Sunday, March 6, 2011

Health apartheid: Israel, Canadian complicity, and hope for the future


Health indicators in Palestine provide an objective measurement of Israeli Apartheid. This health differential is imposed through  policies in which the Harper Government of Canada is complicit. But growing movements are raising hope for freedom and health across the region.

HEALTH APARTHEID
     On the Human Development Index (a standard of wellbeing including life expectancy, literacy, education and standards of living), Palestine ranks 110th while Israel ranks 15th. According UNICEF, Palestinians live 7 years less than Israelis (74 vs 81 years), Palestinian infants have a mortality rate more than 8 times greater (25 vs 3) and a rate of anemia more than 3 times greater (50% vs 15%). Palestinian mothers have a maternal mortality rate more than 5 times Israeli mothers (38 vs 7). This vast health differential parallels economic determinants of health: Palestinians have a GDP per capita of one tenth that of Israelis ($2,900 vs $29,000).
     Significant health discrepancies also exist within Israel between the Jewish and Arab populations. As the journal Pediatrics found, “the prevalence of anemia among Israeli infants is 15.5%. The prevalence is significantly higher in the non-Jewish population (22.5%) as compared with the Jewish population (10.5%).” According to the newspaper Ha’aretz, “Despite Israel's national health law, various mechanisms still prevent Arab citizens from achieving full health equality. The Arab infant mortality rate is more than double that of Jews, Arab life expectancy is significantly lower, and some of the gaps are actually increasing.” This also parallels economic indicators within Israel, where GDP per capita for Jewish citizens is three times that of Arab citizens. 
     There’s a common word that describes such stark segregation and discrimination maintained along racial lines: apartheid. 

HEALTH CATASTROPHES
     The same Western powers who refused boats of Jewish refugees fleeing the Holocaust used this horror to justify their colonial project in Palestine, driving Palestinians off their land and into refugee camps. Canada's Lester Pearson played a leading role in the partition of Palestine. While the US didn't bother to destroy Auschwitz during WWII, it has armed Israel and Arab dictatorships to maintain control over the oil-rich region. This has produced a health catastrophe for Palestinians and the broader Arab population.
     Within Israel health differentials are maintained through conscious policies, from the 2003 targeted layoff of nurses in the Arab sector,  to the 2005 mapping of cancer rates that ignored the Arab sector, to the 2009 cuts to toddler health programs for an Arab neighbourhood while approving funding to the same program for a Jewish neighbourhood. Similar discrimination exists in other sectors, from education to jobs to land distribution. Apartheid conditions are even more obvious in Gaza and the West Bank. According to the UN Development Program’s (UNDP) Human Development Report:
The State of Israel has systematically segregated Palestinians communities into a series of fragmented archipelagos (referred to variously as isolated islands, enclaves, cantons, and Bantustans) under a system that has been deemed 'one of the most intensively territorialized control systems ever created'. Israel controls Palestinian air space, territorial waters, natural resources, movement and the macro-economic instruments that enable economic autonomy.”
In addition to undermining social determinants of health, the military occupation of Palestine targets health by direct attacks on civilians, and by delaying, denying or attacking health care services. The Palestinian Red Crescent compiles a list of daily attacks on civilians—including ammunition, rubber bullets, tear gas and shrapnel—and delays or denials of access to service. According to the Palestinian Ministry of Health, since 2000, 68 pregnant women have had to give birth at checkpoints—resulting in 35 miscarriages and 5 maternal deaths. B'Tselem, the Israeli Information Centre for Human Rights in the Occupied Territories, has compiled a long list of Palestinians—from infants to octogenarians—who died following denials of medical treatment.  Meanwhile, a report by the Health, Development and Policy Institute found that:
Israeli soldiers stopping a Palestinian ambulance
“Between the 29th of September 2000 and the 14th of October 2003, the Israeli occupying forces carried out the following attacks on Palestinian medical services: 121 ambulances were attacked and damaged 36 ambulances were damaged beyond repair, 991 cases of ambulances being denied access to the injured, 25 medical personnel were killed by Israeli soldiers, 425 medical personnel were injured, 71 emergency personnel were arrested, 290 counts of hospitals and clinics attacked & damaged.” 
The scale of everyday violence against Palestinians is such that many Israeli soldiers refuse to serve in the occupied territories. As one refusenik explained, "you are forced to commit war crimes, and to expel and starve and humiliate an innocent population. This is not a democratic act."


INCREASING HEALTH BARRIERS: WALL, SIEGE and WAR
     The daily experience of occupation and its impact of health has escalated during the past decade with the Wall, and the siege and war on Gaza. In addition to its destruction of agriculture and annexation of land, the wall isolates more than 70 primary health clinics from communities. According to a 2009 report in The Lancet, one of the world’s leading medical journals: 
“Israeli control of movement and travel has severe repercussions on access to and quality of health care for Palestinians. In 2005, 18% of those seeking treatment at emergency departments in the West Bank were delayed by checkpoints or occupation related detours. In 2007, 36% of health-care facilities reported that many of their patients were no longer able to access services, with more than half reporting delays in service delivery by mobile teams and difficulty accessing medicines for chronic disease.”

