for additional information on the csp …m.p.h., and donna perry, r.n., ph.d., as well as suzanne...

For additional information on the CSP Palestine/Israel HealthInitiative and the cooperative health programs described in thisreport as well as to submit descriptions of health projects and

resources to be included in future editions of this document and on the PIHI websites, please contact:

Susan Blumenthal, M.D., M.P.A.Stephanie Safdi, [email protected]

Center for the Study of the Presidency1020 19th Street, NW, Suite 250

Washington, DC 20036Phone: 202-872-9800

Fax: 202-872-9811www.thePresidency.org

Center for the Study of the PresidencyPresident: David M. Abshire, Ph.D.

Founded in 1965, the non-profit, non-partisan Center for the Study of the Presidency serves as theinstitutional memory of that high office, and applies the lessons of history to the challenges faced bythe President and Congress.

Mission:• Promote leadership in the Presidency and the Congress to generate innovative solutions to cur-

rent national challenges;• Preserve the historic memory of the Presidency by identifying the lessons from the successes and

failures of such leadership;• Draw on a wide range of talent to offer ways to better organize an increasingly compartmental-

ized Federal Government;• Educate and inspire the next generation of America’s leaders to incorporate civility, inclusiveness,

and character into their public and private lives and discourse.

Health and Medicine ProgramCenter for the Study of the Presidency

Director: Susan J. Blumenthal, M.D.

Health is vital to the economy, productivity, and national security of the United States. From thebeginning of our nation’s history, Presidents have played a significant role in steering a course ofaction for the health of the Nation. Applying lessons from previous Presidents and Administrations,the Health and Medicine Program of the Center for the Study of the Presidency (CSP) frames healthcare challenges and opportunities for the next President and Executive Branch of government, andcrafts recommendations to enhance public policymaking.

The program examines such health issues as re-engineering the health system to increase access,effectiveness, efficiency and decrease costs, health disparities, the chronic disease epidemic, fundingfor biomedical research, ethical issues arising with scientific discovery, the impact of globalizationwith the threat of bioterrorism and emerging diseases such as avian flu and obesity, and the potentialfor health diplomacy and peace-building through health.

The program is also leading an initiative to generate new strategies and actions for the next Presidentof the United States to accelerate progress in science and medicine to improve the health of people inAmerica and worldwide.

Peace Through Health

A Mapping of Cooperative Health Programs in Palestine and Israel

A Report of the Palestine/Israel Health Initiative (PIHI)

A Center for the Study of the Presidency Project on

“Advancing Trust and Reconciliation among Palestinians and Israelis”

by

Susan J. Blumenthal, M.D., M.P.A.Director, Health and Medicine ProgramCenter for the Study of the PresidencyFormer U.S. Assistant Surgeon General

Clinical Professor, Georgetown School of Medicine

and

Stephanie Safdi, M.Phil.Research Assistant

Center for the Study of the Presidency

with Special Acknowledgement to

Beth HoffmanHealth Policy Fellow

Center for the Study of the Presidency

December, 2008

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A MAPPING OF COOPERATIVE HEALTH PROGRAMS IN PALESTINE AND ISRAEL

Table of Contents

Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv

Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v

Palestine/Israel Health Initiative Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Background on Israeli and Palestinian Health Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

History of Cooperation in Health and Medicine between Israel and Palestine . . . . . . . . . . . . . . . . . . . . . . . 8

Recommendations for Improving Health in Palestine and Israel

through Cooperative Activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

• Education, Training, and Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

• Public Health and Emergency Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

• Health Information Technology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Selected Inventory of Palestine/Israel Cooperative Health Initiatives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

• Selected Inventory of Cooperative Projects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

• Selected Organizations Engaged in Palestine/Israel Cooperative Health Programs . . . . . . . . . . . . 38

Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

End Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48

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PEACE THROUGH HEALTH

There are numerous individuals and organizations toacknowledge for their important contributions to thePalestine/Israel Health Initiative (PIHI), a project ofthe Center for the Study of the Presidency (CSP)funded by the U.S. Agency for International Develop-ment (USAID). In particular, we would like to thankCSP President Dr. David Abshire, CSP Vice PresidentDr. Tom Kirlin, Yi-An Ko, Justin Mutter, Michelle Tre-seler, Lisa Phillips, and Limor Ben-Har, for their ded-icated efforts and support. Special thanks also to MarkWard, Mark Walther, Ricki Gold, Charis Nastoff, andElizabeth Drabant of USAID for their assistance. Wewould additionally like to express our gratitude toCSP Health Policy Fellow Beth Hoffman for her out-standing work and significant contributions to thisInitiative and report.

We would like to acknowledge our other colleaguesinvolved in the CSP “Cooperative Program for Ad-vancing Trust and Reconciliation in Israel and Pales-tine,” including Ambassador Dennis Ross,Ambassador Tony Hall, Cardinal Theodore McCar-rick, Benjamin Fishman, Professor Robert Destro, MaxAngerholzer III, Marshall Breger, Dr. Mounzer Fatfat,David Austin, and John Nakamura, among others.

Special acknowledgement and gratitude are given toour Field Director, Michael Silbermann, D.M.D., Ph.D.(Middle East Cancer Consortium), and to our princi-pal Field Coordinator, Ziad Abdeen, Ph.D (Al-QudsUniversity, Palestine), for their tireless work and devo-tion to this Initiative.

Our sincere appreciation is extended to the officials fromthe Palestinian and Israeli Ministries of Health for theirsupport and guidance and their dedicated work to im-prove the health of people in the region, including Dr.Fathi Abu Moghli (Minister of Health, Palestine), AishaMansour (Ministry of Health, Palestine), Dr. Avi Israeli(Director General, Ministry of Health, Israel), and Dr.

Alex Leventhal (Director of International Relations,Ministry of Health, Israel). Our thanks also to Tony Lau-rance (Acting Head, Office of the World Health Organi-zation, West Bank and Gaza), and to Paul Rohrlich (U.S.Embassy, Tel Aviv), for their participation.

We express our gratitude to the many health experts inthe region who brought their perspectives, skills, andinsights to this project including Karen Avraham,Ph.D., Dan Bitan, Ph.D., Rivka Carmi, M.D., ShlomiCodish, M.D., Khuloud Dajani, M.D., Hasan Dweik,M.Sc., Ph.D., Simon Fisher, J.D., Randi Garber, PinchasHalpern, M.D., Andrew Ignatieff, Moien Kanaan,Ph.D., Michael Karplus, M.D., Ron Krumer, YosephMekori, M.D., Shlomo Mor-Yosef, M.D., ArnoldNoyek, M.D., Yehudah Roth, M.D., Dagan Schartz,M.D., Amnon Shabo, Ph.D., Yuval Shahar, M.D.,Ph.D., Harvey Skinner, Ph.D., CPsych., Akiva Tamir,M.D., Dov Tamir, M.D., M.P.H., Ted Tulchinsky, M.D.,M.P.H., and Raphael Udassin, M.D.

Special thanks to the U.S. participants in the Palestine/Is-rael Health Initiative Meetings for their participation andcontributions: Selim Suner, M.D., M.S., Joe Ternullo, J.D.,David Whitlinger, Thomas Dean Kirsch, M.D., M.P.H.,Hani Abujudeh, M.D., M.B.A., Paul Heinzelmann, M.D.,M.P.H., and Donna Perry, R.N., Ph.D., as well as SuzanneRainey and Forum One Communications for their dedi-cated work on website development.

Finally, our deep appreciation to the 50 senior healthand medical experts from Palestine, Israel and theUnited States who participated in meetings of this Ini-tiative in Israel and Palestine as well as those who pro-vided information about their cooperative healthinitiatives for publication in the Selected Inventory in-cluded in this report. It is through the work of these in-dividuals and other committed health professionalswho work together on projects in the region that thegoal of peace through health can be achieved.

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Acknowledgments

| v |


Health is essential to the economy, well-being, na-tional security, and future of the Middle East region.The Palestine/Israel Health Initiative (PIHI) is a cen-tral component of the Center for the Study of thePresidency’s USAID-supported program “Advanc-ing Trust and Reconciliation in Israel and Palestine.”

The Health and Medicine component of thisUSAID-sponsored initiative focuses on usinghealth as a bridge to further knowledge, coopera-tion, trust, and understanding between Israelisand Palestinians. Countries cannot achieve politi-cal stability or flourish economically with un-healthy people. Health is a common currency inthis region of the world to help achieve a better fu-ture – reducing inequalities that lead to mistrustand building the relationships between peoplethat can serve as pillars for peaceful coexistence.

Purpose:• Identify and engage organizations and individ-

uals in joint Palestine/Israel health activities• Foster dialogue and cooperation and enhance

networking between health and medical pro-fessionals in Israel and Palestine

• Highlight priority areas where cooperative ac-tivities between Palestinian, Israeli, and U.S.professionals can effectively improve health inthe region.

• Create sustainability for these efforts

Achievements:• Identified ongoing health projects in the re-

gion and contributed to the development of acooperative network of Palestinian and Israelihealth experts

• Convened working group meetings withPalestinian, Israeli, and U.S. health and med-ical experts to focus on priority areas for im-proving health in the region

• Developed a selected inventory of cooperativeactivities between Palestinians and Israelis inhealth and medicine in the region

• Produced a report with an analysis of healthsystems, cooperative health activities and recommendations for improving health in the area

• Created a “Health e-Commons” Internetworkspace for sustaining health cooperationand networking between Palestinian and Israeli medical and scientific professionals

• Initiated the development of the first publicmultilingual Internet portal for health infor-mation in this region of the Middle East withresources in Arabic, Hebrew, and English

Next Steps:Future initiatives include:

• Enhancing cooperation among Israeli, Pales-tinian, and U.S. health experts and promotingcooperative health initiatives

• Expanding selected inventory of ongoing co-operative activities

• Expanding the content and reach of the healthinformation web portal and increasing utiliza-tion of “Health e-Commons”

• Implementing selected recommendationsfrom the PIHI project

• Identifying additional resources for support-ing cooperative health projects in the region

| v |

Palestine/Israel Health Initiative Overview

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| 1 || 1 |

Health is essential to the economy, well-being, nationalsecurity, and future of the Middle East region. ThePalestine/Israel Health Initiative (PIHI) is a centralcomponent of the Center for the Study of the Presi-dency’s USAID-supported program “Advancing Trustand Reconciliation in Israel and Palestine.” Advancingtrust and reconciliation in Israel and Palestine requiresthe imagination and resolve of local as well as nationalleaders, and the engagement of non-profit organiza-tions as well as governments. Supported by a grantfrom the U.S. Agency for International Development(USAID), the non-partisan Center for the Study of thePresidency (CSP), a 40-year-old public policy and ed-ucation organization, coordinated a series of planningand program activities in Israel and Palestine aimed atfostering reconciliation through local social and eco-nomic development and interfaith cooperation. Theprogram consisted of three major components: inter-religious cooperation and dialogue, socio-economicdevelopment, and health and medicine programs.

The Health and Medicine component of this USAID-sponsored initiative focused on using health as abridge to further knowledge exchange, trust, and un-derstanding between Israelis and Palestinians. Coun-tries cannot achieve political stability or flourisheconomically with unhealthy people. Health is a com-mon currency among nations in this region of theworld to help achieve a better future—reducing in-equalities that lead to mistrust and building the rela-tionships between people that can serve as pillars forpeaceful co-existence.

Just as diplomats have hammered out treaties over thecenturies to build bridges between nations, publichealth officials and humanitarian organizations havebegun sharing best practices and technology in an ef-fort to build a new kind of bridge between countriesto foster peace and development around the world.This field, health diplomacy, is an important and un-derutilized instrument in America’s foreign-policytoolbox and it has provided a framework for this Pales-tine/Israel Health Initiative (PIHI).

Health diplomacy recognizes health as a universal andpowerful language between people and between na-

tions, which necessitates cooperation even in situationsof conflict. Health diplomacy offers a much-needed op-portunity for building bridges between societies, creat-ing links between governments, the private sector, andNGOs and allowing them to work together to improvepublic health. Building such links can facilitate com-munications in other areas, increasing trust and confi-dence and helping improve overall relations.1

In Palestine and Israel, the fields of public health andmedicine offer unique opportunities for cooperation be-tween professionals and leaders in both societies whocome together to craft common solutions to sharedhealth challenges. Palestinians and Israelis draw theirdrinking water and feed their fields and livestock fromcommon water sources, including the Jordan River.They breathe the same air. They occupy a similar geo-graphic landscape, eat similar foods from many of thesame sources, share certain genetic predispositions, andintermingle on a daily basis as Palestinians cross intoIsrael to live, work, and seek medical treatment.

Palestinian and Israeli professionals have been work-ing together in the fields of public health and medicinefor decades out of necessity and irrespective of politi-cal constraints. Though the political climate has af-fected the feasibility of certain projects, the need forthis cooperation has sustained joint Palestinian-Israeliinitiatives in health and spurred the development ofnew programs. This shared work produces relation-ships that are both professional and personal and thatendure despite challenges. These initiatives build trustand reconciliation when patients receive lifesavingtreatments, when health systems are built, when dis-eases and epidemics are monitored and prevented,when cooperation in research is undertaken, and whennew generations of professionals are trained. The com-mon quest for good health knows no borders. Crossingpolitics, borders, and cultures, these cooperative initia-tives in public health and medicine are premised onthe increasing interdependence of societies and theirshared humanity.

The goal of the CSP Palestine/Israel Health Initiativehas been to foster cooperation and facilitate interac-tions between medical, public health, and scientific ex-

Palestine/Israel Health Initiative Introduction

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perts, as well as other relevant organizations and indi-viduals, in Israel and the Palestinian Territories to im-prove the health of people in the region as well as topromote increased cooperation and understanding.This Initiative builds on the foundation of health pro-grams that have been conducted over the past decadein the Middle East region facilitated by governmental,academic, and private sector organizations.

The Initiative consisted of meetings of Palestinian, Is-raeli and American medical experts that produced rec-ommendations to improve primary care, diseaseprevention, and emergency preparedness as well as tofoster cooperation on research, education, training, andthe delivery of health services in the region. Other ac-

tivities of the Initiative included a selected mapping ofcooperative health programs underway betweenPalestinian and Israeli scientists and health care pro-fessionals and building an Internet-based “health e-commons” for networking Israeli, Palestinian, and U.S.health and medical experts to foster cooperation andhealth information exchange. The Initiative also iden-tified innovative opportunities to apply informationtechnology and new media to advance health in the re-gion. Recommendations from the project provide aframework for future work and initiatives. Increasedinvestment in cooperative health activities betweenPalestinians and Israelis is vital to ensuring a health-ier and more prosperous future for people in the re-gion and serves as a pillar for a sustainable peace.

Though geographically intertwined, the health systemsin Israel and Palestine are worlds apart. Since the pas-sage of the 1995 National Health Insurance Law, theState of Israel has assumed responsibility for providinghealth services for all of its residents. State funding pro-vides for a standardized set of medical services, includ-ing hospitalization. Health care in Palestine wasreorganized during roughly the same period, with thecreation of the Palestinian Ministry of Health in 1994.By contrast, unlike Israel’s standardized provider sys-tem, the Palestinian health care system contains a mixof public, non-governmental, United Nations Reliefand Works Agency for Palestinian Refugees (UNRWA),and private sector services. While Israel’s ratio of physi-cians to residents is 372.61/100,000, one of the highestin the world2, this ratio is only 97/100,000 for the Pales-tinian Territories.3 Israel and Palestine have at once verydifferent systems of health care delivery and demo-graphic profiles alongside geographic similarities andphysical proximity, all operating within the constraintsof a complicated and difficult political situation. Thiscomplex background has yielded two populations thathave divergent health status indicators, many similardisease and genetic concerns, and almost unavoidablyintertwined systems of health care delivery.

Israeli Health SystemThe current organization of Israel’s health system has itsroots in structures that were institutionalized with theestablishment of the State of Israel in 1948. At that time,an Israeli Ministry of Health was formed along with re-gional health bureaus, an epidemiological service,mother-and-child health care services, and a medicalcorps to serve the Israeli Defense Force (IDF). Since theestablishment of Israel’s first and largest insurance com-pany, Kupat Holim Clalit, in 1911, health insurance hasbeen provided by four main insurance companies,known in Israel as “sick funds” or “kupat holim.” Othersick funds include Kupat Holim Maccabi, Kupat HolimMeuhedet, and Kupat Holim Leumit. By 1995, approxi-mately 96% of the population was insured. Nevertheless,the financing of health services, which faced periodicbudgetary crises, had long been a topic of public debate.4

On January 1, 1995, the National Health Insurance Lawwas passed, creating a mandatory and nationalized

health insurance system for the State of Israel. The lawestablished the state’s responsibility for the provisionof health services for all of the country’s residents. Astandardized basket of medical services, including hos-pitalization, are supplied through the four sick funds.Health costs are funded through health insurance pre-miums paid for by each resident, employers’ health taxpayments, National Insurance Institute funds, Ministryof Health funds, and consumer payments. All residentsmust register with a sick fund, and no sick fund can barapplicants on any grounds, including state of healthand age. Among others, health services covered includemedical diagnosis and treatment, preventive medicineand health education, hospitalization, surgery, chronicdisease treatment, and obstetrics/gynecology.

With advanced medical technology and a thriving in-formation technology sector, Israel provides some ofthe world’s most advanced and accessible medicalservices. As of 2002, Israel is home to 356 hospitals, in-cluding 48 general hospitals with 14,324 beds. Thehealth system also includes approximately 5400 bedsfor psychiatric patients, 19,600 nursing home beds, and11,500 private in-patient hospital beds. Approximately45% of general hospital beds are operated by the gov-ernment, 30% by Israel’s largest sick fund insurancecompany Kupat Holim Clalit, 6% in two hospitals be-longing to the Hadassah Medical Organization, andthe rest in hospitals run by non-profit and religious or-ganizations. The ratio of hospital beds to Israeli resi-dents is 5.95/1,000.5

The health system also supports over 2,000 commu-nity-oriented primary care clinics throughout thecountry, which are operated by sick funds, the Min-istry of Health, and municipalities. Approximately 850mother and child care centers offer low-cost accessi-ble services throughout the country, including healtheducation programs, regular checkups to monitorchild development, and a comprehensive immuniza-tion program for newborns and children up to the ageof five. 95% of all babies and children in Israel are im-munized, a proportion that is higher than in WesternEurope and the U.S.6 Additionally, Israel’s child mor-tality rate is very low at approximately 4.95 per 1,000live births.7

Background on Israeli and Palestinian Health Systems and Health Indicators

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Israel has four medical schools, two schools of den-tistry, one school of pharmacology, 20 nursing schools,and numerous public health programs. Additionally,Israel has approximately 26,000 physicians, most ofwhom are salaried employees of hospitals and the na-tional sick funds. Israel’s physicians service a popula-tion of approximately 6,930,000, 81% of whom are Jewsand 19% of whom are mostly Arab non-Jews, with themajority of the population residing in urban centers.8

Its ratio of physicians to residents is 372.61/100,000,one of the highest in the world.9 8.7% of Israel’s grossnational product is spent on health, a proportion sim-ilar to Western European countries. Israel’s health indi-cators place its population among the healthiest in theworld. For instance, life expectancy at birth for men is77.56 years and for women is 81.74 years. Israel alsohas an advanced system of secondary care delivery:approximately 25% of its physicians are certified toprovide specialized care.10

Palestinian Health SystemIn contrast to the high degree of specialization found inIsrael, the health care system in the Palestinian Territo-ries is organized principally around the delivery of pri-mary care services. With two medical schools and nocenters for training of specialists, the ratio of physiciansto residents in the Palestinian Territories is 97/100,000,one of the lowest in the world.11 Transferred to Pales-tinian control in 1994, the health system’s underdevel-oped secondary and tertiary health care networks havemade it largely dependent on neighboring countries,including Israel, Egypt, and Jordan, for obtaining ap-propriate health services for its people, particularly foradvanced conditions and specialized procedures. Whilehealth indicators in the Territories are generally betterthan for neighboring Arab states, the area faces partic-ular challenges as a result of the political environmentand its effects on population mobility, security and sta-bility, the availability of supplies, and the training andaccreditation of health care workers.

