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Healthcare under siege: Geopolitics of medical service provision in the Gaza Strip

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  • Smith, Ron J.

Abstract

Siege, a process of political domination aimed at isolating an entire population, represents a unique threat to healthcare provision. This study is a qualitative examination of the impacts of siege on the practices and systems that underlie health in Gaza. Data are from participant observation conducted over a period of six years (2009–2014), along over 20 interviews with doctors and health administrators in the Non-Governmental Organisation (NGO), Governmental, and United Nations sectors. Analyses were informed by two connected theories. First, the theory of surplus population was used, an idea that builds on Marx's conception of primitive accumulation and Harvey's accumulation by dispossession. Second, Roy's theory of de-development was used, particularly as it is connected to neoliberal trends in healthcare systems organizing and financing. Findings indicate that siege impinges on effective healthcare provision through two central, intertwined processes: withholding materials and resources and undermining healthcare at a systems level. These strains pose considerable threats to healthcare, particularly within the Ministry of Health but also within and among other entities in Gaza that deliver care. The strategies of de-development described by participants reflect the ways the population that is codified as a surplus population. Gazan society is continually divested of any of the underpinnings necessary for a well-functioning sovereign health care infrastructure. Instead of a self-governing, independent system, this analysis of health care structures in Gaza reveals a system that is continually at risk of being comprised entirely of captive consumers who are entirely dependent on Israel, international bodies, and the aid industry for goods and services. This study points to the importance of foregrounding the geopolitical context for analysis of medical service delivery within conflict settings. Findings also highlight the importance of advocating for sovereignty and self-determination as related to health systems.

Suggested Citation

  • Smith, Ron J., 2015. "Healthcare under siege: Geopolitics of medical service provision in the Gaza Strip," Social Science & Medicine, Elsevier, vol. 146(C), pages 332-340.
  • Handle: RePEc:eee:socmed:v:146:y:2015:i:c:p:332-340
    DOI: 10.1016/j.socscimed.2015.10.018
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    References listed on IDEAS

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    1. Pfeiffer, J. & Johnson, W. & Fort, M. & Shakow, A. & Hagopian, A. & Gloyd, S. & Gimbel-Sherr, K., 2008. "Strengthening health systems in poor countries: A code of conduct for nongovernmental organizations," American Journal of Public Health, American Public Health Association, vol. 98(12), pages 2134-2140.
    2. Ityavyar, Dennis A. & Ogba, Leo O., 1989. "Violence, conflict and health in Africa," Social Science & Medicine, Elsevier, vol. 28(7), pages 649-657, January.
    3. Gibbons, E. & Garfield, R., 1999. "The impact of economic sanctions on health and human rights in Haiti, 1991-1994," American Journal of Public Health, American Public Health Association, vol. 89(10), pages 1499-1504.
    4. Di Muzio, Tim, 2007. "The 'Art' of Colonisation: Capitalising Sovereign Power and the Ongoing Nature of Primitive Accumulation," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 12(4), pages 517-539.
    5. Beckerleg, S. & Lewando-Hundt, G. & Eddama, M. & el Alem, A. & Shawa, R. & Abed, Y., 1999. "Purchasing a quick fix from private pharmacies in the Gaza Strip," Social Science & Medicine, Elsevier, vol. 49(11), pages 1489-1500, December.
    6. Harvey, David, 2005. "The New Imperialism," OUP Catalogue, Oxford University Press, number 9780199278084.
    7. Maina-Ahlberg, Beth & Nordberg, Erik & Tomson, Göran, 1997. "North-South health research collaboration: Challenges in institutional interaction," Social Science & Medicine, Elsevier, vol. 44(8), pages 1229-1238, April.
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