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Clinic Activities and Home Visits The Women's Health Mobile Clinic Training Health Education Psychosocial Health Women's Health and the Intifada 
The Women's Health Program (WHP), established by UPMRC in 1987 following grassroots initiatives, has since grown to reach Palestinian communities throughout the West Bank and Gaza Strip. It functions in 22 localities, covering a population area of 365,872. Since its inception, its mandate has expanded from providing antenatal gynecological examinations and family planning services to the provision of comprehensive packages of services addressing both the physical well being of women as well as their mental, social and environmental needs.The Women's Health Program focuses on addressing the major health issues that Palestinian women face throughout their lives. It combines direct service provision, preventative work through raising public awareness, training of health professionals, advocacy, coordination with other providers and the development of women's health protocols for national use. Through this program, women in even the most remote villages in Palestine have access to vital services such as health education; prenatal, postnatal, and family planning care; and a host of other basic and specialized services that address their specific needs. In the year 2002, the Women's Health program reached 70,688 women. Clinic Activities and Home Visits: The program's clinical activities include antenatal and postnatal care, family planning, gynecological services, pap smear testing and breast examinations. In 2002, our clinics provided antenatal services for 4,392 pregnant women. Among these women, there were 16,202 follow-up visits. During this time of closure and curfew, the clinics also work to identify high-risk pregnancies in order to assist these women in reaching the hospital. Home visits support the work of the clinics. The WHP's Community Health Workers (CHWs) visit pregnant women at high risk. In 2002, 1,054 women benefited from home visit activities. Home visits also reach post-natal women who gave birth at home or who were exposed to stress en route to the hospital due to closure or curfew. Twenty-four percent of pregnant women registered in our clinics for antenatal care received at least one post- natal home visit. During these visits, women and their children are examined and receive proper counseling and health education. 
The Women's Health Mobile Clinic:The women's health mobile clinic has become a vital component of WHP services. In times of the curfew and closure, the mobile clinic works to meet the newly emerging needs for health services in closed and isolated villages and cities. In 2002, it provided services to 10,114 women in the West Bank and Gaza including services for pregnant women, women in postnatal stages, and women with RTI. Training: The program also offers training in reproductive health to doctors and medical personnel on the national level. In response to the emergency, in 2002 the WHP particularly focused training related to obstetric emergencies and dealing with high-risk pregnancies. Seventy-eight people were trained in 2002. UPMRC also works on the national level by contributing to the nationally adopted protocols and guidelines for the different components. Health Education: UPMRC's Women's Health Program extends beyond direct service provision, it strives to reach communities through outreach activities such as health education campaigns. In 2002, the program reached 15,251 beneficiaries with its health education materials. The health education materials are designed to target different segments of society according to their needs. Psychosocial Health: According to a UN report, "…the current crisis has adversely affected not only Palestinians' general physical health and health-care facilities, but also their psychosocial well-being. Trauma and stress have already become a serious health problem, especially for women and young people.[1]" In response to this situation, the WHP program places special emphasis on socio-psychological health. Our staff of social workers and counselors address issues such as violence, gender, low self-esteem and psychological problems with our patients. In 2002, UPMRC provided counseling services for 8,511 women. The program also cooperates with other NGOs working in the area of social and psychological matters in order to enhance counseling efforts. Different types of psychosocial activities were designed in order to meet the different needs of society. These activities included lectures and group counseling, designed to reach a widespread audience; individual counseling and home visits. One of the main tools of the program for addressing psychosocial issues is the widespread use of lectures and group counseling in order to draw a spectrum of different societal groups and introduce them to the psychosocial issues most pertinent to their situation. A range of topics was developed in order to address the different issues faced by different sectors of society. The topic of behavioral changes in children was the most emphasized in 2002, followed by stress management and gender and violence. Women's Health and the Intifada: Health conditions for women have been severely threatened by the current national emergency. According to a UN report, "The adverse impact of closures and prolonged curfews on Palestinian villages and towns have severely restricted the access of civilians, especially women, to life-saving services such as emergency obstetric care.[2]" The complete siege on Palestinian cities and villages has hindered women doctors and Community Health Workers from making routine and important prenatal visits to pregnant women. A majority of pregnant women who used to give birth with the attendance of a doctor or a midwife are now unable to do so, thus risking the lives of the mother and the infant. According to a UN report Economic and social repercussions of the Israeli occupation on the living conditions of the Palestinian people in the occupied Palestinian territory. |
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The percentage of pregnant women unable to access antenatal care is nearly fives times higher now than before September, 2000 (20% as compared to 4%). There has been a 100% increase in home deliveries, and a shocking 56% increase in stillbirths since the Intifada began (Figures from the Ministry of Heath). Furthermore, at least 49 births have taken place at checkpoints when women in labor were forbidden from passing to reach the hospital. UPMRC has developed practical steps to cope in this situation in which women in labor are often left on their own, without a skilled birth attendant. We distribute delivery kits to our clinics and have trained our community health workers on how to assist parturient women. In 2002, the program trained 78 health providers in emergency obstetrics. We deployed women's mobile health clinics and conduct training in obstetric emergencies and established liaisons with local midwives and traditional birth attendants. During times of closure and curfew when leaving home means taking the risk of being shot and telephone lines often became the only way for women to seek help. Thus, the WHP has begun offering over-the-phone consultations for women. In 2002, there were 18 documented cases in which women giving birth were assisted over the phone by our staff. Two of our doctors, who were living in villages and who were able to get supplies from UPMRC assisted in 16 home deliveries. They worked in cooperation with staff from the Red Crescent Hospital in Ramallah, the Palestine Patients Friends' society in Jenin and the Rafidia hospital in Nablus. The second step was to inform the community about the availability of trained and equipped health providers in their communities and neighborhoods. For this purpose the WHP launched a campaign funded and supported by the United Nations Population Fund (UNFPA) to raise the public awareness and to establish a network of communication between the women and the health providers and health facilities. Materials, designed in line with Information, Education and Communication (IEC) protocols, were developed to inform the women about how to prepare themselves for delivery and how to contact health providers. To further assist pregnant women in danger of giving birth at home, a special program on the subject of home deliveries was produced and broadcasted on the local television station in Nablus in cooperation with the MOH and the Rafidia hospital. The title of the program was "How to Manage the Delivery at Home Assisted by Untrained Relatives." ------------------------ [1]"Report of the Special Committee to Investigate Israeli Practices Affecting the Human Rights of the Palestinian People and Other Arabs of the Occupied Territories" UN General Assembly Document A/57/207, 16 September 2002. [2] "Report of the Special Committee to Investigate Israeli Practices Affecting the Human Rights of the Palestinian People and Other Arabs of the Occupied Territories" UN General Assembly Document A/57/207, 16 September 2002. [3] "Economic and social repercussions of the Israeli occupation on the living conditions of the Palestinian people in the occupied Palestinian territory, including Jerusalem, and the Arab population in the occupied Syrian Golan." Economic and Social Council, Substantive session of 2002, 1-26 July 2002. General Assembly Document A/57/63-E/2002/21 |
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