As of 2004, the Palestinian Territories had a populationof approximately 3.6 million people, growing at an an-nual rate of 2.6% and up from 2.89 million in 1994. Thepopulation is divided between the West Bank, EastJerusalem, and the Gaza Strip, with 58% residing inurban areas.12 According to the Palestinian Central Bu-reau of Statistics, the average population density in thePalestinian Territory was 625 persons per square kilo-meter at the end of 2007. The population density in the

West Bank was 415 persons per square kilometer and3,881 persons per square kilometer in Gaza (one of thehighest ratios in the world). By contrast, the popula-tion density in Israel in 2007 was approximately 317persons per square kilometer.13 In 1997, the fertility ratein the Palestinian Territories was estimated at 6.1 (2.88in Israel), and children less than 14 years of age consti-tuted approximately 47% of the total population. In1997, refugees compromised 65.1% of the populationin the Gaza Strip and 26.5% in the West Bank andJerusalem, and 16% of Palestine’s total population wasresiding in refugee camps.14

Health status indicators for the Palestinian Territorieshave generally improved over time and tend to be bet-ter than in neighboring countries, excluding Israel. Lifeexpectancy, according to 2004 World Health Organi-zation (WHO) estimates, is 72.6 years at birth (71.1 formen and 74.1 for women). Though significantlyhigher as compared to Israel, the infant mortality rateof approximately 20.5 per 1000 live births is compara-ble to or lower than rates in neighboring Arab nationsand less than half the infant mortality rate in the Pales-tinian Territories during the 1970s. Furthermore, ac-cess to health care as well as living standards andhygiene have improved considerably during the pastseveral decades. The WHO now indicates that 100%of the population has access to sanitation facilities,though only 97% has sustainable access to safe watersources. Moreover, while incidence of infectious dis-ease has declined largely due to immunization pro-grams and other public health measures, incidenceand prevalence of cardiovascular diseases, hyperten-sion, diabetes, and cancer has increased, requiringnew public health interventions for chronic diseaseprevention and treatment.15

Meanwhile, regional politics has affected health statusindicators in the Palestinian Territories in recent years.For instance, while childhood immunization coveragerose to approximately 97% by 2001, reports in 2002 in-dicated that immunization rates had declined, partic-ularly in remote areas. This decrease may in part bedue to transportation problems in delivering vaccinesacross checkpoints, electrical shortages affecting vac-cine storage facilities, and constraints on mobility af-fecting surveillance of vaccine-preventable diseases.Reports have indicated a similar decline in the use ofpreventive services, particularly among women visit-ing post-natal care facilities and in the implementation

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of school health programs. UNRWA reported a 58% in-crease in the number of still births from 2001-2002,while the Palestinian Ministry of Health reported thatthe percentage of home deliveries had increased from5% to 50%, as a possible consequence of constraints onmobility affecting access to services.16

In recent years, nutritional status and access to nutri-tious food, particularly for women and children, havealso been issues of concern in the region. Market sur-veys have suggested shortages of high protein foods,caused in part by a combination of road closures,checkpoints, and military conflict. The collection ofwaste and other sanitation issues have also grownmore problematic since the outbreak of the Second In-tifada in 2000, particularly in the Gaza Strip. Addition-ally, ongoing conflict in the region has producedimmediate health effects, causing deaths, physicaltrauma, and mental health concerns in both Israel andPalestine. In 2004, according to the World Health Orga-nization, injuries (including domestic, road, and con-flict-related) represented the leading cause of death forPalestinians 1-59 years of age. In 2004, leading causesof mortality for all age groups included cardiovasculardisease (25.1%), accidents (11.4%), cancer (10%), peri-natal conditions (8%), and respiratory disorders in-cluding pneumonia (6.4%).17

Palestine’s current health system was structured rela-tively recently with the creation of the Palestinian Au-thority’s Ministry of Health in 1994. Prior to 1967,health services in Gaza were administered by Egyptand services in the West Bank and East Jerusalem byJordan. Health institutions in Gaza and the West Bankoperated independently of each other until 1967, whenthe Israeli Defense Ministry assumed responsibility forthe provision of services in the regions. Nevertheless,Gaza and the West Bank continued to have disjointedhealth delivery systems, each with a different ChiefMedical Officer, administrative structure, and proto-cols in certain health policy areas. Beginning in 1948,UNRWA has been responsible for providing basichealth services to registered Palestinian refugees, whonumbered approximately 1.1 million in 1997.18

Between 1967 and 1994, the Israeli Defense Ministry,with supervision from the Israeli Health Ministry,worked according to a stated objective to provide thebest possible health care in the region given the avail-able resources and to maintain financial self-sufficiency

of the government health sector. To do so, it prioritizedpublic health and primary care in the Territories, em-phasizing immunization programs and maternal andchild health programs in particular. Little investment,however, was available for the development of second-ary and tertiary care infrastructure and capacity. As aresult, the number of government hospital beds in theWest Bank and Gaza increased by only 13% between1970 and 1993, and in 1992 only 10% ($5.9 million) ofthe government health budget for Palestine went intodevelopment versus operating expenses.19

Following the Oslo Agreement in 1993, Israel trans-ferred responsibility for health services and health pol-icy in the West Bank and Gaza to the newly formedPalestinian Authority (PA), managed by its Ministry ofHealth (MOH). Currently, the Palestinian health systemis broadly managed by four sectors: the governmentsector led by the Ministry of Health, the private sector,the non-governmental (NGO) sector, and the sector runby UNRWA for the health needs of Palestinian refugees.The MOH is the principal regulatory and administra-tive body for the Palestinian health system, managingpublic health services and delivery of primary, second-ary, and tertiary care in public facilities. Primary careservices are still considered to be the backbone of thePalestinian health care system, and 56.5% of all primaryhealth care centers are run by the MOH.

Government-run health clinics are available in allurban centers in the Palestinian Territories but are lesscommon in rural areas. The Ministry of Health doesnot operate any services in East Jerusalem, where serv-ices are provided by Palestinian NGOs and privateagencies as well as by the Israeli health system.UNRWA provides education, health care, environmen-tal health and support services to refugees in the WestBank, East Jerusalem and Gaza, who together account-eded for 45% of the Palestinian population in 1998.UNRWA also primarily focuses on basic health serv-ices, operating 51 primary health care centers in theWest Bank and Gaza. 49 NGOs provide health careservices to Palestinians, operating 170 primary healthcare centers and 24 hospitals, primarily in the WestBank. For-profit services are concentrated in urbanareas and in the West Bank. As of 2005, there were 77hospitals with approximately 4,000 beds operating inthe Palestinian Territories, 55 of which are located inthe West Bank. Of the 77 total hospitals, 43 were gen-eral hospitals, 10 are specialized, 20 offer maternity

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services and 4 concentrate on rehabilitation. The Min-istry of Health operates 22 of these hospitals.20

The accessibility of hospital beds varies considerablybetween regions. The ratio of beds/ population in thePalestinian Territories was 13.26/10,000 in 2004(14.87/10,000 in Gaza and 12.32/10,000 in the WestBank). In 2004 in the West Bank, the highest bed ac-cessibility was in Bethlehem, at 37.1 beds/10,000 pop-ulation, and the lowest was in Salfiet (near Nablus) at2 beds/10,000 population. In general, tertiary healthcare services are not evenly distributed. Hospitalstend to be concentrated in urban areas, and more re-mote populations often have difficulty reaching cen-ters for appropriate care. According to the PalestinianMinistry of Health, most MOH hospitals are over-uti-lized and crowded while NGO hospitals tend to beunderutilized. The MOH estimates the average occu-pancy rate for MOH hospitals at 80% and the overalloccupancy rate for government and non-governmen-tal hospitals at 65%.21

With resources predominantly flowing into primarycare and community health services, the Palestinianhealth system faces particular challenges with re-gards to the provision of secondary and tertiary careservices. There are only three oncology and cardiol-ogy centers in the West Bank, all located in urbanareas inaccessible to most of the population, and spe-cialized medical personnel is limited. As a result,Palestinian patients needing advanced care are oftenreferred to other countries. According to the WHO,approximately 16% of the Palestinian Ministry ofHealth Budget is devoted to remote care, most ofwhich occurs in Israel, Egypt, and Jordan. In 2004,the total budget of the Ministry of Health was $126million, $32 million of which supported the cost oftreatment provided to Palestinians abroad. A recentreport by the Israeli Health Minister to the WHO es-timated that in 2006 tens of thousands of permits, av-eraging 200 patients each day, were given toPalestinians to pass through checkpoints and receivemedical care in Israel. In 2006, approximately 60,000Palestinians from the West Bank area were treated inIsraeli hospitals, 20,000 of whom were hospitalizedand 40,000 of whom received ambulatory services.2,500 of these patients were children, the majority ofwhom received long-term treatment for cancer andcomplicated operations.22

Financing for health services in the Palestinian Territo-ries is fragmented, coming from a mix of tax revenues,government insurance premiums, out of pocket pay-ments, external assistance, private health insurance, in-vestments, and contributions by the Israeli governmentand workers living in Israel. In 2004, according to thePalestinian Ministry of Health, 55.9% of Palestinianfamilies were covered by governmental health insur-ance, which entitles them to free services provided bythe governmental health sector. In 2001, total health ex-penditure per capita in Palestine was $138, compared to$1,622 in Israel in 2003. In 2004, health care constituted13.5% of the Palestinian gross domestic product, ascompared to 8.7% of GDP in Israel.23

Challenges to the Palestinian economy in recent yearshave impacted financing of the health system. The un-employment rate in Palestine rose to over 60% of thepopulation in 2007, while GDP per capita decreasedfrom U.S. $1,612 in 1999 to $1,129 in 2006. Accordingto a 2007 report by the Palestinian Ministry of Health,after the Second Intifada the late President YasserArafat decided to offer free health insurance to unem-ployed persons and their families, which contributedto a decrease in health insurance revenues. Currently,about half of enrolled Palestinian families receive theircoverage free of charge. The Ministry of Health hasmade the sustainable financing of its health system amajor objective, identifying as a long-term goal thecreation of a national health insurance system thatwould cover all Palestinians.24

While two medical schools exist for the education ofPalestinian physicians, doctors within the PalestinianTerritories generally rely on Israeli hospitals to receivespecialized training. The Al-Quds Medical School, forinstance, began to operate in 1994, offering a 6-year pro-gram in medical education based on the Europeantraining model. By 1998, the program was graduating55 students, trained in Gaza, Jerusalem, and Nablus.Palestinian medical students, however, face numerouschallenges including difficulties financing their educa-tion, access to school facilities, and availability of post-graduate training. The curriculum costs about $4,000U.S. per year, which for many students, whose familiesmay be living on $200 per month, is not financially fea-sible. Government scholarships and outside donationsfrom Arab states help finance the education for a lim-ited number of students. Al-Quds University’s three af-filiated medical campuses in Gaza, Nablus, and East

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Jerusalem are largely cut-off from each other due to bor-der-crossing issues. In addition, students from the WestBank who must access hospitals in East Jerusalem fortheir training face daily difficulties obtaining permitsand passing through checkpoints.

Resources within the Palestinian health system are lim-ited for students seeking specialized training beyondtheir generalized medical degree. Palestinian educa-tion and training programs face difficulties associatedwith their accreditation by international standards.Medical students who wish to specialize must com-plete a residency in a hospital that is accredited by abody that awards a specialty certificate. Only theMakassed Islamic Hospital in East Jerusalem is fullyrecognized and accredited in four major specialties (in-ternal medicine, general surgery, obstetrics/gynecol-ogy, and pediatrics) by the Jordanian Medical Council.Palestinian interns can complete residencies there,which will be certified by the Jordanian medical board.However, Makassed Hospital receives far more candi-dates than it can train. Consequently, a number ofphysicians each year receive specialized training in Is-raeli hospitals such Hadassah Medical Center andthrough the support of Israeli NGOs including Save aChild’s Heart Foundation and the Peres Center forPeace, among others. In 2006, sixty-five physicians andtwo nurses participated in a variety of medical andsurgical training programs in Israeli hospitals, most ofwhich ran for 3-6 months. Only five physicians, how-ever, participated in a complete residency program ofapproximately five years to receive a full specialty cer-tificate. Furthermore, the West Bank currently lacksunified programs and standards for continuing med-ical education, although Al-Quds Medical School hasbeen working to develop infrastructure in this area.

The Palestinian health system faces additional chal-lenges in relation to the training and retention of non-physician health care workers. There is a significantshortage of nurses in the health care system. Nursesalso face the same problems with regards to obtaining

specialized training as do Palestinian physicians. In ad-dition, the Palestinian Territories are impacted by themigration of qualified and trained staff from the gov-ernmental sector to the private sector outside of Pales-tine, where they can receive a higher income than whatis offered by the Palestinian governmental sector. Ac-cording to the MOH’s 2007 report, the current incen-tive system is insufficient to build the health carehuman resource infrastructure needed to improve theperformance and effectiveness of the health system.25

Israel-Palestinian Health System CooperationHealth system disparities between Israel and the Pales-tinian Territories coupled with their geographic prox-imity and interdependence have necessitatedcooperation in the fields of health and medicine be-tween the two societies. The Israeli Ministry of Healthhas explicitly followed a “humanitarian policy” withregards to the treatment of Palestinian patients, pro-viding care for hundreds of patients each day in Israelihealth facilities and absorbing much of the cost whenit is not met by the Palestinian MOH.26 The complicatedpolitical environment, however, has made the transferof patients across checkpoints increasingly difficult.While cooperation also exists in areas like educationand training to promote infrastructure development, asystematic approach is needed to develop, supply, andequip a Palestinian health system capable of meetingthe needs of its population. The National StrategicHealth Plan published by the Palestinian Ministry ofHealth in December 2007 lays out a vision androadmap for these changes.

The CSP Palestine/Israel Health Initiative was con-ceived in an effort to identify, network, and promotecooperative activities between Palestine and Israel inthe fields of health and medicine. The Initiative has en-deavored to help meet goals articulated for improvinghealth in the region while advancing trust, which is acornerstone for sustainable peace and cooperation inthe future.

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Since Israel assumed control of the West Bank andGaza from Jordan and Egypt in the 1967 Six-Day War,professional interactions have occurred on a variety oflevels between Palestinian and Israeli health careworkers. From 1967 until the onset of the First Intifadain 1987, Palestinians and Israelis developed numerouscooperative health projects. These projects rangedfrom initiatives focused on specific diseases and pop-ulations, such as improving poliomyelitis vaccinationrates in the West Bank, Gaza, and Israel, to joint com-mittees on long-term infrastructure planning. Duringthis time, thousands of Palestinian patients weretreated in Israeli hospitals, and many Palestinianhealth professionals were trained in Israel.

The outbreak of violence in 1987 meant that Israelihealth officials were no longer able to move freely inthe Territories, and as a result, professional coopera-tion declined. During this time, the Palestinian author-ities continued to move forward with organizing theirhealth system, beginning with the creation of a planfor caring for those injured in the violence, followedby the preparation of a national health plan. Duringthis period of conflict and tension, however, coopera-tion in the health field did not completely cease, partic-ularly with regards to the provision of essential healthservices. Furthermore, the establishment of the Asso-ciation of Palestinian-Israeli Physicians for HumanRights (PHR) in 1988 marked what may have been thefirst initiative of Israeli civil society devoted to provid-ing health assistance to Palestinians outside the scopeof the Israeli Civil Administration.

The signing of the Madrid Agreement in 1991 and theOslo Accords in 1993 resulted in significant advancesin the field of health cooperation. A section in Annex3 of the Declaration of Principles in the Oslo Accordson the importance of civil society cooperation and peo-ple-to-people activities provided legitimacy for Pales-tinian and Israeli NGOs to launch cooperativeactivities and established a mechanism for interna-tional organizations to provide funds and cooperate intheir efforts. As a result, several foreign programs suchas the United States’ Middle East Regional Coopera-tion Program (MERC) were expanded to include an Is-raeli-Palestinian component.

The transfer of responsibility for the Palestinian healthsystem to the Palestinian Authority in 1994 and the es-tablishment of the Palestinian Ministry of Healthchanged the nature of cooperation. Most interactionin the field of health between Israelis and Palestiniansrevolved around committees established to deal withfood, medicine, and hospitalizations, and the IsraeliCoordinator to the Palestinian Health Authority as-sumed responsibility for issuing health-related permitsfor Israelis and Palestinians to cross the border. In ad-dition to the Palestinian Ministry of Health, the UnitedNations Refugee Works Administration (UNRWA), thePalestinian Red Crescent Society, local and interna-tional NGOs, universities, and the private sector be-came potential partners for cooperation with Israelihealth professionals.

In 2000, JDC-Brookdale, JDC-Israel and Al-Quds Uni-versity jointly published a study of Israeli-Palestiniancooperation in the health field between 1994-1998. Thisstudy identified 148 cooperative projects that tookplace during these four years and profiled nine of themin its published report. Through surveys of Israeli andPalestinian organizations and interviews with partici-pants, the study mapped cooperative projects and an-alyzed the factors influencing cooperative initiativesand their mechanisms.27

In the ten years since this study was completed, in-creased restrictions in mobility and a tenser politicalenvironment have made cooperation more challeng-ing. Israeli citizens are now prohibited from enteringGaza and the West Bank, and Palestinians need per-mits to enter Israel, making it difficult to coordinatepeople-to-people exchanges. A case study published in2007 on Arab-Israeli cooperation noted that increasedviolence from 2001-2004, broader conflicts in the Mid-dle East, and the Hamas takeover of Gaza in 2007 haveall contributed to making Israeli-Palestinian coopera-tion more challenging than ever over the course of thepast decade.28 Other recent studies examining Israeli-Palestinian cooperation note these same issues, em-phasizing the sensitivities involved and the need tomaintain the low profile of many cooperative activitiesin the current political climate.

History of Cooperation in Health and MedicineBetween Israel and Palestine

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With the exception of a few initiatives such as the Mid-dle East Cancer Consortium and the Middle East Con-sortium on Infectious Disease Surveillance, formalcooperation at the government level has been limited.At the beginning of 2008, four joint committees were op-erating between the Israeli and Palestinian Ministry ofHealth on issues such as pharmaceuticals and avian flu.In 2005, Israel’s national emergency medical service,Magen David Adom, signed a memorandum of under-standing with the Palestinian Red Crescent Society tofacilitate cooperation between the two ambulance serv-ices. Although this memorandum has been successfulin many regards, political issues continue to impact theability of the two services to fully work together. Al-though the Israeli Ministry of Health has been explicit infollowing a “humanitarian policy” with regards to thetreatment of Palestinian patients, the complicated polit-ical environment has made the transfer of patientsacross checkpoints increasingly difficult.29

Because of the tense political climate, most health andmedicine cooperative activities during the past severalyears have occurred on a relatively ad-hoc basis be-tween individual professionals, hospitals, and non-governmental organizations. Most of these programsfocus on health issues where it is easy to find commonground, such as children’s health, cancer, genetics re-search, or specialist education and training. The Mid-dle East Cancer Consortium (MECC), founded in 1996,for example, has sponsored numerous cooperativeprojects on cancer and genetics research through itssmall grants program and has also facilitated educa-tion and training. The Israeli-Palestinian Science Orga-nization (IPSO), founded in 2003, received over 100proposals between 2004 and 2006 for cooperative re-search between Palestinian and Israeli investigators inthe medical and environmental fields. Furthermore,Bridges Magazine, founded in 2004 and supported bythe World Health Organization, continues to issue bi-monthly publications written and managed by Pales-tinian and Israeli academics and health professionals.The magazine is intended to embody WHO’s para-digm “Health as Bridge for Peace” and endeavors tocover health topics of common concern to both Israeland Palestinian populations while building “relation-ships, links, and common understanding.”30 Moreover,although Israeli physicians are no longer permitted toenter the Palestinian territories, cooperation still occurs

on a daily basis at the physician-patient interface, asPalestinian patients are treated in Israeli hospitals byIsraeli physicians.

Several organizations such as Hadassah Medical Orga-nization, the Middle East Cancer Consortium (MECC),and the Canada International Scientific Exchange Pro-gram (CISEPO) continue to promote cooperation andfacilitate training and patient care exchanges despite vi-olence and political challenges. Such persistence hashelped ensure the continuation and strength of cooper-ative activities. To facilitate cooperation, several recentprojects are trilateral in nature, involving participantsfrom the United States, Canada or Europe in addition toIsrael and Palestine. These parties play an importantrole in raising funds, maintaining channels of commu-nication, ensuring the equal stature of parties involvedin the work, and facilitating continuation of projectswhen political tensions rise.

Despite some setbacks in funding and delays that occurdue to logistical difficulties, there persists a dedicatedgroup of individuals and organizations committed tocontinuing their work together on both sides of the bor-der. Although many cooperative projects continue tooperate, there is an urgent need for sustained fundingto support programs over the long term that will helpbuild and strengthen the entire health care system. His-torically, the health sector has benefited from ongoingcooperation between Palestinian and Israeli institutionsand individuals, especially in the area of human re-source development. Cooperation in the health field ispart of a broader spectrum of people-to-people ex-changes that operate in the region to build trust and un-derstanding while delivering needed services in spiteof a tense political climate. Just as diseases can crossborders easily today, so can solutions, making healthan important bridge for building partnerships, trustand cooperation among Palestinians and Israelis.

Using this framework, an objective of the CSP Pales-tine/Israel Health Initiative was to describe the cur-rent scope of cooperative activities in health andmedicine, create an inventory of selected initiatives un-derway, and review lessons learned from these proj-ects with the hope of creating a roadmap forstrengthening and developing programs to improvehealth and promote peace in the region in the future.

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The Palestine-Israel Health Initiative (PIHI) focused onkey areas in which cooperative activities in health andmedicine between Palestinian and Israeli profession-als and organizations could be used to systematicallyadvance health in the region. Some of these critical is-sues included licensing and accreditation of health pro-fessionals, facility and human resource development,research and evaluation activities, health informationsystems and educational campaigns, disease preven-tion and health promotion initiatives, and emergencypreparedness programs.

Despite the current tensions in the region, it was foundover the course of this project that considerable sup-port exists among Israelis and Palestinians for contin-uing and strengthening cooperation to improve healthas circumstances permit. Furthermore, health systemdevelopment might be an area where outside parties,including the United States, can play a constructiverole. Several program leaders emphasized during thePIHI Working Group meetings, the important role ofa third party, like USAID, WHO, and foundations, infacilitating projects between Palestinian and Israelihealth and medical experts. These parties provide sup-port, opening up and maintaining venues for commu-nication, ensure the equal stature of parties involvedin the work, and help sustain projects when politicaltensions rise.

Through meetings and discussions convened duringthe winter and spring of 2008, the CSP Palestine/IsraelHealth Initiative identified five areas of critical impor-tance for health and medical cooperative activities be-tween Israel and Palestine. These areas includedprimary care and prevention, education and training,emergency medicine and disaster preparedness, healthinformation technology, and health and medical re-search. Following a number of focused discussions be-tween leaders in these areas over the winter andspring, the initiative convened two days of WorkingGroup meetings in East Jerusalem on April 29 and30th, 2008.

