4TheRcrd Mag.

In the horrific struggle between Palestine and Israel which periodically splashes its way onto our newspapers and television and computer screens, it’s often all-too easy for the media to ignore issues of women’s health. It’s clear that the unjust treatment of the Palestinian people by the Israeli Occupation has a direct impact on women’s lives. It’s important to recognize the links between reproductive health and total well-being, and how issues such as war, nutrition, sanitation, housing conditions, migration, unpaid and paid work loads and access to healthcare affect women. The literature on reproductive health care paints a grim picture of Palestinian women’s experiences.

It’s clear that the Occupation has led to Palestinian people living in unhealthy conditions and has compromised their health, severely and negatively affected their health status. Extended families living in tight spaces in refugee camps, increasing militarization and the weakening of institutional mechanisms to protect women have increased the level of domestic violence Palestinian women face, yet they are often reluctant to discuss issues of family violence for fear of being criticized for addressing personal issues at a time of such violent conflict. Women are primary caregivers and carry the major burden of responsibility for childcare, and this burden has increased with the Occupation. Women provide not only basic childcare but must cope with children who have been injured or psychologically affected by living through conflict.

Reproductive health services, other than delivery and antenatal care, are rarely included in health services that are available to refugees. One study I read of a refugee camp in Al-Ein, published in the International Journal of Environmental Health Research, reported on conditions such as poor healthcare facilities, a single shared toilet for both women and men, a deteriorating sewage system, flooding of wastewater (leading to many cases of diarrhea), unheated schools, and a lack of libraries. Most houses in refugee camps are severely overcrowded, congested, unhealthy and lack greenery.

The overcrowding in refugee homes diminishes women’s privacy and adds to their already large burden on managing the home. 97% of the women interviewed in this study agreed that their poor housing conditions had a greatly negative effect on their physical and mental health. Palestinian women suffer from more diseases then Palestinian men and common and major health problems include gynecological infections, high incidence of diabetes, arthritic pain, and a rising rate of many types of cancer, especially reproductive cancers. They face adverse affects and additional stress resulting from nutritional and water shortages. The status of healthcare for Palestinian women lags far behind Israeli Jews. A case in point: 70 women die for every 100 thousand live births in the West Bank and Gaza, whereas in Israel, 5 women die per 100 thousand live births. The leading cause of death among women of reproductive-bearing age in the Middle East and North Africa is pregnancy-related illness of which the major illnesses are pregnancy-induced hypertension, bleeding and infection.

Currently, checkpoints, curfews, closures, and the 700 km long fence/wall built throughout the West Bank are obstacles which prevent women from having freedom of movement and seeking reproductive health care services. Blockages and refusal of the Israeli military to allow women to pass checkpoints have led to delivery, infant and maternal mortality at checkpoints. The fear of being unable to reach adequate medical care in time for delivery has affected women and their families significantly and become a substantial source of anxiety. Policies of indigenous reproductive health are often used to control women in this conflict, as is evident by Israel’s handling of the reproductive health of Palestinian women. Israel has not included the Occupied Territories in its state health policies since June 1967. Palestinians living in the Occupied Territories are forced to seek medical care in Israel as the Israeli administration has failed to provide adequate local services, but are largely excluded from such services at the same time. Furthermore, Palestinian women and children are the least capable of reaching adequate health services due to the inability to access family income or because of a lack of adequate income for their needs. Often the only available health care in refugee camps is run by international donors; these international and multilateral donors may have political agendas which are at odds with their public objectives and I believe it’s necessary to question how such agendas affect the quality of healthcare for Palestinian refugees.

In this struggle of demographics, the Israeli administration has seriously constrained Palestinian women’s reproductive health in many ways. Intrauterine devices, widely recognized as having a number of health complications, were tested on Palestinian women from the early 1930s to late 1950s. The Israeli administration and military is known to use violent ways of limiting Palestinian women’s reproduction of children which negatively affect their health. The use of tear gas in open spaces had led to intrauterine fetal deaths and miscarriages. As early as 1976 the windows of a Palestinian girls’ school were discovered to have been sprayed with a chemical substance that may affect fertility and induce sterility. The Israeli military also hampers Palestinian women’s access to adequate healthcare. Women are incarcerated for participating in protests, rock-throwing, and participating in demonstrations. Sexual assault and ill-treatment of Palestinian women by Israeli soldiers is common and takes place in jails after they have been incarcerated. Also, Israeli soldiers have been known to handcuff pregnant women going into labour. Due to such complications, family planning services for Palestinians living in Israel are fraught with difficulties. During clinical encounters, Palestinian women are reluctant to discuss health matters as some understandably believe Israeli health practitioners advocate family planning out of a pro-Israeli nationalist agenda rather than concern for their health. The Israeli legacy and discourse of family planning with respect to Palestinians and population control positions healthcare as suspect for Palestinian women. As such, these difficulties undoubtedly create tensions and affect the level of communication between women and health care service providers.

Although tangible actions can and are being taken by the transnational development community to improve immediate reproductive health and physical well-being, improving social well-being proves to be more difficult and complex. Statistics and indicators don’t capture the fear and anxiety that Palestinian women must cope with under the Occupation. Clearly, the reproductive health of women Palestinian women needs to be improved, and this can only be addressed by addressing the violent conflict resulting from the Israeli Occupation. The injustice done by the Israeli state goes far beyond what I’ve outlined here; this is genocide and colonialism in the making. Unfortunately, the majority of us are only exposed to a very specifically constructed fragment of events. Given the biased glimpses of what we see in the local media, I think its important for us to have alternative sources of material on what’s going on in Palestine. Here’s a start:

Electronic Intifada

International Middle East Media Centre

ZNet Middle East Watch

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