either unable to complete their studies or receive a lower quality of professional training.
International law grants special protection to the sick, wounded, the infirm, and pregnant women, and states that medical teams and sick and wounded persons must be allowed open passage. The many restrictions on Palestinian movement in the West Bank and the extensive period in which these restrictions have been imposed have resulted in a systematic, protracted breach of the law and in grave harm to the health of West Bank Palestinians and to the Palestinian health system.