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Sentenced to Darkness
Electricity and Chronic Patients in the
Unrecognized Bedouin villages in the Negev
December 2008
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""""Sentenced to DarknessSentenced to DarknessSentenced to DarknessSentenced to Darkness""""
Electricity and Chronic Patients in the UnrecognizedElectricity and Chronic Patients in the UnrecognizedElectricity and Chronic Patients in the UnrecognizedElectricity and Chronic Patients in the Unrecognized
Bedouin villages in the NegevBedouin villages in the NegevBedouin villages in the NegevBedouin villages in the Negev
December 2008December 2008December 2008December 2008
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Sentenced to DarknessSentenced to DarknessSentenced to DarknessSentenced to DarknessElectricity and Chronic Patients in the Unrecognized BedouinElectricity and Chronic Patients in the Unrecognized BedouinElectricity and Chronic Patients in the Unrecognized BedouinElectricity and Chronic Patients in the Unrecognized Bedouinvillages in the Nvillages in the Nvillages in the Nvillages in the Negevegevegevegev
WritingWritingWritingWriting: Wasim Abbas and Shir Alon
AbstractAbstractAbstractAbstract: Wasim Abbas
ResearchResearchResearchResearch: Dr. Ye'ela Ra'anan The Regional Council for the
Unrecognized Villages
Wasim Abbas Physicians for Human Rights
PhotosPhotosPhotosPhotos: Physicians for Human Rights
TranslationTranslationTranslationTranslation: Noga AlmiDesigDesigDesigDesignnnn: David Moscovitz
ProductionProductionProductionProduction: Gafrurei Dafdefet
This document has been produced with the financial assistance of the European
Commission.
The contents of this document are the sole responsibility of Physicians forPhysicians forPhysicians forPhysicians for
Human RightsHuman RightsHuman RightsHuman Rights---- IsraelIsraelIsraelIsrael and can under no circumstances be regarded as reflecting
the position of the European Commission.
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AbstractAbstractAbstractAbstract
Half of the Arab-Bedouin population in the Negev lives today in villages
the government consistently refuses to recognize.
Some of the villages existed before the establishment of the State of Israel
and others are a result of population transfers in the 1950's, under the
military regime. In order to put pressure on the Bedouin residents and
concentrate them in townships established by the state, the government
abstains from providing them with basic infrastructures and services
water, electricity, roads and health clinics as long as they reside in their
villages. The refusal to recognize the villages is a deliberate discrimination
of the residents and a violation of human rights. The prevention of basic,
crucial services from the residents of the unrecognized villages in the
Negev inflicts upon them severe health problems that sometimes cost
them their lives.
The refusal to connect the villages to the electricity infrastructure is one of
the most severe violations not only because it denies the right to health
from all the residents, sometimes while risking their lives, but mainly
from the chronically ill, the children and the elders. Without electricity,
the residents of the unrecognized villages cannot store food and
medications or maintain reasonable living conditions, such as safely
heating or cooling the house, maintaining it clean and hygienic or using
electrical medical equipment required for their recuperation.
This discrimination is especially overt when we deal with the chronic
patients. For them, electricity is a crucial part of their treatment. A
mapping prepared by PHR-Israel and the Regional Council for the
Unrecognized Villages in the Negev, shows that 21% of the entire
population are chronic patients in need of electricity on a regular basis as
part of their treatment. Electricity is needed for various purposes storing
medicines that require refrigeration, such as insulin injections for
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diabetics; operating electrical medical appliances, such as Ventolin for
those who suffer from asthma or inhalation and respiration support
appliances for other respiratory patients; cooling or heating the house in
order to create conditions necessary for recuperation. The findings of themapping show that the lack of electricity caused the deterioration of
around 70% of the patients, out of whom 2% died. When we examined the
identity of those affected, we found that 31% of the women who live in the
unrecognized villages suffer from chronic diseases. Among the children,
the measure was 20% (their measure in this population is 58%).
The population of the unrecognized villages is the only population fromwhich electricity is prevented. Recurring applications of chronic patients
from the unrecognized villages, requesting to connect their houses to the
national electricity network in order for them to use electrical medical
appliances, met a decisive refusal on the part of the government.
