From ONE Magazine
Striving for Health and Social Justice in the Galilee
text by Lise Grandephotos by Karen Lagerquist
In 1981, a group of Palestinian doctors and health professionals founded the Galilee Society for Health Research and Services in the small Arab town of Rama in Israel. Long celebrated for its beauty and sacred history, the Galilee is home to most of Israels Arab population.
According to Dr. Hatim Kanaaneh, one of the Societys original members and its current president, Arab communities in the Galilee have suffered from substandard health care for decades, consistently ranking far above the Israeli average in rates of childhood diseases and infant mortality and below the norm in terns of life expectancy. Nearly 40 percent of all stillbirths and deaths under the age of five in Israel occur in Arab communities despite the fact that Arabs comprise less than 20 percent of the countrys total population. Israeli Jews live longer than Arabs, have access to more and better health care facilities and benefit from a significantly higher overall standard of living.
In contrast, the people most at risk in the Galilee, Arab mothers and young children, are the ones least likely to receive proper medical care and the ones most likely to live in poverty. Poor health among Israeli Arabs reflects a long-standing pattern ofneglect by Israeli health care providers and social welfare institutions, a situation the Galilee Society was created to change.
Our goal today is the same as it was when we first started to work for equitable health opportunities and to improve the overall level of health care to Arabs by closing the gap between the services the two communities receive, Dr. Kanaaneh explained during a recent visit to the New York headquarters of Catholic Near East Welfare Association. We want the Israeli state to offer the same level of care to its Arab citizens as it does to its Jewish citizens.
Dr. Kanaaneh feels that persuading Israel to treat Arab communities equitably is an uphill struggle and the Galilee Society has been forced to develop a strategy combining advocacy, education and civil initiative.
This community, he continued, needs a voice before it will have any kind of impact at the policy level and thats what we try to provide at the Galilee Society a strong voice.
One of the Galilee Societys most successful strategies is to set up programs that the government is then encouraged to take over. Since its creation, the Society has built seven health clinics in Galilee communities with no medical facilities. Four of these clinics have been turned over to Israels Ministry of Health and the remaining three are scheduled for transfer. Where the Ministry has taken over Galilee Society clinics, the quality of government health care in these locations has improved dramatically.
According to Dr. Kanaaneh, one of the Societys main goals is to pressure the Health Ministry into providing health services even in poor and outlying areas. In many cases, the only way to push the Ministry into delivering care is for the Society to provide it first.
It would be better if the government did what it should, but since it doesnt always, the Society is here to take the initiative, he explained.
The Galilee Society has recently established four permanent clinics in the Negev, another underdeveloped area in Israel with poor health care. The clinics were built in full consultation with the Ministry of Health and will also be turned over to the government.
To reach the many villages that still have no infirmaries, the Galilee Society maintains a mobile health clinic. The mobile clinic was one of the Societys first projects, and the Pontifical Mission was one of its first financial supporters. The fully equipped van is staffed by a local nurse and provides basic primary health care to hundreds of local Arabs, including Bedouin. Dr. Kanaaneh explains that the nurse has a double role:
We wanted young Bedouin girls, most of whom have few opportunities, to benefit from a positive role model. It is gratifying to see that more Bedouin girls now go to high school than ever before.
The mobile unit has been so successful in bringing basic care to isolated communities that Israels Health Ministry has agreed to assume full responsibility for continuing the service in several villages.
During its first months of operation, the mobile clinic sparked one of the Societys most impressive campaigns and helped put the Society at the center of a struggle for equal rights. The clinic was faced with an outbreak of hepatitis in several unrecognized villages. One child died and several more were hospitalized. The Galilee Society used the hepatitis outbreak to draw attention to the appalling conditions in these isolated, mostly Bedouin villages. (Until the creation of Israel, the Bedouin of Palestine were nomads.)
