A medical student at the Medical School for International Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
An emergency medicine resident physician at the Department of Emergency Medicine, Mayo Clinic, Rochester, United States.
Health Hum Rights. 2022 Dec;24(2):255-263.
The development of robust emergency care systems as a critical platform for addressing the global burden of disease has been increasingly recognized by global health policy makers over the past decade. A human rights-based approach to securing the right to quality emergency care is also essential to respond to the structural and political determinants of poor health outcomes. In the occupied Palestinian territory, human rights violations have contributed to significant deficiencies in health and quality of health care. In this scoping review, we identify deficiencies in the management of high-risk presentations to emergency departments in the Palestinian health care system for traumatic injury, acute myocardial infarction, and stroke. We subsequently apply a human rights-based analysis to demonstrate how structural racism in the administration of the occupation has contributed to deficiencies in emergency care. Specifically, deficiencies in resource and system organization within the Palestinian emergency care system arise due to occupation-related restrictions on freedom of movement, the procurement of essential drugs and medical equipment, and the development of a national Palestinian health care system. Further research and intervention are needed to understand gaps in emergency care for Palestinians and, in turn, to improve the management of emergency medical and traumatic conditions through capacity building of a Palestinian emergency care system. Importantly, deconstruction of the structural determinants of poor health for Palestinians in the occupied territory is needed to improve public health and ensure the protection of human rights.
在过去十年中,全球卫生政策制定者越来越认识到,建立健全的紧急护理系统是应对全球疾病负担的关键平台。从人权角度出发,确保获得高质量紧急护理的权利,对于应对健康结果不良的结构性和政治性决定因素也是至关重要的。在被占领的巴勒斯坦领土上,侵犯人权行为导致卫生条件和医疗保健质量严重不足。在本次范围界定审查中,我们确定了巴勒斯坦卫生保健系统在创伤、急性心肌梗死和中风等方面管理高危就诊情况方面存在的缺陷。随后,我们应用基于人权的分析方法,展示了占领管理中的结构性种族主义如何导致紧急护理方面的不足。具体而言,巴勒斯坦紧急护理系统在资源和系统组织方面存在缺陷,原因是与占领有关的行动自由限制、基本药物和医疗设备的采购以及国家巴勒斯坦医疗保健系统的发展。需要进一步研究和干预,以了解巴勒斯坦人在紧急护理方面的差距,并通过巴勒斯坦紧急护理系统的能力建设,改善对紧急医疗和创伤情况的管理。重要的是,需要消除被占领土上巴勒斯坦人健康状况不佳的结构性决定因素,以改善公共卫生并确保保护人权。