According to the government, without the right certificate of approval
from the planning authorities an approval that cannot be obtained as
long as the villages are unrecognized it cannot connect them to the
electricity network. Yet, this claim doesnt hold water: private farms in the
Negev and illegal settlements in the occupied territories that have no legal
planning status were connected to the electricity network during the
building process. Therefore, the refusal of the state to connect the villages
to the electricity network is a deliberate discrimination, originating from
the ethno-national attribution. When the state refuses to connect even the
homes of those patients in need of electricity for medical treatment and
saving lives, this discrimination is a pure bureaucratic evil.
Mhamad Abu-Ashiba, 79 years old, resided in Umm-Matnan, a village
that had been recognized lately, near Arara. However, the village had not
yet been connected to basic infrastructures, amongst them the electricity.
Four years ago he became ill with an acute chronic lung disease (Chronic
Obstructive Pulmonary Disease) ever since he had been ventilated using a
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gas canister around the clock. In September 2006, his condition
deteriorated and he was hospitalized. Upon his release, his physicians
instructed a BIPAP machine treatment (an electric device which regulates
the pressures of air flow in the lungs and prevents its blockage). Thephysicians determined that the machine is crucial for Abu-Ashibas life
and health, and that it does not have any medical alternative. The
machine can be leased from Yad Sarah, yet there was no point in doing
so since electricity is needed for its operation: like all houses in the village,
the state refuses to connect Abu-Ashibas house to the national electricity
network. Unable to use the machine, Abu-Ashibas condition deteriorated
and he was admitted to the hospital once more. There he was connected tothe BIPAP machine until his condition improved. Yet, after returning
home, his condition deteriorated again.
Recurring requests from Physicians for Human Rights to the Ministry of
Health, the Ministry of National Infrastructures and the Ministry of
Interior, demanding to connect his house to the electricity network due to
his medical condition, failed. The Minisrty of National Infrastructures and
the Ministry of Interior claimed that his house was built illegally and
therefore cannot be connected. The Ministry of Health pointed out the
need for a solution, but took no measures in order to advance such a
solution. Without electricity Abu-Ashibas condition continued to
deteriorate until on 23.4.2008, after much suffering, he passed away.
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BackgroundBackgroundBackgroundBackground
The purpose of this position paper is to present a wide phenomenon of
violation of the right to health of the Arab-Bedouin residents of the
Unrecognized Villages in the Negev. This document will focus on the
violation of the right to health of a large group of chronic patients and
respiratory chronic patients, caused by the states refusal to connect their
homes to the national electricity network.
More than half of the Arab population in the Negev approximately
83,000 people live in 45 villages which are not recognized by the state,
and its planning status has not been determined. Lately, ten villages have
been recognized within the Abu-Basma Regional Council. However, none
of these villages have been connected to basic infrastructures and its
residents continue to suffer from discrimination in their living conditions,
connection to the water and electricity networks, road-building and health
services.
The connection to the electricity is crucial to health, especially for chronic
patients who need it as part of their treatment, including Asthma
patients, diabetes patients and other respiratory patients. A condition that
can easily be treated becomes complicated, and sometimes dangerous,
requiring recurring admissions to the hospital. Chronic patients, old and
young, are denied from the right, and the possibility, to use electricalmedical appliances, to store medications, vaccinations and food in their
homes. At best, they are forced to long period admissions. In other cases
they are sentenced to death due t o an ongoing deterioration in their
condition.
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The Problem of Electricity CThe Problem of Electricity CThe Problem of Electricity CThe Problem of Electricity Connectiononnectiononnectiononnection
All the unrecognized villages, and those which have recently been
recognized within the Abu-Basma regional Council, are not connected to
the national electricity network. The existing connections were initiated
and paid for by the residents. Some of them use generators that work
between one to four hours a day, or expensive solar systems that operate
only on sunny days and their output is poor. Most residents cannot
maintain alternative systems of electricity due to the high cost, and
therefore remain without electricity. The few clinics recently built due to
Supreme Court ruling1 are still not connected to the electricity network,
but only to a generator operating during the opening hours. Thus,
medications that require refrigeration or basic medical appliances cannot
be used.
The population of the unrecognized villages is the only population which is
deprived of a connection to electricity. The explanation of the different
authorities, that they cannot connect the houses due to an unresolved
planning status, turns out to be an unfounded excuse, since that same law
is not activated when it comes to the occupied territories and the
individual farmsteads scattered throughout the Negev, whose dwellers
enjoy a connection to the electricity network and all the other
infrastructures, although their planning status has not been resolved.