     For the past five years an illegal siege has put a stranglehold on the economy and health of Gaza and its 1.5 million inhabitants. A 2008 survey by the Gaza Community Mental Health Program  found: 
“most common impact of siege of Gaza items were:  prices are sharply increased (90.8%), I feel I am in a big prison (88.5%), I can not find things I need in the market (91.70%),  I was not able to get specific medicine for me or for one of the family member due to shortage of fuel and absence of transportation (73.4%), and I was not able to get specific medicine for me or for one of the family member due to shortage of physicians and nurses (62.58).” 
The Mubarak regime has been complicit by sealing off the Rafah border, which has continued despite Mubarak’s departure as a sign of the incompleteness of the Egyptian revolution. In 2008-2009 Israel launched a war on Gaza, free from sanctions or no-fly zones, which caused widespread death and destruction. According to the UNDP,
In the three weeks of this military incursion, approximately 1400 Palestinians were killed and more than 5,320 were wounded; 350 of them seriously. Large areas were reduced to rubble with approximately 15,000 houses damaged or destroyed, and extensive disruption was caused to water and sanitation networks, energy supplies and facilities, roads and bridges, and the telecommunications system. There was also widespread destruction of cultivated land, greenhouses, livestock and poultry farms, water wells, irrigation networks and other productive assets, and approximately 14.6% of the total cultivated area was completely destroyed. This Operation raised widespread allegations of war crimes including the use of white phosphorous.”

Then last year Israeli troops boarded a flotilla in international waters and killed humanitarian workers bringing medical supplies to Gaza. 

CANADIAN COMPLICITY
     While there is a growing global movement against Israeli Apartheid, Canadian Prime Minister Stephen Harper has been complicit--continuing Canadian foreign policy in the region since Pearson. In order to bolster US imperialism in the region, and the benefits for Canadian corporations that flow from this, Harper has supported Israel militarily, politically, economically and ideologically. 
     Militarily, Harper has continued a Canadian tradition of selling weapons to Israel, Egypt and other repressive regimes in the region. Politically, Harper supported Israel’s 2006 war on Lebanon that killed hundreds of civilians (including several Canadians) as a “measured response”. In 2009 Canada was the only country among 47 to vote against the UN Human Rights Council resolution to condemn the war on Gaza. In 2010 Harper welcomed Israeli Prime Minister Benjamin Netayahu as Israel was killing people on the aid flotilla, and in 2011 Harper and Netanyahu were the last to support Egyptian dictator Hosni Mubarak before he was overthrown.
     Economically, Harper has undermined health in Gaza directly and indirectly. In 2006 he made Canada the first country to cut humanitarian aid. In 2009 he cut funding to humanitarian NGOs Kairos and Alternatives, who support human rights in Palestine and elsewhere, while creating a crisis in the NGO Rights and Democracy. In 2010 Harper cut funding to the UN Relief and Works Agency, which provides food and health services to 4.7 million Palestinian refugees in Jordan, Lebanon, Syria and occupied Palestine.
     These cuts have accompanied increasing ideological attacks at home on anyone who criticizes Israel, eroding the freedom of speech of Canadians. In 2009 Harper cut funding to the Canadian Arab Federation (who help newcomers settle in Canada) for criticizing his support of Israel. In 2009 Immigration Minister Jason Kenney labeled British MP George Galloway a supporter of terrorism for bringing medical supplies to Gaza, and banned him from the country. In 2010 the government delayed the visa—resulting in the cancellation of a speaking tour—for Palestinian physician, MP and Nobel peace prize nominee Dr. Mustafa Barghouti, while a Conservative MP put forward a motion to condemn Israeli Apartheid Week on campuses across the country. Finally, both Conservatives and Liberals have formed the so-called Canadian Parliamentary Committee to Combat Anti-semitism (CPCCA) to smear those who criticize Israel as anti-semitic. 
 
LIBERATION
     But there are three international movements emerging to build solidarity with the Palestinian struggle for self-determination. The first--heeding the 2005 call by 170 Palestinian organizations representing those living under occupation, within Israel and refugees--is the international campaign of Boycott, Divestment and Sanctions against Israel.
     Secondly, campaigns are opposing its Western backers and their attempts to silence the Palestine solidarity movement. In Canada a campaign defeated the ban against Galloway and a scandal is brewing around the government minister who cut funding to Kairos. There is growing opposition to the McCarthyism of the CPCCA (including opposition within the Jewish community: watch the video made by Independent Jewish Voices). Meanwhile there is growing international criticism of Canada’s support for Israel, which—along with criticism of Harper’s occupation of Afghanistan and obstruction of climate talks—cost Canada a temporary seat on the UN Security Council.
     In 2011 we’re seeing the emergence of a third front: liberation movements across the Arab world. This is crucial to address an important difference between South African Apartheid and Israeli Apartheid: while the former was based on exploitation, the latter is based on expulsion and exclusion. In South Africa the black population was the majority and was exploited for their labour, so mass strikes were able to combine with an international solidarity movement to overthrow the regime. But under Israeli Apartheid, Palestinians are artificially kept to a minority within Israel, while the occupied territories are peripheral to the Israeli economy—with unemployment at 45%  in Gaza. On their own Palestinians cannot use strikes to bring down Israeli Apartheid the way South African workers did, but their brave resistance can inspire movements in Egypt and the broader Arab world to bring down complicit dictators, break open the Rafah border, and raise the hope of a democratic secular state where Jews and Arabs can once again live in peace. 
     These are exciting times. As Ali Abunimah recently wrote after the Egyptian revolution:
“Two months ago, few could have imagined that the decades old regimes of Tunisia's Zine el Abidine Ben Ali and Egypt's Hosni Mubarak would fall -- but fall they did under the weight of massive, broad-based popular protests. Indeed, such movements hold much greater promise to end Israel's apartheid regime and produce a genuine, representative and democratic Palestinian leadership than the kinds of cumbersome institutions created by the Oslo Accords. The end of the peace process is only the beginning.”
 This will be good for all our health.

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