The Israeli government maintains that these communities are illegal, Dr. Kanaaneh reported. It refuses to grant them official municipal charters, making them ineligible for any form of government assistance. Their status is precarious. Excluded from the national water and electrical grids, these villages are the most backward and poverty-stricken in all of Israel.
Based on data gathered by its mobile clinic, the Galilee Society was able to show that the primary cause of the outbreak was the lack of clean water. In 1992, the Society took its case to the International Water Tribunal in the Netherlands, charging Israel with discrimination. The court decided in favor of the Galilee Society and ordered the Israeli government to supply water to the unrecognized villages as well as to settle the question of their legality. To date only four of the more than 70 illegal villages have been granted official status by the Israeli government; however, the Galilee Society sees this recognition as a first step.
The case was doubly significant in that it put the issue of water on Israels political agenda. Israels Labor Party has recently included an explicit water policy in its platform. With justifiable pride, Dr. Kanaaneh explains that during the last elections, Labor candidates spoke openly about the need to provide clean water to the Galilee. This represents a major political breakthrough. Finally, Israeli politicians are beginning to listen to the needs of our communities.
Getting the Israeli government to listen to its Arab citizens is quickly becoming one of the Societys strong suits. This past year, the Society filed an appeal with the Israeli Supreme Court against Israels own Ministry of Environmental Protection for allowing a new glass factory to endanger the health of Galilee residents by illegally polluting the regions air with poisonous sulphur dioxide.
As part of its ongoing effort to monitor new developments in the region, the Galilee Society noticed the construction of a new factory in the village of Cana, the biblical site where Jesus miraculously turned water into wine. The Galilee Society decided to investigate and discovered that contrary to legal procedure, the factory was being built without a proper license and worse, that the Ministry of the Environment had given its approval without first conducting a full investigation into the factorys environmental impact. The case was settled out of court and represented another significant victory for the Society. The company agreed to install chemical filters to limit the amount of air pollution produced by the factory. In addition, they agreed to let a third party monitor the toxic content of its emissions.
Although pleased with the settlement, Dr. Kanaaneh is anxious about the Galilees future. Israel is planning a major wave of industrial expansion in the region. Factories that used to be located in mostly Jewish cities are being moved to the mostly Arab Galilee. The government has plans for three industrial zones, each containing several factories. Israel is counting on massive foreign investment to finance these zones, investment that will probably be forthcoming as a result of the recent agreement with the P.L.O.
Israeli authorities justify this new wave of industrialization by saying the factories will provide jobs for Russian immigrants and for Arabs. They give Arab unemployment as a reason for locating the factories in the Galilee. In fact, in the glass factory, 500 of the workers are Jewish and only 60 are Arab. he commented.
Dr. Kanaaneh worries that industrialization could have a disastrous impact on the Galilee. He mentions several major problem areas: Natural resources will be depleted and the water table will be polluted with toxic effluents from the factories. Our tourist industry, which is developing very quickly and provides jobs, will be undermined. Dr. Kanaaneh is concerned that industrialization threatens the entire lifestyle of rural communities, irreparably altering a form of civilization that has existed for centuries. For the Galilee Society, the most troubling aspect of industrialization is that it threatens to destroy the areas environment.
A good environment is essential for good health. If air is toxic and the water table is polluted, the health status of the local residents can only worsen.
We are here to promote the health of local people. In the current situation, this means protecting the environment and fighting the consequences of Israels new industrialization, he continued. The Galilee Society is prepared to struggle in many arenas if that is what it takes to improve conditions.
The Galilee Societys own record in persuading Israel to take account of its Arab communities needs is truly impressive. Asked what the Society plans to do in the future, Dr. Kanaaneh replied, The struggle for social justice goes on. One of our goals is to press the Israeli government into fulfilling its responsibilities to its Arab citizens. A second goal is to show Arab communities how to help themselves.
Lise Grande served as the press coordinator for the Coordinating Committee of International NGOs (CCINGO) in East Jerusalem.