Approximately 50 participants were involved in thistwo-day exchange convened at the American ColonyHotel in East Jerusalem. Participants included leaders

in health and medicine from Israel and Palestine, rep-resenting the Ministries of Health, academia, hospitals,insurance companies, and NGOs. Representatives ofinternational bodies including the World Health Orga-nization (WHO) and USAID also participated in themeetings. Additionally, the sessions featured a groupof 12 professionals from the United States, includingexperts from universities such as Harvard, Brown, andJohns Hopkins and the private sector in the fields ofhealth information technology, emergency medicine,international nursing, medical research, primary andsecondary health care, education and training pro-grams, and health website development.

The two-day event included presentations by healthprofessionals from the United States and Palestinianand Israeli experts and leaders of cooperative projectsin health and medicine in the region. Participantsdrew on the discussions that took place at previousmeetings of the Palestine/Israel Health Initiative andproduced a series of recommendations for each of theWorking Group topic areas. The five primary topicareas were consolidated to form three final WorkingGroups: education, training and research; publichealth and emergency medicine; and health informa-tion technology. Recommendations and findings fromthese Working Groups were presented at the conclu-sion of the meetings. A follow-up session was con-ducted between PIHI’s Project Director and Managerand several of the U.S. participants with the Palestin-ian Minister of Health and staff at the Ministry ofHealth Office in Ramallah.

Needs articulated by experts and leaders from thePalestinian and Israeli health sectors provided aframework for discussions that took place duringPIHI Working Group discussions. The National Strate-gic Health Plans published by the Palestinian Ministryof Health (1994, 1999, 2001, 2007) articulate a vision ofhow the health system should develop over time, in-cluding short, medium, and long-term objectives. Thisvision has emphasized public and primary health careas the “cornerstone” of service delivery, with ex-panded emphasis on health promotion and diseaseprevention capabilities. The 2007 National StrategicHealth Plan emphasized that the health system has

Recommendations for Improving Health in Palestine and Israel through Cooperative Activities

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been challenged by the lack of human resources, ac-credited programs for training and education, distri-bution of hospital beds, and the availability ofspecialized personnel.

Discussions emphasized the importance of joint andcooperative projects in health and medicine in the re-gion both in terms of their role in advancing trust andin opening channels for cooperation between Israelisand Palestinians. Detailed recommendations producedfrom the Working Groups are listed below and coverthe following topic areas:

• Education, training and research• Public health and emergency medicine• The application of information technology to im-

prove health

It is hoped that the recommendations from these Work-ing Groups and the meetings convened during thecourse of this project will provide a valuable frame-work to help inform work on future cooperative proj-ects in health and medicine in the region.

Education, Training, and ResearchBackgroundAlong with licensing and certification procedures,Palestinian health professional education programs re-quire strengthening for all types of health providers, in-cluding clinicians, pharmacists, health systemadministrators, public health workers, research andevaluation staff, and other relevant personnel. In manyof these fields, the supply of appropriately trained pro-fessionals for the health system is currently inadequate.Historically, human resource development has been adomain in which cooperative activities between Pales-tinian and Israeli professionals and institutions havebeen very strong. Medical centers and hospitals includ-ing Hadassah Medical Center in West Jerusalem andAugusta Victoria Hospital in East Jerusalem as well asNGOs such as Save a Child’s Heart and the Peres Cen-ter for Peace have been critically important in provid-ing opportunities for Palestinian physicians and nursesto train alongside their Israeli counterparts. The recom-mendations of this working group highlight the impor-tance of building on existing cooperative programs andcreating mechanisms for Israeli and Palestinian profes-sionals and institutions to work together to systemati-cally expand human resources for health.

There are two medical schools in the Palestinian Terri-tories, Al-Quds University at Abu Dies and Al-NajehUniversity in Nablus. Each of these schools admits ap-proximately 50 new undergraduate students per year.While these schools are essential to training future gen-erations of health professionals to meet the needs ofthe Palestinian population, they face difficulties gain-ing accreditation by accepted international standards.Basic science and clinical education programs must bestrengthened as necessary so that international accred-itation can be achieved.

Furthermore, postgraduate medical training for Pales-tinians is currently very limited. Medical graduatesmust go abroad for specialty training in nearly everyfield of specialty, including internal medicine and fam-ily practice. The supply of highly qualified physiciansis inadequate, particularly in many medical subspe-cialties. Specific areas of shortage include: psychology,psychiatry (particularly child psychiatry), neurology,oncology (especially radiation oncology and pediatriconcology), cardiovascular surgery, and trauma,among others.

There are also two dental schools in the PalestinianTerritories as well as training programs in otherhealth professions, including nursing, pharmacy,midwifery, and medical social work, which were es-tablished prior to the medical schools. These pro-grams have helped to meet human resource needs intheir respective fields for the Palestinian Territories.However, shortages of qualified professionals stillexist in important fields, including dentistry, nursing,midwifery, and psychology.

One major area of need is the establishment and im-plementation of a human resource development strat-egy for the health professions to ensure an adequatesupply of appropriately trained personnel for thePalestinian health system. The Palestinian NationalStrategic Health Plan (2007) identifies the developmentof such a human resource planning and managementprocess as a critical goal. It reports that current trainingand education programs “do not meet the needs of thehealth sector” due to: 1) unavailability of an accredita-tion system of educational institutions and programsbased on international standards; 2) shortages in somespecialties such as family medicine, psychiatry, andpreventive medicine; 3) lack of diversity in publicheath programs and subspecialties, including epidemi-

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ology, reproductive health, nutrition, health informa-tion systems, and scientific research; and 4) scarcity offinancial and human resources, which are necessary toenable postgraduate studies.

The 2007 Palestinian National Health Plan enumeratesseveral areas of need for human resource developmentfor the health professions. They include: updating,standardizing, and enforcing licensing and accredita-tion of human resources; accrediting new and existingeducational institutions and programs using appropri-ate international standards; developing continuing ed-ucation programs and encouraging their utilization;developing an incentive system to motivate qualifiedhealth professionals to work in the Palestinian healthsystem; and initiating an ongoing training program formanagers in the health sectors. In addition, the humanresources planning and management process shouldbe developed by identifying the “exact number, spe-cialty and the place of work for the available healthhuman resources” and assessing the “shortage and thesurplus in the various fields to develop a plan to over-come this.”31

Recommendations Recommendations on enhancing education, training,and research in this region through cooperative activ-ities include:

• Health Professional Training ExchangesPolicymakers and local institutions should considerdevelopment of cooperative agreements with for-eign institutions regarding training and academicexchanges. In terms of meeting medium term goalsfor human resource development, the Palestinianhealth system is likely to benefit from the develop-ment of bilateral agreements with foreign countriesand/or institutions to designate training slots forsuitably qualified Palestinian students and to enableperiodic exchange of faculty. Training in Israel canbe a very cost-effective option for Palestinians, andthe exchange itself can contribute to greater under-standing between the peoples in the various com-munities. Ongoing programs are in place in severalIsraeli health institutions for the training of Pales-tinian health professionals. These programs are de-scribed in some detail in the Selected Inventory ofPalestinian-Israeli Cooperative Initiatives in healthand medicine. Some Palestinians trained in Israelmay be able to live at home, or at least to travel

home frequently and inexpensively. In addition,Palestinians trained in Israel, rather than in othercountries, may be more likely to return to Palestinewhen their training is completed.

• Medical Specialist Training Strategy in PalestineThe need for adequate funding is a constraint formost Palestinian-Israeli training partnerships anda concern for the sustainability of these cooperativeefforts. Outside funding would likely be needed toincrease the number and duration of postgraduatetraining opportunities for Palestinians in Israeli in-stitutions. Most training programs are currentlyconducted for a period of three to six months. ThePalestinian health system is in need of fully trainedand certified health and medical specialists, includ-ing both physicians and nurses. Expanding andfunding full residency programs in medical special-ties in addition to more short-term training pro-grams can be an important area for sustained andexpanded cooperation between Israeli and Pales-tinian professionals and institutions. Cooperativeefforts with Israeli institutions to systematically de-velop human resource capacity in the Palestinianhealth system should be based on a thorough un-derstanding of the distribution of health profession-als in existing specialties and be tailored to meet theshort and long-term needs of the health system. Inorder to develop such training programs, specialagreements regarding the training of Palestinianfellows and residents may need to be signed withspecific hospitals in Israel. In addition, the estab-lishment of postgraduate programs at Al-QudsUniversity Medical School could help fill the long-term need for the training and certification of healthand medical specialists in Palestine. A specialisttraining program at Al-Quds could be establishedin cooperation with Israeli institutions, strengthen-ing ties between Palestinian and Israeli counter-parts and helping to gradually build withinPalestine an independent and sustainable infra-structure for the full training of an adequate sup-ply of health workers. Funding for these programsmight be provided from international sources.

• Tailored Postgraduate Training Curriculum and Workshops in PalestineOne recommended strategy for building moremedical specialty capacity in Palestine includes theestablishment of a curriculum of postgraduate

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training for Palestinian residents and fellows by Al-Quds University Medical School for each medicaldiscipline. The educational training experiencecould be designed by special committees consist-ing of qualified Palestinian, Israeli, and U.S. spe-cialists working independently and in cooperationas well as online through Internet classrooms. Ad-ditionally, specialists from the United States couldparticipate in the training of Palestinian fellows andresidents by visiting the region for short periods topresent workshops on specific topics—for example,at the Al-Quds University campus.

• Technical AssistanceIsrael can provide a source of technical assistance,particularly regarding faculty development and re-search, to help meet the goal of development ofhuman resources and infrastructure in the Palestin-ian Territories. Israeli institutions have played thisrole successfully in the past. Israeli and Palestinianprofessionals report their willingness to work to-gether in this area. In addition to building ties be-tween health professionals in Palestine and Israel,the goal of these programs should be to build infra-structure in Palestine for the training and independ-ent certification of its own professionals, includingresidents and fellows across medical specialties.

• People-to-People Exchanges to Advance Trust and ReconciliationParticipants in the Working Group involved in co-operative projects in research and training empha-sized the important human component of theseactivities. In addition to helping to meet health sys-tems needs for education and training, there areopportunities to build relationships between Pales-tinian and Israeli health professionals premised onmutual trust, understanding, and respect. Ex-changes and training programs for Palestinian pro-fessionals in Israeli institutions tend to producerelationships that last well beyond the conclusionof the training period. In the current political cli-mate where mobility is restricted and opportuni-ties for Israelis and Palestinians to developpersonal and professional relationships are limited,these opportunities for relationship-building areboth unique and vitally important.

In fact, many of the cooperative programs presentedduring the Working Group sessions stemmed fromrelationships that began during training exchanges.Palestinian physicians trained in Israeli institutionshave gone back to the Palestinian Territories to beginclinical programs informed by the Israeli ones thatthey participated in. Israeli and Palestinian physi-cians and nurses who trained together tend to main-tain their contact, both on a personal and professionallevel. These training programs and exchanges mayrepresent a rare and significant mechanism for build-ing and sustaining relationships of mutual trust andunderstanding between health leaders in Palestinianand Israeli communities.

• Cooperative Research ProjectsWorking Group participants emphasized the im-portance of cooperation in health and medical re-search between Palestinian and Israeli scientists.The Israeli-Palestinian Science Organization andthe Middle East Cancer Consortium have been in-strumental in facilitating and supporting suchpartnerships, financially and in other aspects. Co-operative projects in health and medical researchtake place between academics at universities andother research institutions, and are essential forpromoting the exchange of knowledge and expert-ise, for building research capacity, for the insightsthey produce, and for the professional and per-sonal channels that they open.

• Peace Through HealthCooperative projects in education, training, and re-search in health and medicine are vital opportuni-ties for Palestinian and Israeli leaders andprofessionals in both health systems to learn fromeach other and work together. Though the politicalclimate makes contact difficult, these relationshipsseem to endure and grow over time, producing out-comes that are important for knowledge-sharing, re-search, and the development of health systems inthe area, as well as for fostering trust, understand-ing and friendship.

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Public Health and Emergency Medicine BackgroundPrimary care is the current cornerstone of the Palestin-ian health care system and will likely continue to be soin the near future. The 2007 Palestinian National Strate-gic Health Plan underscores its centrality, calling pri-mary health care the “major tool” and the “promotingand improving mechanism to restore and sustain thewell-being of the Palestinian people.”32 Certain aspectsof primary care in the Palestinian Territories requirestrengthening, including health promotion and diseaseprevention, as well as screening and diagnosis, partic-ularly of child developmental disorders and adultchronic and non-communicable diseases.

The relative importance of the primary health care de-livery system in the Palestinian Territories has in-creased with recent political and military conflictsbecause primary care clinics are widely distributedand thus relatively accessible during periods of re-stricted mobility. Problems with mobility in the re-gion, have strengthened the role of nurses as well,who tend to live closer to primary care clinics andhave been more available to patients than physiciansduring this time.

Currently, the dynamic of disease and illness is chang-ing in Palestine, with the adoption of a more Westernlifestyle and the rising rates of chronic diseases. Healtheducation, health promotion, and early detection pro-grams that address the double burden of infectiousand chronic disease as well as the changing Palestinianlifestyle and its associated risk factors (e.g. smoking,obesity, lack of physical activity, etc.) must be built intoa public health approach in the region.

Efforts to strengthen health promotion and disease pre-vention in both Israel and the Palestinian Territoriesmight include additional training and empowermentof health educators, social workers, and skilled laypeople such as community health workers. Critical is-sues to be addressed in the context of public health in-clude sanitation and water quality, workplace safety,diet, nutrition, physical activity, tobacco use, and clin-ical concerns such as developmental disorders, psy-chosocial problems, and chronic illness. One importantstep for the Palestinian national health system in par-ticular is to strengthen psychosocial support and men-

tal health services within the primary care setting.Proactive and community-based strategies utilizingpeer groups are generally valuable for addressing psy-chosocial problems and particularly in the treatmentof psychosocial trauma; indeed relatively few traumavictims receive effective care in the absence of commu-nity outreach programs.

With regards to emergency response, pre-hospitalemergency medical services in the Palestinian Territo-ries are provided by the Palestinian Red Crescent Soci-ety (PRCS), which operates with a total yearly budgetof $7 million. Services are provided through a national“101” telephone number, a PRCS headquarters in Ra-mallah, 8 main stations and 23 substations in the WestBank, 6 main stations and 2 substations in Gaza, andan average of 120 vehicles and 350 EMTs and ambu-lance drivers on-duty 24 hours a day.33 Emergencymedical services in Israel are provided by the MagenDavid Adom (MDA), with a 2002-2003 expenditurelevel of approximately $114 million34, 1,400 paid em-ployees, and over 10,000 volunteers estimated as of2006.35 In November 2005, a Memorandum of Under-standing (MOU) — an Agreement on OperationalArrangements — was signed between MDA and PRCSto facilitate the entry of both societies into the Interna-tional Red Cross by June 2006. As of November 2007,the MOU had provided for five PRCS ambulances tooperate in East Jerusalem and created a system toscreen PRCS ambulances quickly when emergencycases require access to East Jerusalem hospitals. In ad-dition, joint programs have recently begun to ensurethat PRCS ambulance drivers and EMTs based in EastJerusalem receive the training required by Israeli reg-ulations. However, other aspects of the agreement,such as the provision to create a formal hotline for thePRCS, have not yet been implemented, and relationsbetween MDA and the PRCS have faced challengesdue to tensions in the region.

RecommendationsThe CSP Palestine/Israel Health Initiative WorkingGroup discussions stressed the importance of cooper-ation between Israelis and Palestinians in areas includ-ing the provision of emergency medical services andthe training and augmentation of primary care andprevention strategies and services. Because disasterslike earthquakes and infectious disease pandemics donot recognize political boundaries or regional borders,disaster management and emergency preparedness is

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an area that necessitates cooperation between Palestin-ian and Israeli experts and professionals. With the ge-ographic proximity and daily intermingling ofPalestinian and Israeli communities, infectious dis-eases affecting one population will unavoidably affectthe other. Consequently, creating a regional disaster re-sponse and emergency preparedness infrastructuremay be a topic that can foster cooperative planning be-tween Palestinian and Israeli experts in this field, whowill need to work together on these issues of criticalcommon concern to the region. This foundation can bebuilt concurrently with the cooperative emergencymedical systems project and the development of pa-tient transfer procedures. These issues can be compli-mentary and might benefit from a coordinated plan fordevelopment and implementation.

Cooperative activities and exchange on emergencypreparedness are underway between Israeli and Pales-tinian health systems leaders facilitated through thework of organizations including the World Health Or-ganization (WHO) and the Middle East Consortium onInfectious Disease Surveillance (MECIDS). Presenta-tions by regional leaders of organizations includingMECIDS at the Working Group Meetings emphasizedthe necessity of these cooperative partnerships for dis-aster preparedness and planning for the region. Ex-changes have occurred in the past in response to eventslike the SARS outbreak and in preparing for a potentialpandemic with avian influenza. During 2007, publichealth experts from the Palestinian Authority, Israel,and Jordan met on several occasions, convened by theNGO Search for Common Ground, to address thethreat of avian influenza, which emerged in poultry inthe Gaza Strip and Israel, and began joint preparationsfor a possible pandemic.

Recommendations on Public Health and EmergencyMedicine for this region include the following:

• Health Education and Health Promotion ProgramsThe Palestinian lifestyle is changing and with theadoption of a more Western lifestyle, chronic diseaseis on the rise in the Palestinian Territories. Conse-quently, health education and health promotionprograms must be built into the Palestinian publichealth system to directly address the double burdenof chronic and infectious disease. One recommen-dation for such a program would be the establish-ment of a three month health promotion course for

Palestinian nurses and social workers to providethem with the theoretical and practical tools for fu-ture development of health promotion programs intheir communities. Such a course could be led inArabic and English by Israeli health experts orjointly by Palestinian and Israeli health profession-als. In its next stage, graduates of this course woulddevelop local health education training programsfor local peer instructors. Furthermore, the devel-opment of a school health curriculum, particularlyfor grades 1-6, is critical to the prevention of infec-tious and chronic diseases. Models for such pro-grams have been developed (including by theHealth Promotion Unit team at Ben Gurion Univer-sity Faculty of Health Sciences) and could be shared,implemented, and brought to scale.

• Disease Prevention: Smoking Prevention, Stress Management, and Screening ProgramsDisease prevention, including early detection andmental health programming, should be a corner-stone of a public health approach. An important ed-ucational challenge for the Palestinian Territorieswill be the development of a course for the preven-tion and cessation of smoking for physicians andnurses, as the smoking rate in Palestine is very high(above 50%) for men and increasing among women.Furthermore, mental health problems are a concernin Palestine and Israel due in part to the presence ofconflict in the region. Stress management program-ming is needed for Palestinian communities but iscurrently lacking. Interventions for stress reductionmay be taught by physicians, nurses, peer instruc-tors, social workers, and psychologists. Further-more, early detection of behavioral and physical riskfactors (including through population-wide screen-ing programs) for cardiovascular disease and can-cer is needed for the entire population andparticularly to detect diabetes.

• Establish Emergency Medicine Infrastructure in PalestineThe most effective way to begin planning for disas-ters is to establish and maintain a strong publichealth system and medical infrastructure. Toachieve this goal, it was suggested that the possibil-ity be explored of forming a paramedic “train-the-trainer” program based in Jerusalem for Palestinianpersonnel. This program would last 3-5 months andcover an advanced emergency medical technician

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curriculum. The graduates could continue on-the-job training in the Palestinian Territories and obtainthe skills needed to train additional Palestinianhealth care workers in these areas. Reducing theprogram time from the 6-12 months typically allot-ted for paramedic training and concentrating onhigh impact practical topics in this condensed cur-riculum would make the program more viable aswell as reduce costs without significantly compro-mising didactic content. On-the-job training mightreduce some ride-along requirements, which extendthe time required in typical paramedic programs.

• Use of Medical Simulation for Training PurposesWorking Group participants discussed the possibil-ity of using high fidelity medical simulation to con-duct joint educational exercises. Medical simulationis an effective tool for training health care person-nel in the recognition and treatment of diseaseprocesses, teamwork, responding to emergencies,and practicing procedures to help reduce errors. Theresources available in Israel, at the Hadassah Med-ical Center and elsewhere, could be leveraged tocreate cooperative training programs involving ex-perts from Israel, Palestine, and the United States.These programs could place emphasis on responsesto shared threats such as earthquakes and the pan-demic influenza as well as play a role in the educa-tion and ongoing training of paramedics.

• Standardized Electronic Emergency Health Records and ProtocolsDevelopment of standardized protocols for the de-livery of care, particularly in the area of pre-hospi-tal care, was also recommended as a potentialcooperative initiative. Maintaining consistency inpatient care in the pre-hospital setting will improvequality, as the continuum of care transcends politi-cal boundaries between Palestine and Israel. Pa-tients are often transferred between facilities andbetween PRCS and MDA ambulances, and jointprotocols would help ensure continuity of care.These protocols could be strengthened by formulat-ing standard agreements and memoranda of under-standing for mutual aid and surge capacity betweeninstitutions in the region.

The initial effort towards unified standardized pro-tocols could also involve the development of a jointcoordination center to facilitate inter-facility and

scene transfer of patients from the Palestinian Terri-tories. This center could utilize a simple electronicinformation transfer protocol to help with patienttracking and to reduce the logistical difficulties anddelays experienced during emergency patient trans-fers into Israel. A unified coordinating body sta-tioned in a single dispatch center with representationfrom Israel and Palestine could act as a clearing-house for all transfer requests. It could facilitate in-stitutional transfers by maintaining open lines ofcommunication with officials granting permits aswell as the hospitals and checkpoint personnel. Fur-thermore, to facilitate the transfer of information be-tween hospitals, emergency medical services, andhealth ministry officials, a simple Internet-basedelectronic patient transfer information form accessi-ble to all parties simultaneously could be developedand maintained under the current EMS structure.Expanding patient transfer procedures to includereal-time Internet-based hospital bed capacity mon-itoring would expedite patient transport and trans-fer during times of disaster and surge as well. To thiseffect, a low-technology web-based solution was de-veloped and is currently being used effectively in thestate of Rhode Island in the United States. This or asimilar system could be used in Palestine and Israel,as the geographic size and number of hospitals issimilar to Rhode Island’s.

