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Palestinian Territories: “An Unacceptable and Illusory Decision”
Following the January 2006 legislative elections that brought
Hamas to power, the United States, Canada, the European Union and Japan
decided to suspend their bilateral financial aid to the Palestinian Authority.
They also proposed that part of those funds be reallocated to the United
Nations and other international aid organizations working in the Palestinian
Territories. Médecins Sans Frontières (MSF) finds this proposition
unacceptable. Why did MSF speak out after this decision/announcement? We have taken a public position against this proposition, which treats humanitarian aid as a stopgap measure to ease the serious impact of this action on the Palestinian population. We believe that halting all direct aid to the Palestinian Authority and distributing part of it to international organizations and NGOs as a “damage control” effort is unacceptable. This decision is hypocritical, illusory in practical terms, and unacceptable as a matter of principle. It is incorrect to think that humanitarian organizations as well as UN agencies, whose skills are very specific, would have the ability, legitimacy, and resources to assume administrative responsibility for an entire country, specifically in terms of overseeing social services, managing the ministries, and the public health system and handling civil servants’ payroll. With regard to principles, we can offer high-quality services in the Palestinian Territories, as elsewhere, only if we are independent. Our decisions cannot be based on political agendas, but only on the needs of the most disadvantaged and our ability to address them. If we did not distance ourselves publicly from this proposal to serve as “clean-up crew” in the wake of this decision, we would be a party to this sanction and to carrying it out. Furthermore, why would we substitute for a chosen and elected government? Accepting the U.S., European Union, Canadian and Japanese proposal would mean legitimizing their political choice, while rejecting the Palestinians’ choice. We will, of course, refuse any institutional funds. In 2006, all our activities in the Palestinian Territories will be financed by private contributions. What does MSF mean by a “confusion of categories and roles”? This is not the first time that political decision makers—States—have asked us to play the role of social service assistant. This was the case, albeit in different form, in Iraq and Afghanistan, where coalition forces manipulated humanitarian aid to justify, among other goals, military operations and win the population’s compliance. This category confusion harms the effectiveness of aid operations by separating victims into “good” and “bad” groups and by associating humanitarian operations with a particular side. It exposes us and could turn us into targets. This likely contributed to the killing of our five colleagues in Afghanistan in June 2004. If we are well-regarded in the Palestinian Territories, it is specifically because we are impartial and independent. Our years of work in the field have allowed us to build solid relationships with the population, which acknowledges our work and trusts us. People know that our efforts are not linked to particular political decisions and that we act exclusively in the interest of those individuals we are assisting. Are the effects of the U.S., Canadian, European Union and Japanese decision already being felt in the Palesitnian Territories? It is too soon to make a precise assessment of the direct and specific impacts on the health system of suspending bilateral aid. However, it will certainly add to an already critical situation and will worsen the hardships that Palestinians are experiencing. In the Gaza Strip, nearly half the 1.4 million residents live below the poverty line and the unemployment rate is close to 70 percent. The European Union provides 500 million euros in annual aid, which makes it the principal financial supporter of the leading local employer, the Palestinian Authority. The 140,000 civil servants—who, according to the World Bank, support nearly 23 percent of the population—have not been paid since March. Furthermore, although settlements in the Gaza Strip have been dismantled, the economic blockade of the Territories and the prohibition on the circulation of goods and people between the Occupied Territories and Israel continues. Shortages are already being felt, with increasing impoverishment within the population and a chronic lack of resources at health facilities (which operate primarily on the basis of outside aid). Hospitals are relying on medical supplies that are being quickly depleted. Individuals suffering from major and complex illnesses, like cancer, who cannot be treated in the Palestinian health system, find it increasingly difficult to go to Israel to seek care. Palestinians consider the decision to stop aid as a collective punishment. Families’ situations will not improve when financial aid is halted. The notion that humanitarian organizations will ease the situation is completely cynical. Furthermore, in keeping with the Geneva Conventions, Israel, as the occupying power, is responsible for ensuring decent living conditions for the Palestinian population in the Occupied Territories. What is MSF doing in the Palestinian Territories? Why not work in Israel, too? In 1989, during an acute phase of the conflict, MSF began working in the Palestinian Territories to support the health system. Initially, our activities involved emergency medical programs. Since then, our programs have been adapted several times in response to the care that is or is not available through local health services. Today, in Gaza and the West Bank, our teams provide medical and psychological care and medical and social service assistance to families exposed to years of continuing violence and the impact of occupation (including isolation, limitations, and prohibitions on travel, and problems accessing treatment). Most of our patients are confined to enclaves, with their comings and goings subject to the vagaries of military checkpoints (areas near the settlements, the separation wall, sensitive borders like the Egyptian border, and areas of frequent Israeli incursions). We are also always prepared to take emergency action if necessary. MSF does not challenge the fact that a climate of violence, linked to attacks, and problems also exist in Israel. We deplore the situation and the suffering of the civilian populations on both sides. However, Israeli health facilities and the medical care system are effective and fully-functioning. This is not the case in the Palestinian Territories, where the population experiences violence but does not benefit from the same access to medical and psychological care.
» Read other articles on MSF activites in the Palestinian Territories
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