Medical Apartheid in Palestine; Interview with Dr. Alice Rothchild
Last month, and for the first time ever, the International Court of Justice (ICJ) ruled on Israel’s occupation of the West Bank, East Jerusalem, and the Gaza Strip. The historic ruling exposed discriminatory Israeli policies, which enforce a system of oppression and dominance over Palestinians in all regions it controls, including Israel, the Occupied Palestinian Territories (OPT), and against Palestinian refugees, in favor of Jewish Israelis. This constitutes apartheid, and naming this crime brings the Palestinians one step closer to the self-determination they have been struggling for since before the 1948 Nakba. Though the ICJ ruling on Israeli apartheid is nonbinding, it adds to the pressure on the international community to take action, pursue divestment, and challenge Israel’s discriminatory and illegal policies.
The consequences of apartheid in Palestine extend beyond racial and religious segregation, they permeate every aspect of basic human rights and freedoms, including healthcare access for Palestinians. For example, in January 2021 during the COVID pandemic, Israel managed to get 14 million vaccines for the 8 million Israeli citizens but gave no consideration to the 5.2 million Palestinians in the OPT, which includes the West Bank, East Jerusalem, and the Gaza Strip. However, 750,000 illegal Israeli settlers in the West Bank were able to receive COVID vaccines in January 2021.
This denial of responsibility by Israel as an occupying power is one example which illustrates its discriminatory policies. But institutionalized Israeli discrimination against Palestinians certainly didn’t begin with the pandemic. Alice Rothchild, a retired physician, author, filmmaker, and member of Jewish Voice for Peace’s Health Advisory Council, first visited the West Bank as a medical professional in 2004. Upon her first visit, Rothchild bore witness to the healthcare situation for the Palestinians, who neighbor Israel’s first-world healthcare system, yet, living under occupation, have a completely different experience. Rothchild has returned to different parts of the OPT almost every year after her first visit, with the goal of helping Palestinians get the healthcare access they need. Each time Rothchild returns to the United States, she brings stories of what she witnessed in Palestine back, helping us understand what ‘medical apartheid’ really is.
The term ‘medical apartheid’ helps clarify and draw attention to the disparities in healthcare between Jewish Israelis and Palestinians in the OPT, who face numerous barriers when seeking healthcare services. These barriers are not incidental or accidental, they are a direct result of deliberate policies and practices manufactured by the state of Israel.
“In the occupied territories in the West Bank, there are settlers living in these well-funded, well-supported, heavily militarized settlements who have access to first world healthcare through the Israeli medical system. But if you live in the West Bank and you’re Palestinian, your healthcare is under the control of the Palestinian Authority, which was set up by the Ministry of Health, as well as UNRWA for the refugees, and a huge number of NGOs and private providers. But overlying this whole system is an Israeli policy of de-development.” said Rothchild.
“This was particularly clear in Gaza, but it also goes on in the West Bank, where, because of Israeli policies about what can get in and what goes out, the Israeli government has a policy of not letting medical institutions develop, not letting medical staff get training, and not allowing people to go to [medical] conferences.”
Rothchild went on to provide examples of how this plays out in everyday situations. She explained that when she was providing care in a hospital in Hebron, there was a CT scanner that had a broken piece, which could not be fixed because the new piece was held up at an Israeli checkpoint for months.
“The policy of holding up a part of a CT scanner is a way to be sure that they can’t use the CT scanner, which ensures that patients won’t get the diagnostic treatment that they need. This is a way of de-developing the healthcare system, so the Palestinians can’t function as a first world healthcare system.” Rothchild explained.
The same thing is happening right now in Gaza, where Israeli policies deny entry of crucial medical supplies and have cost many Palestinians their lives. For nearly 10 months now, trucks containing millions of dollars of vital aid have been queued up at the Gaza-Egypt border, and research shows that Israel has denied the entry of arbitrary items due to claims of ‘dual use.’ These rejected items include anesthetics and anesthesia machines, oxygen cylinders, ventilators and water filtration systems, sleeping bags, medicines to treat cancer, water purification tablets, and maternity kits. As a result, many patients in Gaza are withstanding amputations and other life-changing surgeries with neither anesthesia nor proper medical equipment.
The systematic denial and restriction of healthcare access in Palestine constitutes a form of collective punishment, which is prohibited under international humanitarian law. Rothchild explains, “For Gazans, before October 7th – when they had a healthcare ‘non-system’, as opposed to a destroyed healthcare system – if people were very sick, they would apply for permits to get treatment in East Jerusalem or sometimes in Israel, Jordan, Egypt, wherever, and Israel restricted these permits. So, you had thousands and thousands of people with critical illnesses that couldn’t be treated in their location who couldn’t get a permit to get treatment where they needed, or they would get a permit and it would come the day after the appointment had been made in the hospital. Or they would get the permit for the first chemo, but not for the second chemo. Or if there was a kid with cancer, the kid would get the permit, but the mother wouldn’t get the permit [to travel with her child for treatment].”
A study from the World Health Organization showed that between 2019 and 2021, only 65% of patients in Gaza who were referred to outside hospitals were able to get that treatment, and only 46% of patient companions were accepted to go with them. Since October 7, 2023, only 4,900 patient requests for treatment abroad have been approved out of over 13,500 requests that were submitted. Since May 7, 2024, only 23 patients have been taken out of the Gaza Strip for medical treatment.
Mental health is a whole other conversation. There are many Palestinians who need mental health treatment because of the Israeli occupation’s effect on their lives. Rothchild explains that there is a “high number of men and boys who’ve been imprisoned or detained without charges for so many months and released, tortured, etc. So, there is this vast amount of trauma. And all those folks do not get treatment for trauma.”
“There’s a whole issue of funding, availability, and accessibility if medications can’t get in. If you have a regular health disorder, you may not have the ability to access medication, pay for it, or it may be the medicine that was used 10 years ago that’s now being dumped in the third world. All that kind of stuff happens.”
In Gaza, Rothchild explains that since the destruction and damage is on-going, the trauma never really ends, which makes treatment extremely difficult. “If you’re being bombed, you can’t get over your traumatic stress disorder because it’s not post and it’s never post.”
So, what can we do? It is clear that medical apartheid exists in Israel-Palestine, and the ICJ’s ruling last month reaffirms just how seriously apartheid affects the lives of the Palestinians. Rothchild calls on medical professionals worldwide to demand a cease-fire and an end to the Israeli occupation and siege on Gaza. She emphasizes the need for professional organizations to speak out about medical apartheid, because the individual voices that are speaking up are being silenced by the medical community, highlighting the institutional racism that is going on in the U.S. healthcare system as well. The international community at large must also speak up; increased global pressure on Israel will weaken its apartheid system and bring us closer to eliminating it forever.
To learn more about Dr. Alice Rothchild’s work, please visit her website here.
To read testimonies of how Israeli policies and military practices affect the lives of Palestinians in Gaza, read AFSC-published Light in Gaza and Displaced in Gaza.