Chronic Patients do not Receive Proper Treatment
From February-May 2008 Physicians for Human Rights and The Regional
Council for the Unrecognized Villages in the Negev, conducted a field
research in the villages. The research was conducted using a cluster
1Supreme Court ruling 4540/00 Physicians for Human Rights, The Association for Civil Rights inIsrael, The Regional Council for the Unrecognized Villages in the Negev and the Negevcoexistance forum.
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sampling: two villages were randomly selected, in each of which a
neighborhood was randomly selected, where all the residents were
examined. The sample included 404 participants. Villages that suffer from
exceptional environmental hazards, such as the proximity to RamatHovav, were excluded from the research.
Table 1: The Distribution of the Sample Population According to Age and SexTable 1: The Distribution of the Sample Population According to Age and SexTable 1: The Distribution of the Sample Population According to Age and SexTable 1: The Distribution of the Sample Population According to Age and Sex
GeneralGeneralGeneralGeneralNumberNumberNumberNumber
PercentagePercentagePercentagePercentagefromfromfromfromPopulationPopulationPopulationPopulation
Number ofNumber ofNumber ofNumber ofPatientsPatientsPatientsPatients2222
PercentagePercentagePercentagePercentageof Patientsof Patientsof Patientsof Patients
PercentagePercentagePercentagePercentagefrom Patientsfrom Patientsfrom Patientsfrom Patients
ChildrenChildrenChildrenChildren 255 63% 50 20% 58%MenMenMenMen 69 17% 11 16% 13%WomenWomenWomenWomen 80 20% 25 31% 29%TotalTotalTotalTotal 404 100% 86 100%
The research shows that 21.2% of the residents in the villages are chronic
patients, who need electricity as part of their treatment.3 70% of the
chronic patients, who constitute 15% of the entire population, suffer long
and hard due to the lack of electricity, which can also cause deterioration
in their condition and death. Out of the entire patients in the research,
47% are chronic patients who need extended, ongoing treatment. The data
shows that 50% of the patients suffer from Asthma. 20% of them are
chronic respiratory patients who regularly need inhalation and oxidation
machines, including children and elders who have no access to electricity,
oxygen generators or respiratory supporters.
2This refers only to the chronic patients hurt by the lack of electricity.3The mapping of the chronic patients in both villages was conducted by the councils field coordinator.
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Table 2: Chronic Patients and Types of IllnessesTable 2: Chronic Patients and Types of IllnessesTable 2: Chronic Patients and Types of IllnessesTable 2: Chronic Patients and Types of Illnesses
PercentagePercentagePercentagePercentageofofofofPopulationPopulationPopulationPopulation
PercentagePercentagePercentagePercentageof theof theof theof thePatientsPatientsPatientsPatients
MultiplicityMultiplicityMultiplicityMultiplicityooooffffIllnessesIllnessesIllnessesIllnesses4444
PercentagePercentagePercentagePercentageofofofofPopulationPopulationPopulationPopulation
Percentage ofPercentage ofPercentage ofPercentage ofthe Patientsthe Patientsthe Patientsthe PatientsNumberNumberNumberNumberofofofof
PatientsPatientsPatientsPatientsType ofType ofType ofType ofIllnessIllnessIllnessIllness
11%50%438.6%40.7%35AsthmaAsthmaAsthmaAsthma1%3%30.2%1.2%1RespiratoryRespiratoryRespiratoryRespiratory
otherotherotherother4%
17%151.7%8.1%7DiabetesDiabetesDiabetesDiabetes
2%12%101.2%5.8%5HeartHeartHeartHeartDiseaseDiseaseDiseaseDisease
0%1%10.2%1.2%1
RRRRheumatismheumatismheumatismheumatism
2%8%70%0%0BBBBloodloodloodloodpressurepressurepressurepressure
2%9%82%9.3%8
MentalMentalMentalMental
0%2%20.2%1.2%1
CancerCancerCancerCancer
1%6%50.7%3.5%3BloodBloodBloodBlood otherotherotherother
3%15%132.5%11.6%10OtherOtherOtherOther3.7%17.4%15MultiplicityMultiplicityMultiplicityMultiplicity
of Illnessesof Illnessesof Illnessesof Illnesses
100%86TotalTotalTotalTotal
Chronically ill Children
63% of the sample is children under the age of 20 - 51% boys, 49% girls.
