Family Health Clinics in Lagiyya and Hura in the Naqab.

HCJ 786/04, Ahlam el-Sana, et al. v. Ministry of Health, et al.

Adalah filed a petition to the Supreme Court in 1/04 on behalf of two mothers, three married couples, all Palestinian Bedouin citizens of Israel living in Lagiyya and Hura, Physicians for Human Rights-Israel, the Galilee Society, the Regional Municipality of Lagiyya, and in Adalah’s own name demanding that the Ministry of Health (MOH) and the Ministry of Finance (MOF) allocate the necessary physician and nurse positions needed to operate two family health clinics in the Arab Bedouin towns of Lagiyya and Hura in the Naqab (Negev). According to the MOH, the role of family health clinics is to prevent infectious diseases through immunizations, to facilitate the early detection of health problems through regular check-ups, and to provide training and guidance to the local community for a healthy and disease-preventative lifestyle. Additional functions of family health clinics are to provide guidance to women on general health issues, domestic violence, and family planning.

The petition included affidavits from individuals living in the two towns describing the poor services provided by the existing clinics. At the time of the filing of the petition, there was one family health clinic operating in Lagiyya, providing health services to some 11,000 people who reside in the town and other surrounding unrecognized Arab Bedouin villages. The average annual birth rate in Lagiyya stands at 260. In 2003, there were 1,345 children between the ages of 0-6 living in Lagiyya; the number of children aged 0-14 stood at 2,934. The one family health clinic which was operating concurrently in Hura provided services to its 7,000 inhabitants as well as to Arab Bedouin living in the surrounding unrecognized villages. In 2003, there were 1,695 children between the ages of 0-4 living in Hura; the number of children aged 0-14 stood at 3,899. MOH regulations require that a family health clinic be established in any community with at least 30 births per year; the number of births in Lagiyya and Hura far exceeds this level.

The MOH acknowledged on various occasions the need for additional clinics, and recognized the lack of suitable health services in both villages. However, while the MOH approved the construction of an additional clinic in each town, it failed to open them, claiming a lack of the necessary funds to finance physicians and nurses. The petition argued that the MOH’s failure to operate the new clinics was illegal and violated the rights to life, health, dignity, and privacy. Adalah emphasized the necessity of staffing and operating these clinics, particularly noting that the Arab Palestinian Bedouin living in the Naqab have the highest infant mortality rate in Israel: 17.1 per 1,000 births, as compared with 4.7 per 1,000 births among Jewish Israelis living in this region.

In 4/04, the state responded to the petition, admitting that the family health care provided for the villages' residents was substandard, and committing that the MOH would allocate 3.5 positions (three registered nurses and a 0.5 physician position) needed to operate an additional family health clinic in each town. At a hearing held later in 4/04, Adalah argued that the posts should be filled immediately, given the low quality of health services being provided at the time. At Adalah’s request, the state undertook to submit a timetable and provide other logistical information for the implementation of this decision to the petitioners and to the Court by 5/04. After the state submitted this information, Adalah responded that, according to the required number of medical staff stipulated by the MOH's own criteria, the state's proposals were inadequate.

Result: In 7/04, the Court delivered its final decision on the petition. The Court decided that the petitioners had received what they had demanded in the petition, and ordered the MOH and MOF to pay legal expenses in the amount of NIS 5,000. The Court also decided that the petitioners reserve the right to approach the Court again, should the two clinics fail to provide suitable health services for the residents of the two villages.

H.C. 786/04, Ahlam el-Sana, et. al. v. Ministry of Health, et. al. (decision delivered 8/7/04).