Children, making up roughly half of Gaza’s population, are particularly vulnerable to the diminishment of basic services and human rights protections, including acutely the protection of the right to health, caused by the ongoing illegal closure of Gaza.
Deprivation of healthcare
The situation in 2017 is critical. The World Health Organisation (WHO) reports that over 42% of Palestinian requests for permits to travel to hospital appointments outside Gaza have been denied or delayed by Israel in April 2017. Among those denied were 3 children. Denials of permits can have the most grave consequences on patients. In January 2017, a 17-year old Palestinian died after having been refused travel for medical needs. The teenager required treatment for a congenital heart defect.
Equally, delays in accessing care can have fatal consequences. According to the WHO, April saw three people, including a 5 year-old girl, die while waiting for a permit to access health care. In April alone, 178 children had their access to healthcare delayed by delays in being granted Israeli-issued permits.
Children from Gaza in need of hospital appointments continue to wait for travel permits. Defence for Children International Palestine reports that a 17-year-old, shot and left in critical condition by Israeli forces in May this year, is in need of medical attention attainable only through access to a Jerusalem hospital. The boy had his application to travel to the hospital denied and must wait for the outcome of his second application. In arbitrarily restricting children’s access to healthcare, Israel appears to breach both the spirit and the letter of children’s right to ‘the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health’, as enshrined in Article 24 of the UN Convention on the Rights of the Child (CRC). Israel also breaches the obligation laid out in Article 24 of the CRC to ‘strive to ensure that no child is deprived of his or her right of access to such health care services’.
Economic constraints and impact of poor infrastructure on child well being
The delay or denial of access to healthcare suffered by many residents of Gaza is directly linked to the economic constraints engendered by the decade-long illegal closure of Gaza. This crippling Israeli policy has stymied the facilitation of an adequate healthcare system in Gaza. As a result, Israel, as the occupying power, has breached and obstructed the realisation of children’s basic human rights, including the fundamental right to life. For example, Israel restricts the freedom of movement of health professionals. In the last two years, the number of travel permits granted to Palestinian health workers has decreased by 28%. At the moment, there is an extremely limited workforce in Gaza. There are only 21.5 medical doctors and 25.3 nurses per 10,000 people. In Gaza, 17 hospitals and 56 primary clinics were damaged in 2014, and reconstruction has been incredibly slow due to the restriction on importing basic building materials by Israel. The United Nations has criticised the closure for creating an “artificial scarcity of construction materials”. The delays and restrictions placed on development and reconstruction, especially in the wake of a particularly destructive military operation in 2014, undermines the realisation of children’s fundamental rights, for which Israel, as the occupying power, is primarily responsible.
Gaza’s separation from the West Bank leaves it in an isolated position, affecting its economic development and access to international funding. Nonetheless, even if Gaza did possess a proper infrastructure for healthcare and a sizeable workforce, Gaza’s lack of supplies (such as a water treatment process, desalination and electricity generation) would inhibit its proper functioning. Even before Gaza’s sole power plant in April 2017 completely shut down after exhausting its fuel reserves (it resumed partial operations in late June with fuel purchased from Egypt), Gaza only received half the power it required. This situation is wholly unacceptable in light of the adverse health impact of the long running electricity crisis, which has resulted in children having limited access to clean water and an increased risk of waterborne diseases. Additionally, electricity shortages impact the ability of parents to cook for children, with Gazans reporting that they have to wait up to three weeks to have their gas cylinder refilled, during which time it becomes nearly impossible to provide sufficient nourishment for their children. Families resort to utilising unsafe methods to cook and to provide light, which has caused at least 13 child deaths since 2013. To this end, Gaza’s chronic energy crisis has shocking fatal consequences as regards the safety and welfare of children.
The decision by Israel’s Security Cabinet on 11 June 2017, at the request of the president of the Palestinian Authority, Mahmoud Abbas, to reduce its own electricity supply to Gaza by 40 per cent, has compounded the critical issue of Gaza’s limited basic services. In mid-July 2017, Gaza was plunged into darkness after its only power plant ceased operating due to lack of fuel, leaving almost two million people reliant on just 70 MW of power now provided by Israel – well short of the 450 MW per day required. As the UN humanitarian coordinator for the occupied Palestinian territory, Robert Piper, has warned: “The situation in Gaza has become increasingly precarious over recent months. No one is untouched by the energy crisis. And restrictions by the Palestinian Authority in the medical sector are hitting some of the most vulnerable adults and children in the Strip.” He cautioned that the continuation of electricity blackouts will likely lead a total collapse of basic services, including critical functions in the health, water and sanitation sectors.
Responsibilities of the occupying power
As an occupying power, Israel has legal responsibilities for the general safety and welfare of Gaza’s population. Additionally, under the Fourth Geneva Convention, Israel has a specific duty to protect the sick and children under the age of fifteen. It must also enable the free passage of medicines and enable medical teams to provide assistance, and refrain from imposing collective punishment. The reduction in electricity, and the closure as a whole, is at odds with these legal responsibilities, as well as other duties incumbent from being a signatory to major international human rights treaties, that recognise the right of every person to freedom of movement, to work, to an adequate standard of living, to education, to adequate health care, and to family life. The closure amounts to collective punishment and its impact on children is accordingly severe.
Overlapping rights guaranteed by Israel as a signatory to the UN Convention on the Rights of the Child to all children under the age 18 in Gaza, including the right to health (Article 24), rehabilitation (Article 23) and recovery (Article 39), are also being severely curtailed by Israel’s imposed policy of closure of Gaza.
In sum, Israel’s decade-long illegal closure of Gaza has cruelly resulted in poor access to healthcare that does not spare children. By crippling Gaza’s local infrastructure and workforce, and severely limiting people’s freedom of movement, Israel is denying many Gazan children their basic human right to healthcare, and scandalously contributing in some grave cases to the violation of their fundamental right to life.
The information in this blog is taken from the in focus section – which is fully footnoted – of the LPHR Child Rights Bulletin for the period May 2017 – 31 July 2017.
Beatriz Esperança, Eva Milne