PhilMUN 2010 15 level specialized care is increasingly difficult to access. According to the WHO, “the proportion of patients given permits to exit the Gaza Strip for medical care decreased from 89.3 percent in January 2007 to 64.3 percent in December 2007, an unprecedented low figure.” 51 Patients with urgent and life threatening conditions are particularly vulnerable. In 2007, twenty deaths occurred (including five children) due to the lack of access to referral services within a three-month period. 52 Patients with chronic diseases, such as diabetes, cancer, and heart disease are unable to receive regular follow up care and treatment because they, as well as health care personnel, are unable to access specialized care centers and health clinics. 53 The closure system and separation barrier have significantly hindered UNRWA’s ability to provide health assistant to the refugees. A break down in preventative services has lead to a 10.4 percent increase in the incidence of low birth weights and a 52 percent increase in the stillbirth rate. The reduced and irregular access to primary health care centers, for example, has lead to the significantly increased prevalence of iron-deficiency anemia among pregnant women in the West Bank because they could not seek proper antenatal care during their course of pregnancy. In addition, patients suffering from diabetes and hypertension could not control their conditions. The dire circumstances also hinder the implementation of projects for development of the infrastructure of camps. 54 Difficulties in the movement of staff and goods and increases in procurement prices of goods including medicines and food commodities, as well as the problems and complications of logistics and operational costs, are two of the main issues challenging UNRWA’s health programs and services. 55 51 “Health conditions in the occupied Palestinian territory, including east Jerusalem, and the occupied Syrian Golan “Report of the director of Health. UNRWA 2007. http://apps.who.int/gb/ebwha/pdf_files/A61/A61_ID2-en.pdf 52 Ibid. 53 “Healing the Wounds”. The Union of Palestinian Medical Relief Committees. 2001. http://www.pmrs.ps/content/publications/2001_newsletter.pdf (Accessed 11/22/2009). 54 “Health conditions of, and assistance to, the Arab population in the occupied Arab territories, including Palestine”. WHO. 2002. http://apps.who.int/gb/archive/pdf_files/WHA55/ea55id3.pdf 55 “Health conditions in the occupied Palestinian territory, including east Jerusalem, and the occupied Syrian Golan “Report of the director of Health. UNRWA 2007. http://apps.who.int/gb/ebwha/pdf_files/A61/A61_ID2-en.pdf
PhilMUN 2010 16 Actors and Interests Refugees The wellbeing of refugees is significantly impacted by the quality of public health in their communities. It affects both their physical and mental health, and consequently their functionality as a whole. Health affects their ability to find employment, provide for their families, educate themselves, and positively contribute to society. The conditions in which refugees find themselves are significantly ameliorated by public health interventions. It is important that the international community plays a role in implementing public health measures and interventions in refugee camps. Infant mortality rates (IMR) are useful indicators for the health and development. The IMRs among Palestinian refugees are 32 in Jordan, 33 in Gaza, 35 in Lebanon, and 29 in Syria. 56 To put these numbers in perspective, the infant mortality rate in a developed country such as the United Kingdom is 4.85, while the rate in a developing country such as Mali, is 102. 57 However, there is a significant deviation from the infant mortality rates of the countries acting as hosts to these refugees. For example, the infant mortality rates in Jordan, Lebanon, and Syria, are 14.97, 21.82, and 25.87 respectively. 58 Thus, it is clear that there is a disparity in the quality of healthcare and public health services that refugees receive in these countries. While all these refugees exist in various social and economic conditions, the preferred policy constitutes voluntary repatriation in a dignified manner to their home state and finding an end to exile and ultimately preserving their identity. However, when repatriation is not a viable option, the optimal outcome is one in which their host state, together with other members of the International community and non-governmental organizations, provide them with adequate public health, which would ultimately ease their reintegration, resettlement, or repatriation. 56 “Infant and child mortality rates among Palestinian refugee populations” H.Madi The Lancet, Volume 356, Issue 9226, Pages 312-312 57 “Country Comparison: Infant Mortality Rates”. CIA World Factbook. https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html. (Accessed 11/22/2009) 58 Ibid.