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Delivering Primary Healthcare through mobile teams in the West Bank

Photo credit: Health Cluster. Location: Khan Al Ahmar, one of the communities being services by the mobile health teams

Humanitarian Bulletin: Delivering Primary Healthcare through mobile teams in the West Bank

Access to basic health services remains a critical challenge for Palestinians living in Area C, H2 and seam zone, particularly for communities located close to settlements, the separation wall, closed military areas, or areas closed by gates. Furthermore, some communities are unable to reach healthcare services due to the expense or lack of transportation. Distances have lengthened and are more difficult because of the need to travel circuitous ways on by-pass roads around settlements and barriers.

In health emergencies such as childbirth, heart attacks, accidents or injuries, access to health services must be timely to address urgent life-death situations, but for these communities, access to emergency services is most challenging as even ambulances face delays in reaching the community.

Women, children, elderly and persons with disabilities are critically affected by poor health access. Women are most vulnerable during pregnancy, childbirth and newborn care, sick children and infants may also need emergency care at night, and the elderly, chronically ill and disabled depend on others for access. The knowledge that health access may be difficult and risky also serves as a psychological stressor and can affect health directly.

Currently, a population of over 220,000 people rely on visiting mobile health teams and clinics provided by the humanitarian community, however the lack of funding means that some of these mobile health clinics have had to close their services, or face risk of closure. On the 20th February, the acting Humanitarian Coordinator, released financial support from the Humanitarian Fund for the occupied Palestinian territory (oPt HF), preventing the closure of UNRWA’s six medical teams in 39 communities, mainly in Area C, where they will provide primary health care in mobile clinics.

However, over 40 communities with a population of 12,883 are still without access to basic primary healthcare services including basic rehabilitation, an additional 11 communities located in Hebron, with a population of 9,598 people, are at risk of losing these basic services within the first quarter of 2018. Health Cluster partners are trying their best to mobilise resources.

 

Photo credit: Health Cluster / Nabila Mousa is a nurse working with PMRS in the mobile health clinic in the E1 area.

Photo credit: Health Cluster / Nabila Mousa is a nurse working with PMRS in the mobile health clinic in the E1 area.

Khan al Ahmar – Mobile Health Clinic

Khan al Ahmar is a Palestinian Bedouin village, inhabited by approximately 32 families. It is located in Area C of the West Bank, between the Israeli settlement of Ma’ale Adumim and Kfar Adumim and it is one of several Palestinian communities facing forced relocation because it falls within the “E1” plan that would link the Israeli settlements with West Jerusalem.

Khan al Ahmar lacks the most basic life services including water, electricity and access to health. There are no health clinics within the vicinity of the village and the access of its inhabitants to emergency medical services have been extremely difficult as ambulances and health personal heading to the village are delayed by the Israeli security forces. The only health provider is a local NGO, Palestinian Medical Relief Society (PMRS), funded by Medico International, providing healthcare through its mobile health clinics.  

Nabila Mousa is a nurse working with PMRS in the mobile health clinic in the E1 area.  Nabila has been working for seven years in the mobile clinic where they visit six Bedouin communities each week.  Nabila explains: “It is a huge responsibility to work in the mobile health clinic, because we are the only health care providers for all these communities. We are responsible for the lives of thousands of people.  Our small team consists of the general practitioner, two nurses and a midwife. These communities trust us and depend on us.”

Photo credit: Health Cluster

Nabila continues: “Every Wednesday we go to Khan el Ahmar, we use the mosque structure as the clinic. Patients will be waiting for us. If we are 10 minutes late, they will start calling us. We use solar energy to use basic medical equipment. On average we see 70 patients, 60 of them are women and children.  The nearest city with a primary health clinic or hospital is Jericho, which is 20 km away. Transportation to Jericho is expensive for the community, and the majority prefer to stay sick rather than bear the hardships of getting there.  The mobile health clinic is an essential need to the community. It is lifesaving.  In the clinic, we provide G.P. consultations, women health services, health education and all the necessary medications.  Many of the patients we meet have chronic diseases, like diabetes and high blood pressure, and we have to follow up with them and constantly provide them with the needed medications.  The village became completely devoid of any health service in November 2011 after PMRS was forced to stop its mobile clinic to the village due to funding shortages. This was a disaster. We managed to resume the work after 6 months, and the condition of patients with chronic diseases was tragic. The majority of them stopped taking medications and their health dramatically deteriorated. Once we resumed our services, we found that many children were suffering from extreme skin and respiratory conditions that would have been easily treated if it was detected in the early stages. The community was angry at us and we felt terrible. At that moment we realized that we have to do everything we can to continue our work with these communities.” 

Nabila added, “We treat acute and chronic illnesses and provide preventive care and health education to patients. The latter is an extremely important part of the clinic as we focus on educating women on their health and on their children health. We educate them on the importance of breast feeding, pregnancy follow ups and on breast cancer early detection.  We also offer a modest pharmacy in the clinic. It has oral contraceptives, condoms, cough medications, antibiotics, medications for chronic diseases and skin care tubes.  People in the community keep asking us to visit them more than once a week.”

There are currently 73 communities receiving healthcare through the mobile health clinics run by different Health Cluster Partners. However, 40 communities are still without access to basic primary healthcare services including basic rehabilitation, and an additional 11 communities located in Hebron are at risk of losing these basic services within the first quarter of 2018.

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