20% of the children suffer from chronic diseases and the electricity
shortage harms them. The sick children suffering from electricity shortage
constitute 58% of the population of chronic patients.
Yassin is a 3.5 years old child, from Al-Surra village, the firstborn of Iad (31
years old, unemployed) and Sarah (27). Yassin suffers from Asthma ever since he
was 6 months old. He suffers strong and frequent seizures 4 times a month on
average and needs electrical inhalation. When he has a seizure at night his
4Patients who suffer from additional illnesses, apart from the above mentioned illness.
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father operates the generator in order to use the inhalation machine. When he
has a seizure in the morning, his father drives him to the nearest clinic, situated
in Kseifah. If the child has a seizure when the clinics are closed, his father is
forced to take him to the medical emergency center in Arad. Every visit costs 75
Shekels. In order to reach the clinic or the emergency center the father has to
drive a car, which he does not have, or walk a five kilometers distance with the
child up until the main road, where they have to wait for a bus. After opening the
medication kit necessary for inhalation, it has to be kept in refrigeration. The
family keeps the inhalation kit in a cool place under the cupboard or in the
freezer purchased for that purpose, yet does not operate most of the time, only in
the short while when the generator operates. Without permanent refrigeration,
the medication loses its effectiveness and, with time, is ruined. The childscondition deteriorates when he suffers from high fever. The Asthma seizures are
strong and in the past, he was forced to be admitted to hospital for a period of one
to two weeks each time.
Abir, an 8 years ol child from the unrecognized village of Al-Sara, became ill with
bladder cancer three years ago. The treatment included visits to the hospital
twice a week. Yet, due to the lack of electricity which didnt allow for a clean
environment and refrigeration of medications she was admitted to Soroka
hospital for almost two years in a row. Today, Abir still needs a clean and air-
conditioned environment and needs to be safeguarded from physical contact with
other people. Abir goes to school every-day and the desert environment hot
during the day and cold at night worsens her health.
Ill Women
Women constitute 20% of the survey population. The lack of electricity
hurts women more than any other population. The research shows that
31% of the women residing in the two unrecognized villages suffer chronic
diseases, which are worsened due to the lack of electricity.
Wadha Al-Atrash, a 32 years old woman from the unrecognized village of
Khashm Zinna suffers from acute Asthma and needs to ise an electrical ventolin
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on a regular basis. Since her house is not connected to the national electricity
network, and due to the fact that there is no clinic in her village, she is forced to
visit the nearest clinic in Segev-Shalom. The ill Wadha has to walk a 2
kilometers distance to the main road, and then exchange two buses in order to
reach the clinic, a journey that takes about four hours. In the past three years,
due to an ongoing lack of oxygen, her heart was severely damaged and today she
is under constant medical surveillance.
Wadha has a 7 years old child, also suffering from Asthma; Every time he is
exposed to a cold weather, he has to be taken to a clinic in order to enable him to
breathe using an inhalation machine.
Unable to receive the proper treatment, patients have to rely on less
effective alternatives temporary solutions that not only endanger their
lives but also entail higher expenses, to both the patient and the state, due
to recurring admissions to hospitals. In order to use a simple electrical
Ventolin machine, these patients need to go to the nearest clinic, which is
usually situated a few kilometers away from the main road. The patients
have to walk a few kilometers by foot in order to get there, and then use
public transportation. Moreover, children and elders need to be driven by
a relative, who misses a days salary in order to aid the patients.
Respiratory Patients In Need of Oxygen Generators or a
BIPAP Machine
Respiratory chronic patients, who need electric respiration machines on aregular basis, are the main victims of the states refusal to connect the
villages to the national electricity network. Lacking regular electricity
supply to their homes, they cannot receive basic and necessary treatment,
and their right to health is brutally violated.
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Due to the poor living conditions in the unrecognized villages, the rate of
those suffering from respiratory diseases is especially high, resulting in an
increased need for electrical medical appliances.
