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While Israel, the occupying power, abdicated responsibility for Palestinian healthcare in 1994, it has maintained control over all determining factors for their health prospects - whether that is access to a specialist, the latest medical technology, clean water, or a nutritious diet.

A new new report published by Physicians for Human Rights in Israel (PHR) finds stark disparities between the health of Palestinians and Israelis.

Looking at the grim findings in the report we learn that infant mortality among Palestinian children is five times higher than that of Israeli children; Palestinian life expectancy is, on average, 10 years less than Israelis (a gap that appears to be growing); and Palestinian women die in childbirth - in cases that are nearly all preventable - at a rate that is four times greater than Israeli women.

The premature mortality of Palestinians, revealed in statistics, is not only the result of the outright violence they suffer by Israeli soldiers' and snipers' bullets or even bombing campaigns. It is the result of a ubiquitous, accretive, and noxiously unhealthy environment, born of and sustained by the insidious control Israel exercises over Palestinians.

For example, the report tells us that today, the leading cause of death among Palestinians is from cardiac diseases. Technological advances in this field have made most of these diseases highly treatable, dramatically reducing fatalities.

Access denied

However, because of Israel's embargo on travel permits, Palestinian doctors are routinely denied access to education in these developments in techniques and equipment.

Furthermore, while Israel's control over movement and travel has made it nearly impossible for Palestinian doctors to specialise in areas in dire need of practitioners, or even work in hospitals that serve Palestinians, the Palestinian Authority is responsible for paying for Palestinians' treatment abroad. As a result, 30 percent of the Palestine's Ministry of Health's budget is devoted to sending Palestinians elsewhere for adequate care.

Doctors warn of looming Gaza health crisis

While Israel, the occupying power, abdicated responsibility for Palestinian healthcare in 1994, it has maintained control over all determining factors for their health prospects - whether that is access to a specialist, the latest medical technology, clean water, or a nutritious diet.

But some of the most stunning findings in this new report are in fact not new. For example, 20 years ago, in June 1995, PHR in Israel asked why children in Gaza were dying from heart defects that were operable.

But in Gaza there was neither a paediatric cardiologist nor the equipment and facilities needed to perform surgeries that could save those childrens' lives - all vestiges of the underdeveloped medical infrastructure created by Israel during its direct occupation.

The 27 years of direct Israeli occupation - prior to the Oslo Accords - had seen a set of contradictory developments; an underdeveloped healthcare sector paradoxically coupled with an enhancement of certain services, such as the routinised administration of vaccines for children, an increase in women giving birth in hospital settings, and even a higher caloric intake.

Infant mortality reduced

In 1997, Israeli professor and author, Neve Gordon, wrote that during the 27 years of Israel's direct occupation, Palestinian infant mortality was reduced by three-fifths and life expectancy grew but both still lagged behind Israel and "developed" countries.

After detailing the woefully inadequate healt care to which Palestinians had access, Gordon indicted Israel with violating the Geneva Conventions of 1949 "which stipulates that the adequacy of healthcare services must be determined by the extent to which the real medical needs of a population are being met".

Israel's healthcare system for Palestinians, in place from 1967 to 1994, provided a veneer of parity with Israelis', allowing the last 20 years to pass with no improvement to, and some deterioration in, Palestinian health prospects.

In fact, the strategies of the occupation's healthcare system had been designed by Israel to maintain order while assisting in the larger project to dismantle geographic boundaries between the Israel established on Palestinian lands in 1948, and those of the West Bank and Gaza.

At the turn of the millennium, two former chief medical officers for the Civil Administration wrote: "The overall goal was to keep the population satisfied and quiet, and to provide a stable, calm, and reasonable background for future negotiations that would lead to a political solution."

The strategy certainly did not provide a framework for a good healthcare system for occupied Palestinians, but it may have whittled away a bit at the more glaring disparities between Israeli and Palestinian health in order to lay a groundwork for long-term occupation, and, yes, a "political solution" - wherein the longest military occupation in history is regarded as normal.

It is easy to fixate on individual life choices as causal factors for life expectancy, but as the report's dismal findings make very clear, the general health of a population is the consequence of environmental and social factors that lie far beyond individuals' control.

For Palestinians, their control is limited by a hermetically sealed border, a beleaguered budget out of their control, checkpoints, blocked roads, disconnected water pipes, and old hospitals with outdated equipment and few medicines.

Charlotte Silver is an independent journalist in San Francisco, formerly based in the West Bank, Palestine.

The views expressed in this article are the author's own and do not necessarily reflect Al Jazeera's editorial policy.

Source: Al Jazeera