Ramallah, Occupied West Bank – The death of a 16-year-old cancer patient from the besieged Gaza Strip after he was denied admission to a hospital in the occupied West Bank has revived accusations of “favouritism” and mismanagement against the Palestinian Authority (PA).
Saleem Nawati was transferred to the West Bank in late December to receive treatment as there is no specialised cancer treatment available in Gaza Strip. The healthcare system in the enclave of two million people is near collapse due to a 15-year Israeli blockade.
Nawati was diagnosed with leukaemia, a cancer of the blood, in November, but like all other cancer patients in the besieged enclave, he had to wait for weeks to secure an Israeli medical permit to travel to the West Bank for treatment. Palestinians in Gaza have to wait for weeks or even months to get an Israeli permit to travel outside for treatment, business, or higher studies.
Saleem arrived with his uncle in the West Bank city of Ramallah on December 26 after managing to get the Israeli permit. But the An-Najah National University Hospital in Nablus refused to admit him citing a dispute with the government over unpaid hospital bills.
Government-run hospitals in the West Bank do not have specialised cancer treatment, so the PA, which governs the occupied territory, incurs high bills from private hospitals or from transferring patients to Israel, Jordan, or Egypt.
Not one hospital in the West Bank agreed to receive him, citing either financial reasons or because they lacked the treatment needed, Saleem’s family told Al Jazeera.
On January 9, Saleem died at the Ministry of Health office in Ramallah as he was waiting with his uncle, Jamal, to secure a hospital bed. His death was announced shortly after an ambulance escorted his body out of the ministry offices.
‘Am I going to die?’
“Am I going to die,” Jamal recalled his nephew saying when he heard a hospital staffer stating they don’t admit cancer patients referred by the government any more.
Jamal told Al Jazeera that the family was unaware that Saleem’s condition was that severe at the time. “Saleem’s parents are still in shock,” he said.
The family believes that Saleem’s death could have been avoided if they had better connections with PA officials, accusing the government of favouritism in referring patients.
“When Saleem went to the hospital, they refused to admit him, saying the PA has not paid its debts, but three other people were admitted – I am sure they had better connections and managed to get themselves in,” Mohannad Nawati, Saleem’s brother, told Al Jazeera.
Al Jazeera reached out to the health ministry but received no response until the time of the publication. We will update the article if we receive a response.
On January 12, the ministry formed a committee to investigate Saleem’s death.
In a news conference after the investigation concluded, the committee called the teen’s death a “moral and human failure”, saying all parties involved failed to act in time. On January 22, the ministry announced the transfer of the case to the public prosecution “to complete the legal procedures” against those responsible.
A member of the investigation committee confirmed that a hospital employee told the Nawatis that the hospital was not admitting new patients transferred by the government.
‘Where’s the hospital?’
Saleem’s death reminded people of six-year-old PA plans to build a specialised Khaled Al-Hassan Cancer Hospital in the town of Surda near Ramallah, which never came to fruition.
Many shared pictures of the proposed building on social media with a hashtag asking “Where’s the hospital?”.
Businessmen and philanthropists donated about $10m to build it, but the site of the proposed hospital stands as an empty dug-up piece of land. Plans for the 15-storey building with more than 200 beds were changed multiple times and the public was kept in the dark, activists say.
On January 14, the Ministry of Health announced that the project had been frozen due to a lack of funds.
“We started with the first phase, but didn’t have enough donations to cover the construction cost of $160m,” Prime Minister Mohammed Shtayyeh said days later, and that the donations allocated for the hospital have been placed in a separate bank account. The PA, however, has given no proof that the money has been kept in a bank.
He added that President Mahmoud Abbas recently encouraged investments for cancer departments in public and private hospitals in the West Bank, where the healthcare infrastructure is bursting at its seams due to decades of Israeli occupation.
Head of the Ramallah-based Bisan Center for Research and Development, Ubai Aboudi, said mismanagement is worse than financial corruption.
“A whole project has stopped. If you spend a huge sum of money digging up for a project and you don’t have the cash flow, then who benefitted from that money,” he told Al Jazeera.
The PA has been struggling with deep financial woes, and has been unable to pay civil servants’ salaries in full.
Shtayyeh, the PA prime minister, has urged President Abbas to launch an investigation into what happened regarding the cancer hospital.
But activists and NGOs working to advance the culture of transparency for decades say they do not see individuals being held accountable.
More than 60 percent of Palestinians believe that corruption is high in PA institutions, and that it increased in 2021, according to a December 2021 poll (PDF) by the Ramallah-based Coalition for Accountability and Integrity-AMAN that sampled 1,320 people above 18.
A quarter of respondents said they believe the most widespread crime of corruption is nepotism followed by misappropriation of public funds at 23 percent.
The Palestinian public has been growing more dissatisfied. A protest movement against PA corruption and authoritarianism gained momentum last year when matters escalated over the beating of outspoken political activist Nizar Banat to death during his arrest by PA security forces.
Jihad Abdo, the head of the Enough is Enough anti-corruption movement, told Al Jazeera, “Whenever we hear of public money or resources, we automatically think there is corruption involved.”
Azmi Shuabi, AMAN commissioner for combating corruption, said the PA has been taking steps to consolidate its power leading to a rise in lack of transparency and accountability in its public dealings.
“There’s a weak rule of law,” he told Al Jazeera. “The president’s office has been getting more authority. This has led to more decisions that benefit certain officials in power circles around the president.”
The internal Palestinian split between the two main political parties, Fatah in the West Bank and Hamas in the Gaza Strip, has frozen the operation of the PA’s parliament since 2007. To fill that gap in the West Bank, President Abbas has been promulgating laws by decrees.
While many disapprove of the PA’s decisions, most are afraid to speak out. The AMAN report stated that many people fear retaliation despite protections under anti-corruption laws on whistleblowers, and that two-thirds of people in the West Bank are not satisfied with the PA’s anti-corruption institutions and question their independence.
Marwa Farah, who worked as the acting Office Manager of the Secretary-General of the Supreme Court, said she was not protected, and that she paid the price for reporting alleged corruption in her workplace.
“After I gave my testimony to the anti-corruption commission, my identity was exposed to my employer,” Farah told Al Jazeera.
She was fired from her job two years ago at the Supreme Court.
Al Jazeera reached out to the Palestinian anti-corruption commission about Marwa’s case for comment but did not receive a response.
Shuabi, head of Aman, explained that President Abbas hires the head of the anti-corruption commission and the head of the judicial council, which makes it hard to guarantee their independence from the PA.
The main challenge remains the lack of political will to fight corruption, says Shuabi.