An oxygen generator is a domestic electric appliance which separates the
oxygen from the other gases in the air and releases a high concentration of
oxygen to the patient. When usage of the generator is prevented, as is the
case in the unrecognized villages, respiratory patients are forced to use
ready-to-use oxygen balloons. Some patients use five balloons a week,
which they purchase from private companies. The HMOs fund 80% of the
cost and the rest is paid by the patient. This is an atrocious waste for theHMOs, especially when one takes into account the need to supply the
balloons to the patients homes, sometimes, a few times a week. The
patients medical condition is utterly reliant upon this delivery, which is
sometimes delayed or goes missing due to the bad roads in the
unrecognized villages. An electrical oxygen generator, on the other hand,
reassures an ongoing, secure supply of oxygen, independent of suppliers
and recurring balloon replacement.
Slama Abdalla alamarani, about 70 years old, is residing in Qasr Assir (Al-
Hawashle), a village in the process of becoming recognized that has not been
connected to infrastructures yet. Mr.alamarani has been suffering from a chronic
lung disease in the past two years, and due to deterioration in his condition in
the last five months, his physicians ordered him to use a domestic inhalation
machine (an oxygen generator). Although he received the machine from Yad
Sarah he still suffers from breathing, since the machine does not work due to
a lack of electricity at night. Apart from breathing problems, he also suffers from
diabetes but cannot store Insulin in his house since he does not own a
refrigerator. From time to time his condition deteriorates and he has to be
admitted to hospital. This is an ongoing situation, with no solution in sight.
The condition of the patients in need for a BIPAP machine is much more
dangerous. This is an electric machine that regulates air flow pressure in
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the lungs and prevents its blockage. A patient who needs the BIPAP
machine has no alternative non-electric treatment. Indeed, the respiratory
patients who need it use oxygen balloons, but these cannot replace the
machine. Without it, their condition deteriorates rapidly and they areforced into frequent hospital admissions. These machines are usually
supplied by HMOs or organizations such as Yad Sarah, yet lacking a
connection to the electricity, they cannot be used.
The lack of electricity prevents the elderly and the ill of the right to stay at
home, with their family members a right that every elderly has and
forced them into long periods of hospitalization which entail a highexpenditure of public money. This is especially difficult in the Bedouin
society, where it is not customary to send older members of the family to a
parents home or a nursing home. The older members of the family stay in
their familiar environment, with their family who take care of them, thus
remaining an active and important part of the social-domestic fabric. The
Bedouin familial structure disintegrates when the head of the family is
forced into long-period hospital admission and the burden of the recurring
admissions falls on his family.
Mitab Al-Ktzazi, 70 years of age, resides in the unrecognized village of Umm Al-
Hieran. He is a father of five small children and lives on an allowance. Seven
years ago he was diagnosed with COPD an acute chronic lung disease. Two
years ago his condition deteriorated and his physician ordered him to use the
BIPAP machine. His physician, Professor Abu-Shakra from the Sorokahospital, wrote a professional evaluation to PHR-Israel, indicating that the
patient has to be connected to oxygen 24 hours a day, and also to the BIPAP
machine at least 16 hours a day a regular activation of the BIPAP machine
based on a regular supply of electricity is a necessary, most essential treatment
which improves and saves lives.5 On Februaty 28, 2008, Mr. Al-Ktzazi was
admitted to hospital due to a severe deterioration in his condition. He was
hospitalized for over a month. His physicians did not release him to his home
5 Professor Abu-Shakra Mahmud, a letter to PHR-Israel, 08.05.2007.
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since they feared deterioration. Recently he was released from hospital after his
family, who lives on a 3200 shekels pension, had rented him a one room
apartment in Rahat.
Alshimah Abu-Sbieh is a seven month old baby from the Al-Bat village (Marit).
The village was recognized on January 2008, yet the state had not yet connected
it to the infrastructures. She was born with a considerable retardation due to an
insufficient development of the brain, which is manifested by an expansion of the
front and rear brain ventricles and lacking the corpus callosum the longitudinal
fissure that connects the left and right cerebral hemispheres and facilitates
communication between the two hemispheres.
