The global health community must realize how important peace and other political factors are to human health. This is one of the points that will be underlined by Akihiro Seita when he speaks at this year’s Global Week at the Sahlgrenska Academy. Akihiro Seita is the Director of the UN Relief and Works Agency health programme, the health programme within the UN’s relief organization for Palestine refugees.
Since the establishment of UNRWA in December 1949, social and economic changes have impacted on demographic and epidemiological trends. During the first decades, malnutrition and infectious diseases were common and relief efforts were focused on emergency survival. From the 1970s, needs were centered on the health of mothers and children.
“In recent decades, the focus has shifted to non-communicable diseases, such as diabetes, hypertension and mental illness.“ ”These diseases are believed to be the cause of between 70 and 80 per cent of deaths among Palestinian refugees,” says Akihiro Seita.
Despite UNRWA providing primary care at a relatively low cost, it is difficult to adequately stretch the funds. The Palestine refugees’ health care costs between 20 and 30 U.S. dollars per care seeker:
“This is a difficult reality.“ ”Both the recipient population and the cost of medicines and other services continue to rise, but our budget does not increase at the same rate.”
The relief organization UNRWA also provides health care for Palestinian refugees in another war zone: Syria. Of the 500,000 Palestinian refugees in Syria, more than half have fled to other parts of the country, while over 150,000 have fled Syria completely.
“Instability is the biggest obstacle. UNRWA previously had 23 medical centers in Syria, but half of these have already been closed. Even if we open another 10 medical centers in shelters, the access to health care is often compromised. “ ”The regular distribution of medicines to medical centers from central storage facilities is also affected to a great extent by the troubles,” says Akihiro Seita, who also points out that the domestic pharmaceutical industry has collapsed and that the organization must buy more expensive medicines on the international market.
Of the UNRWA employees in Syria, over 90 per cent are still working, but the high degree of instability in the area affects employee motivation and morale. At present, they only have a small number of hospitals to which they can refer patients. The war has also caused major damage to the basic infrastructure, including the water supply. The spread of diseases is another problem. Recently, for example, a wave of hepatitis A and typhoid fever has been reported in Syria.
UNRWA is working to create better conditions for the health care they provide, both in terms of efficiency and quality.
“The Family Health Team approach is a way to better address the problems of non-communicable diseases.“ ”Electronic medical records is another way. “ ”We are also working to improve the management of the supply chain. “ ”Such work will improve the resilience of our health care.”
UNRWA also encourages innovations that can meet specific needs. One example of such innovation is the medical centers in shelters that have opened in Syria. Another example is the use of text messaging for employment in Jordan and Gaza. The organization is also working hard to help and inspire the staff.
“Our staff are the most dedicated I have seen among public health care workers in developing countries, despite working under very difficult conditions. It is important to help them by responding to their needs as quickly as possible, with the limited resources we have, of course.”
It is impossible for UNRWA alone to meet all the health care needs of the refugees, and the organization strives to expand cooperation with national and international partners. Among its partners are health ministries and NGOs, as well as global health institutions such as WHO and academic institutions.
During his speech at the Sahlgrenska Academy on 20 November, Akihiro Seita hopes to highlight three important points: What fantastic people the Palestinian refugees are despite their great suffering due to the lack of international solutions. What amazing staff UNRWA has, almost all of them being Palestinian refugees themselves. And the importance of peace and how much political factors impact on human health.
Akihiro Seita is speaking at the Sahlgrenska Academy, Thursday 20 November at 14:00 – 15:00, in the auditorium “Ivan Östholm”, Medicinaregatan 13A.