Health and Advocacy in Palestine

During the past two weeks here, we have met many incredible, brilliant, intelligent, and motivated people that I am so honored to have met. One of these individuals was during our rotation in the Palestine Medical Complex Pediatric Department. Dr. Tony Waterston (Picture below) was a guest lecturer from Britain that has worked with the Palestine Medical Complex for several years and is expanding his role into the Gaza Strip. I have the pleasure to post a document that he wrote up exclusively for this blog regarding health and advocacy in Palestine.

Health and Advocacy in Palestine

by Dr. Tony Waterston

When I led a teaching group in Ramallah hospital recently, I was surprised to find four American medical students among the paediatricians.   This was a pleasure to me as I have been thinking a lot about how to spread information in the outside world on the reality of life as it is for Palestinians.  There is a particular deficit in understanding in the United States as publicity is much greater on the Israeli point of view than on the Palestinian point of view.

As a paediatrician who is a frequent visitor to the occupied Palestinian territories (oPt), I am well used to the feelings of horror that well up when you first observe the daily life of the Palestinians. And yet I recognize the basic humanity and good intentions of the majority of Israelis, together with their anguished past history which they are rightly determined not to see repeated.  But do they really understand what is going on under their military rule?

For every person who visits the occupied Palestinian territories, the reality of the situation quickly becomes clear.  The ever present road blocks, the problems in gaining access to Jerusalem, the separation wall which prevents villagers from reaching their fields, and the economic pressure of the occupation are daily hurdles for every Palestinian to overcome. As a paediatrician, I am particularly concerned by the effect of the occupation on child health.  As a contributor to the Lancet Palestinian health series1 I recommend health professionals to read these papers to reveal the effects on health which range in children from low birth weight, malnutrition and mental health problems to child injuries and a lack of access to effective health care owing to road blocks and the separation wall.

My own programme in oPt has been running since 2000 and is under the umbrella of the Royal College of Paediatrics and Child Health. We have developed a child heath course for doctors and nurses in primary care which leads to a Diploma in Palestinian Child Health, presently in the West Bank but we are now working with Gaza paediatricians also.  We have a high level of cooperation with the Palestinian paediatricians and will soon hand over to their leadership, though the RCPCH role will continue.

What can we as health workers do about this overwhelming political problem?  Is it our business to take a stance or do we sit back and avoid any involvement? I believe strongly that we do have a role for the following reasons:

  • There has always been a medical role in health advocacy on public health issues
  • Doctors are seen as objective and not politically affiliated, and should assist both sides in a conflict
  • The social determinants of health problems have been well recognized in the WHO commission on social determinants of health chaired by Michael Marmot – there is a clear connection between population health and political issues such as poverty, food marketing and conflict.

Hence I strongly recommend that health workers expand their knowledge about the facts in Israel and Palestine and get beneath the stereotypes. There are two narratives which need to be understood, but to my mind many Israelis do not genuinely understand the Palestinian situation. This is perhaps born out by a recent paper in the BMJ in which an Israeli and a Palestinian doctor write on the benefits and difficulties of dialogue.2.

It is even better if you can meet Palestinians, as the students are now doing, and work in a Palestinian health centre.

Then disseminate what you have learned, using clear language without exaggeration or ambiguity.

And finally, write to medical leadership organizations and politicians to ask them to speak out about violations of human rights in health care such as occurred in the Gaza war only two years ago 3. If we use the language of health and human rights then we cannot be accused of bias.

Tony Waterston


  1. Waterston T, Hallileh S, Odeh J, Rudolf M, Hamilton P. Teaching child health in the occupied Palestinian territory. Lancet 2009, 373, 878-880
  2. Odeh J, Clarfield M, Waterston T. What can dialogue between Israeli and Palestinian doctors achieve? BMJ 2010; 340: 278-281
  3. Waterston T. Eyewitness accounts from surgeons in Gaza. Lancet 2011; 377: 19

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