The Israeli Prison Service (IPS) has adopted a systematic policy of medical negligence in prisons and detention centers housing Palestinian detainees. Long delays in providing substandard medical treatment are typical. Although all prisons include a medical clinic, physicians are on duty irregularly and specialized medical healthcare is generally unavailable. Prisoners are not treated outside the assigned clinic hours and typically must wait for long periods of time before being examined. Once they are examined, however, most prisoners are often prescribed painkillers without any thorough medical follow-up. Transfers to hospitals for needed treatment may take place only after weeks or months.
Detention conditions have a huge impact on the health of prisoners and detainees. The lack of natural sunlight, the presence of moisture in the prisons and detention centers, compounded by a poor and unbalanced diet, the lack of adequate recreation facilities and restrictions imposed on the use of the prison yard for physical exercise, often lead to bone pain and at times, rheumatism. As a result of their imprisonment, released detainees often faced chronic health problems such as skin diseases, extreme fatigue, anemia and weakness, kidney problems, rheumatism, dental problems and ulcers.
Language is a fundamental problem as most clinic doctors do not speak Arabic and not all prisoners speak Hebrew. The communication difficulties often negatively impact a prisoner’s treatment and hinder the development of the trust necessary in the relationship between a doctor and his patient.
Human rights organizations estimate that, since the beginning of the Al-Aqsa Intifada in 2000 until 2008, 17 Palestinian prisoners have died in Israeli prisons and detention centers as a result of medical negligence. During visits to Israeli prisons and detention centers conducted in 2008, Addameer documented 178 cases of medical neglect.
THE ISSUE OF DUAL LOYALTY
Doctors and other medical staff employed by the IPS find themselves in a situation of “dual loyalty”, whereby their primary obligation is towards the State and the Israeli security apparatus, rather than the patient. Doctors working in detention and interrogation centers often fail to report incidents of torture and ill-treatment to the relevant legal authorities for fear of losing their jobs. Similarly, physical signs of torture and abuse are rarely reported in the detainee’s medical files making it almost impossible for the victims to seek justice and compensation. Doctors also often advise Israeli Security Agency officers on the health condition of a detainee held under interrogation and as such, they become complicit in the practice of torture and physical and mental abuse.
CHILD’S TESTIMONY ON MEDICAL NEGLECT
Eighteen year-old Muhammad talks about his case of appendicitis in Ofer prison:
I was arrested on 25 February 2009 from Katana after clashes erupted around the Wall in the village. A group of four undercover forces arrested me and started beating me. Then the [Israeli] army came; they took me and transferred me to the police station in Atarot. There again, two border police beat me on my legs, head and stomach using their rifles. They were beating me in a room called the “container”, after which they took me to Atarot. It was in the evening at the time of the Maghreb prayer. I was left there until 4 a.m., after which I was transferred to Ofer prison. There, I was immediately placed in section 11, room number 4, specially used for detaining juveniles. I was held there for two months; then they transferred me to the tents where I stayed another two months. I was sentenced to four and a half months of prison and a 500 shekel fine. Although I was supposed to be released on 25 June 2009, there was a delay and I was released only on 2 July 2009. A week before 25 June, I started feeling pain in both sides of my stomach. It started hurting more and more, so the officer of the section called the nurse who was on duty that day. He came with a urine container and took a sample. Then, he asked that I go the clinic and the next day I was allowed to go. A doctor was there who performed a routine examination to check the pressure on the both sides of my waist. Then she told me: “drink more water” and gave me an envelope filled with blue pills the size of lentils. And they brought me back to the section. Every time I would feel the pain I would take one of the pills. At first, they were working for 10 hours. Then, they stopped. When I went back to the clinic, I was told that I am dehydrated. This was the case until my release on 2 July 2009. I took two pills before I was released on a Thursday. They worked until Saturday noon. Then I felt a sharp pain and immediately went to the doctor in the village clinic. From there I was immediately transferred to the hospital in Ramallah and then to the operating room. After a few X-rays and tests, the doctors performed surgery which lasted an hour and a half. It turned out that my appendix had burst and an infection spread throughout my abdomen. I had to stay in the hospital for 16 days.