In July 2004, the International Court of Justice (ICJ) ruled the Separation Wall illegal, saying its route inside the West Bank, and associated gate and permit system, violated Israel's obligations under international law, ordering the completed sections dismantled, and "all legislative and regulatory acts relating thereto" repealed or rendered "ineffective forthwith."
The ICJ also mandated reparations for the "requisition and destruction of homes, businesses, and agricultural holdings (and) to return the land, orchards, olive groves, and other immovable property seized," obligating member states to reject the illegal construction and demand Israel comply with international law.
Most nations ignored the ruling. Israel defied it and continued building, now 61% finished, another 8% under construction, and the remaining 31% planned but not begun. When completed, its expected to be over 800 km, twice the length of the Green Line, four times as long as the Berlin Wall, and in some places twice as high on about 12% of stolen Palestinian land, its erection devastating the people affected.
Based on its current route, about 33,000 Palestinians with West Bank ID cards in 36 communities will be located between the Wall and the Green Line, in the so-called Seam Zone along with most East Jerusalemites. Another 126,000 in 31 communities will be surrounded on three sides, and 28,000 more in nine communities entirely, with a tunnel or road connection to the West Bank, requiring hard to get permits to access.
In July, the UN's Office for the Coordination of Humanitarian Affairs released a Special Report titled, "The Impact of the Barrier on Health," especially patient and staff access to East Jerusalem's specialized medical facilities (unavailable in Gaza or the West Bank) because of the Wall's intrusive route and associated permit/gate system.
Since October 2003, Palestinians "have been obliged to obtain 'visitor' permits to access" their own Seam Zone farmland, also called a "closed military area," another way Israel confiscates land, a recent military order keeping residents of four villages off their land. Beit Ula's mayor said farmers had to evacuate over five square km and abandon their equipment to make way for Separation Wall construction.
To access any restricted areas, including their own property, Palestinians must submit documents proving a "connection to the land" to satisfy security considerations. Entry, by permit only, is then channelled through official access points, gates or other checkpoints, 57 open daily, seasonally or on a seasonal/weekly basis with unannounced closures possible anytime.
Most open only during olive harvest season, and for limited daytime periods, farmers required to leave by late afternoon or early evening, denied needed time to plough, prune, fertilize, control weeds and pests, harvest, and live freely.
Because of the permit system, the difficulty getting them, the gates and other checkpoints, and limited working hours, agriculture and rural livelihoods have suffered, especially in the northern West Bank from 2006 - mid-2009 where permit issuance "sharply decreased."
In January 2009, "closed area" designation extended south to Ramallah, Hebron, and parts of Salfit, Bethlehem and Jerusalem. Previously, farmers only needed ID cards. Now they need permits. For example, 470 Hebron area farmers applied during the 2009 olive harvest season, 100 of them denied, in contrast to 2008 when about 1,500 farmers worked freely.
In the Ramallah governorate, most farmers objected, refusing to apply. As a result, six of 10 gates and checkpoints remain virtually deserted, a similar situation in the Jerusalem area where only seven farmers got permits, the others also refusing.
The Wall and gate system affect thousands of farmers and their ability to access medical care any time, especially for emergencies, those at night particularly worrisome when gates are closed until scheduled openings. Further, vehicle restrictions require transportation by horse, mule or tractor, causing delays and long detours over rugged terrain.
Since 2003, about 10,000 northern West Bank residents in closed areas have needed permits to live in their own homes and reach hospitals, health clinics, schools, workplaces, friends and relatives. Doctors, ambulances, mobile teams and other health professionals are also impeded from reaching the sick or injured.
Barta'a straddles the Green Line in the northern Wadi Ara region near Jenin. Council member Abu Rami, responsible for coordinating with Israeli authorities, lost his mother at a checkpoint because security guards ordered her ambulance sent back. As a result, he relates to others in need saying:
"I deal almost daily with cases of sick people who need to cross the checkpoint. Anyone who cannot walk needs special coordination with the Israelis as well as anyone who has to cross (at) night when (it's) closed. Expectant mothers leave the village weeks before (giving) birth, just to make sure (they can) reach the hospital in time." What used to be a 15-minute drive to Jenin, now takes about an hour or longer.
"I know the procedure and I have all the telephone numbers," he said. Yet, "I could not even save my own mother."
Its six hospitals provide most specialized care to West Bank residents, unavailable to most Gazans under siege, including dialysis, oncology, open-heart surgery, neurosurgery, neonatal intensive care, eye surgery, and rehabilitation for handicapped children.
Restricted access began prior to the Wall's construction. In 1993, Israel required permits for non-East Jerusalemites, including for medical care. At the time, doctors needed permission from the Palestinian Ministry of Health's Referral Abroad Department (RAD) to access hospitals. If granted, the convoluted procedure required patients to arrange appointments, RAD or the hospital then needing Israeli Civil Administration permits to keep them.
The combination of illness and stress waiting for permit issuance or denial is further complicated when multiple visits or operations are required. In addition, males aged 15 - 30 are often denied for security reasons, and parents are impeded from getting treatment for sick children or family members.
Permits are also invalid during closure periods - 50 occurring from April 2009 - March 2010 for "security alerts" or Israeli holidays, and unannounced ones can occur any time.
Before the Wall's construction, permits were enforced at checkpoints and random spot checks. However, they weren't required to access Jerusalem, especially on foot. Since 2007, however, West Bank residents may only do so through three of 14 checkpoints at Qalandiya, Gilo and Zaytoun - the procedure time-consuming and challenging, especially during rush hours when queues are long, resulting in delays up to two hours or more.
Nonetheless, nearly half of all patients (over 19,000 or 365 a week) were referred to East Jerusalem hospitals for specialized care, up from 26% in 2006, despite vehicles with Palestinian license plates denied entry through checkpoints, creating added hardships for the sick, those unable to walk, or do it easily.
The Wall also affects East Jerusalemites, residing in neighborhoods like Kafr'Aqab and the Shu'fat Refugee Camp, now separated from the city. In addition, delays impede ambulances from reaching these communities, a serious problem when emergencies arise.
Also for patients needing same day access, the required procedure involving the Palestinian Red Crescent Society (PRCS) to request permission from the Israeli District Coordination Office (DCL). If gotten, then for authorization through a specific checkpoint, and back-to-back ambulances, West Bank ones denied Jerusalem entry.
Even then, delays are common. In 2009, PRCS recorded 440, including ambulance denials, mostly for Jerusalem. Medical staff are also impacted, despite special permit stamps once facilitating passage through any checkpoint. However, what used to be 15-minute trips now take two hours or longer, and if checkpoints are closed or queues especially long, they're interminable, now worse since November 2008 after Israel implemented new restrictions, obliging West Bank staff working in East Jerusalem to enter through three designated points.
Only doctors may use them all, not nurses or other staff. They must cross on foot and use public transportation to reach hospitals, resulting in long delays and occasional denials, severely disrupting efficient operations and the health of patients.
Medical students are also affected, about 160 in their fourth, fifth and sixth years of study at Al Quds medical school, eligible for training at East Jerusalem hospitals. About 90% live in the West Bank so need permits to access training in pediatrics, neonatology, surgery, cardiology, internal medicine and other areas - available only in East Jerusalem.
Yet in June 2010, Al Quds medical school reported that 11 students were denied permit renewals, preventing their essential training.
Long before Separation Wall construction began in 2002, West Bank and East Jerusalem residents suffered horrifically under what Israeli Professor and Coordinator of the Israeli Committee Against House Demolitions (ICAHD) Jeff Halper calls a "Matrix of Control" comprised of:
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