Cancer is the bitter enemy of right-wing, moderate and left-wing Israeli oncologists and of Palestinian physicians who want to learn from them how to better treat their own patients.

The Palestinian Authority (PA) used to provide funds to send cancer patients to advanced Israeli medical centers, and the US government allocated money to help hospitals in east Jerusalem that treat Palestinians. Israel was supportive of this approach by annually providing 100,000 travel permits to Palestinians. From 2011 to 2015, the number of patients treated in one Palestinian hospital in east Jerusalem decreased by eight percent, while the number of those referred for treatment in Israel medical centers almost doubled.

But in July 2018, this situation changed after the PA’s health ministry suspended most of the funding for patients being treated in Israel and in August, 2018, the US State Department announced its intention to redirect to projects elsewhere $25 million it had committed for hospitals in east Jerusalem.

These policy changes affected the provision of healthcare services in areas governed by the PA and increased the load on hospitals in east Jerusalem, which were already experiencing shortages in medications and equipment, said Prof. Ziv Gil, head of the Head and Neck Center and the Head and Neck Surgery department at Haifa’s Rambam Medical Center in an interview with Breaking Israel News. His center is the largest referral facility of its kind in Israel.

Since the US and PA turnabouts, Israeli cancer specialists at Rambam have boosted their efforts begun a few years ago to help their Palestinian colleagues at Augusta Victoria Hospital in east Jerusalem located on the southern side of Mount of Olives and owned and operated by the World Lutheran Federation.

The compound was opened in 1914 by the Empress Augusta Victoria Foundation as a center for the German Protestant community in Ottoman Palestine, in addition to the Church of the Redeemer from Jerusalem’s Old City.

Since then, the compound was used mostly as a hospital, either by the military during the First and Second World Wars and during Jordanian rule) or for Palestinian refugees and general public (from 1950 until today).

Today, August Victoria Hospital is the second-largest hospital in east Jerusalem, as well as the sole remaining specialized care unit located in the West Bank or Gaza Strip. It provides specialty care for Palestinians from across the West Bank and the Gaza Strip with services including a dialysis unit, cancer center and a pediatric center – which is why the Rambam doctors decided to get involved.

The hospital has some 120 inpatient beds, 52 outpatient beds and 400 staff members. Among its facilities is an oncology department that performs cancer treatments, including surgery and radiation.

A “Comment” article on the Rambam-Augusta Victoria partnership appeared in the November 2019 issue of The Lancet medical journal that Gil wrote together with Dr. Salem Billan and two from Rambam, two from Augusta Victoria and one from Nazareth. It was titled: “Developing an Independent Palestinian Cancer Care Capacity.”

While some Israeli oncology departments would, out of vested interests, be happy to accept Palestinian patients due to additional income, in the long run it is “much better” for Augusta Victoria specialists to improve their medical knowledge and treat patients who would not have to travel to more distant Israeli hospitals, Gil explained. “They should not be dependent on Israeli medical centers, which, in any case, are full of Israeli patients and should not have to be burdened by a a catchment area in the West Bank and Gaza of five million residents,” he stated. “The PA has to expand its health services.”

Gil said that while cancer is the number-one cause of death in Israel, cardiovascular diseases are still number one among Palestinians, followed by cancer. Many cancer cases in the West Bank and Gaza, he added, result from the high rate of tobacco smoking among Palestinian men. These include lung cancer and tumors of the head and neck, which he specializes in treating.

In the past decade, Augusta Victoria has played a pivotal role in the process of establishing an independent Palestinian healthcare system. “We have been training Augusta Victoria doctors at Rambam, holding joint conferences several times a year and going to the east Jerusalem hospital to see patients,” continued Gil.

“Israel’s Health Ministry is not involved in the project, just as the PA has not been involved. Neither is the European Union or the World Health Organization. But the personal connections among Rambam and Augusta Victoria doctors has been excellent. We in Haifa are all volunteers working in the project in our free time. But we need substantial financial support for fellowships and other activities to raise the level of the east Jerusalem oncologists,” the Rambam oncologist concluded.

According to the article in The Lancet, the death rate from cancer among Palestinians rose 6% between 2015 to 2016. “The treatment protocols established by the Israeli–Palestinian teams have allowed patients with cancer to have a higher standard of care in their community and at a lower cost than in neighboring countries, saving the lives of thousands of Palestinian patients,” said the journal article. “In a peace scenario, Israel is likely to be a valuable source of such training.”

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