The toddler is frequently hospitalized and is under surveillance in the Sorokapediatric outpatient ward. The disease causes an extreme deficient functioning of
the brain, due to which the body does not hold oxygen in the blood (SAT). That is
why Abu-Sbieh needs an oxygen generator treatment 24 hours a day. In order to
operate the generator, the family bought a generator which operates all day. The
family thus faces expenses that she cannot bare due to the fuel consumption for
the daily operation of the generator. The response of the Abu-Basma regional
council to our request to connect the Abu-Sbieh family to the national electricity
network since the village belongs to its area of jurisdiction was as follows: The
Abu-Basma regional planning and building council has no authority to issue a
building permit to the Abu-Sbieh residency, which is a necessary condition for an
electricity connection
And in the meantime, the toddler is fighting for her life.
Both patients need a regular, daily, 24 hours a day connection to the machine in
order to ensure their medical stability. Since both of them live in unrecognized
villages or in a village that is still not connected to the infrastructures, their
homes are not connected to the electricity and they cannot use the machine and
cannot receive the necessary treatment. Then, they have to be rushed and
admitted to the hospital in Beer-Sheva. In the past year, Mr. Al-Ktzazi was
admitted at least ten times.
In conclusion, the cases of Mr. Al-Ktzazi, Mr. Abu-Ashiba, Wadha and the
Abu-Sbieh child, and all the other chronic patients living in the unrecognized
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villages, are examples of a distorted, inhumane and hopeless reality. The
necessary, right treatment is prevented from the patients and causes direct
deterioration of their condition. The wandering in unfitted roads on the way to
the hospital every time that their condition is deteriorated is unnecessary and
endangers their health. One should remember that long periods of admission
cause for a heavy load on public money, expenses that could have been prevented
were the patients able to receive treatment at home, beside their families.
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The States OThe States OThe States OThe States Obligationbligationbligationbligation
Accessibility to electricity is a decisive condition for health, thus it is the
states obligation to provide it to its residents in order to ensure their right
to a healthy life. The right to health is anchored in Israeli law and in
international conventions signed by Israel, emphasizing that the right to
health does not only mean accessibility to medical treatment, but also the
fulfillment of a complex of environmental conditions and basic services,
electricity being one of them, which enable a healthy living.
Moreover, the UN committee on economic, social and cultural rights, bases
the right to health on the principle of accessibility and availability of
health services for all, in an equal manner. The residents of the
unrecognized villages in the Negev are the only ones from whom the
connection to electricity and other basic infrastructures is prevented, in
order to force them to leave their lands and move to the townships built by
the state. This situation, in which a necessary, sometimes life-savingmedical treatment is prevented from a patient, due to the states refusal to
connect his home to the electricity, is invalid and discriminative and
violates basic living and health rights. The state must immediately
connect the homes of these patients to the electricity network in order to
allow them to fulfill their right to health and to living a life in dignity.
Many of the respiratory chronic patients are elders and children, and TheInternational Covenant on Economic, Social and Cultural Rights by the
UN especially emphasizes their needs as a vulnerable population. General
Comment No. 14 indicates the obligation to spare elders avoidable pain
and enable them to die with dignity. The meaning of this comment is
undoubtedly to allow each person to remain in his familiar environment,
beside his family, and maintain an independent way of life as long as
possible.
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A full description of the rights of the elderly appears in comment number
6, indicating that the state has the duty to protect the rights of the elderly,
by all available means. Comment number 6 also acknowledges thathousing for the elderly must be viewed as more than mere shelter and
that, in addition to the physical, it has psychological and social
significance which should be taken into account. Accordingly, national
policies should help elderly persons to continue to live in their own homes
as long as possible, through the restoration, development and
improvement of homes and their adaptation to the ability of those persons
to gain access to and use them, in order to maintain the traditionalfamilial structure and the elders basic right to dignity.
The rights of children are ensured as well, being humans with special
needs and citizens of the state of Israel. Amongst the rights is the right to
health, anchored in the Israeli law as well as in international conventions.
The UN Convention on the Rights of the Child (1989), which was ratified
by Israel in 1991, determinates in the issue of the right to health:
States Parties recognize the right of the child to the enjoyment of the
highest attainable standard of health and to facilities for the treatment of
illness and rehabilitation of health. States Parties shall strive to ensure
that no child is deprived of his or her right of access to such health care
services. (Article 24(1))
In the Israeli law corpus, the right to health is evident from the Basic
Law: Human Dignity and Liberty (1992), which does not merely prohibits
the violation of life or body of any person as such, but also indicates that
all persons are entitled to protection of their life, body and dignity.
