A Red Crescent ambulance is searched at an Isr...
A Red Crescent ambulance is searched at an Israeli checkpoint at the entrance to Jerusalem from Bethlehem. (Photo credit: Wikipedia)

Palestinian hospitals in East Jerusalem are considered the most advanced in the oPt. They have specialist units for complicated heart operations, dialysis, radiotherapy and intensive neonatal care. In theory, Palestinian ambulances should be allowed to travel anywhere in Israel and the West Bank without being stopped for security checks. However, the reality is sobering.

Palestinian ambulances travelling from the West Bank are not allowed to reach Palestinian hospitals in East Jerusalem, without prior coordination. Patients cannot be accompanied by Palestinian family members, or even, on occasion, Palestinian medics. At checkpoints, they are required to transfer the patient from a Palestinian ambulance into an Israeli one, in order to reach the hospital. This is known as the back-to-back method, and it is still regularly denied. Patients are regularly kept at checkpoints for extended periods, often up to an hour.

In many cases, ambulances have been forced to turn back despite the patient requiring urgent medical attention. This gross injustice violates the patients right to treatment and can lead to prolonged suffering, deterioration of condition and death. Physicians for Human Rights Israel (PHRI) have collected data from ambulance crews of such cases. I have included some examples below;

Date, Description of patient, Delay (Checkpoint), Outcome:
19.01.06 – Toddler aged 18 months with eye injury – Delayed 15mins at Hizma CP – request denied, ambulance turned back.

03.08.06 – Man injured in road accident, multiple fractures – Delayed 1hour at A-Zam’im CP – back-to-back method despite prior co-ordination and increased health risks.

01.06.05 – Woman in advanced stages of labour – Delayed at A-Zam’im CP – gave birth at CP, baby died.

08.12.05 – Patient suffering from heart attack – Delayed at A-Zam’im CP for 25mins – request permitted only after PHRI intervened.

01.03.06 – Baby aged 20 days with pneumonia – Delayed at A-Zam’im CP for 40mins – request permitted only after PHRI intervened.

19.04.07 – Woman aged 80 with hip injury – Delayed at A-Zam’im CP for 40mins despite being in an ‘authorised’ ambulance – Permitted in a private ambulance, ‘writhing in pain’

02.07.07 – Man critically ill with fluid in lungs – Delayed at Tunnels CP for 1.45hours despite prior coordination – passage denied, returned the next day.

The time element is one of the most important components of treating a patient. The shorter the time until the beginning of care, the higher the chances of saving the patient. Moving and transferring a patient between ambulances can additionally lead to the deterioration of condition, particularly patients’ suffering from hip/spinal injuries. Trained medical professionals need to provide treatment on route to the hospital, not allowing them through checkpoints eliminates a critical aspect of a patients’ care.

Finally, giving check point guards and military officials the responsibility to decide whether or not a patient is in a life threatening condition effectively puts them in a position to chose who will live and who will die.

PHRI (2007) Emergencies On Hold: Entry of Palestinian Ambulances into East Jerusalem.


One thought on “Back-to-Back

  1. This does not only break my heart and irritate me, it disgusts me. Thank you for shedding a light on a subject not widely and openly discussed. Also, as a Palestinian I would like to thank you for your effort.

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