“We walk for hours to reach health facilities," said Mahmud Mousa Abu Eram, a Palestinian man from Hebron in the West Bank. "Sometimes we use donkeys to transfer sick people to the hospital or to the clinic. There hasn't been transportation in this area for a long time. Even if there is a car to drop us off at any clinic, the Israeli army confiscates the cars.”
Hebron is one of the oldest cities in the West Bank, located in a dry mountainous region known for its vineyards dating back thousands of years. The city is also an epicenter of violence, particularly since the eruption of war in Gaza in October 2023. Since then, 479 Palestinians have been killed in the West Bank (including 116 children), the majority by Israeli forces and settlers. The volatile situation, along with the realities of life under occupation, have pushed health care out of reach for many Palestinians living throughout the area.
Doctors Without Borders/Médecins Sans Frontières (MSF) teams are trying to bridge the gap by running mobile clinics, with teams traveling to patients, as well as by providing first aid training to medical and non-medical volunteers so they can respond to urgent medical needs in cases when an ambulance is delayed or stopped at a checkpoint.
Checkpoints impede access to life’s essentials
An estimated 61 percent of the West Bank is off-limits to Palestinians. Over 2.9 million Palestinians live in the territory, along with more than 630,000 Israeli settlers living across the West Bank and East Jerusalem.
Across the territory, checkpoints, roadblocks, and incursions by the Israeli army and settlers have long cut off towns and villages from each other, blocking Palestinians from accessing basic services including health care and markets to buy food. This has caused residents to run out of water, fuel, and other supplies, and has prevented Palestinians from reaching their schools, work, family, and friends.
For Palestinians in Masafer Yatta, a district in Hebron, frequent roadblocks, military raids, and attacks by settlers make accessing health facilities increasingly difficult. To make matters worse, no local organizations can provide basic health care services due to a lack of funds, restrictions imposed by the Israeli army, and poor road infrastructure that limits access to the area.
No safety, even within one’s home
The severity of the violence in Masafer Yatta has left many Palestinians too afraid to leave their homes. “Most of the time it is forbidden to stand at the window,” said an MSF patient who wished to remain anonymous. “One day when I was standing at the window, a settler saw me and complained to the soldiers. The soldiers stormed my house and destroyed everything in it.”
In Jenin and Tulkarem districts, in the north of the West Bank, Israeli forces have been carrying out regular ground raids accompanied by air and drone strikes, with deadly consequences. Along with the military incursions, settler violence in the north of West Bank is one of the main obstacles Palestinians face in their daily lives. Of the 479 Palestinians killed in the West Bank since October 2023, one-third were killed in refugee camps in or around the cities of Tulkarem and Jenin.
Arbitrary denial of transportation to hospitals
Palestinians who live in the refugee camps in Tulkarem and Jenin are trapped and blocked from accessing health care facilities, especially during military incursions. People with life-threatening injuries are forced to wait to reach a hospital, and in many cases, they die before getting there. In both Jenin and Tulkarem, MSF teams have been providing emergency care reinforcement and supporting volunteer paramedics with donations and training.
On April 21, a volunteer paramedic was shot in the leg while on duty in Tulkarem and Nur Shams camps. Due to the hostilities, it took seven hours for him to reach the hospital. In another incident, one of our staff members administered CPR to a 16-year-old child after he was shot in the head; they were unable to save him.
MSF mobile clinics now reach 13 locations covering the areas outside and inside Hebron's Old City (left); an elderly Palestinian woman waits her turn to enter MSF medical clinic in Almajaz in Masafer Yatta, south of Hebron for a primary care check-up (right). Palestine 2024 © Candida Lobes/MSF
"His father, also a paramedic trained by MSF, learned the news of his son’s killing while working in the ambulance,” said Itta Helland-Hansen, MSF project coordinator in Jenin.
The few medical staff that are still able to carry out their work are pushed to their professional limits. "Most of the time, ambulances are blocked at checkpoints. Even in cases of medical emergencies and when we have the siren on,” said a medic from Al Arrub refugee camp between Hebron and Bethlehem in the southern West Bank.
“How long they stop us for does not depend on the medical emergency, it depends on the mood of the soldiers,” the medic continued. “They make us wait for one or two hours, or they make us take another road. If the patient has a gunshot wound from the Israeli army, they can arrest the patient and even confiscate the ambulance. We don’t know what will happen to the patient—if they [will] bring him to a hospital or to a prison, and if he [will] receive medical care in the prison.”
For many, the only alternative to avoiding long waiting times and harassment at checkpoints is receiving no medical care at all.
2023 is the deadliest year on record for Palestinians in the West Bank
Read more“Before October 7, the situation was somewhat lighter,” said an MSF mental health patient from Nablus, in the north of the West Bank. “I used alternative routes to get where I needed to go, and my mental health therapist contacted me to ensure I continued my sessions. Coming here for the session comforts me. I don't feel like I'm in danger when I'm here.”
Our work in the West Bank
MSF teams have been present in the West Bank since 1989. Our teams in Masafer Yatta run three mobile clinics in Um Qussa, Al Majaz, and Jinba, providing outpatient consultations, reproductive health, mental health support, and nutritional screening. In 2024, MSF increased the number of mobile clinics in Hebron district to 13 to meet the increasing needs in the community. Between January and March 2024, our team provided over 6,000 outpatient consultations and around 1,400 individual mental health sessions, including assessments of new patients and follow-up consultations.
In Hebron, MSF teams have adapted and expanded activities to ensure continuous care and access to primary health care services for the most vulnerable and isolated patients. In Jenin and Tulkarem, MSF teams are supporting and training medical and paramedical staff to provide first aid and lifesaving services in and outside the hospital in case of mass casualty events and obstructions to access to the premises.
MSF teams are also providing mental health support in clinics in Nablus and Hebron, aiming to address critical gaps in mental health care provision and to ensure that those in need receive the support and care they require.
