The third question we asked was about the Palestinian health-care system. We can’t say that we were surprised by the generally negative impression that local Palestinians, in particular, have towards their health-care system. Not to justify the rather weak position of our health system, but we truly believe that many of its woes are the consequences of the occupation and the restrictions on movement inside the occupied territories and on travel to Jerusalem. Ending on a positive note, hats off to Sam Bahour who wrote “Having any ‘system’ operating given our state of affairs, or lack thereof, is a huge success.”

Question: On a scale of 1 to 10, how would you grade the health-care system in Palestine and why?
(1 = not at all healthy; 10 = very healthy).

1. Extremely poor. I live in the Gaza Strip, and the health services in Gaza are very poor and inefficient.
Mkhaimar Abusada, Gaza

I must admit I do not know! But I can tell you that there are many qualified good Palestinian medical doctors and medical professionals working in Germany!
Martin Ohlen, Germany

4.
Ayman Safi, Ramallah

4.
Daoud Kuttab, Jerusalem, Amman

2. Really poor, especially for children.
Liana Badr, Ramallah

1.
Randa Farah, Canada

6. Poor health insurance, not applying the International Classification of Functioning, Disability and Health (ICF), medical mistakes, shortage of personnel and medications, and low-quality medical performance.
Lana Bandak, Jerusalem

3.
Majdi Habash, Ramallah

8. I have had the pleasure of working as a physician in both Palestine and the United States, and people too often believe that because the West has access to better resources, it necessarily means there is better health care, but that is far from the truth. Palestinian public hospitals, while unfortunately overcrowded, exhausted, and destitute by no fault of their own, make up for said deficiencies by offering some of the most brilliant and compassionate health care providers the world has to offer. It’s no surprise that many Palestinian-taught physicians go on to perform at the highest levels of residency and fellowship programs across the world; their skill, tenacity, and intelligence are unmatched. With that said, we need to invest more in our hospitals and provide the appropriate technology (and teachers to train new technicians and doctors) so that we can offer our people the best that modern science has to offer. The foundation to be the best health care system in the world is available, but we need money and access.
Athar Joseph, Hebron/Chicago

5. Health care is not only medical services and medication, it is also an attitude and a life priority that is lacking among the Palestinian health services.
Adnan Abdelrazek, Jerusalem

7.5. It depends on one’s income, location, and general health.
Paul Parker, Chicago

4. It could be improved on the level of customer care and if national health insurance would be free and equal for all people.
Mahmoud Khweis, Jerusalem

Being from Jerusalem, it is difficult for me to assess, but I know that all Palestinians are eligible for free medication and care against cancer, and this is the most expensive treatment. This is excellent in my opinion.
Simon Kouba, Jerusalem

6. Since I’m now based in London and I’m exposed to both the British health care system and the Palestinian, I can confirm that the Palestinian system is unique in terms of service; I would give 6 for the Palestinian system and 5 for British. This is not an exaggeration; only when I experienced the British system did I begin to appreciate the Palestinian one where there is a high level of care available when needed, access to private doctors is not impossible and out of reach, and any checkup is possible with reasonable fees and competent doctors. I am not sure about the governmental services as I have not tried them.
Yara Sharif, Ramallah/London

4 to 5. There is a lack of general practitioners who can advise on when to visit specialists and who offer individual and family advice about good health practices and conducting preventive tests.
Of course, there is the issue of incomplete medical insurance or lack of medical insurance which means that many do not go for the right medical care. Many good specialist services are in Jerusalem or Israel and therefore not easily accessible. Primary health care is a big issue.
Toine van Teeffelen, Bethlehem/Holland

4.
Bisan Samamreh, Hebron

I rate it as 0! It is extremely poor. It requires full and profound restructuring with serious budgets to be allocated for its development. In some hospitals and family clinics, one would encounter disastrous issues like dirt and no hygiene whatsoever!
Doha Al-Wazany, Nablus

5. Good medical care costs money, and there are disparities between hospitals and a haphazard way of finding good doctors, usually through word of mouth. There is no integrated health system that can track a patient’s history. Also, as in other places, doctors are rushed and too quick to prescribe medication, of which the average person takes too much.
Fida Jiryis, Fassouta, the Galilee

4. It is not holistic. It’s often a factory line. One of the doctors I see doesn’t even keep a file or medical history on me. In and out. Next please.
Morgan Cooper, Ramallah

4. No good investment in public health and no accountability for medical mistakes.
Terry Bullata, Jerusalem

7. Sometimes mistakes are made in diagnosis, not much responding on time, emergency not available at all hospitals, at night not many services provided.
Ibtisam Husary, Ramallah

4. It depends on which hospitals or clinics you go to. Unfortunately, public hospitals don’t offer the best service. In addition, some doctors treat patients as customers, so they talk to them as though they are ignorant and prescribe many tests in order to get extra money.
Haneen Battrawi, Ramallah

3. Health care has many dimensions. Just pay a visit to the Palestine Medical Center in Ramallah then one will know what I mean. Health care provision in Palestine needs a lot of work, including health insurance, the quality and monitoring of health care delivery, and nationwide electronic medical records, etc. I have put a lot of effort into providing health care software solutions in the past three years and am proud to say that we have accomplished a lot in the electronic health (medical) record and managing software solutions.
Yahya Al-Salqan, El-Bireh

7. It could be better if regulations were better enforced and the government would invest more in human resources and equipment, which would have to be regularly maintained.
Ramzi Sansur, Ramallah

6. That’s because of the shortage of medicine in the public clinics, and the lack of a comprehensive healthcare system, including treatment for chronic disease such as cancer and complicated surgical operations capabilities.
Nader Dagher, Ramallah

If I want to exaggerate my rating, I would give it 4! As for why, this is a huge issue and a long story, but I would summarize it in six points 1) corruption; 2) a lack of effective strategy; 3) a lack of technical infrastructure and trained human resources 4) a lack of professionalism; 5) too much bureaucracy; 6) significant misuse of resources. (This is not a reflection of the hospital point of view in any way, but rather my own personal opinion based on my experience in the health sector.)
David Dahdal, Jerusalem

10. Having any “system” operating given our state of affairs, or lack thereof, is a huge success.
Sam Bahourthe weather.
Liana Badr, Ramallah

6. We have a good health system compared to others in the region.
Rajiah Abu Sway, Jerusalem

6.
Ahlam Tarayra, Hebron

Overall, I only know the Gaza part where the situation has become more complicated even with regards to basic services. Still, and that is why I really cannot give a figure, there are huge differences. The UNRWA primary health care certainly is very good, and there are some high-quality doctors and medical facilities.
Bo Schack, Norway (previous director of UNRWA in Gaza)