  by Judy Siegel-Itzkovich From an article in the Jerusalem Post, July 14, 2002 It is possible - and probably inevitable - say chapter authors of Separate and Cooperate, Cooperate and Separate: The Disengagement of the Palestine Health Care System from Israel and its Emergence as an Independent System. The volume is the result of five years of work. "It documents and analyzes the links - past, present and future - between the Palestinian and Israeli health systems and examines the process by which the Palestinian system separated from the Israeli system and developed as an independent system," write the co-editors Tamara Barnea and Dr. Rafiq Husseini. Barnea is director of the JDC-Middle East Program of JDC-Israel and the JDC Brookdale Institute in Jerusalem, while her co-editor is ex- secretary general of the Palestine Academy of Science and Technology and now director of operations of a private Geneva-based foundation called "Welfare Association," devoted to Palestinian well being. Among the prominent Israeli professionals who wrote chapters are former Hadassah Medical Organization director-general Prof. Shmuel Penchas; Sheba Hospital director (and former Health Ministry director-general) Prof. Mordechai Shani; Transport Minister (physician and former health minister) Ephraim Sneh; and Prof. Theodore Tulchinsky (an associate professor at the Hebrew University-Hadassah School of Public Health and former longtime governmental coordinator of public health in the territories). The Palestinian authors include honorary president of the Palestine Red Crescent Dr. Fathi Arafat (brother of Yasser Arafat); Palestinian Health Minister Dr. Riad Za'noun; Augusta Victoria Hospital CEO Dr. Rawfiq Nasser; and Prof. Hassan Abu-Libdeh, president of the Palestine Central Bureau of Statistics… THE HISTORY of Israeli and Palestinian health institutions and problems since 1917 are charted in detail. There are today a total of 42 hospitals with more than 2,600 beds in the West Bank and Gaza Strip. While Palestinian disease rates remain higher and life expectancy is lower than the corresponding Israeli rates, the level of health care in the territories is surprisingly good, and outstanding compared to those in most Arab countries. Cilla Acker, a nurse and consultant to the Israeli Health Ministry on planning and building medical institutions, writes about tetanus neonatorium, which killed dozens of Palestinian babies for decades because their umbilical cords got infected when bitten with the midwife's teeth or cut with a contaminated knife or razor blade. Israeli educational work and more hospital deliveries reduced the death rate from this kind of tetanus to zero by 1994, according to Aliza Ben-David, chief nurse for the Civil Administration in Gaza for 14 years. Acker finishes her chapter by noting that "it was a privilege" to be involved in improving Palestinian health, "thanks to the marvelous professionals I met and worked with, both Palestinians and Israelis - professionals who truly cared for the health of the Palestinian people and were prepared to work endless hours to achieve their goals." Tulchinsky notes in his chapter that Palestinians and Israelis are "one epidemiological family," as the same diseases threaten both and need to be fought in a coordinated effort. He concludes, "health may not be a bridge to peace because health sectors rarely have much political impact, but Israeli-Palestinian cooperation in health did touch the peace process. Both sides knew that the mutual interests and the largely non-partisan atmosphere of health helped those working in other fields to see the potential of cooperation and mutuality of interest... The transmission of diseases can be deadly to both sides. But perhaps improving health makes a valuable contribution to the chances for peace and stability in the Middle East." Despite the difficulties, the Palestinian health minister writes, "the idea of peace must prevail. Sensitivities will then disappear, and true cooperation will take place in areas such as prevention, public health, medicines and vaccination. In fact, the fields of cooperation in health are almost unlimited." Yitzhak Sever, director of the Division of General Medicine in Israel's Health Ministry who with Tulchinsky probably knows more about Palestinian health services than any other Israeli, adds that "cooperation in the field continues every day - getting approval for patients to pass roadblocks to get care, facilitating the transfer of medications and equipment donated from abroad, and vaccinations. I think that once the violence ends, relationships and joint projects could be rehabilitated very fast. It's natural for the Palestinians to be 'cool' to us in public, as they fear being accused of being 'collaborators.' I believe that if medical people were in charge of the two nations, there would be peace between them." Professor Mordechai Shani, regarded as an international expert in health systems, and whose own Sheba Medical Center has long cooperated with the Palestinians, concludes that the aloof nature of the Palestinian articles is not surprising, as "they are on the receiving end, and have a lot to catch up on. Israel annually spends $1,500 per capita on the health of its residents, compared to $100 by the Palestinian Authority." Shani says: "I truly hope that we won't have to take charge of health services again due to the temporary takeover of Palestinian cities, because establishing infrastructure is a very long process and they must stand on their own feet. "The book is important because it's an analysis of health services in a coming Palestinian state. Let there be no doubt about it. There will be a Palestinian state, and they will have to provide good-quality health care to their own population."
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