Social determinants of health in countries in conflict - What is GIS ...

46 Social determinants of health in countries in conflict
in central cities such as Ramallah and Jerusalem [61], and 71 clinics will be isolated,
assuming that existing clinics will remain functioning.
Some specialized services for Palestinians in the Gaza Strip and the West Bank are
only available in East Jerusalem, such as eye surgery, open heart surgery, oncological
treatments and heart surgery for children; and hospitals in East Jerusalem have reported
a drastic decline in the number of patients, jeopardizing their existence.
The completed wall will place 46% of West Bank land out of reach of Palestinians.
Residents in the area between the Green Line, the internationally recognized boundary
between Israel and the occupied Palestinian territory, and the wall will be especially
affected as they require permits to live there and to cross into the West Bank proper
[110,111,114]. The stress of negotiating all these barriers on a day-to-day basis cannot
but have a serious effect on the physiological well-being of residents. Restricted mobility
will increasingly affect all aspects of the life of those living in enclosed areas; access to
employment, social activities, relatives and friends; and to services such as health care
and schools.
6.5 Surviving in Somalia
The Somali civil society report was compiled by the nongovernmental organization,
Somali Organization for Community Development Activities, in Mogadishu, in April
2007, under great difficulty because of the daily escalation of the conflict in the city.
While conditions in the north-west and north-east are fairly secure, they reported that
current conditions in the rest of Somalia are dire after 16 years of civil conflict.
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There is no effective government or infrastructure, or regional health authorities.
Over 1 million civilians have fled the country and 0.5 million are in IDP camps.
Unarmed civilians are suffering most acutely, with at least six civilians being killed
every day and many more injured, by sniper fire and unexploded combat devices.
Droughts, floods and the Indian Ocean tsunami in 2004 have affected health, resulting
in epidemics of diarrhoea and cholera.
Free education has disappeared.
People with mental health disorders wander around urban centres.
People smuggling across the Arabian Sea to Yemen continues, with many fatalities
en route [115].
State health services collapsed when the government ceased to exist in January
1991; all government hospitals in Somalia, especially in Mogadishu, were looted and
destroyed. Currently, some private hospitals and clinics have been established, but
only the upper class business people can afford them; refugees, IDPs, people with
physical disabilities, orphans, street people and the unemployed cannot afford health
SDH-chapters-countries in conflict-7 Oct.indd 46 08/10/2008 14:24:52