The state succeeded in anchoring the principles detailed in the
international convention in local laws. The Patients rights act (1996)
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explicitly determines that A patient shell be entitled to proper medical
care, having regard both to its professionalism and quality, and to the
personal relations incorporated in it.6 And that No medical facility or
clinician shall discriminate between patients on grounds of religion, race,sex, nationality, country of birth, or other such grounds.7 In addition, the
National Insurance Law (1994), which regulates the HMOs obligation to
grant medical treatment to the citizens of Israel and is based on the
principle of equality, determines that: The health care organizations are
required to supply all the services enumerated in the standardized basket,
within reasonable time and distance from the insured persons homes.
One can see that according to these laws, the chronic patients who are notconnected to electricity are not receiving the proper treatment to which
they art entitled by law. On the contrary, the lack of adequate
infrastructures deteriorates their medical condition and dramatically
harms their health. In addition, we stand before a harsh violation of the
non-discrimination principle in providing health services, as indicated in
the law. The medical appliances necessary for the patients are accessible
and available, yet since the patients are Arab-Bedouin; its utilization is
prevented from them.
Indeed, the Israeli law does not explicitly ensure the elders right to live or
die with dignity in their homes, beside their family, yet this right directly
stems from the states obligation to provide adequate access to health
services and from every persons basic right to live in dignity. Inasmuch as
the choice to remain at home and receive nursing services is open for every
Israeli citizen, it should be open for the Arab-Bedouin citizens residing in
the unrecognized villages in the Negev.
6Clause 5.7Clause 4.
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The States TreatmentThe States TreatmentThe States TreatmentThe States Treatment
Despite the states obligation towards the international law and its laws,
she renounces its responsibility to the situation. She categorically refuses
to connect the homes of the patients to the electricity network, yet does
not provide alternative solutions, thus renounces its obligation to ensure
the realization of the basic rights of its citizens. PHR-Israel applied on
behalf of Mr. Al-Ktzazi, the Abu-Sbieh child and Mr. Abu-Ashiba to the
states authorities, requesting an immediate intervention, but received
laconic and evasive answers, in which the main argument was that the
connection to the electricity is not possible since the homes were built
without building permits and illegally.8
The electricity company, a national company committed to provide
electricity to the citizens of the state on an equal basis, refuses to connect
the homes of the patients claiming that they have an unresolved legal
status and transfers the responsibility to government offices theMinistry of Interior and the Ministry of National Infrastructures. The
Ministry of Health, legally responsible for public health, transferred the
cases to other offices, although Professor Avi Israeli, The Director General
of the Ministry of Health pointed out in a letter he addressed to the
Ministry of Interior and the Ministry of National Infrastructures in the
matter of Mr. Al-ktzazi, that even though I am not familiar with the
facts and meanings, on your side, of this specific case from a human,humanitarian and medical point of view, it is clear to us all that we must
try and assist, as much as possible, to resolve this case.9
8 In the case of Mr. Al-Ktzazi: letters to Avi Israeli, Director General, Ministry of Health; Hezi Kugler,Director General, Ministry of National Infrastructures; David Cohen, in charge of the Southern district ,
Ministry of Interior.9 Professor Avi Israeli in a letter to Mr. Ran Blinkov, Director General, Ministry of Interior and Mr.Hezi Kugler, Director General, Ministry of National Infrastructures, a copy received at PHR-Israeloffice on 27/2/2007.
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The Ministry of Interiors position, refusing to connect the homes of
patients whose right to health is violated due to the policy of refusal to
connect the villages to the electricity network, was justified in the
Supreme Court ruling 8062/05 in the matter of Inas Al-Atrash. The judgesexplicitly ruled that the planning and building laws justify violation of
human rights.10 In that same ruling, dealing with the destiny of a child
suffering from cancer who needs electricity in order to maintain a cool and
hygienic environment in her home and to allow her to store the
medications in refrigeration, judges Aharon Barak, Dan Gronis and Dorit
Beinish ruled against Inas right to health, since her parents chose to live
in an unrecognized village, knowing it has no electricity. This ruling isarbitrary and does not reflect reality since Inas family, like most of the
residents in the unrecognized villages, has been living in the village for
many generations, before the establishment of the Israeli state, but the
state does not acknowledge it. It is not a matter of Choosing. Moreover,
in conditions of poverty, unemployment and a harsh daily reality, leaving
the village means giving up the only support source of the family the
extended family and the community.
