Health system crisis in Palestine: U.S. physicians bring relief to West Bank and Gaza

Eid B. Mustafa, MD, has seen plenty of pain and suffering since his first medical mission to the West Bank in 1988: patients with skin cancer, babies with cleft lips, young girls with severe burns.

The need for medical care keeps the Texas doctor going back. A June mission with Physicians for Peace, a nonprofit, international humanitarian organization based in Norfolk, Va., was his 16th trip. While the illnesses Dr. Mustafa and other volunteer doctors treat have remained the same, the medical climate in the area has deteriorated.

The Palestinian health system is in a deepening crisis. The doctors said international sanctions against the Hamas-led government have caused depletion of supplies and medications. Health care professionals have worked for months without being paid by the government.

Dr. Mustafa and other U.S. physicians who have visited the region this year fear Palestinian health care will only get worse. They said the death toll of patients would continue to rise unless conditions improve in the West Bank and Gaza.

"It's never been very good, but it was manageable. But this time, the health care system is on the verge of a meltdown. With the lack of funding, the system is running on empty," said Dr. Mustafa, a plastic and reconstructive surgeon in Wichita Falls, Texas.

Dr. Mustafa was the team leader of the Physicians for Peace group that traveled to the West Bank in June. The mission's focus was burn care, with the medical team teaching medical and surgical aspects, including showing burn teams how to make compression garments and splints.

"I go to the West Bank because I can be more effective there, and there's no place where promoting peace through medical collaboration is more profound," Dr. Mustafa said.

The doctors could not donate supplies during the mission because of U.S. Treasury Dept. regulations, Dr. Mustafa said. "Occasional aid trickles in. Our intention is to fill the gaps [in medical care]," he said.

Trying to make a difference

Some physicians said patients fear they won't get adequate care due to the medical crisis.

"The major difference [from previous trips] is the lack of hope. When I went the last few times, everyone was hopeful. This time, it was a mood of desperation and a lack of hope. In the medical field, that is a bad thing," said Rajai Khoury, MD, a cardiovascular surgeon in Wheeling, W.Va., who also went on the June trip.

That same month, Walid Yassir, MD, made his third trip to the region through the Palestine Children's Relief Fund, an Ohio-based organization. For a week, he did spine surgeries on children who might otherwise have gone untreated.

"Every day you think it can't get worse and it gets worse," said Dr. Yassir, chief of pediatric orthopedics and scoliosis at Tufts-New England Medical Center in Boston.

Most of the U.S. physicians who volunteer in the Palestinian health care system are of Palestinian descent. Hugh Watts, MD, is an exception. Dr. Watts learned of the Palestine Children's Relief Fund through his work with the Shriners Hospital for Children in Los Angeles. He has been to Gaza a few times and went to the West Bank in November 2005; he has performed surgeries on children with deformities.

"[Children] are being abused in the sense they are not getting a fair shake. They are not getting the care that they need," said Dr. Watts, clinical professor of orthopedic surgery at the David Geffen School of Medicine at UCLA.

Fareed N. Fareed, MD, spent 12 days in the West Bank and taught a two-day advanced cardiac life support course in Ramallah to certify 20 physicians and nurses according to American Heart Assn. guidelines. He also visited emergency departments in Nablus.

He said resources at the hospitals were limited, and the emergency departments were overburdened and overcrowded. Hospital employees had not been paid for four months

"It's basically like a Third World country. Some basic drugs were not even available," said Dr. Fareed, assistant clinical professor of medicine at Columbia University Medical Center in New York. "There's a lot to be done there."