The creation in 2002 of the Quartet on the Middle East, comprising the United States, Russia, the European Union and the United Nations, raised hopes for its critical contribution to the peace process in the Israeli-Palestinian conflict. A report released on Sept. 25, “The Middle East Quartet: A Progress Report,” severely questions its role and criticizes its scant achievements. The report was prepared by 21 nongovernmental organizations working in the Palestinian Occupied Territories including CARE, Christian Aid, OXFAM, Save the Children Alliance and World Vision.
The report notes that the quartet, represented by former British Prime Minister Tony Blair, has only achieved partial successes on issues such as security reform, donor pledges to the Palestinian Authority and private sector growth. But it also indicates that the citizens of Gaza have been largely left out of the process. As Martha Meyers, from CARE International, declared to the U.N. Office for the Coordination of Humanitarian Affairs, “The 1.4 million citizens of Gaza, who are largely innocent and blameless, are hostage to political forces, decisions and lapses over which they have no control.”
On some key issues, such as Israeli settlements in the West Bank, Palestinians freedom of movement and improvement of the humanitarian situation in the Gaza Strip, the Middle East Quartet has completely failed, according to the report. Daleep Mukarji, head of Christian Aid, stated, “The quartet is losing its grip on the Middle East peace process.”
The quartet’s failure has led to the further deterioration of health in the occupied territories, particularly in the Gaza Strip. Dr. David Nabarro, the World Health Organization’s (WHO) director for health in crisis situations, who visited the territories, said that the situation was becoming increasingly precarious, with malnutrition levels on the increase and vaccination levels falling.
Although the Palestinian territories benefit from generous medical aid and skilled doctors and nurses, increasing restrictions on movement caused by checkpoints and by the new security barrier, often result in medical supplies unable to get through to those who most need it. Patients cannot go to the hospital and medical staff cannot get to work.
The WHO is particularly concerned about the health of very young children, the elderly and people with chronic diseases. The Palestinian territories population of 3.7 million, 52 percent of whom are children, continue to struggle to meet their basic needs.
Many hospitals are facing severe fuel shortages. The Gaza European Hospital and Nasser Hospital in Khan Younis have 18,750 liters of fuel out of their 152,000 liters storage capacity. The two hospitals had to declare a “state of emergency” and stop their activities except for emergency cases and work in the Intensive Care Units (ICU). Many patients had to be transferred to other hospitals for proper treatment.
Severe restriction on movement of goods and people are hindering access to quality health care. A system to refer patients to tertiary care services available only outside the occupied Palestinian territory can no longer be implemented due to the frequent closures of the Gaza borders.
Health-care providers are not paid regularly. According to Dr. Pierre-Pascal Vandini, from Doctors Without Borders, physicians working for the public health system are obliged to have multiple jobs so that they can achieve a reasonable standard of living. People are increasingly unable to pay for private health care.
Major illnesses like cancer, genetic diseases and congenital deformities that until now had been treated in neighboring countries (Jordan, Israel, Egypt) can no longer be treated for lack of resources. In addition, many people with diseases such as diabetes are not getting needed treatment.
The report stresses the lack of progress on the issue of settlements, one of the critical areas of contention between Palestinians and Israelis. The report states, “While the quartet can be commended for raising the issue of settlements and outposts, there has been a marked failure to hold the Israeli authorities to their obligations under the roadmap and international law.”
The quartet has emphasized that progress in several key areas is the only way to prevent further deterioration in the lives of both Israelis and Palestinians and achieve peace. That so little progress has been achieved so far, seriously questions the existence of the quartet.
Dr. Cesar Chelala is an international public health consultant.