10The starting point of the discussion is that due to a prohibition in the law (clause 157a to the planningand building law, 1965) the petitioners houses cannot be connected to the electricity networkDavid Cohen, a letter to Yael Vidan, PHR-Israel, received at 15/03/2007.
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Summary and RecommendationsSummary and RecommendationsSummary and RecommendationsSummary and Recommendations
This position paper presents an intolerable situation, in which the state
endangers the lives of her citizens, ill and elders. As time passes by, their
medical condition deteriorates and the state authorities do not offer any
solution.
Every person has the right to health, adequate care and access to the best
medical services the state can provide. Yet, the patients residing in the
unrecognized villages find themselves in an unacceptable situation the
appropriate treatment is accessible, yet they cannot use it due to the
states refusal to connect the villages to the electricity network. This
refusal, together with the lack of other basic infrastructures such as
water, sanitation and health services, is part of ongoing ethno-national
discrimination, from which the Bedouin residents suffer more than 60
years.
There is no doubt that the land problem is a complex one, yet we maintain
that the state has to place the health of its citizens above all political
considerations, and that using health services as a means of pressure on
the Bedouin population in order to force them to move to townships
established by the state is morally and legally wrong.
The states authorities use the planning and building law in theunrecognized villages as a means of evading its responsibility a moral
and a legal responsibility to provide proper, equal health care to all its
residents. The state does not make sufficient efforts to provide solutions
for the chronic patients residing in the villages, especially the ones who
need a regular supply of electricity. It should be noted that the cost of the
connection to tax payers is less than the expenses required in the current
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situation be it the provision of oxygen balloons or the funding of long
hospitalization periods.
PHR-Israel and The Regional Council for the Unrecognized Villages in the
Negev view this policy of service and basic infrastructure prevention asinfected with discrimination, stemming from invalid motivations the
expulsion of the Bedouin residents from their lands and their
concentration in townships. Therefore, every move stemming from this
policy is invalid, and must be ended. Since we know that this aim is still
far, we recommend taking the following actions without delay:
Change the discriminatory policy toward the Arab-Bedouinresidents and acknowledge them as residents with equal rights.
The problem of the unrecognized villages should be solved in
accordance with the residents and should, by no means, affect the
provision of basic services, necessary for their health, such as
electricity and water.
The villages must be immediately connected to the electricity
network, prioritizing the homes of respiratory chronic patients,
diabetics and every chronic patient who needs electricity, before
their condition deteriorates even more. As long as the state does
not provide them with this solution the lives of these people are
in danger.
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The Regional Council for the Unrecognized Bedouin Villages in Negev(RCUV)
was founded in 1997, as the elected popular leadership of the local village committees
and represents the village residents. The High Follow Up Committee for the Arab
Citizens of Israel recognized the RCUV and its chairman as official members. The
RCUV acts as the representative body for the residents of the unrecognized villages:
deals with the different decision makers, works to empower the community, conducts
a judicial rights-based struggle, submits alternative plans for the Negev, produces
an infrastructure of information on the villages for various entities, and more.
Tel: 08-6283043 | Fax: 08-6283315
Address: 47 Haatsmaout St. | P.O.B 10002 Beer-Sheva 68135
Mail: rcuv rcuv@gmail com | Site: www rcuv net
Physicians for Human Rights-Israel (PHR-Israel) believes that every person has
the right to health in its widest possible sense, as defined by the principles of human
rights, social justice and medical ethics. It is the responsibility of the State of Israel
to ensure the fulfillment of this right in an egalitarian manner for all populations
under its legal or effective control: residents of Israel who are eligible for National
Health Insurance, Bedouin residents of unrecognized villages in the Negev desert,prisoners and detainees, migrant workers, refugees and asylum seekers, and
Palestinian residents of the occupied Palestinian territory.
Tel: 972-3-6873718 | Fax: 972-3-6873029
Address: 9 Dror St., Tel Aviv-Jaffa 68135, Israel
Mail: [email protected] | Site: www.phr.org.il
ISSN # 0793-6222
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