On 15 July, US President Joe Biden capped off a trip to Israel and the occupied West Bank with a visit to East Jerusalem, where he pledged $100m in aid to hospitals in the occupied city, which suffered significant cuts in donor funding during the Trump administration.On its face, this appeared to be a good-faith attempt to provide needed health services. Yet, a Facebook post by Palestinian stand-up comedian Alaa Abu Diab captured much of the cynicism and disillusionment Palestinians felt towards the promised aid package: “We’re the only people in the world whom they don’t want to live nor die! #funding_the_hospitals”.
Abu Diab’s comment reflects the paradox of these types of sporadic funding announcements coupled with the reality of Biden’s visit: tacit approval of a system in Israel that human rights organisations like Human Rights WatchAmnesty International, and B’Tselem have recently recognised as apartheid, as have Palestinians for decades.

When questioned about the small but growing corner of the Democratic Party that has acknowledged this reality, Biden responded, “I think they’re wrong. I think they’re making a mistake. Israel is a democracy. Israel is our ally. Israel is a friend.”

Humanitarian efforts have long been used as political tools in conflict-affected environments, and the occupied Palestinian territories are among the most representative settings where this has been the case.

Indeed, Palestinian hospitals in Jerusalem are underfunded and in urgent need of support. East Jerusalem has more advanced hospitals, specialised doctors, and updated equipment than any other hospitals in the occupied Palestinian territories. As a result, the city draws patients from the West Bank and Gaza Strip.

But in the larger existing context, this $100m aid, while much needed, will do little to improve Palestinian health.

‘Medical apartheid’

Jerusalem has historically been at the centre of the Palestinian healthcare system. But ongoing Israeli policies that followed the occupation of East Jerusalem in 1967 transformed the city into a colonial frontier, a heavily militarised locale with the declared aim of keeping a Jewish majority in an “undivided capital”.

Discriminatory policies have dismembered the city by limiting land and zoning, promoting de-development, and cutting its historical and natural ties with neighbouring Palestinian cities. The health care system is no exception.

Palestinian patients from the West Bank or Gaza Strip in need of the advanced services available in East Jerusalem cannot merely access the city of their own volition. They require medical permits issued by the Israeli government.

Medical staff that live in the occupied West Bank similarly need work permits to enter the city. These movement restrictions, among other restrictive policies, have greatly damaged the hospitals in the city and slowly marginalised them in the Palestinian healthcare landscape.

Regulations of the pharmaceutical trade with the West Bank have forced Jerusalem hospitals to buy drugs at prices similar to the Israeli market, while lacking the same governmental and financial support.

Further, hospitals in Jerusalem are regularly subjected to Israeli military violence and raids, the most recent example being when the Israeli army raided the French hospital during the funeral of Shireen Abu Akleh, a Palestinian journalist who, as multiple independent sources have found, was killed by Israeli fire.