MSF Warns Settler Violence and Economic Hardship Are Severing Health Access in West Bank

Key facts

According to reporting released by Doctors Without Borders, the humanitarian situation in the Hebron area has reached a critical juncture due to the compounding pressures of insecurity and financial exhaustion. Medical teams operating in the region report that civilian populations living in isolated villages and high-friction urban enclaves face systemic barriers when attempting to obtain routine care, preventative treatments, or emergency medical interventions.

Dr. Mohammad Haroub, the assistant medical coordinator for MSF in Hebron, stated that a substantial portion of the population is living with unmanaged chronic illnesses because public facilities lack necessary supplies and patients cannot shoulder the financial burden of private healthcare providers. The economic decline across the West Bank has stripped family households of basic financial security, rendering basic consultations and essential medications unattainable for vulnerable communities.

Beyond the financial barriers, physical access to health facilities has deteriorated significantly. Israeli military checkpoints, road closures, dirt mounds, and security gates placed around Palestinian villages frequently prevent ambulances and medical workers from moving freely. Residents seeking medical attention are often forced to cross military barriers on foot or navigate long, unpaved detours through farmland. Furthermore, harassment and violent acts committed by Israeli settlers near agricultural hamlets and settlement outposts have deterred patients from traveling to urban medical centers for fear of physical assault.

To address these expanding coverage gaps, MSF has deployed mobile medical clinics to deliver basic healthcare, pediatric examinations, maternal health services, and psychological support directly to underserved communities in the Hebron governorate. However, humanitarian coordinators emphasize that mobile units offer only a temporary safety net and cannot substitute for a functioning, accessible public health infrastructure capable of managing severe trauma, complex surgeries, or continuous chronic disease care.

Why it matters

The convergence of violent disruption and healthcare access barriers carries profound consequences for public health, local economies, and regional humanitarian operations across the West Bank. When patients with chronic conditions such as hypertension, diabetes, and cardiovascular disease are forced to forgo routine monitoring and medication due to travel restrictions or poverty, manageable medical issues rapidly transform into life-threatening emergencies.

The systemic obstruction of emergency transport further elevates mortality risk. Ambulances transporting acute patients face prolonged inspections and unpredictable delays at military checkpoints, eroding the critical window required for trauma care, stroke management, and complicated childbirths. This operational delay directly threatens patient survival rates and places immense pressure on frontline emergency workers.

Economically, the healthcare crisis reflects the broader collapse of the domestic West Bank economy. The cancellation of Israeli work permits for tens of thousands of Palestinian laborers, combined with severe disruptions to local trade and agricultural harvests, has eliminated primary household incomes across the territory. Without income, families are forced to prioritize basic nutritional survival over medical expenses, driving up community vulnerability to preventable diseases.

For the international aid community, the situation highlights the unsustainable burden placed on non-governmental organizations. While groups like MSF provide vital primary relief, non-profit institutions cannot indefinitely finance or replace public state services for a population of over three million people. The erosion of standard public health delivery risks creating long-term health deficits that will persist for generations.

The governorate of Hebron, located in the southern West Bank, has long served as a primary flashpoint for regional tension. Under the 1997 Hebron Protocol, signed between Israel and the Palestinian Authority following the Oslo Accords, the city of Hebron was split into two distinct administrative zones: H1 and H2. H1, comprising roughly 80 percent of the city, was placed under Palestinian Authority civil and security administration. H2, which covers the remaining 20 percent and encompasses the historic Old City, was retained under full Israeli military control to protect several hundred Israeli settlers residing in fortified enclaves alongside tens of thousands of Palestinian residents.

Across the wider West Bank, administrative control remains partitioned under the Oslo II framework established in 1995. Area C, which constitutes approximately 60 percent of the West Bank's total landmass and includes vital agricultural terrain and rural hamlets, remains under complete Israeli civil and military oversight. Building permits for healthcare infrastructure, water facilities, and housing in Area C are rarely granted to Palestinian communities, severely restricting local institutional development.

Security conditions and movement restrictions across Area C and the Hebron region escalated dramatically following the outbreak of conflict in Gaza in October 2023. Israeli military forces implemented widespread road closures, erected dozens of new physical barriers, and intensified search operations throughout West Bank municipalities. Concurrently, incidents of settler-related violence against Palestinian agricultural communities increased sharply, resulting in the displacement of several rural hamlets, destruction of water storage systems, and severe damage to agricultural lands.

Compounding these physical barriers is a severe public finance crisis within the Palestinian Authority. Withheld clearance revenues and declining direct foreign aid have severely restricted the authority's operating budget, leading to persistent delay or reduction in municipal civil service salaries. Healthcare workers within public clinics and hospitals have frequently received partial pay for extended periods, contributing to severe medical staffing shortages and reduced operating hours across public facilities.

Reaction

International rights organizations, humanitarian agencies, and public health officials have repeatedly voiced alarm regarding the impact of military restrictions and physical violence on healthcare access in the occupied Palestinian territories. Representatives from the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) and the World Health Organization (WHO) have consistently called for the protection of civilian infrastructure and emergency medical workers, highlighting that health services must remain strictly neutral and accessible during conflict.

Humanitarian law experts routinely point to the Fourth Geneva Convention, which establishes clear obligations for an occupying power regarding civilian welfare. Under international law, the occupying authority must ensure the maintenance of medical and hospital establishments and permit the unhindered passage of medical personnel, equipment, and emergency vehicles.

While Israeli security officials generally maintain that checkpoints and movement restrictions are required to prevent security threats and protect citizen lives, human rights bodies contend that sweeping movement bans and failure to restrain non-state violence constitute collective punishment. The ongoing humanitarian situation in the West Bank is expected to remain a central topic during upcoming debates at the United Nations General Assembly and in formal hearings before international human rights bodies in Geneva.

What we don't know yet

Despite detailed field reports provided by relief agencies, several critical aspects of the healthcare situation in the southern West Bank remain difficult to quantify due to fluid security conditions and data gaps:

What to watch

To understand how the medical crisis in Hebron and the broader West Bank will evolve, several key indicators require close monitoring:

This report is based on original documentation and field assessments published by Doctors Without Borders (MSF).