• Emergency Medicine TeleconsultationsThe formation of an emergency medicine tele-con-sultation program was recommended, whichwould be run on a cooperative basis by Israeli,Palestinian, and U.S. experts in health, medicine,and information technology. Such a system couldbe helpful in emergency cases when expertise isnot available locally and provide expertise thatmay not be immediately available as a result of re-strictions on the mobility of health professionals inthe Palestinian Territories. These systems could beused to triage patient transfers and offer interimrecommendations to health care providers for pa-tients awaiting tertiary care. This system could uti-lize low-bandwidth technology or more complexsolutions. Email-based histories and physical ex-aminations of patients augmented by photographysent over the Internet would be one possible sys-tems approach. A real-time web-conference sys-tem with connections between hospitals would beanother. There appears, however, to be little buy-

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in at this time to these types of programs becausedirect interaction and examination of the patient isvalued highly and there is minimal use of healthIT currently. In this region, it is important todemonstrate that Internet technologies and newmedia can and should be incorporated into cooper-ative activities in such as way that they supportand facilitate rather than supplant person-to-per-son interactions and exchanges.

• Disaster Medicine Fellowship ProgramThe establishment of an international fellowshipprogram in disaster medicine was recommendedas an important area for cooperation in developingexpertise and exchanges in emergency and disastermedicine in the region. This program could haveseveral components including an on-line didacticcurriculum, an on-site program at a designated hos-pital, and a simulation-based training component.Programs that are longitudinal in nature involvingthe cooperation of Palestinian and Israeli health careprofessionals are essential to building long lastingand durable relationships. Many examples exist ofcooperative research projects and educational andtraining programs involving Palestinian, Israeli andU.S. health care professionals. Existing programsshould be continued and expanded and new oppor-tunities created where possible. International fel-lowship programs should include post-graduatemedical students from Palestine, Israel and othercountries in the region. These programs could besupported by local experts as well as those from theUnited States.

• Establish Specialty Treatment Centers in PalestineAs the impact of infectious disease on the health ofPalestinians has declined, the relative importance ofnon-communicable and chronic illness has risen. Asin most countries, ischemic heart disease, stroke, hy-pertension, diabetes, and cancer together account

for more than half of adult mortality, and incidenceand prevalence rates for these conditions have beenrising over time. Accordingly, among the top prior-ities in Palestine are the establishment of a centralcardiac center (including interventional cardiologyand cardiac surgery) and a cancer center equippedwith all the necessary equipment to provide com-prehensive oncological treatment (radiotherapy,medical oncology, pediatric oncology, and psycho-logical and family support services).

• Establish a Palestinian Trauma CenterAmong infants and children in the Palestinian Terri-tories, one-third of deaths are due to injuries, morethan any other identifiable category of causes. Ac-cordingly, a centralized trauma center is urgentlyneeded which would include the following surgicaldisciplines: general, orthopedic, chest, pediatric,neuro, ophthalmic, maxillo-facial, and ENT, alongwith the necessary imaging systems: CT, MRI andothers. Expertise in Israel in the area of trauma med-icine is quite advanced. Hadassah Medical Center inparticular has developed an integrated trauma centerwhich serves as an international model. Israeli ex-perts from this and other institutions appear verywilling to engage with and share expertise with theirPalestinian colleagues to help develop a trauma cen-ter in the Palestinian Territories. The development ofa trauma center as well as cancer and cardiac centersfor the Palestinian Territories represent potentiallyfeasible and important cooperative initiatives be-tween Palestinian and Israeli as well as U.S. profes-sionals and institutions. However, the establishmentof comprehensive centers in cardiology, oncology, ortrauma ultimately relies on a strong public healthand primary care foundation. When contemplatingthe formation of these centers, links to public health,EMS, primary care providers, and educational cen-ters must be considered and be available.

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Health Information Technology BackgroundHealth information and data collection are the scaf-folding for advancing health care in societies acrossthe world. “Health Information” is a broad conceptwhich includes all types of data that are directly rele-vant to health system planning, operations, and eval-uation. Such data include both vital statistics andepidemiological data (vaccine coverage, nutritionalstatus, measurement of behavioral risk factors, dis-ease incidence and death rates, cost of health care, useof pharmaceuticals, health insurance registry, pur-chasing of health services, etc.). In the 21st century,health information technology also includes the toolsof new media that function as conduits for transport-ing data, including the Internet, cell phones, PDAs,and telemedicine systems.

The Palestinian Ministry of Health has identified thestrengthening of its health information management sys-tem as a strategic goal. The 2007 Palestinian NationalStrategic Health Plan indicates that “in spite of effortsmade by MOH and several partners to strengthen healthinformation management there is still much room for im-provement.”36 In the Palestinian Territories, the Palestin-ian Health Information Center at the Ministry of Healthcollects data on health status indicators and serviceswhile the Palestinian Bureau of Statistics provides forvital statistics. Quality of data collection in Palestine aswell as data analysis capacity require strengthening. Theabsence of comprehensive health data in the PalestinianTerritories impedes national planning efforts, policy de-velopment, research, and evaluation. In addition to theMinistry of Health’s efforts, data tends to be gathered ina fragmented way, by NGOs, international agencies, andproviders, all of which use this information for their ownmonitoring and programmatic purposes, resulting in aflow of information which can be contradictory and lack-ing in cohesion.

The Palestinian Territories need to improve data col-lection on the incidence and prevalence of non-com-municable diseases and behavioral risk factors. Dataon conditions such as heart disease, diabetes, hyper-tension, and cancer are incomplete. The 2007 Palestin-ian National Health Plan also reports that “the healthsector urgently needs to identify basic health indica-tors (base-line indicators) and the development of aninformation system capable of collecting and analyz-

ing data and trends for these indicators and produceperiodic reports routinely and timely.”37 Furthermore,the Palestinian health system is also likely to benefitfrom a surveillance system of behavioral risk factors,including tobacco use, diet, and physical activity,which would help in targeting and implementing in-terventions to specific population groups. The WorldBank is currently sponsoring a major project with thePalestinian Ministry of Health to strengthen varioushealth information systems, including national reg-istries for health insurance and international referrals.Ongoing population-based nutritional monitoring isbeing conducted or supported by various organiza-tions, including Al-Quds University, Johns HopkinsUniversity, CARE, USAID, the United Nations Chil-dren’s Fund, and others.

In Israel, the Health Information Department in theMinistry of Health serves as the focal point for healthstatistics and data collection. Additionally, individualhospitals and universities are involved in data collec-tion and research. The use of electronic medicalrecords (EMRs) is widespread in Israel. A 1999 surveyby the Israeli Medical Association revealed that of the26 general hospitals in Israel, 21 (91.3%) use EMR sys-tems.38 However, this same survey also showed thatthere are 27 different types of EMR systems in use in Is-raeli hospitals, and generally more than one type isused in any given hospital. An ongoing InteroperableHealth Information Infrastructure (IHII) project has thegoal of developing state-of-the-art technologies thatpromote interoperability of EMRs.

Furthermore, health information technology today alsoincludes the tools of new media, which are reshapingthe way that individuals and societies communicate andshare information. The Internet, email, cell phones,PDAs, iPods, satellite television, and other rapidlyspreading technological devices are only beginning tobe explored as methods for advancing public healthand medicine. Cell phones, for instance, owned by mostPalestinians and Israelis, can help with data collectionand public health outreach. Functioning as miniaturehand-held computers, cell phones and PDAs have cre-ated an unprecedented level of connectivity, which canbe harnessed for public health purposes and in supportof cooperative activities in this and other regions of theworld. These devices may soon take their place next tothe stethoscope as essential instruments in health pro-fessional toolboxes as well as for consumer empower-

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ment. The Internet too can be used in new and creativeways to promote cooperative activities that advancehealth and medicine. Telemedicine systems, remotemonitoring for conditions like hypertension and dia-betes, online networking websites, and health informa-tion portals all represent powerful ways of connectingprofessionals and the public with critical informationand with each other. In this region in particular, newmedia tools can help to transcend geopolitical divideswhich can make communication and cooperation diffi-cult. Online workspaces immunized from politics canfacilitate cooperation between Palestinians and Israelisfor the advancement of health in the region as well asto promote trust and reconciliation.

RecommendationsRecommendations on applying health informationtechnology to advance health in the region include:

• Create Compatible and Comprehensive Systems for Health Information SharingRegional and international systems for data ex-change require strengthening. Given the relativestrengths of Israel’s health information systems andits technology sector, the development and exten-sion of health information systems in the PalestinianTerritories is an area where cooperation and thesharing of expertise would be particularly benefi-cial. Cooperation in the area of health informationsystems development could help meet goals laidout by the Palestinian Ministry of Health. At thesame time, the development of compatible healthinformation technology systems would be of con-siderable benefit to both Israel and Palestine by fa-cilitating data exchange and the monitoring andtreatment of patients and risk factors. Health inPalestine is closely bound to health in Israel as wellas Egypt, Jordan, and other countries in the region.As a result, these countries are likely to benefit fromthe development of ways to rapidly and accuratelyexchange epidemiological data and informaiton.

• Establish an Electronic Medical RecordThere is a need in both Israel and Palestine forwidespread adoption of an interoperable elec-tronic medical record to collect and analyze shareddata for research and evaluation. This is vital formonitoring and combating public health issues of

common concern. A web-based program has beendeveloped as a component of the Middle EastConsortium on Infectious Diseases to assist Israel,the Palestinian Authority, and Jordan to combatfood-borne diseases and avian flu. This systempermits public health researchers and organiza-tions to rapidly report, share, and act on medicaland health information across borders. These threesocieties share a common waterway, the JordanRiver, and their citizens breathe the same air andcross borders on a daily basis. All of these factorsmake the tracking of infectious diseases includingfood-borne illnesses essential to the well-being ofeveryone in the region. In addition to the monitor-ing and evaluation of disease and risk factortrends, improved health information systemswould greatly benefit other areas of health andmedical research that are important for Palestin-ian and Israeli scientific cooperation, such as ge-netics research.

• Utilize online Health e-Commons and Listservs for Medical Specialty NetworkingOnline tools and websites can serve as importantvehicles for networking and information-sharing inthe region to aid in health promotion and health sys-tems development. The Palestine/Israel Health Ini-tiative has explored the use of online media forfacilitating networking and cooperative activitiesbetween Palestinian and Israeli health and medicalexperts. Through the pilot PIHI “Health e-Com-mons” website run in conjunction with WorkingGroup Meetings, the Initiative determined thatthese networks and web spaces can be a useful andcost-effective mechanism in the region for connect-ing health professionals in meaningful ways andsustaining their relationships and information-shar-ing between and beyond face-to-face meetings.

One strategy to enhance networking among med-ical specialties would be the development ofPalestinian and Israeli Internet listserv groups forspecialties, such as Pediatrics, Emergency Medi-cine, and Radiology, or use of the PIHI “Health e-Commons” for this purpose. This online strategyfacilitates communication, cooperation, informa-tion-sharing, and relationship-building amongPalestinian and Israeli health specialists.

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• Develop an Online Patient Transfer SystemThe development of an online system could help tomanage the transfer of patients between health facil-ities in Palestine and Israel. Currently, patient trans-fers are often accomplished by fax, particularlywhen the transfer occurs from a Palestinian to an Is-raeli hospital. A comprehensive electronic systemfor exchange and storage of patient information is anecessary step in the development of compatiblehealth information systems in the Palestinian Au-thority and Israel, and the Internet should be har-nessed to accomplish this goal.

• Create an Inventory of Health Information TechnologyA first step in a concerted strategy to develop com-patible information technology systems would be ajoint Palestinian-Israeli Information Technology in-ventory and research project to detail existing healthIT in the region and create an analysis of gaps andcosts to inform future development work. Addition-ally, a Palestinian-Israeli research team could selecta single disease or condition of mutual concern,such as breast cancer, around which a health careprovider organization in Israel and an organizationin Palestine could jointly pilot electronic medicalrecord implementation. Small steps such as thesewould both facilitate joint work between Palestin-ian and Israeli researchers and health and medicalexperts and lay the groundwork for systematic andcompatible health information system developmentin the future.

• Explore New Media and Information Tools to Improve Health in the RegionNew media and information tools include telemed-icine and tele-health, which allows professionals toshare information and expertise and practice med-icine together across borders. Teleconferencing andInternet-based networking tools can help facilitateinteraction, exchange, and virtual meetings betweenPalestinian and Israel public health and medical ex-perts when they cannot consistently meet in person.In addition, mobile phones are a largely unexploredresource for public health purposes, which might beparticularly useful in this region for public healthoutreach as well as data collection and data sharing.The use of the Internet and new media devices likecell phones, satellite TVs, iPods, and PDAs are rap-idly proliferating, and their potential should be crit-

ically examined now for their applications to sup-port cooperative activities between Palestinians andIsraelis to advance health in the region.

• Establish a Health e-CommonsAs a first step, the Palestine/Israel Health Initiativelaunched an online networking “Health e-Com-mons” workspace, “PIHI Project Spaces.” The tech-nology and the domain-name (http://www.pihi.projectspaces.com) were donated by an online strat-egy consulting firm. This workspace provides apassword-protected forum for Working Group par-ticipants and other individuals interested in coop-erative health work. It allows them to conveneonline in an electronic commons to share best prac-tices, health information, and data through the In-ternet. The space fosters the sharing of informationand the discussion and development of cooperativehealth activities in the region. In this “Health e-Commons,” users post announcements and re-sources, view documents related to meeting topicsand health programs in the region, and originateand contribute to discussions pertaining to theWorking Group topic areas. Links are also providedto open-university public health courses, health tu-torials, online medical brochures and a range ofother useful materials, which is evolving and grow-ing with the contributions of the participants. Pales-tinian, Israeli, and U.S. participants in the Initiative’sWorking Group meetings are currently using thesite to share insights and maintain connections fa-cilitated by the Working Group sessions. It is hopedthat activity on this site will continue and grow andthat it can be a model for the development of futureonline networking tools used by Palestinian and Is-raeli health and medical experts for the advance-ment of cooperative projects in health and medicinein the region. The “Health e-Commons” is buildingan online community of Palestinians and Israelihealth care providers, researchers, and policymak-ers, with tools that facilitate active networking andthe sharing of information and experiences withinthis online forum.

• Establish a Middle East Health Information WebsiteThe Palestine/Israel Health Initiative has begun de-veloping one of the first public health informationportals for sharing of health information and clini-cal guidelines in the region, with resources in He-

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brew, Arabic, and English. This public website(www.HealthMiddleEast.org) is geared toward a gen-eral audience of health professionals and consumersin the Palestinian Territories and Israel. It will in-clude and link to a wealth of information on dis-eases and medical conditions of common concern inthe region and provide helpful resources to preventdisease as well.

This expansion of the resources available in the“Health e-Commons” through a public portal willextend their reach to Palestinian and Israeli profes-

sional and public audiences. The portal will also in-clude a section that links to descriptions of coopera-tive programs and activities in health and medicinebetween Palestinians and Israelis, helping to facili-tate the growth of these Initiatives and build supportfor this work. Furthermore, a website of this kindcan provide information for outside parties, such asinterested organizations in the United States andother countries, on health systems in the region andlink collaborators from other areas of the world toexperts and joint activities in Palestine and Israel.

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BackgroundIn recent years, few studies have been conducted toidentify ongoing partnerships and cooperative healthprograms underway between Israelis and Palestinians.The most recent selected mapping of cooperative ini-tiatives was published by the JDC-Brookdale Institutein 2000 and included information on Israeli-Palestin-ian cooperation in the health field from 1994-1998.”39

Much has changed since the conclusion of this studyperiod, including the Second Intifada, changes in gov-ernment leadership, the emergence of new diseasesand public health threats, and innovations in the fieldsof public health and medicine. Many of the programsprofiled in this prior report no longer exist and somenew initiatives have been created over the past decade.

The lack of knowledge regarding the landscape forongoing cooperative initiatives between Palestiniansand Israelis impedes investment in these activitiesand networking between those involved. As a firststep to overcoming this knowledge gap, the Pales-tine/Israel Health Initiative (PIHI) has created a se-lected mapping of cooperative health programsunderway between Palestinian and Israeli scientistsand health care professionals. The PIHI Selected In-ventory identifies cooperative programs conductedfrom 2005 to the present between Israel and the Pales-tinian Territories as well as highlights many organiza-tions that have been deeply involved in cooperativeactivities over the past several years.

Because of the sensitive nature of these projects or dueto lack of funding and publicity, many of these initia-tives are not widely known. The majority of these co-operative projects and organizations were identifiedthrough structured Internet-based research and fieldinvestigations carried out over the course of the CSPPalestine/Israel Health Initiative. The Selected Inven-tory contains information on over forty cooperativeprograms in health and medicine between Palestinianand Israeli professionals, including a description of theprogram’s mission and goals, its partnering organiza-tions, and contact information.

MethodologyAfter identifying key individuals and organizations in-volved in cooperative projects through structured In-ternet research and personal communications, thewebsites of these organizations were examined forjoint projects that had been conducted since 2005. A co-operative health project was defined as an activity cen-tered around improving health service delivery, healtheducation and training, and/or research that involvedat least one Palestinian and one Israeli health profes-sional or organization. After examining the websites ofthese organizations, a search was done through GoogleWeb and Google Scholar for news about these organi-zations and their cooperative health projects. Searchterms included the name of the organization, the nameof the organization’s leader, as well as the name of theorganization and/or the organization’s leader com-bined with the search terms below.

To identify cooperative projects for this inventory, bothGoogle Web and Google Scholar searches were per-formed. The following search terms were used in bothsearch engines:

“Palestinian Israeli Health Cooperation”“Palestinian Israeli Collaboration”“Joint Palestinian Israeli Health Projects”“Middle East Health Cooperation”“Middle East Health Projects”“Israel, West Bank, Gaza Health Projects”“Israel, West Bank, Gaza Health Cooperation”

As individual projects were identified, the names ofthose projects were searched for additional informa-tion, both individually and in conjunction with thesearch terms above, on both Google Web and GoogleScholar for additional information. Key individualsfrom the identified projects and organizations werealso searched on Google Web and Google Scholar.

To advance understanding of these activities and fur-ther identify additional joint health projects, partici-pants in the PIHI Working Group meetings were askedto describe cooperative initiatives that they have par-ticipated in or are aware of. Through this method, sev-

Selected Inventory of Palestine/IsraelCooperative Health Initiatives

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eral additional projects and their key contacts for theseinitiatives were identified for more information abouttheir programs.

DisclaimerDescriptions of the projects and organizations includedin this Selected Inventory were obtained either fromdocuments published on the Internet or directly fromparticipating individuals. All people noted in this in-ventory who are involved in these projects were in-formed of the intent to publish information about thesecooperative programs in this Selected Inventory.

NOTE: Several cooperative initiatives listed are um-brella organizations for many smaller projects. For ex-ample, the Middle East Cancer Consortium and theIsraeli-Palestinian Science Organization help to coordi-nate and oversee many cooperative programs each yearbetween Israeli and Palestinian scientists and healthcare providers. However, due to the lack of detailed in-formation about some of these projects and their sensi-tive nature, the smaller programs under each of theseorganizations were not described independently.

Additionally, this inventory is not a comprehensivemapping of all activities but rather highlights selectedprograms as models for cooperative work on healthand medicine in the region. Such a selected mappingcan serve as a useful tool for experts and health pro-fessionals as well as a guide to promising programs fordonors and for governmental and nongovernmentalorganizations.

Contact InformationFor additional information on these cooperative programsand to submit descriptions of health projects to be includedin future editions of this selected inventory, please contact:

– [email protected]

Selected Inventory of Cooperative ProjectsBedouin Genetic Research ProjectMission and Goals: Dr. Ohad Birk (an Israeli geneti-cist), Dr. Izzeldin Abuelaish (a Palestinian physicianfrom Gaza), and Dr. Khalil Elbedour (a Bedouin-Israeliphysician) are working together at Ben Gurion Univer-sity to identify the mutant genes that cause genetic dis-

eases prevalent in the Bedouin community linked inlarge part to intermarriage among relatives. In addi-tion to working with the Bedouin population in Israel,Dr. Abuelaish, a physician from Gaza, is collecting dataand constructing family trees from his patients inGaza. The researchers are providing confidential anddiscreet genetic testing to interested families and areworking closely with Muslim leaders to spread mes-sages about the benefits of genetic testing. From 2004-2006, the team identified eight mutant genes notpreviously associated with a disease and dozens ofnew mutations in other genes previously linked towith genetic disorders. The lab work is sponsored byIsraeli philanthropist Morris Kahn.

