Dozens of Palestinians may die if Israel does not act to ensure their medical care after a planned military withdrawal from the Gaza Strip later this year, according to the report by Physicians for Human Rights-Israel.

Israel's current position is that it is not responsible for the fate of patients in Gaza, and is willing, at best, "to take into account humanitarian considerations" and "exceptional cases", without explaining what these may constitute, says the medical rights group. 

"Past and present experience shows that Israel does not interpret urgent medical need in a manner consonant with the accepted definition among medical professionals," said the report, titled The Morning After, which was released Thursday.

The Gaza health system is strained to serve about 1.5 million people. According to PHR, there is one bed per 715 people in Gaza hospitals, a rate almost a quarter that of the lowest acceptable standard in the Israeli healthcare system.  

In addition, a number of services, including catheterisation and cardiac surgery, burn treatments, neurosurgery, radiotherapy, eye operations and organ transplants are unavailable in the war-torn coastal strip.

Bureaucratic nightmare

Currently, Palestinians requiring medical treatment abroad must navigate a matrix of roadblocks and administrative procedures imposed by Israel, a time-consuming process they often can ill afford.

Israeli forces are to withdraw
from Gaza this year

"If Israel continues to ignore the urgent medical needs in the Gaza Strip, we expect to witness an increase in the mortality rate of Gaza patients following the disengagement due to the lack of proper medical treatment," concluded the report.

The PHR says that Israel was to blame for the poor state of Palestinian healthcare during the occupation and that it will not be absolved of its responsibility after the proposed disengagement from the Gaza Strip, a plan it says will only remove visible markers of the occupation. In fact, Israel would be legally obliged to provide a solution to the Gaza healthcare crisis, something it has for decades avoided.

Geneva Conventions

Its view was echoed by the UN human rights envoy to the Occupied Territories, John Dugard, in his annual report to the UN Commission on Human Rights. The South African law professor said Israel will still be bound by the Geneva pact on the treatment of civilians under military occupation after withdrawal because Israel still would retain control over Gaza's borders, and air and sea space.

"[Israel] will remain an occupying power still subject to obligations under the Fourth Geneva Convention," Dugard said in the report, posted on the website of the Geneva-based forum.

The PHR said that if Israel and donors do not plan the rehabilitation of the system, a humanitarian disaster can be expected.

But according to Dr Mustafa al-Barghuthi, president of the Union of Palestinian Medical Relief Committees (UPMRC) and former presidential hopeful, a humanitarian disaster is already under way.

"The humanitarian disaster has already happened in both the West Bank and Gaza," he said. 

"Israel has caused a severe disaster by building the wall and establishing over 300 checkpoints. The result is that ... 20% of all children who die before the end of their first year of life die because of Israeli checkpoints," said al-Barghuthi in a telephone interview with Aljazeera.net.

'One huge prison'

"The disengagement plan is not about withdrawal, it is about redeployment; it is about reinstating and restructuring the occupation in the form similar to the apartheid system, and this will further complicate medical services. Gaza will become one huge prison," al-Barghuthi said.

Aid agencies continue to assess
needs in Gaza

International aid agencies were mostly cautious about the health report, saying a professional assessment of Gaza's healthcare needs was necessary.

A US Agency for International Development (USAID) official said of the report: "We take issue when people throw around that kind of language. You can't keep crying wolf.

"We also have to wonder where they are getting their figures from."

Costs

The PHR report said it would take about 10 years, at a cost of $250 million annually, to bring the Gaza healthcare system up to Jordanian levels, and $500 billion to establish the physical and professional medical infrastructure.

Nonetheless, the USAID official said the donor community is taking precautionary steps to avert a post-withdrawal crisis. 

"The donor community is evaluating what might be needed should there be severe closures for an extended period of time," the official said.

"We are pre-positioning pharmaceuticals and medical supplies and food assistance throughout Gaza before disengagement, and we are actively in discussion with implementing partners now to ensure that happens."

Assessment needed

The World Bank was similarly cautious when it came to the sums of money the medical rights group estimated would be needed to overhaul Gaza's healthcare system.

"The report is correct in pointing out that disengagement from Gaza is unlikely to improve this situation without measures to allow patients and medical staff free entry and exit into Gaza," said Anne Johansen, senior health specialist at the World Bank's Jerusalem office in an interview with Aljazeera.net.

"But I would strongly caution against such large investments without a careful assessment of the increase in operating costs. Great care must be taken to develop the Palestinian health system in a cost-effective and financially sustainable manner."

"We need to shake people to alert them to the reality on the ground. There is no nice terminology to describe the situation"

Ibrahim Habib, PHR

The PHR says the figures are estimates based on Israeli and Palestinian health data. It also says the Gaza situation should be called what it is.

"Do we have to have a tsunami to call it a humanitarian disaster? Every day all we see in the news is Gaza, Gaza, Gaza, to the point where people have become desensitised. We need to shake people to alert them to the reality on the ground. There is no nice terminology to describe the situation," said Ibrahim Habib of the PHR. 

"We have seen so many cases of people dying because they are unable to receive proper medical care. We know what the reality is. The problem is Israeli society does not want to know. It is easier for them not to know."
 
An Israeli government spokesperson did not return a call for comment on the report.