RamallahOnline.com

The occupation of Palestine affects every aspect of the daily lives of Palestinians, and healthcare is certainly no exception. The Palestinian health care system has transformed from civil society providing health care services – mainly primary health care – into a governmental system introduced in 1995. Hence, the health care system in the occupied Palestinian Territories is fairly recent. However and due to the Israeli occupation, it has been totally crippled and is unable to meet the needs of its population, forcing patients and their families to rely on attracting international aid in order to receive medical attention.

The health care system is not ready to confront many of the devastating illnesses that the population suffers. There lacks proper diagnostics, treatment and most importantly professional psychological and emotional support. It is easy to understand how devastating it is for a young person to suddenly discover that he or she has a serious disease. Hence, it is less easy to comprehend how this sad moment can be just the beginning of a drama for people in Palestine.

Last Wednesday, 27th May, was the first International Multiple Sclerosis Day, and many countries celebrated this as a success in the battle against this incurable disease. Although medical research is playing a fundamental role in helping people affected by Multiple Sclerosis, patients living in Palestine are out of the loop of medical advancement or clinical trials. This is because the lack of specialists and specialized centers. For this reason, on this day Palestinians suffering from MS decided to open the ‘Palestine Multiple Sclerosis Society’ Centre in the Occupied Palestinian Territories in the city of Nablus. They seek to work locally and internationally in order to facilitate better health care provision and support for MS patients through attracting local and international solidarity to this issue.

Multiple Sclerosis is a neurological disease that causes numerous physical and mental symptoms, and in many cases leads to physical and cognitive disabilities.

However while there is currently no cure available, there are several therapies that have proven to be helpful in mitigating the intensity of symptoms and in enhancing the life style of many patients, allowing them to have the most normal life possible.

These medicines are extremely costly and largely unavailable in the West Bank; they are totally unavailable in the Gaza Strip. In fact, the Ministry of Health is only able to provide one kind of medication for this disease and even this is in insufficient quantities to treat all Palestinian patients.

However the lack of medication is only the secondary issue facing sufferers of MS in Palestine. The absence of MS specialists in the Palestinian Hospital is the first huge obstacle that must be overcome. Ramallah is the main center of the West Bank and only one neurologist is available in the whole city, working only in two different hospitals and also having his out-patient clinic to serve the local population. It means that the probability of diagnosing this kind of disease quickly is very low: most of the time the patients are released from the hospital with a diagnosis of stress or other psychological problems.

This phenomenon has two important implications. First, the psychological aspect plays a huge role in this disease and the lack of consideration and misperception of medical staff can cause further suffering, as patients perceive this condition as shameful and themselves as misunderstood. Consequently, cases of depression are quite common.

The second implication is that this type of chronic illness requires immediate attention and treatment upon diagnostic. Experts are eager to treat patients aggressively upon diagnostics – in most cases by Steroids through IV – in an effort and hope to minimize the damage that can be done to the nervous system during an exacerbation. The difficulties of diagnosing the disease combined with the lack of medical records and the shame of going to hospital make it very difficult to accurately estimate the number of people with MS in Palestine. This lack of data has created uncertainty and ambiguity at the Ministry of Health in regard to the situation and numbers of MS patients which can be classified as being in crisis. This underestimation of MS reality in Palestine effects real and practical attention to their issues especially receiving priority interest at the Public Health System – the main provider of health care services.

However the problem does exist and the reality is severe, approximate statistics which compare the population of Palestine and Jordan, estimate that between 4 and 5 thousand people are affected by the disease in Palestine. This lack of information affects MS sufferers with a double burden: not only are they condemned to a more difficult life, they are also socially excluded due to the inequitable health care provision available.

Multiple Sclerosis affects mainly young people and often leads to temporary disability which can cause them to lose their jobs and any sources of income. In the case of young women, the sickness can be a cause for divorce, even if there are absolutely no risks for children health (MS is not a genetic disease). On top of these traumatic events, patients and families are totally deprived of any kind of support from the government, communities or hospitals as the system is yet to accept the burdens of this illness.

For this reason families decided to act autonomously though the Society in Nablus. It is does not seek to provide health care services or medications to patients, but it aims, above all things, to provide moral and psychological support to its members. The Society will also try to attract international volunteers to Nablus, as physiotherapists, psychologists and yoga teachers who will teach the patients how to manage their illnesses in the most efficient means possible.

The situation of patients affected by Multiple Sclerosis has received more attention thanks to the work of those families who for years have been working hard to establish their own society. However the institutional and social problems faced by those with MS are also shared by many others suffering from chronic diseases in the occupied Palestinian Territories.

The Palestinian Authority is not the only institution that is providing health care in Palestine, but all the organizations and institutions that are working in this field are mainly focused on primary and secondary health care or other unrelated, yet burdensome, illnesses such as Thalassemia.

The prosperity of basic health care services compared with the absolute lack of MS specialists and higher level health care suggests an inefficient allocation of economic resources. Most of the time the only solution available for patients is to make a private visit to a specialist in Israel, but even if the necessary permission is granted by the Israeli Army, the cost of this kind of visit is too high for most Palestinian families to afford.

The only hope for those sufferers is that civil society will play a greater role in promoting knowledge about the disease and improving the support available to families, as the “State” is presently unable to guarantee either of these. Further, pharmaceutical companies can definitely play a major role in this regard in cooperation of the international community.