Project Partners: Ben Gurion University, IsraelInformation: http://www.nytimes.com/2006/03/ 21/science/21bedo.htmlKey Contacts:

• Ohad Birk, MD, PhD - Acting Director, GeneticsInstitute, Soroka Medical Center, Ben Gurion University; Group Leader, Human MolecularGenetics Lab, Ben-Gurion University. email: [email protected]

• Izzedlin Abuelaish, MD – Genetics Institute,Soroka Medical Center, Ben Gurion University;OB/GYN, Jabalya refugee camp, Gaza strip.email: [email protected]

Brandeis University/Al-Quds University PartnershipMission and Goals: The goals of this administrativeand academic partnership between Brandeis and Al-Quds Universities include strengthening the Al-QudsUniversity infrastructure, providing educational op-portunities for students and faculty, and fostering cul-tural understanding. The Brandeis University/Al-QudsUniversity partnership grew out of a 1997 visit to Bran-deis by Al-Quds President, Dr. Sari Nusseibeh. The ini-tial phase of the partnership, which ran through June2007, focused on administrative and academic ex-changes. For example, during this initial phase, theVice President for Administrative and Financial Affairsat Al-Quds University spent two years at BrandeisUniversity developing a strategic plan for Al-Quds.During this period, four master’s degree students fromthe American Studies Program at Al-Quds Universityspent two weeks at Brandeis University. The secondphase of the partnership runs through December 2009

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and is focusing on teaching and academic exchanges,including health programs. A description of the pro-gram and participant list can be found athttp://www.brandeis.edu/ aqu/en/bios.html.

Project Partners: Brandeis University, Waltham,Mass, USA; Al-Quds University, East JerusalemWebsite: http://www.brandeis.edu/aqu/en/about.htmlKey Contacts:

• Dr. Daniel Terris - Associate Vice President forGlobal Affairs; Director, International Center forEthics, Justice and Public Life at Brandeis Uni-versity. email: [email protected]

• Dr. Khuloud Khayyat Dajani, Professor of SocialMedicine and Health Policy, Al-Quds University. email: [email protected]

Bridges MagazineMission and Goals: Bridges, the first Israeli-Palestin-ian Public Health magazine, was first published in De-cember 2004. Its overall aim is to promote greaterdialogue and understanding between the Palestinianand Israeli public health communities. It also aims tobe informative, educational and entertaining. Eighteenissues have been published to date and 3,400 copies ofeach issue have been printed and distributed to over3,000 addressees in Palestine, Israel, and other coun-tries. The Editorial Board of Bridges, chaired by WHOand comprised of Israeli and Palestinian health profes-sionals, is responsible for producing the magazine. TheBoard has also promoted various workshops andmeetings between the two health communities to dis-cuss common health issues. The last workshop washeld in December 2007 on “Access to Health in theGaza Strip”.

Project Partners: World Health Organization, Pales-tinian and Israeli health professionals Website: http://www.bridgesmagazine.org/Key Contact:

• Tony Laurance - Head of Office, World HealthOrganization, West Bank and Gaza. email: [email protected]

Cancer Genetics Course for Palestinian Genetic CounselorsMission and Goals: In January 2008, six Palestinianwomen participated in a Breast Cancer Research Foun-

dation-funded course on breast cancer genetics and ge-netic counseling. These women are now completingtheir in-service genetic counseling training at AugustaVictoria Hospital in East Jerusalem and Shaare ZedekMedical Center in Israel. The training focuses on pro-viding breast cancer genetic testing and counseling toPalestinian women for the first time in history. Mentor-ing these women is a team of Palestinians, Israelis, andAmericans, including Dr. Ephrat Levy-Lahad from ShareZedek Medical Center in Jerusalem, Dr. Moien Kanaanfrom Bethlehem University, Dr. Samir Khatib from Beth-lehem University, and Dr. Mary-Claire King from theUniversity of Washington. This team will also begin ge-netic analysis of breast cancer in Arab women living inthe Palestinian Authority and Israel. The group plans toapply the knowledge gained in studies of AshkenaziJewish families to understanding the genetics of breastcancer in Arab women, and to offer the first systematiccare and follow-up program for women with inheritedbreast cancer risk in the region. The program is under-way at Share Zedek Medical Center in Jerusalem andAugusta Victoria Hospitals, in cooperation with Bethle-hem University. The genetic testing and counseling pro-gram is a first step in raising public awareness about thedisease, promoting early detection, and in these ways en-hancing the possibility of positive health outcomes forArab women who have breast cancer.

Project Partners: Breast Cancer Research Founda-tion, United States; Share Zedek Medical Center, Is-rael; Bethlehem University, West Bank; AugustaVictoria Hospital, East Jerusalem; University ofWashington School of Medicine, United StatesWebsite: http://www.bcrfcure.org/action arab women.htmlKey Contact:

• Moien Kanaan, PhD - Dean of Science andHereditary Research Lab Director, BethlehemUniversity. email: [email protected]

Cerebral Palsy CollaborationMission and Goals: This initiative is investigating dif-ferent approaches to improving motor function inPalestinian, Israeli, and Jordanian children with cere-bral palsy through work at three clinical sites in Jor-dan, Israel and East Jerusalem. The objectives of theproject are to both increase cooperation among healthcare professionals in Jordan, Israel, and Palestine andto disseminate and standardize a new cerebral palsytherapy. The program provides a consistent and evi-

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dence-based system of clinical care, establishes a small,cohesive consortium of clinical researchers, and fostersinterdisciplinary communication in the region. Theproject was launched in February 2006 with an open-ing conference held in Aqaba, Jordan, under the aus-pices and with the participation of Princess MagdaRaad, chairperson of the Al-Hussein Society in Jordan.This project is sponsored by a grant from the MiddleEast Regional Cooperation Program (MERC) and co-ordinated by researchers at Ben Gurion University.Project Partners: United Cerebral Palsy Research andEducational Foundation, United States; Ben GurionUniversity, Israel; Al-Hussein Society RehabilitationCenter, Amman, Jordan; Basma Rehabilitation Center,East Jerusalem; Child Development and RehabilitationCenter at Assaf Harofeh Medical Centre, Israel

Website: http://www.ucpresearch.org/newsandevents/111207-middleeast.phpKey Contact:

• Professor Jacob Kaplanski – Associate ProfessorEmeritus, Ben Gurion University Faculty ofHealth Sciences. email: [email protected]

Child Nutrition in Israel and Palestine Con-ference: Fostering Joint InitiativesMission and Goals: A conference was convened in Feb-ruary 2005 by the Friedman School of Nutrition andScience Policy, Tufts University, Al-Quds University,and Ben Gurion University, in association with the En-vironmental Protection and Research Institute in Gaza.The purpose of the meeting was to address the currentchallenges of food insecurity and inadequate nutritionfor children in some parts of Palestine and Israel.

Project Partners: Tufts University, United States; Al-Quds University, East Jerusalem; Ben Gurion Uni-versity, IsraelWebsite: http://nutcent.bgu.ac.il/Final_Program %20Jan_29th-1.htmKey Contacts:

• Drora Fraser, Ph.D – Professor of Epidemiologyand Health Sciences Evaluation, Ben GurionUniversity. email: [email protected]

• Irwin Rosenberg, MD – Friedman School of Nutrition Science and Policy, Tufts University.email: [email protected]

• Dr. Mohamed Shaheen - Dean, School of Public Health, Al-Quds University.email: [email protected]

Child Rehabilitation Initiative for Safety and Hope (CHERISH)Mission and Goals: CHERISH is a partnership betweenthe Israel Center for Treatment of Psychological Traumaat Herzog Hospital in Israel, the Center for Develop-ment in Primary Health Care at Al Quds University, andthe JDC-Middle East Program. This multidisciplinaryproject focuses on psychological and social rehabilita-tion of Israeli and Palestinian children exposed to vio-lence. It addresses two target groups – the professionalcommunity and children and their families. Since its es-tablishment in November 2002, CHERISH has devel-oped a circle of more than sixty Palestinian and Israelihealth professionals who have participated in its vari-ous forums, workshops and activities. In 2006-2007,Project CHERISH trained over forty Palestinian and Is-raeli social workers and school counselors in cognitivebehavioral therapy for children suffering from psycho-logical trauma. The project’s goal is to increase aware-ness of the symptoms of psychological trauma inchildren and to streamline procedures for children andtheir families to access treatment.

Project Partners: JDC–Middle East Program, Israel;Israel Center for Treatment of Psycho social traumaof Herzog Hospital, Israel; Center for Develop-ment in Primary Health Care/Al-Quds University(Ramallah)Website: http://www.projectcherish.org/ index.phpKey Contacts:

• email for project: [email protected]• Randi Garber - Director, JDC – Middle East Pro-

gram. email: [email protected]• Prof. Mohammad Shaheen - Dean, School of

Public Health, Al-Quds University. email: [email protected]

• Dr. Danny Brom - Director, Israel Center forTreatment of Psychotrauma, Herzog Hospital.email: [email protected]

Canada International Scientific ExchangeProgram (CISEPO): Student Summer Cooperative ProgramMission and Goals: The CISEPO student summerelective brings Israeli, Palestinian, Jordanian andCanadian medical students and PhD candidates to-gether to study child nutrition issues at the Hospitalfor Sick Children at the University of Toronto. This

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summer student cooperative program, which beganin June 2003 (with 2003 focusing on pediatric cancer;and 2004 focusing on genetic hearing loss), is a com-ponent of CISEPO’s mission in the Middle East tobuild trust and confidence across the Arab and Israelidivide by working with the next generation of com-munity and health leaders. The current leadership ofthe International Pediatric Emergency Medicinesummer student elective (CISEPO/IPEME) – now inits fifth year – includes Abi Sriharan, (Deputy Direc-tor (Peter A Silverman Centre for InternationalHealth, Mount Sinai Hospital), Dr. Dennis Scolnik(Hospital for Sick Children) and Dr. Rahim Valani,(Sunnybrook Health Sciences Center). As the stu-dents work and live together, the bridges of humanunderstanding built on the common ground of thehealth sector forges lasting people-to-people linksacross borders. The ultimate objective for the pro-gram is for returning students to foster a wider net-work of knowledge and cooperation among theircolleagues using this CISEPO model.

Project Partners: Canada International Scientific Ex-change Program (CISEPO), Israel; University ofToronto, Canada; Al-Quds University, EastJerusalem; Jordan University of Science and Tech-nology; Edith Wolfson Medical Center, Israel; TelAviv University, Israeli; other Palestinian and Israelihealth institutionsWebsite:http://128.100.113.105/Student_Projs.htmlKey Contact:

• Professor Arnold Noyek – Chair, CISEPO.email: [email protected]

Coexistence Through Medicine – Emek Medical CenterMission and Goals: Over the past several years, EmekMedical Center in Afula, Israel, has hosted seminarsfor health care and hospital officials from the Palestin-ian territories. Attendees participated in a day-longseries of medical lectures in Arabic and Hebrew pre-sented by members of Emek’s multi-ethnic staff.

Project Partners: Emek Medical Center, Israel; Pales-tinian health professionals and hospital officialsWebsite: http://www.clalit.org.il/haemek/Content/Content.asp?CID=122&u=352

Key Contact:

• Dr. Larry Rich - Director of Development andInternational Public Relations, Emek MedicalCenter. email: [email protected]

Cooperative Program in Public HealthMission and Goals: Four institutions located in Is-rael, the Palestinian Authority, and the United States,signed a memorandum of understanding to facilitatecooperative efforts in public health. Participating inthis initiative are three schools of public health - TheBraun School of Public Health of Hebrew Universityand Hadassah Medical Organization, Al-Quds Schoolof Public Health, Rollins School of Public Health ofEmory University - as well as the U.S. Centers for Dis-ease Control and Prevention (CDC). The project hasobtained funding from the United States-Israel Bi-na-tional Science Foundation to hold a workshop inJerusalem in 2009 as one component of a series of ini-tiatives that will occur to implement the memoran-dum of understanding. Additional funding has beenobtained from Hebrew University and Emory Uni-versity. At the 2009 meeting, teams from the fourpartner institutions, in addition to other invited par-ticipants, will discuss opportunities and develop re-search and programmatic proposals for funding infour thematic areas: (a) Non-infectious diseases andlifestyle; (b) Environmental health; (c) Reproductivehealth; and, (d) Health promotion and education. Theinitiative is now in the preparatory phase in whichthe four thematic groups moderated by Palestinianand Israeli researchers are working through the webto discuss ideas and prepare working documents. Inaddition, these researchers are developing a programproposal to be submitted for funding to privatedonors as well as developing a proposal on familyplanning and contraceptives.

Project Partners: Braun School of Public Health andCommunity Medicine of Hebrew University andHadassah Medical Organization, Israel; Al-QudsSchool of Public Health, East Jerusalem; RollinsSchool of Public Health of Emory University, UnitedStates; Centers for Disease Control and Prevention,United StatesKey Contacts:

• Dr. Henry Falk – Director, Center for Environ-mental Health and Injury Control, Centers forDisease Control and Prevention. email: hxf1 @cdc.gov

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• Professor Mohammad Shaheen – Dean, Schoolof Public Health, Al-Quds University. email: [email protected]

• Dr. Ronny Shtarkshall - The Braun School ofPublic Health and Community Medicine of theHebrew University and Hadassah Medical Or-ganization. email: ronnys@ ekmd.huji.ac.il

• Professor Aryeh D. Stein, Rollins School of Pub-lic Health, Emory University. email: aryeh.stein@ emory.edu

Coping with Breast Cancer among Palestin-ian and Israeli Women (Project COPE)Mission and Goals: The mission of Project COPE is toaddress the needs of Israeli and Palestinian breast can-cer patients and improve the skills of health care pro-fessionals to diagnose and treat the disease in theregion. The project ran from 2000-2006, and includedjoint meetings of Palestinian and Israeli breast cancersurvivors, health care professionals, and trainingcourses. Between 2000-2003, forty breast cancer sur-vivors and fifty health professionals participated in 25educational events. This project established a networkof volunteers to advise women recently diagnosedwith breast cancer, as well as created a breast cancerinformation and support hotline. Israeli and Palestin-ian participants also traveled together to attend inter-national conferences, gaining skills and sharing theirexperiences with the global community.

Project Partners: JDC-Middle East Program; the Pa-tient’s Friends Society (PFS), Jerusalem; the IsraelCancer Association (ICA); Augusta Victoria Hospi-tal; Israel Association for the Advancement ofWomen’s Health (IAAWH)Website: http://brookdale-en1.pionet.com/files/Project-COPE-Breast-Cancer.pdfKey Contact:

• Randi Garber – Director, JDC – Middle East Program. email: [email protected]

Delivery Systems for Substance AbuseTreatment: An International ConferenceMission and Goals: In September 2005, prominentsubstance abuse experts from Israel, the PalestinianAuthority, and twenty-three countries gathered in Is-tanbul, Turkey to share information on the public

health problem of substance abuse, promoting regionalcooperation on substance abuse issues, and discussingthe integration of substance abuse treatment serviceswith primary care, mental health, and social servicesystems. Countries in attendance included Iraq, Iran,Israel, Palestine, Afghanistan, Russia, and the UnitedStates. The conference included presentations on diag-nosing substance use and providing services for peo-ple with addictive disorders. The conference alsoaddressed the benefits and limits of integrating sub-stance abuse treatment within the health, social, andcriminal justice systems. Based on the evaluations andfollow-up to the meeting, many of the participantspursued professional exchanges based on discussionsand contacts made at the conference.

Project Partners: Substance abuse experts from 23different countries; UCLA Integrated SubstanceAbuse Programs, United States; World Health Orga-nization; United Nations Office on Drugs and CrimeWebsite:http://www.uclaisap.org/dssat2005/index.htmlKey Contact:

• Valerie Pearce - Project Director. email: [email protected]

Dermatology for PeaceMission and Goals: The Dermatology for Peace pro-gram, established by Hadassah Medical Organization,has provided training opportunities for Palestinianphysicians interested in the field of dermatology. Fac-ulty at Hadassah Medical Center met with Palestiniandermatologists in Nablus and hosted these health carespecialists at the Dermatology Department of HadassahHospital. A number of cooperative projects have beenagreed upon, including a postgraduate training coursefor Palestinian dermatologists, monthly consultationsrotating between Nablus and Jerusalem, and a series ofsymposia on dermatological issues featuring invitedspeakers from around the world. The program was es-tablished by Professor David Enk, a senior dermatolo-gist at Hadassah Medical Organization, but is no longerin operation.

Project Partners: Hadassah Medical Organization,Israel; Palestinian dermatologists, West BankWebsite: http://www.hadassahinternational.org/news/article.asp?id=961

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Key Contact:• Ron Krumer - Director of External Affairs,Hadassah Medical Organization. email: [email protected]

Empowering Communities in Home Safety (ECHOS)Mission and Goals: Through the ECHOS initiative,project partners are working to prevent home acci-dents (the leading cause of injury and death amongchildren worldwide) and to help parents to create safeenvironments for their children. The project is a part-nership of the JDC-Middle East Program, the Patient’sFriends Society - Jerusalem, the Jerusalem PrincessBasma Center, and Beterem – Israel Center for Chil-dren’s Safety and Health. The goal of the initiative is toengage community “agents of change” around theissue of home safety and to develop culturally appro-priate materials. In 2007, a survey of home uninten-tional injuries was carried out in clinics in bothcommunities. The findings are being used by the part-ner organizations to target child safety education ini-tiatives and will be presented in international forumsand through a joint report.

Project Partners: JDC-Middle East Program; Pa-tient’s Friends Society – Jerusalem; JerusalemPrincess Basma Center; Beterem – Israel Center forChildren’s Safety and HealthWebsite: http://www.jdc.org/nonsect_currrespmideast.htmlKey Contact:


Empowerment and Resilience in Children Everywhere (ERICE)Mission and Goals: Founded in 2004, ERICE hasbrought together child mental health professionalsfrom Israel, the West Bank and Gaza to discuss howbest to work together to improve the lives of childrenin the region. The first meeting was held in 2004 inJerusalem, and the group continues to convene in theregion and in Europe. ERICE is affiliated with a num-ber of leading Israeli, Palestinian, Italian and Ameri-can universities. Six pilot programs have beenpartially funded: “Assessing Post-Traumatic Distressin Infants and Young Children: A Multi-DimensionalApproach”, “Children in War: A Look at the Inner

World of Palestinian and Israeli Children via theirDreams”, “The Development of an Evidence GuidedApproach to Child Mental Health in Arab Populationsin Palestine and Israel”, “An Evaluation of Special Ed-ucation Programs for Palestinian and Israeli Children”,“Pilot Surveillance of PTSD among Children in Israeland the Palestinian Authority”, and “Enhancing thePsychosocial Health and Empowering the School AgeChildren in Gaza.” The next round of grant requestswill support capacity building projects that involveboth Israeli and Palestinian professionals focused onpositively impacting the lives of Palestinian and Israelichildren. The work has been supported by the Fon-dazione per lo Studio e la Ricera sull’Infanzia el’Ado-lescenza, the Italian Government, and the InternationalAssociation for Child and Adolescent Psychiatry andAllied Disciplines. Thus far, the project has also se-cured external funding from the National Alliance forResearch on Schizophrenia and Depression and theUnited States-Israel Bi-national Science Foundation.

Project Partners: Yale University, United States; Al-Quds University, East Jerusalem; Tel Aviv Univer-sity, Israel; Hadassah Medical Organization/HebrewUniversity, Israel; Bar-Ilan University, Israel; Univer-sity of Rome, ItalyWebsite: http://studentpages.scad.edu/~rstern20/erice/index.htmlKey Contacts:

• James Leckman, MD - Professor of Child Psy-chiatry and Pediatrics, Yale University. email: [email protected]

• Esti Galili, MD - Chief of Child Psychiatry,Hadassah Medical Organization. email: [email protected]

• Mustafa Qossoqsi, PhD• Al Hazem Hashour, M.D.

Genetic Research CollaborationMission and Goals: Beginning in the late 1990s (underthe auspices of the Canada International Scientific Ex-change Program’s (CISEPO) Middle East Associationfor Managing Hearing Loss (MEHA) initiative), Pro-fessor Moien Kanaan of Bethlehem University andProfessor Karen Avraham of Tel Aviv University begana cooperative initiative on genetics research. Alongwith researchers at the University of Washington, theyhave been investigating the genes behind inheriteddeafness. This project has received funding from the

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National Institutes of Health and other organizationsto conduct research as well as to sponsor Palestiniansscientists to study at Tel Aviv University. A graduateresearch program has been established to enable Pales-tinian students to pursue post-graduate research in thisfield at Tel-Aviv University.

Project Partners: Tel Aviv University, Israel; Bethle-hem University, West Bank; University of Washing-ton, United StatesWebsite: http://www.bethlehem.edu/centers/hrl.shtml and http://www.tau.ac.il/~karena/Key Contacts:

• Karen Avraham, PhD - Chair, Department ofHuman Molecular Genetics and Biochemistry,Sackler School of Medicine, Tel-Aviv University.email: [email protected]

• Moien Kanaan, PhD - Dean of Science andHereditary Research Lab Director, BethlehemUniversity. email: [email protected]

The Hadassah Medical Center - Augusta Victoria Hospital Exchange ProgramMission and Goals: The Augusta Victoria Hospital inEast Jerusalem has established a Cancer Center toserve patients from the West Bank and Gaza. This Cen-ter includes basic radiation and chemotherapy serv-ices. The Hadassah Medical Center has committedresources to help train staff and provide physicist ex-pertise to ensure the delivery of quality oncology serv-ices at the Augusta Victoria Hospital. Furthermore,Hadassah’s Department of Oncology provides treat-ment for complicated patient cases whose care requiresspecialized services that are not available at the Au-gusta Victoria Hospital. This cooperative program hashelped foster dialogue between Israelis and Palestini-ans as well as the development of a much needed can-cer program to serve the Palestinian population of theWest Bank and Gaza.

