MPH Practicum

My Masters in Public Health Practicum took place in the summer of 2009 in the West Bank of the Middle East. My practicum entailed assessing healthcare accessibility for Palestinian Refugees in the West Bank. I have summarized the practicum and results below. This work helped to inspire the current project of bringing a group of medical students with me to the West Bank to experience what I had seen, heard, and touched but in multiple avenues of society.

The matter of Israel and Palestine, a seemingly unending disagreement, has resonated throughout the world affecting both policy and perceptions. Focus on important initiatives such as peace and co-existence have overpowered other important issues such as healthcare, education, and employment, among others. Consequently, healthcare accessibility has not been comprehensively assessed for Palestinian refugees, a fundamental yet controversial right for human beings. This research provides an assessment of accessibility for Palestinian Refugees in the West Bank.

Health is a keystone to the livelihood and sustainability of an individual. Unfortunately, millions of people do not have access to quality care due to many reasons. This varies from political conditions, economic plight, infrastructure, and cultural practices, to poor quality and non-availability of health facilities. Access to quality health care and quality education are basic human rights issues. Healthy and educated people will build better communities; contribute to economic development and stability. This research assesses healthcare accessibility by evaluating obstacles of transportation, political turmoil, and economic plight. More specifically, the categories include: Transportation (>2 taxis or walking >30 minutes), Financial, or Political (Occupation, separation wall, checkpoints).

This practicum was a cross sectional analysis of the incredible achievements the United Nations Relief and Works Agency (UNRWA) has accomplished as well as identifying issues that can be potentially addressed seen as essential to increasing healthcare accessibility. 750 surveys were completed at 5 different camps through interviews in order to assess these obstacles and develop context. For the majority of Palestinian refugees, primary care is accessible through UNRWA health clinics free of charge. Consequently, 74% of the population does not face any obstacle to healthcare because of UNRWA’s persistent and vast networking within the population.

For Palestinian Refugees that do face obstacles to healthcare accessibility, it is clear that the primary factors hindering accessibility for Palestinian refugees are transportation and the Israeli occupation.

Furthermore, it appears that 94% of the rural population faced some sort of obstacle to healthcare while only 18% of the urban population faced an obstacle.

This practicum identifies the obstacles that Palestinian refugees face when accessing their healthcare. However, it should be emphasized that the research is merely an indication of obstacles that have been overcome allowing for the refugees to access healthcare – and consequently involved in this research. There is an incredible amount of physical obstacles and barriers – totaling 563 in the West Bank in 2007. These obstacles may not allow a significant number of Palestinians and Palestinian refugees to access healthcare. Since they were not able to reach clinics, I was not able to survey them and incorporate them into the data.

Not only does this research highlight the right of healthcare for Palestinians, but in a broader context, the human rights violations against Palestinians living under an internationally illegal Israeli military occupation. UNRWA and other organizations can address these issues in order to improve healthcare accessibility and quality of life. The peace process is critical to improve the livelihood and health of Palestinians within the West Bank and the Gaza Strip. There are many possibilities that can unfold in the near future, but time will tell.

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