Project Partners: Augusta Victoria Hospital, EastJerusalem; Hadassah Medical Organization, IsraelWebsite: http://www.jmeduk.org/portal/articles/30/1/Hadassah-And-The-Palestinian-Authority/Page1.htmlKey Contacts:

• Ron Krumer - Director of External Affairs,Hadassah Medical Organization.email: [email protected]

• Dr. Tawfiq Nasser - Chief Executive Officer/Director General, Augusta Victoria Hospital.email: [email protected]

Hadassah Medical Organization - Advanced Resuscitation TrainingMission and Goals: This two-week summer school ed-ucation and social program has taken place annuallyover the past three years. The course is conducted inEnglish and is intended for a select group of 14-18year-old high school students from Palestine, Israel,Jordan, and other countries in the Middle East. Thecourse is convened at different locations in the regionand allows students to learn from some of the world’sleading cardiologists and other health educators.

Project Partners: Hadassah Medical Organization,IsraelWebsite: http://www.hadassahuk.org/why.asp?IntID=147Key Contact:

• Ron Krumer - Director of External Affairs,Hadassah Medical Organization. email: [email protected]

The Hadassah-St. John Eye Hospital Human Resources Development Program in OphthalmologyMission and Goals: This project, dedicated to exchang-ing knowledge about eye diseases between Palestinianand Israeli hospitals and health professionals, repre-sents a unique opportunity to raise the standard of carein both communities while simultaneously harnessingmedicine in the service of peace. The program involvesjoint specialist clinics at St. John Eye Hospital, a com-bined residency program at St. John Eye Hospital andthe Hadassah Department of Ophthalmology, and jointspecialist clinics at Hadassah Medical Center for pa-tients who have been referred from St. John’s Hospital.

Project Partners: St. John Eye Hospital, EastJerusalem; Hadassah Medical Organization, IsraelWebsite: http://www.stjohneyehospital.org/content_subsection.asp?id=60&catid=23Key Contacts:


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• Dr. Jeanne Garth - Medical Director, St. JohnsEye Hospital. email: [email protected]

Healing Across the Divides – Breast Cancer ProjectMission and Goals: Partially funded by the NGOHealing Across the Divides, and implemented byPhysicians for Human Rights–Israel and the Union ofPalestinian Medical Relief Committees, the Breast Can-cer Project is working to increase awareness and pro-mote screening and treatment of breast cancer in Israeliand Palestinian women. The objectives of this projectare to enhance awareness about breast cancer amonghigh risk women, improve breast self-examinationrates, increase the utilization of mammography, im-prove self-esteem in the participants, and provide so-cial support.

Project Partners: Healing Across the Divides,United States; Physicians for Human Rights, Israel;the Union of Palestinian Medical Relief Committees,Palestinian TerritoriesWebsite: http://www.healingdivides.org/pages/breastCancer.htmKey Contact:

• Norbert Goldfield, MD - Executive Director,Healing Across the Divides. email: [email protected]

Healing Across the Divides - Diabetes andHypertension Monitoring and TreatmentSystem in Disadvantaged Israeli and Palestinian CommunitiesMission and Goals: Sponsored by Healing Across theDivides, a non-governmental organization, this proj-ect seeks to improve access to care and promote em-powerment in Palestinian and Israeli patients withdiabetes. This initiative represents a partnership be-tween Healing Across the Divides, the Union ofPalestinian Medical Relief Committees and TheGalilee Society, a Palestinian non-partisan NGO op-erating in Israel. The project objectives are to estab-lish a trilateral steering committee to oversee thedevelopment and operation of a diabetes and hyper-tension monitoring system, develop and implementtreatment protocols, train local project leaders inhealth promotion/self-management techniques, andestablish a system for monitoring hospital admissionsrelated to cases of diabetes and hypertension. The

project encourages interaction among Israeli, Pales-tinian, and American health professionals and ex-poses U.S. organizations to the health issues faced bydisadvantaged Israeli and Palestinian communities.

Project Partners: Healing Across the Divides,United States; Union of Palestinian Medical ReliefCommittees, Palestinian Territories; The Galilee So-ciety – The Arab National Society for Health Re-search and Services, IsraelWebsite: http://www.healingdivides.org/pages/projects.htmKey Contact:

• Norbert Goldfield, MD - Executive director,Healing Across the Divides. email: [email protected]

Holy Land Medical ProjectMission and Goals: The Holy Land Medical Project isa partnership of the Rotarian Medical Aid Charity inthe United Kingdom called Saving Lives and the Uni-versal Peace Federation’s Middle East Peace Initiative.The founder of Saving Lives and several doctors andofficials from Birmingham Children’s Hospital in theUnited Kingdom have visited Israel and Palestine tomeet with officials and identify areas for cooperation.The program has the support of several Palestinianand Israeli health professionals and leaders, includingthe staff at Caritas Baby Hospital in Bethlehem andseveral staff members at Hadassah Medical Organiza-tion in Jerusalem. Thus far, Birmingham Children’sHospital has agreed to support pediatric training,equipment needs and telemedicine support for Cari-tas Baby Hospital. The program is also exploring es-tablishing medical training centers in the West Bankand a local committee of Israeli and Palestinian med-ical professionals to oversee the delivery of services.

Project Partners: Saving Lives, United Kingdom;Universal Peace Federation’s Middle East Peace Ini-tiative, Europe; Birmingham Children’s Hospital,United Kingdom; Hadassah Medical Organization,Israel; Caritas Baby Hospital, West Bank; HebronGovernment Hospital, West BankWebsite: http://www.upf-deutschland.de/upfn ews/medicalproject.htmKey Contact:

• Robin Marsh - Secretary General, UniversalPeace Federation, United Kingdom. email: pa@ iifwp.org.uk

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International Congress on Chronic Disorders in ChildrenMission and Goals: Convened in April 2007, this con-ference brought together 300 Israeli and 100 Palestiniandoctors and other health professionals to discuss thetreatment and prevention of pediatric chronic diseasesincluding asthma, diabetes and genetic disorders. Theconference also marked the opening of Israel’s firstcomprehensive center for the treatment of pediatricchronic diseases at Hadassah Hospital – Mt. Scopus.Four more annual conferences on chronic disease inchildren are planned.

Project Partners: Hadassah Medical Organization,Israel; Shalva, the Jerusalem Center for Mentallyand Physically Challenged Children, IsraelWebsite: http://ima.org.il/wf/atg/atg-jun-07/atg6591.pdfKey Contact:

• Eitan Kerem, M.D. – Chair, Department of Pediatrics, Hadassah University Hospital -Mount Scopus

International Network of Knowledgethrough Electronic LearningMission and Goals: Created in 2005, the InternationalNetwork of Knowledge through Electronic Learning isan education and distance learning system managed bythe Peter A. Silverman Global eHealth Program at theCenter for International Health at Mount Sinai Hospital,in Toronto, Canada. Tele-health rounds are delivered inreal time in Canada and the Middle East on topics thatinclude the diagnosis and current treatment of some ofthe most devastating neurological and psychiatric condi-tions afflicting aging adults, such as Alzheimer’s disease,depression, and Parkinson’s disease. Medical expertsand community health professionals, residents and stu-dents view the same patient cases and then engage indiscussion, exchanging ideas and expert opinions.

Project Partners: The Peter A. Silverman Centre forInternational Health at Mount Sinai Hospital,Canada; Canada International Scientific ExchangeProgram (CISEPO), Canada; The Baycrest Center,Toronto, Canada; Department of Public Health Sci-ences at the University of Toronto, Canada; EdithWolfson Medical Center, Israel; Tel Aviv University,Israel; Jordan University of Science and Technology;Al Quds University, East Jerusalem

Website: http://www.baycrest.org/News_and_Media/News_Releases_2005/default_8832.aspKey Contacts:


• Yehudah Roth, MD – Israeli Co-Director,CISEPO. email: [email protected]

• Ziad Abdeen, PhD, MPH – Palestinian Co-Di-rector, CISEPO. email: [email protected]

Israeli-Palestinian Science Organization(IPSO)Mission and Goals: The Israeli-Palestinian Science Or-ganization (IPSO) is a non-political, not-for-profit or-ganization based in Jerusalem. IPSO is dedicated tofostering and sustaining cooperation between Israelisand Palestinians to promote dialogue and interactionamong scholars and scientists in the region. The orga-nization’s mission is to identify areas of science wherecooperation between Israelis and Palestinians is feasi-ble and productive, to build a science and scholarship-based bridge of good will, to create an environment forIsraeli and Palestinian scholars and scientists to meetand establish dialogue, and to support joint scholarlyand scientific projects through funding and adminis-trative assistance. In 2004-2006, IPSO received over100 proposals requesting funding for cooperative workin the medical and environmental fields.

Project Partners: Israeli and Palestinian scientistsand universitiesWebsite: http://www.ipso-jerusalem.org/Key Contacts:

• Dan Bitan, PhD - Co-Director, The Israeli-Pales-tinian Science Organization. email: danbitan@ ipso-jerusalem.org

• Hassan Dweik, MSc, PhD - Executive Vice Presi-dent, Al-Quds University; Co-Director, The Is-raeli-Palestinian Science Organization. email: [email protected]

Master of Public Health Degree Program at the Braun School of Public Health, Hebrew UniversityMission and Goals: Each year physicians, nurses andhealth administrators from the Palestinian Authority

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participate in a full time course organized by the BraunSchool of Public Health and Community Medicine atHebrew University. Students who complete the train-ing receive a Masters in Public Health (MPH) degree.

Project Partners: Hebrew University of Jerusalem,Israel; Hadassah Medical Organization, IsraelWebsite: http://publichealth.huji.ac.il/eng/programs.asp?cat=100&in=0Key Contact:

• Professor Theodore Tulchinsky - Senior Profes-sor, Braun School of Public Health and Commu-nity Medicine, Hebrew University-HadassahMedical Organization.email: [email protected]

Medilink - Training Palestinian Doctors in IsraelMission and Goals: The objective of this program is tostrengthen the Palestinian medical system by provid-ing fellowships and training programs for Palestiniandoctors in Israeli hospitals, thereby enhancing the serv-ices available through the Palestinian medical systemand nurturing Palestinian-Israeli relationships. Overseventy Palestinian doctors have participated in thisinitiative so far, undertaking fellowships in Israeli hos-pitals in a wide variety of fields. Some specific train-ing programs include Peace in Sight, a three yearinitiative to train Palestinian ophthalmologists, carriedout in partnership with St. John Eye Hospital andHadassah Medical Center and supported by the U.S.State Department; and Bridging the Gap, a two yearprogram of monthly meetings for Palestinian and Is-raeli pediatricians, carried out in partnership withMakassed Islamic Hospital, Augusta Victoria Hospi-tal, Palestinian Red Crescent Society Hospital in GazaCity and the Pediatric Department of Hadassah Mt.Scopus Medical Center.

Project Partners: Peres Center for Peace, Israel; St.John Eye Hospital, East Jerusalem; Hadassah Med-ical Organization, Israel; Makassed Islamic Hospi-tal, East Jerusalem; Augusta Victoria Hospital, EastJerusalem; Palestinian Red Crescent Society Hospi-tal, Gaza CityWebsite: http://www.peres-center.org/SectionProject.asp?cc=01140202

Key Contact:

• Dr. Danny Shanit - Deputy Director General andDirector of Medicine and Health Care Depart-ment, Peres Center for Peace. email: [email protected]

Middle East Association for Managing Hearing Loss (MEHA)Mission and Goals: Facilitated by the Canada Interna-tional Scientific Exchange Program (CISEPO), this ini-tiative was established in May 1998 as the first jointArab and Israeli professional association. As of 2005,six meetings of the MEHA steering committee havebeen held in the region. Through this program almost17,000 Arab and Israeli newborns were tested for hear-ing loss between April 2001 to June 2004, and over 300Canadian hearing aids have been distributed to infantsin the region.

Project Partners: Canada International Scientific Ex-change Program (CISEPO), Canada; University ofToronto, Canada; Al-Quds University, EastJerusalem; Jordan University of Science and Tech-nology; Edith Wolfson Medical Center, Israel; TelAviv University, Israel; and other Palestinian and Is-raeli health institutionsWebsite: http://128.100.113.105/Project1.htmlKey Contacts:



• Ziad Abdeen, PhD, MPH – Palestinian Co-Director, CISEPO. email: [email protected]

Middle East Association for Mother and Child Health (MEMCHA)Mission and Goals: MEMCHA’s vision is to deliverquality medical and public health care for women andchildren in the Middle East through the cooperative ef-forts of Israeli, Palestinian and Jordanian professionals,institutions and non-governmental organizations.

Project Partners: MEMCHA is a project of theCanada International Scientific Exchange Program(CISEPO), Canada; University of Toronto, Canada;Al-Quds University, East Jerusalem; Jordan Uni-versity of Science and Technology; Edith Wolfson

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Medical Center, Israel; Tel Aviv University, Israel;and other Palestinian and Israeli health institutionsWebsite: http://128.100.113.105/MEMCHA.htmlKey Contacts:

• Professor Arnold Noyek – Chair, Canada Inter-national Scientific Exchange Progarm (CISEPO).email: [email protected]



Middle East Cancer Consortium (MECC)Mission and Goals: The Middle East Cancer Consor-tium (MECC) was established in 1996 through an offi-cial agreement of the Ministries of Health of Israel, thePalestinian Authority, Cyprus, Egypt, Israel, and Jor-dan (Turkey joined in 2004). The signing of this agree-ment was witnessed by the United States Secretary ofHealth and Human Services and the Director of theNational Cancer Institute. The goal of the MECC is toraise cancer awareness in the Middle East, and ulti-mately, to reduce the burden of cancer in the regionthrough the support of cooperative research. Specificprojects include the establishment of population-basedcancer registries in all six jurisdictions, the develop-ment of a cooperative research grants program, and thedevelopment of training programs in palliative care.Many important cooperative projects have been car-ried out between Israeli and Palestinian researchersand physicians under the MECC small grants pro-gram. Additionally, numerous productive conferencesand workshops have been conducted involving re-searchers and health professionals from the MiddleEast and the United States.

Project Partners: Health Ministries of Israel, thePalestinian Authority, Cyprus, Egypt, Jordan,Turkey, and the United StatesWebsite: http://mecc.cancer.govKey Contact:

• Michael Silbermann, DMD, PhD - Executive Director, MECC.email: [email protected].

Middle East Consortium on Infectious Disease Surveillance (MECIDS)Mission and Goals: The Middle East Consortium onInfectious Disease Surveillance is a partnership be-tween the Ministries of Health in Israel, the Palestin-ian Authority, and Jordan to share data on food-bornedisease outbreaks and other infectious disease con-cerns. The Consortium is assisted by the Global Healthand Security Initiative of the Nuclear Threat Initiativeand other international regional organizations. TheEgyptian Ministry of Health has also participated inthis project. As part of the initiative, joint trainingcourses have been convened on epidemiology and onlaboratory technologies for evaluating infectious dis-eases, further promoting collaboration in the region.With the support of IBM, a project is underway to de-velop innovative software for a data-sharing networkfor the MECIDS partners. MECIDS will strengthen theability to detect and monitor infectious diseases in theparticipating nations, creating a new mechanism forsharing medical information across borders.

Project Partners: Al Quds University, EastJerusalem; Cooperative Monitoring Center,Amman, Jordan; European Program on Interven-tional Epidemiology Training; Health Ministriesof Israel, Jordan, and the Palestinian Authority;Sandia National Laboratories, United States;Search for Common Ground, United States; TelAviv University, Israel; Nuclear Threat Initiative’sGlobal Health and Security Initiative, Washington,D.C., United States; World Health OrganizationWebsite: http://www.ghsi.org/projects/mecids.htmlKey Contact:

• Terence Taylor, MD - Director, Nuclear ThreatInitiative. email: [email protected]

The Middle East Regional Cooperation Program (MERC), USAIDMission and Goals: The U.S. Agency for InternationalDevelopment MERC Program funds cooperative re-search projects in the areas of agriculture, health, envi-ronment, economics, and engineering between Israeland its Arab neighbors. In general, MERC grants focuson research rather than institution building, with a de-velopmental impact (economic, environmental, policy,etc.) expected in the near rather than distant future.MERC has two primary goals: promoting research fordevelopment and improving cooperation in the region.

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Established as a result of the Camp David Peace Ac-cords to promote Arab-Israeli cooperation, it has ex-panded beyond its original participants, Egypt andIsrael, to include many institutions throughout the re-gion. To date, the program has also funded activitieswith participation from Jordan, Morocco, WestBank/Gaza, Lebanon, and Tunisia. MERC grants arefunded at a level below $1,000,000 (usually over a 3-5year period) and pre-proposals are required.

Project Partners: Arab and Israeli institutions thatdevelop and submit joint research proposalsWebsite: http://www7.nationalacademies.org/dsc/USAID_MERC_Program.html; http://usembassy-amman.org.jo/enviro/merc1.htmlKey Contact:

• Research Support Program for USAID. email: [email protected]

Middle East Symposium on Dental MedicineMission and Goals: This symposium on dental im-plants was held during the winter of 2006-2007. Al-Quds University Faculty of Dentistry and HebrewUniversity-Hadassah School of Dental Medicinesigned an agreement to promote cooperation betweenacademic faculty and students in research, teachingand clinical work. The symposium was conductedunder the auspices of the Walter Cohen Middle EastCenter for Dental Studies at the Hebrew University-Hadassah School of Dental Medicine and also includedCase Western Reserve, Drexel, Harvard, and the Uni-versity of Pennsylvania in the United States andHacettepe University in Turkey. Additionally, the Wal-ter D. Cohen Middle East Center for Dental Studies of-fers a six-week course for dentists from the PalestinianAuthority, Jordan and other countries in the MiddleEast. This program began in 1998 with the participa-tion of eight dentists (two each from Palestine, Jordan,Turkey, and Cyprus). Last year, eleven participantswere included, and in 2008, a course was held for sixstudents. Another symposium is being planned forlater this year.

Project Partners: Walter D. Cohen Middle East Cen-ter for Dental Studies, Israel; Al-Quds UniversityFaculty of Dentistry, East Jerusalem; Case WesternReserve University, United States; Drexel Univer-sity, United States; Harvard University, UnitedStates; University of Pennsylvania, United States;Hacettepe University, Turkey

For more information: http://www.nature.com/bdj/journal/v202/n1/full/bdj.2007.6.htmlKey Contacts:

• Dr. Adam Stabholz - Dean, Hebrew University-Hadassah School of Dental Medicine.email: [email protected]

• Dr. Musa Bajali - Dean, Al-Quds University Fac-ulty of Dentistry. email: mbajali @ med.alq uds.edu

The Mother and Child Fellowship Program at Hebrew University-HadassahMedical OrganizationMission and Goals: A course for Palestinian physi-cians is held on maternal-child health issues at theSchool of Public Health and Community Medicine atHebrew University-Hadassah Medical Organization.

Project Partners: Hadassah Medical Organization,IsraelWebsite: http://www.jmeduk.org/portal/articles/30/1/Hadassah-And-The-Palestinian-Authority/Page1.htmlKey Contact:


Palestinian-Israeli Students Mental Health Working GroupMission and Goals: In January 2007, the Peres Centerfor Peace, working with the Gaza Community MentalHealth Program and Ossim Shalom – Social Workersfor Peace, conducted a workshop for Palestinian andIsraeli students studying mental health issues. Theparticipants came from Israel and the Gaza strip. Theworkshop focused on the connection between mindand body in reaction to trauma and treatment tech-niques developed by the Center for Mind-Body-Med-icine in Washington, D.C. Participants also wereinvolved in team building activities and touredJerusalem together. A second gathering was held inFebruary 2007 for students studying social work, psy-chology and related fields.

Project Partners: Peres Center for Peace, Israel: GazaCommunity Mental Health Program, Gaza Strip;Ossim Shalom – Social Workers for Peace, Israel;Center for Mind-Body Medicine, Washington, DC

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Website: http://peres-center.org/SectionProjectasp?cc=0111020404Key Contact:


Israeli-Palestinian Pediatric Rehabilitation ForumMission and Goals: The goal of the Pediatric Rehabil-itation Forum is to bring together Palestinian and Is-raeli professionals in the pediatric rehabilitation field(physiotherapists, occupational therapists and speechand language pathologists) to share information oncurrent developments and discuss practical and cul-turally sensitive ways to meet the needs of childrenwith developmental disabilities and their families. In2008, the Forum will begin an applied research projectto evaluate the effectiveness of a parent-centered inter-vention to improve the participation of school-agedchildren with cerebral palsy in the region.

Project Partners: JDC-Middle East ProgramWebsite: http://brookdale.jdc.org.il/default.asp?catid=%7BE6974578-E2BC-4A1E-955D-5104048B4ABC%7DKey Contact:


Partnership on Specialist Graduate Training for PhysiciansMission and Goals: This training program at Hadas-sah University Medical Center in Jerusalem allowsPalestinian physicians completing a full-time specialisttraining course to receive a diploma that will allowthem to provide medical care in their home towns inthe West Bank and Gaza. Physicians who have com-pleted this program often return to Hadassah Hospitalto participate in meetings, receive medical consulta-tions on their patients if needed, and in some instances,continue to work at Hadassah Medical Center. Eight toten Palestinian physicians participate in this programannually. Approximately thirty physicians have com-pleted this specialty training program, which is coordi-nated with the Palestinian Authority. Many types ofspecialty care were previously unavailable in the Pales-tinian Territories, including dermatology, endocrinol-

ogy, oncology, hematology, radiology, anesthesiologyand neurosurgery. A doctor who specialized in neuro-surgery at Hadassah Medical Center is now the Headof Neurosurgery at Beit Jallah Hospital near Bethle-hem, and a physician who received specialist trainingin neurology at Hadassah Hospital is now one of themost prominent neurologists in the West Bank and onthe staff of the Beit Jallah Hospital. This program isone of the many cooperative programs initiated byHadassah Medical Center, as part of their mission toserve as a bridge to peace.

Hadassah Medical Center was founded and is ownedand supported by Hadassah, the Women’s Zionist Or-ganization of America.

Project Partners: Hadassah University Medical Or-ganization, Israel; Palestinian Authority and Pales-tinian health professionals

Website: www.hadassah.org.il

Key Contact:


Peace of Mind Initiative – Peres Center for PeaceMission and Goals: The Civil Society Cooperation andDialogue Unit of the Peres Center for Peace establishedthe “Peace of Mind” Initiative in 2004. The mission ofthis Initiative is to promote cooperation between thePalestinian and Israeli mental health sectors and to en-courage the exchange of knowledge and expertise. Thisproject brings together Palestinian and Israeli mentalhealth professionals (psychologists, psychiatrists, socialworkers, educational consultants and others) throughworking group activities led by joint professional teamsthat address specific clinical topics. The Japanese Gov-ernment has helped sponsor two working groups on“Socio-Emotional Development of Infants and Tod-dlers” (2004-2006) and investigating “Community In-tervention in Times of Crisis” (2005). In addition to theworking group activities, the Peres Center recently helda public meeting on “Dealing with Trauma: The Role ofMental Health Professionals in Conflict Societies, theIsraeli-Palestinian Case” (2006).

Project Partners: Peres Center for Peace, Israel;Japanese government; Palestinian and Israeli Men-tal Health Professionals

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Website: http://peres-center.org/SectionProject.asp?cc=01110202Key Contact:


Pediatric Hematology-Oncology Unit: A Partnership of Augusta Victoria Hospitaland Hadassah Medical OrganizationMission and Goals: This initiative provides supportto the Pediatric Oncology Center for the diagnosis andtreatment of cancer in children at Augusta VictoriaHospital in East Jerusalem, in cooperation with the De-partment of Pediatric Hematology-Oncology at Hadas-sah Medical Organization in Israel. The programincludes an intensive training program in specializedcare for clinical and supportive teams and services. Italso includes an acquisition program for equipmentand supplies to establish a point-to-point broadbandtelemedicine network that can enable the support teamat the Hadassah Medical Center to provide medicalconsultations to the Palestinian Hematology-Oncologyteam at Augusta Victoria Hospital. Assistance is alsobeing provided to physically refurbish the PediatricDepartment at Augusta Victoria Hospital. FifteenPalestinian doctors and medical personnel have com-pleted a 2-year training program in Israeli hospitals.

Project Partners: Peres Center for Peace, Israel; Au-gusta Victoria Hospital, East Jerusalem; HadassahMedical Organization, IsraelWebsite: http://www.peres-center.org/SectionProject.asp?cc=01140203Key Contact:


Save A Child’s Heart – Heart of the Matter ProjectMission and Goals: Save a Child’s Heart (SACH) pro-vides free pediatric heart surgery and follow-up carefor children in developing countries. The organizationoperates out of the Edith Wolfson Medical Center in asuburb of Tel Aviv, Israel. Since its founding 13 years

ago, SACH has provided lifesaving open-heart surgeryto over 2000 children from developing countries, in-cluding 900 children from the Palestinian Authority.SACH has been working in cooperation with promi-nent cardiologists from the West Bank and Gaza sinceits founding.

Over the past four years, Save a Child’s Heart has beenconducting the Heart of the Matter project, which pro-vides free cardiac treatment for Palestinian childrenand offers capacity building for Palestinian physiciansthrough an outreach training program in pediatric car-diac care. The Heart of the Matter project has been co-sponsored by the European Commission’s Partnershipfor Peace Program. Under the auspices of this project,SACH was able to substantially increase the number ofPalestinian children treated and Palestinian physicianstrained: over 800 Palestinian children have receivedcare at a free weekly cardiology clinic for Palestinianchildren, and over 400 Palestinian children have under-gone open-heart surgery under this project. SACH hasalso provided in-depth post-graduate training forPalestinian physicians in pediatric cardiology, anesthe-siology and prenatal diagnosis, and coordinated jointmedical conferences and seminars between physiciansfrom the Palestinian Authority, Israel and the interna-tional medical community. The Israeli and Palestiniancardiologists examine children on a daily basis both inIsrael and the Palestinian Authority, and conduct jointconsultations on the children’s cases. When needed, thePalestinian children are referred for treatment at theEdith Wolfson Medical Center. SACH also conductedsurveys and published two reports assessing the effectof SACH activities on the attitudes of Palestinian andIsraeli parents of children hospitalized during the pro-gram towards the members of each other’s communi-ties. The program has also assessed the level ofcooperation and communication between Palestinianand Israeli physicians participating in the program. Thefunding received by the EU Commission has recentlyended and SACH is currently seeking support in orderto maintain the scope of this project.

Project Partners: Edith Wolfson Medical Center, Israel;West Bank and Gaza Cardiologists and HospitalsWebsite: http://www.saveachildsheart.orgKey Contact:

• Simon Fischer, JD - Executive Director, Save aChild’s Heart Foundation. email: director@ saveachildsheart.org

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Saving Children ProjectMission and Goals: The “Saving Children” projectwas launched in 2003 to facilitate the referral of Pales-tinian infants and children to Israeli hospitals for com-plex case and diagnostic evaluations and surgicalprocedures, when such services are unavailable in thePalestinian Authority. The Peres Center facilitates lo-gistical arrangements and covers the cost of the proce-dures for these children. The project is based on anextensive referral network of Palestinian pediatricianswho review, prioritize, and refer the cases accordingly.One specific project involves children with severe hear-ing impairments who require cochlear implants (CI).As part of the program, Palestinian speech therapistsas well as ear, nose and throat physicians are beingtrained in audiometry and advanced ear, nose, andthroat (ENT) surgical procedures.

Project Partners: Peres Center for Peace, Israel;Hadassah Medical Organization, Israel; Al-HaadahWomen’s Association Center, Ramallah; AugustaVictoria Hospital, East Jerusalem; Micha JerusalemOrganization, Israel; Sheba Medical Center, IsraelWebsite: http://www.peres-center.org/Section Project.asp?cc=01140201

Saving Children Project - Educational ComponentMission and Goals: To enhance the skills of Palestin-ian and Israeli pediatricians, the Saving Children Pro-ject has facilitated a number of conferences thatengage Palestinian, Israeli and Italian pediatricians,providing a forum for the exchange of knowledgeand expertise. Since 2005, two conferences have beenconvened each year in Israel, the West Bank, or Italy.Past conference topics included Advanced PediatricLife Support training at Augusta Victoria Hospital inEast Jerusalem and a two day meeting on pediatriccardiology and cardiac surgery. Physicians partici-pating in “Saving Children” also attended the 2007International Conference on Chronic Disorders inChildren organized by the Pediatric Department atHadassah Medical Organization.

Website: http://www.peres-center.org/SectionProject.asp?cc=0114020101

Slim Peace Support GroupsMission and Goals: In February 2006, Director YaelLuttwak filmed a documentary entitled “A Slim

Peace” that tells the story of American settlers, Pales-tinians, Israelis and Bedouins who participated in aweekly nutrition and weight loss support group fa-cilitated by both a Palestinian and Israeli dietician. Inresponse to the film, the United Kingdom Founda-tion, Charities Advisory Trust, funded Slim Peace Nu-trition and Weight Loss support groups lead bydietician Suha Khoury. The groups were establishedin October 2007.

Project Partners: A Slim Peace Ltd; the United King-dom Foundation, Charities Advisory Trust

Website: http://homepage.ntlworld.com/discod og/slimpeace/html/groups.html

Key Contacts:

• Odelya Gertel – Program Coordinator/Facilitator, Slim Peace Groups.email: Odelya.slim [email protected]

• Yael Luttwak – Director, A Slim Peace. email: [email protected]

Trauma Care Training Course – A Partner-ship of the Palestinian Red Crescent Societyand Hadassah Medical Organization

Mission and Goals: The Palestinian Red Crescent So-ciety (PRCS) and the Hadassah Medical Organizationhave been working together to improve trauma carein the region. This major joint activity has involvedconducting two trauma courses organized by Hadas-sah Medical Organization. The objectives of thecourse were to improve trauma care in the region, toimprove communication between the PRCS workersand the staff of the Hadassah Trauma Unit, and topromote cooperation in their joint work through peo-ple-to-people exchanges. The trauma courses weretaught in Arabic and English. The first conference wasattended by 18 people from the West Bank and thesecond by 23 students from Gaza and the West Bank.The courses included three weeks of lectures, demon-strations, and on-site visits as well as a one-week ex-perience related to clinical areas, including surgery,emergency medicine, the trauma unit, orthopedics,neurosurgery, the recovery room, and the respiratoryand pediatric intensive care units. The course, orig-inally designed for nurses, paramedics and ambu-lance drivers, has also been delivered to physicianswith a specially designed curriculum.

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Project Partners: Hadassah Medical Organization,Israel; Palestinian Red Crescent Society, West Bankand GazaKey Contact:


Umbilical Cord Blood BankingMission and Goals: Developed in partnership withMagen David Adom in Israel and the Palestinian RedCrescent Society, this initiative provides Palestinianswith the opportunity to share in the benefits of cordblood banking. This contribution to local and interna-tional umbilical cord blood banks might be used in thefuture for procedures such as bone marrow transplan-tation. Relatively little HLA (Human Leukocyte Anti-gen – tissue type matching for transplant purposes)data is available from the Arab world, and thus thework of this initiative may help enhance the survivalchances of Palestinian children with leukemia andother major blood disorders. Palestinian nurses andmidwives have received training on the extractionprocess for umbilical cord blood in Israeli and Pales-tinian hospitals as well as in Palestine from Israelihematologists and nurses.

Project Partners: Peres Center for Peace, Israel;Magen David Adom, Israel; Palestinian Red Cres-cent Society, West Bank and GazaWebsite: http://www.peres-center.org/SectionProject.asp?cc=01140204

Youth Voices Middle EastMission and Goals: The goal of this project, organizedby CISEPO (established and led since 2004 by Profes-sor Harvey Skinner, Dean of Health, York Universityand former Chair, Department of Public Health Sci-ences, University of Toronto), is to examine ways to en-gage youth in health promotion activities and createyouth driven community action in the Middle East.Using low-cost technologies such as photography aswell as Internet-based approaches, young people par-ticipating in this initiative document aspects of theircommunities and take action on selected issues of im-portance to them. Through these projects, youth learncooperation, research and leadership skills. This ini-tiative explores the potential of Internet technology to

permit young people from diverse communities to in-teract in their own spaces, with the goal of creating in-novative models for community health promotion.While the initial project was conducted in Israel’sBedouin community in 2005, it has expanded sincethen to include Israeli, Palestinian, and Jordanianschools in subsequent years.

Project Partners: Canada International Scientific Ex-change Program (CISEPO), CanadaWebsite: http://www.globalyouthvoices.org/middle-east/index.htmlKey Contact:

• Professor Arnold Noyek, MD, FRCSC, FACS –Chair, Canada International Scientific ExchangeProgram (CISEPO). email: arnold.noyek@utor onto.ca

Selected Organizations Engaged in Palestine/Israel Cooperative Health ProgramsAl-Quds UniversityDescription: Al-Quds University was founded in 1984,with its official constitution written in 1993. It is theonly Arab University in Jerusalem, and provideshigher education and community services within theJerusalem area and to the neighboring towns, villagesand refugee camps in the West Bank. It has ten aca-demic faculties on four campuses: Arts, Science andTechnology, Medicine, Dentistry, Public Health, Law,Qur’an and Islamic Studies, Health Professions, Engi-neering, and Jurisprudence. These faculties accommo-date more than 6000 students from the Jerusalem areaand from the districts of Bethlehem, Hebron, Jenin,Jericho, Nablus, Ramallah and Tulkarem. Faculty andstudents from Al-Quds University have participatedin numerous joint research and training projects withIsraelis related to health and medicine.

Selected Projects: Brandeis University/Al-QudsUniversity partnership; Child Nutrition in Israeland Palestine: Seeking Joint Initiatives; Child Reha-bilitation Initiative for Safety and Hope (CHERISH);Empowerment and Resilience in Children Every-where (ERICE); International Network of Knowl-edge through Electronic Learning; Middle EastAssociation for Managing Hearing Loss (MEHA);

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Middle East Association for Mother and ChildHealth (MEMCHA); Middle East Consortium on In-fectious Disease Surveillance (MECIDS); MiddleEast Symposium on Dental Medicine; Student Sum-mer Cooperative ProgramWebsite: http://www.alquds.edu/Key Contact:

• Hassan Dweik, MSc, PhD - Executive Vice Presi-dent, Al-Quds University. email: hdweik@ planet.edu

American Jewish Joint Distribution Commit-tee – JDC Middle East ProgramDescription: The American Jewish Joint DistributionCommittee (JDC) is an apolitical, non-partisan organ-ization devoted to sponsoring rescue, relief and recon-struction programs for Jews throughout the world. In1993, JDC launched a Middle East Program to promotecooperation among health and rehabilitation profes-sionals in the region. Program activities aim to developservice delivery models, provide professional-to-pro-fessional seminars and training, and build local capac-ity. Currently, the program is focused on pediatrichealth, disability and rehabilitation, and learning fromthe cooperative experience. In partnership with otherorganizations, the JDC-Middle East Program is cur-rently engaged in the Child Rehabilitation Initiative forSafety and Hope (CHERISH) for the psychosocial well-being of Israeli and Palestinian children, the Empow-ering Communities through Home Safety (ECHOS)Project, and the Pediatric Rehabilitation Forum.

Selected Projects: Past projects include Coping withBreast Cancer among Palestinian and Israeli Women(Project COPE); Development of Palestinian Lend-ing Center for Medical Equipment; InternationalConference on Aging in the Mediterranean and theMiddle East; Study of Israeli-Palestinian Coopera-tion in the Health Field, 1994-1998Website: http://www.jdc.org/Key Contact:

• Randi Garber – Director, JDC – Middle EastProgram. email: [email protected]

Augusta Victoria HospitalDescription: The Augusta Victoria Hospital, a recipientof funding from the Lutheran World Federation, pro-

vides health services for Palestinian refugees in cooper-ation with the United Nations Relief and Works Agency(UNRWA). The hospital provides training programsfor health professionals and has nine major medical de-partments. The Hospital is involved in numerous co-operative programs, including “Peace Through Health:Partnership in Emergency Medicine,” a trilateral pro-gram between Augusta Victoria Hospital, HadassahMedical Organization, and Brigham and Women’s Hos-pital in Boston, Massachusetts.

Selected Projects: Hadassah-Augusta Victoria Hos-pital Exchange Program; Medilink - Training Pales-tinian Doctors in Israel; Peace through Health:Partnership in Emergency Medicine; PediatricHemato-Oncology Unit; Saving Children ProjectWebsite: http://www.avh.org/Key Contact:

• Dr. Tawfiq Nasser - Chief Executive Officer/Director General, Augusta Victoria Hospital.email: [email protected]

Ben Gurion UniversityDescription: Ben-Gurion University is a major centerfor education and research, with over 17,000 studentsenrolled in the faculties of Engineering Sciences,Health Sciences, Natural Sciences, Humanities andSocial Sciences, the Guilford Glazer School of Busi-ness and Management and the Kreitman School ofAdvanced Graduate Studies. It also includes the Na-tional Institute for Biotechnology in the Negev, theJacob Blaustein Institutes for Desert Research, the Al-bert Katz International School for Desert Studies andthe Ben-Gurion Research Institute for the Study of Is-rael and Zionism. The University has campuses inBeer-Sheva, including the Marcus Family Campus, aswell as in Sede Boqer and Eilat. The Faculty of HealthSciences includes the Health Sciences GraduateSchool, the Joyce and Irving Goldman MedicalSchool, the Recanati School for Community HealthProfessions, the Medical School for InternationalHealth (in cooperation with Columbia UniversityMedical Center), the School of Medical LaboratorySciences , the School of Pharmacy, and the School ofContinuing Education.

Selected Projects: Bedouin Genetic Research Pro-ject; Cerebral Palsy Collaboration; Child Nutritionin Israel and Palestine: Seeking Joint Initiatives

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Website: http://web.bgu.ac.il/Eng/Home/Key Contact:

• Sofer Shaul, M.D. – Dean, Faculty of HealthSciences, Ben-Gurion University. email: shsofer@ bgu.ac.il

Canada International Scientific ExchangeProgram (CISEPO) and the Peter A. Silverman Centre for International HealthDescription: The Canada International Scientific Ex-change Program (CISEPO) works to build peace in theMiddle East by promoting cooperation between healthprofessionals and enriching exchanges in academicmedicine, public health and health care. CISEPO wasestablished in 1984, and began developing cooperativeprograms in health between Jordanians and Israelis in1995; Palestinians joined the initiative in 1997.CISEPO, in conjunction with the American CISEPO(founded by Dr Robert Shprintzen of Upstate MedicalUniversity, Syracuse; Dr Gavin Setzen of Albany; andDr. Dennis Bojrab and Dr. Shukri David of Detroit), hasarranged for more than 2,500 Arabs and Israelis tomeet in the Middle East through joint educational andresearch projects and public workshops. CISEPO alsosponsors research and education initiatives, includingcontinuing medical education exercises, joint planningmeetings between heads of Palestinian, Israeli and Jor-danian universities, and cooperative research projectsbetween Israelis and Palestinians. The Peter A. Silver-man Centre for International Health is located at theMount Sinai Hospital in Toronto, Canada. The Centerworks through its CISEPO program to develop rela-tionships between the hospital and global partners tobuild a “Network of Knowledge” for health and sci-ence. The Peter A. Silverman Center has trained morethan 100 health professionals and students in Canadaand internationally and brought more than 2,500health professionals across borders to cooperate onhealth projects, including health professionals from theMiddle East. Furthermore, the creation of the Peter A.Silverman Global eHealth Program (PASGeP) and thedevelopment of the Canadian Connection Collabora-tion provides eHealth programming for capacitybuilding in Canada and the Middle East including Is-rael and the Palestinian Territories.

Selected Projects: Genetics Research Collaboration;International Network of Knowledge through Elec-

tronic Learning; Middle East Association for Man-aging Hearing Loss (MEHA); Middle East Associa-tion for Mother and Child Health (MEMCHA);Middle East Youth Smoking Website Cultural Adap-tation Project; Student Summer Cooperative Pro-gram; Youth Voices M.E.Website: http://128.100.113.105/ andhttp://www.mtsinai.on.ca/PASCIH/default.htmKey Contacts:

• Professor Arnold Noyek, MD, FRCSC, FACS –Chair, Canada International Scientific ExchangeProgarm (CISEPO). email: arnold.noyek@ utoronto.ca



Edith Wolfson Medical CenterDescription: The Wolfson Medical Center is located inHolon on the Tel Aviv / Jaffa border and has over 60 de-partments and wards. The Wolfson Medical Center is anaffiliate of the Sackler School of Medicine at the Tel AvivUniversity, and over 100 doctors employed by The Wolf-son Medical Center also hold positions at the Tel AvivMedical University in Tel Aviv, Israel. The Edith WolfsonMedical Center serves as the home for the Save a Child’sHeart program and many Canada International Scien-tific Exchange Programs (CISEPO) initiatives.

Selected Projects: International Network of Knowl-edge through Electronic Learning; Middle East Asso-ciation for Managing Hearing Loss (MEHA); MiddleEast Association for Mother and Child Health (MEM-CHA); Middle East Consortium on Infectious DiseaseSurveillance (MECIDS); Save a Child’s Heart; Stu-dent Summer Cooperative ProgramWebsite: http://www.wolfson.org.ilKey Contact:

• Yehudah Roth, MD – Israeli Co-Director,Canada International Scientific Exchange Program (CISEPO). email: [email protected]

• Simon Fisher, Adv. - Executive Director, Save aChild’s Heart. email: [email protected]

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Emek Medical CenterDescription: Known as an Israeli “hospital of peace,”Emek Medical Center is located in the city of Afula inNorthern Israel. It is a community hospital with Araband Jewish staff that serves a culturally rich popula-tion equally divided between Jews and Arabs. EmekMedical Center treats any person arriving at its en-trance who needs help – whether they are an IsraeliJew, Arab, Christian, Druze or Palestinian. At theheight of violence several years ago, Emek MedicalCenter treated hundreds of Palestinian men, womenand children. Prior to the outbreak of violence in 2000,Emek was involved with the Jenin Hospital exploringways to incorporate Palestinian children into a healthcare network. It has hosted day-long seminars forhealth care and hospital officials from the Palestinianterritories. The hospital also conducts exchanges withAmerican institutions, such as The Miriam Hospital ofBrown University and emergency medical teams fromCalifornia. Given Emek’s expertise in trauma care,these exchanges often focus on emergency medicineand disaster preparedness.

Selected Projects: Coexistence through Medicine;Treatment of Palestinian patientsWebsite: http://www.clalit.org.il/haemek/defaultEng.aspKey Contact:

• Dr. Larry Rich - Director of Development and International Public Relations, Emek Medical Center. email: [email protected]

Hadassah Medical OrganizationDescription: Hadassah Medical Center in Jerusalem isthe flagship of Hadassah, the Women’s Zionist Organi-zation of America. A leading teaching hospital and re-search institution, the Medical Center includes twouniversity hospitals and five health professionalschools operated in cooperation with Hebrew Univer-sity. Hadassah health professionals have participatedin numerous peace-building cooperative programswith Palestinian health care providers.

Selected Projects: Advanced Resuscitation Train-ing; Dermatology for Peace; Hadassah-AugustaVictoria Hospital Exchange Program; Hadassah –St. John Eye Hospital Human Resources Develop-ment Program in Ophthalmology; InternationalConference on Aging in the Mediterranean and theMiddle East; International Congress on Chronic

Disorders in Children; Master of Public HealthCourse at the Braun School of Public Health;Medilink - Training Palestinian Doctors in Israel;Middle East Symposium on Dental Medicine; Fel-lowship Program for Palestinian physicians; Peacethrough Health: Partnership in Emergency Medi-cine; Pediatric Hemato-Oncology Unit; SavingChildren; Specialist Graduate Training; TheTrauma CourseWebsite: http://www.hadassah.org.il/EnglishKey Contact:

• Ron Krumer - Director of External Affairs,Hadassah Medical Organization. email: ron@hadas sah.org.il

Healing Across the DividesDescription: Healing Across the Divides assists Israeliand Palestinian health care organizations in imple-menting bridge building programs that improve thehealth of both Israelis and Palestinians within a com-munity based framework. The organization has spon-sored initiatives related to diabetes monitoring andtreatment, breast cancer screening and treatment, andthe challenge of dual loyalty (simultaneous obligationsto patients and the state) among physicians. HealingAcross the Divides has worked with numerous organ-izations in Israel and the Palestinian Territories. Ratherthan support direct cooperative work, in each of its ini-tiatives, Healing Across the Divides funds at least oneIsraeli and one Palestinian community-based organi-zation, providing varied opportunities for them to in-teract as appropriate.

Selected Projects: A Diabetes and HypertensionMonitoring and Treatment System in Disadvan-taged Israeli and Palestinian Communities; BreastCancer Project; and Dual Loyalty ProjectWebsite: http://www.healingdivides.org/Key Contact:

• Norbert Goldfield, MD - Executive Director,Healing Across the Divides. email: [email protected]

Peres Center for PeaceDescription: The Peres Center for Peace is an inde-pendent, non-profit, non-partisan, non-governmentalorganization founded in 1996 by Shimon Peres, NobelPeace Laureate and the current President of Israel. The

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Peres Center for Peace aims to further Shimon Peres’vision of building peace through socio-economic co-operation, development initiatives, and people-to-people interaction. The Center has also been activelyinvolved in supporting Palestinian physicians train-ing in Israeli hospitals. Initiatives include the “Peacefor Sight” program (a three year initiative to trainPalestinian ophthalmologists, carried out in partner-ship with St. John Eye Hospital in East Jerusalem andHadassah Medical Center in Israel supported by theU.S. State Department) and Bridging the Gap (a twoyear program of monthly meetings of Palestinian andIsraeli pediatricians, carried out in partnership withMakassed Islamic Hospital, Augusta Victoria Hospitalin Jerusalem, the Palestinian Red Crescent SocietyHospital and the Pediatric Department at HadassahMedical Center at Mt. Scopus in Israel).

Selected Projects: Medilink - Training PalestinianDoctors in Israel; Palestinian-Israel Mental HealthStudents Working Group; Peace of Mind Initiative;Pediatric Hemato-Oncology Unit; Saving Children;Umbilical Cord Blood Banking InitiativeWebsite: http://www.peres-center.org/

Physicians for Human Rights — IsraelDescription: Physicians for Human Rights—Israelwas founded in 1988 with the goal of advancinghuman rights, in particular the right to health, in Is-rael and the Palestinian Territories. Physicians forHuman Rights conducts activities that integrate ad-vocacy and action to enact policies to improve healthand enhance provision of health care. Physicians forHuman Rights-Israel has more than 1150 members,over half of whom are health care providers. Cur-rently, the organization is overseeing several projectsin both Israel and the Palestinian Territories, as wellas running a mobile health clinic in the PalestinianTerritories and a clinic in Tel Aviv.

Selected Projects: Managing several projects in Is-rael and the Palestinian Territories, including a mo-bile health clinic in the Palestinian Territories and aclinic in Tel Aviv.Website: http://phr.org.il/phr/Key Contact:

• Dr. Ruchama Marton - President and Founder,Physicians for Human Rights, Israel. email: [email protected]

Rambam Health Care Campus (RHCC)Description: Rambam Health Care Campus (RHCC),established in 1938, is the largest medical center innorthern Israel. The medical center comprises 36 de-partments with some 1000 beds, 45 medical units, 9 in-stitutes, 6 laboratories and 30 administrative andmaintenance departments. It also includes the MeyerChildren’s Hospital. Some of the RHCC departments,are the exclusive providers of comprehensive servicesfor all of northern Israel, including trauma treatment,oncology, and neurosurgery. As an academic hospital,RHCC maintains teaching and research links with theTechnion’s Rappaport Faculty of Medicine, providinga clinical environment for diagnosis, treatment and re-search. Rambam Medical Center physicians treatPalestinian patients and also train Palestinian physi-cians, receiving financial support for these trainingprograms in large part from the Peres Center and theMiddle East Cancer Consortium

Selected Projects: Medilink - Training PalestinianDoctors in Israel; Middle East Cancer ConsortiumWebsite: http://www.rambam.org.il/Home+Page/

St. John’s Eye HospitalDescription: St. John’s Eye Hospital is the chiefprovider of expert eye care in the West Bank, Gaza andEast Jerusalem. The Hospital is renowned for itsteaching programs that are closely linked with Hadas-sah Medical Center and Al-Quds University MedicalSchool. Additionally, the hospital operates three com-munity health centers, a health clinic in the Gaza strip,and mobile outreach teams targeting isolated commu-nities. The hospital is committed to its goal of Vision2020 that aims to eliminate the main causes of prevent-able blindness as well as to implement affordable eyecare programs.

Selected Projects: Hadassah – St. John Eye HospitalHuman Resources Development Program in Oph-thalmology; Medilink - Training Palestinian Doctorsin IsraelWebsite: http://www.stjohneyehospital.org/Key Contact:

• Dr. Jeanne Garth - Medical Director, St. JohnsEye Hospital. email: [email protected]

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Tel Aviv University/Tel Aviv Sourasky Medical CenterDescription: Tel Aviv University is the largest univer-sity in Israel as well as the largest Jewish university inthe world. It is a major center for teaching and re-search, comprising nine faculties, 106 departments,and 90 research institutes. The Sackler Faculty ofMedicine is Israel’s largest institute of higher medicaleducation, and includes the School of Medicine, theSchool of Continuing Medical Education, the Schoolof Dental Medicine, the Stanley Steyer School ofHealth Professions, the Dr. Miriam and Sheldon G.Adelson Graduate School of Medicine, the Gold-schleger School of Dental Medicine, and the School ofPublic Health. Faculty from Tel Aviv University andthe Sackler Faculty of Medicine have been involvedin numerous joint research and training projects withtheir Palestinian counterparts.

Selected Projects: Child Nutrition in Israel andPalestine: Seeking Joint Initiatives; Empowermentand Resilience in Children Everywhere (ERICE);Genetic Research Collaboration; International Net-work of Knowledge through Electronic Learning;Middle East Association for Managing Hearing Loss(MEHA); Middle East Association for Mother andChild Health (MEMCHA); Middle East Consortiumon Infectious Disease Surveillance (MECIDS); Stu-dent Summer Cooperative ProgramWebsite: http://www.tau.ac.il/Key Contact:

• Yoseph A. Mekori M.D. – Dean, Sackler Facultyof Medicine, Tel Aviv University. email: [email protected]

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The health and medical fields provide special opportu-nities for building bridges between societies. Whetherthrough prevention programs, the delivery of healthservices, or conducting research, the quest to improvehealth facilitates cooperation between health care pro-fessionals and patients from across the region. Healthcare providers in Palestine and Israel who work to-gether do not simply deliver care and prevent illness.They have taken on a role as health diplomats, build-ing bridges between these two societies, creating ven-ues for cooperation, and laying the seeds for a peacefulfuture in the region.

The need to treat and prevent diseases and epidemicsof common concern in the region has necessitated co-operation in the health field between Palestinian andIsraeli scientists, clinicians, and public health practi-tioners for decades. The political climate has presentedmany challenges to the operation and sustainability ofcooperative programs. Nevertheless, a significantgroup of individuals and organizations from bothsides of the border remain committed to continuing towork together. Their cooperation serves as a vehicle forstrengthening health systems, improving the healthstatus of people in the region, and creating the profes-sional and personal relationships that build trust andcreate peaceful ties between the societies.

The goal of the Palestine/Israel Health Initiative hasbeen to foster cooperation and facilitate interaction be-tween health and medical experts in Palestine and Is-rael to improve the health of people in the region aswell as to promote increased cooperation and under-standing. During the winter and spring of 2008, thePalestine/Israel Health Initiative (supported by theCenter for the Study of the Presidency in Washington,D.C.), convened meetings in Israel, the West Bank, EastJerusalem, and the United States that brought togetherPalestinian, Israeli, and U.S. health experts to discussareas of common concern and priorities for advancinghealth in this region. Meetings culminated in two daysof Working Group sessions in East Jerusalem, whereover fifty participants gathered to share insights,knowledge, and experiences. The meetings includedrepresentatives from the Ministries of Health, the NGOcommunity, the World Health Organization, USAID,

academia and the private sector as well as physicians,public health practitioners, and nurses from Palestine,Israel, and the United States. Working groups pro-duced joint recommendations for advancing coopera-tion between Palestinians and Israelis in the fields ofhealth education and training, primary care and pre-vention, emergency medicine and disaster prepared-ness, medical research, and the application ofinformation technology to improve health.

Another product of the Initiative has been to begin amapping of the programs and organizations involvedin Palestinian-Israeli health cooperative activities. Fewstudies have been conducted in recent years to iden-tify such initiatives. This has impeded investment inand growth of these activities as well as networkingbetween those involved. The Initiative consequentlyproduced a Selected Inventory of ongoing cooperativeactivities between Israelis and Palestinians working toimprove health in the region. The creation of the Se-lected Inventory included in this report has revealedover forty programs and thousands of individualscommitted to working together across borders to ad-vance the health of people in Palestine and Israel. It il-lustrates the importance and necessity of the workthat these programs accomplish. The Selected Inven-tory provides an important lens into the inspiringdaily interactions that occur, often below the radar, be-tween people who believe that the need to heal tran-scends politics and the need to advance health knowsno borders.

The process of convening meetings between healthprofessionals in Palestine and Israel, however, wasoften challenging. Political tensions, border crossing is-sues, and funding constraints all created obstacles tobringing together Palestinian and Israeli health andmedical experts over the course of this Initiative, de-spite their commitment and willingness to attend jointmeetings, collaborate, and expand opportunities towork together. Furthermore, sustaining cooperationand communication after the conclusion of meetingsis a problem faced by most initiatives and a particularproblem in this region where tensions can restrict com-munication and mobility. Given these constraints in theregion, a new paradigm for connecting health profes-

Conclusion

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sionals and patients is required, facilitating greater in-teraction that is immunized from geopolitical divides.In the Information Age, the Internet and new mediacan enable communication and engagement whenmeaningful interaction would otherwise be impossi-ble, connecting large numbers of people despite thechallenges of geography, distance, and time.

A critical insight of the Palestine/Israel Health Initia-tive has been that information technology and newmedia can be a vehicle to successfully enhance cooper-ative activities in health and medicine globally, andspecifically between Palestinians and Israelis, both byfacilitating dialogue and communication and aiding inpublic health and service delivery. The creation of thePIHI “Health e-Commons” Internet workspace overthe course of the Initiative has allowed the health andmedical experts involved in this initiative to conveneonline to share best practices, health information, anddata through the Internet. The space connects Palestin-ian, Israeli, and U.S. participants in the PIHI WorkingGroups for continuing cooperation to share insights,best practices, and applications of information technol-ogy to facilitate cooperation.

The “Health e-Commons” enables its membership tomaintain dialogue, interaction, and information shar-ing as well as to access resources of mutual benefit be-tween and beyond meetings. This online networkingsite helps sustain dialogue between meetings as wellas to grow communities. The Initiative is also estab-lishing a public health information portal for sharinghealth information and best practices in the region,with resources in Hebrew, Arabic, and English. Boththe online workspace and public health portal are cre-

ative tools that can help to ensure the strong and sus-tainable future for cooperative activities in the area aswell as to increase knowledge and awareness of healthissues in the region.

It is hoped that by promoting cooperative activities inhealth and medicine, the products of the CSP Pales-tine/Israel Health Initiative will make meaningful con-tributions to the continuing process of building trustand reconciliation, paving the way toward a morepeaceful future in the region. In many ways, healthcare professionals in this area of our world have takenon a new role in addition to their traditional duties tocure and prevent illness. This special role of “peacepromotion” through health is a vital function thatphysicians, public health practitioners, and otherhealth care providers play when working in areas ofconflict. Cooperative activities between Palestinianand Israeli medical professionals are necessary both toimproving health and serving the broader social func-tion of building a peaceful future for this region.

The words of President John F. Kennedy remind uswhy this agenda is so important: “Our most basic com-mon link is that we all inhabit this small planet. We allbreathe the same air. We all cherish our children’s fu-ture.” The common quest for good health knows noborders. Crossing societies, politics and cultures, thecooperative activities supported by the CSP Pales-tine/Israel Health Initiative are helping to foster in-creasing interdependence and interconnections in theregion and its shared humanity through the advance-ment of health.40

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End Notes


1 Blumenthal, Susan, “Health Diplomacy: Rx for Peace,” Washington Times, 26 August 2007.

2 World Health Organization (WHO), Regional Office for Europe, “Extract from Health For All Database: Israel,”http://www.euro.who.int/main/WHO/CountryInformation/ HFAExtracts?Country=ISR&language=English.

3 World Health Organization (WHO), Regional Office for the Eastern Mediterranean, “Country Profiles: Palestine,”http://www.emro.who.int/emrinfo/index.asp?Ctry=pal.

4 Israel Ministry of Foreign Affair,. “The Health Care System in Israel – An Historical Perspective,” 26 June 2002.

5 Ibid, 2.

6 Ibid, 3.


8 Israeli Ministry of Foreign Affairs, 2002.


10 Ibid.


12 Ibid.

13 Palestinian Central Bureau of Statistics, “Executive Summary of the Computer, Internet and Mobile Phone Survey,” Ramallah - WestBank, Palestine, April 26, 2007.

14 Palestinian Central Bureau of Statistics, “Population in the Palestinian Territory, 1997-2010,” Ramallah, Palestine, 1997.


16 World Health Organization, “Health Situation of Palestinian people living in the occupied Palestinian Territory: Statement by Dr.Gro Harlem Brundtland Director-General World Health Organization,” September 2002.

17 World Health Organization, Health Action in Crises, “Occupied Palestinian Territory,” July 2006.


19 Schoenbaum, Michael, A. Afifi, and R. Deckelbaum, Strengthening the Palestinian Health System, (2005), 17.

20 Palestinian National Authority, Ministry of Health, “Hospitals,” May 2005.

21 Ibid.


23 Palestinian National Authority, Ministry of Health, “Demographic and Health Characteristics of the Palestinian Population,” May 2005.

24 Palestinian National Authority, Ministry of Health, Health Planning Unit, “National Strategic Health Plan: Medium Term Develop-ment Plan 2008-2010,” December 2007.

25 Ministry of Health, Palestinian Authority, “National Strategic Health Plan,” 2007.

26 World Health Organization, “Health Conditions in the Occupied Palestinian Territory, Including East Jerusalem, and in the Occu-pied Syrian Golan: Report of the Israeli Ministry of Health to the Sixtieth World Health Assembly,” 15 May 2007.

27 Barnera, Tamara et al., “Study Report: Israeli-Palestinian Cooperation in the Health Field 1994-1998,” JDC-Brookdale Institute, JDC-Israel, AJJDC, Al-Quds University, May 2000.

28 Skinner, Harvey and Abi Sriharan, “Building cooperation through health initiatives: an Arab and Israeli case study,” Conflict andHealth, 2007, 8.

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29 World Health Organization, “Health Conditions in the occupied Palestinian Territory, Including East Jerusalem, and in the occupiedSyrian Golan: Report of the Israeli Ministry of Health to the Sixtieth World Health Assembly,” 15 May 2007.

30 Bridges: Israeli-Palestinian Public Health Magazine, http://www.bridgesmagazine.org/nindex.php.

31 “National Strategic Health Plan,” 35

32 “National Strategic Health Plan,” 19.

33 Ibid.

34 “Magen David Adom in Israel,” Partnerships in Profile 2002-2003.

35 “MDA in Israel,” American Friends of Magen David Adom.

36 “National Strategic Health Plan,” 41.

37 Ibid., 42.

38 Izabella Lejbkowicz et al., “Electronic medical record systems in Israel’s public hospitals,” Israeli Medical Association Journal, 6 (10):583-587.

39 Barnea, “Study Report: Israeli-Palestinian Cooperation in the Health Field 1994-1998,” May 2000.

40 Blumenthal, Susan, “Health Diplomacy: Rx for Peace,” Washington Times, 26 August 2007.

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Susan Blumenthal, M.D, M.P.A.Director, Palestine/Israel Health InitiativeDirector, Health and Medicine Program Center for the Study of the PresidencyFormer U.S. Assistant Surgeon General

Rear Admiral Susan J. Blumenthal, M.D., M.P.A. (ret.) serves as Director of the Health and Medicine Program atthe Center for the Study of the Presidency (CSP). She is also Director of the Palestine/Israel Health Initiative, acritical component of a program to advance trust and reconciliation in Palestine and Israel that was initially sup-ported by a planning grant from USAID. Dr. Blumenthal is the Founder of the initiative’s website MiddleEast-Health.org. She is a Clinical Professor at Georgetown and Tufts University Schools of Medicine, and Chair of theGlobal Health Program at the Meridian International Center. For more than 20 years, Dr. Blumenthal served insenior leadership positions in the U.S. Federal government as Assistant Surgeon General of the United States, asthe first Deputy Assistant Secretary of Women’s Health, as a White House advisor on health issues, as SeniorGlobal Health Advisor where she established a Middle East Health Initiative, and as a research branch chief atthe National Institutes of Health. She has been a pioneer in bringing major public health issues including globalhealth, women’s health, and disease and violence prevention to increased public and scientific attention. Dr. Blu-menthal has been at the forefront of harnessing information technology to improve health, having designed andimplemented several award-winning U.S federal government health websites. She has chaired many committees,conferences and commissions, published widely in the scientific literature, served as the health columnist formagazines and as Medical Director for an acclaimed television series on health. Admiral Blumenthal has receivednumerous awards including honorary doctorates and has been decorated with the highest medals of the U.S.Public Health Service for her national leadership and landmark contributions to improving health in the UnitedStates and worldwide.

Stephanie Safdi, M.PhilProject Manager, Palestine/Israel Health Initiative

Stephanie Safdi serves as the Project Manager for the Center for the Study of the Presidency’s Palestine/IsraelHealth Initiative, a key component of a program to build trust and reconciliation in Palestine and Israel initiallysupported by a planning grant from USAID. In 2005, Stephanie graduated summa cum laude with a Bachelor ofArts from Harvard University, with a concentration in History and Literature. Her undergraduate thesis wonthe Hoopes Prize, the highest university prize for an undergraduate thesis, the Ethnic Studies prize for the bestHarvard thesis related to ethnic studies, and the University prize for best History and Literature thesis. She wasawarded the Harvard-Cambridge scholarship to spend a year studying at Cambridge University in England,where she completed a Masters of Philosophy in Historical Studies. She subsequently completed a post-bac-calaureate fellowship at the Harvard Initiative for Global Health, where she researched global health issues, witha focus on quality, access, and financing of health care in the United States and abroad. Stephanie Safdi is a2008/2009 Fulbright Fellow in Israel, sponsored by Ben Gurion University of the Negev, where she is workingon public health outreach to communities in the region as well as providing leadership for the Palestine/IsraelHealth Initiative.

About the Authors

For additional information on the CSP Palestine/Israel HealthInitiative and the cooperative health programs described in thisreport as well as to submit descriptions of health projects and

resources to be included in future editions of this document and on the PIHI websites, please contact:

Susan Blumenthal, M.D., M.P.A.Stephanie Safdi, [email protected]

Center for the Study of the Presidency1020 19th Street, NW, Suite 250

Washington, DC 20036Phone: 202-872-9800

Fax: 202-872-9811www.thePresidency.org

Center for the Study of the PresidencyPresident: David M. Abshire, Ph.D.

Founded in 1965, the non-profit, non-partisan Center for the Study of the Presidency serves as theinstitutional memory of that high office, and applies the lessons of history to the challenges faced bythe President and Congress.

Mission:• Promote leadership in the Presidency and the Congress to generate innovative solutions to cur-

rent national challenges;• Preserve the historic memory of the Presidency by identifying the lessons from the successes and

failures of such leadership;• Draw on a wide range of talent to offer ways to better organize an increasingly compartmental-

ized Federal Government;• Educate and inspire the next generation of America’s leaders to incorporate civility, inclusiveness,

and character into their public and private lives and discourse.

Health and Medicine ProgramCenter for the Study of the Presidency

Director: Susan J. Blumenthal, M.D.

Health is vital to the economy, productivity, and national security of the United States. From thebeginning of our nation’s history, Presidents have played a significant role in steering a course ofaction for the health of the Nation. Applying lessons from previous Presidents and Administrations,the Health and Medicine Program of the Center for the Study of the Presidency (CSP) frames healthcare challenges and opportunities for the next President and Executive Branch of government, andcrafts recommendations to enhance public policymaking.

The program examines such health issues as re-engineering the health system to increase access,effectiveness, efficiency and decrease costs, health disparities, the chronic disease epidemic, fundingfor biomedical research, ethical issues arising with scientific discovery, the impact of globalizationwith the threat of bioterrorism and emerging diseases such as avian flu and obesity, and the potentialfor health diplomacy and peace-building through health.

The program is also leading an initiative to generate new strategies and actions for the next Presidentof the United States to accelerate progress in science and medicine to improve the health of people inAmerica and worldwide.

for additional information on the csp …m.p.h., and donna perry, r.n., ph.d., as well as suzanne...

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