Doctors at Beit Jala Government Hospital, the only government hospital in Bethlehem governorate, are reporting shortages of chemotherapy drugs, staff on half salaries and cancer patients regressing after missing appointments, as the occupied West Bank's healthcare system rapidly deteriorates under the collapse of Palestinian Authority finances.
Khaldoun Atwan, head of the daytime oncology unit at the hospital, described the daily uncertainty of his commute from Hebron. The Nabi Yunis checkpoint at Halhul appears "always closed," so he leaves his car and finishes the journey by taxi. His car has more than once been found with a broken mirror or broken wipers, in an area he says settlers are now active.
Atwan said he does not know whether he will reach the hospital, whether his patients will, or whether the drugs they need will be on the shelf. Beit Jala is the only government hospital in Bethlehem governorate, home to some 320,000 people. He said cancer patients have regressed because they missed crucial appointments or essential chemotherapy drugs, and that even during the second Intifada drug supply was never an issue. "Everything's short ... whatever's available we give," he said. "It's a disaster."
The Palestinian Authority's finances have collapsed over the last three years, according to the report, because of a reduction in international aid and disruptions in Israel's transfers of tax receipts. Israeli actions in the occupied West Bank since October 2023, including road closures, checkpoints and settler attacks on Palestinian communities, have also weighed on the economy.
Staff now receive only half their salaries, and the authority cannot pay for essential medications. Ministry clinics operate part-time, with doctors seeing well more than 100 patients a day when they are open. An older cancer patient said a routine checkup now costs 200 shekels (about $65). Another described doctors and cleaning staff doing their best every month "but they aren't provided with anything."
Iyad Dari, the attending physician at the hospital's dialysis unit, said the problem is not a shortage of people. "It's not a story of there being no staff," he said.
Analysis
Why This Matters
- A single government hospital is the backbone of care for some 320,000 people in Bethlehem governorate, and its drug supply and staffing are now unreliable.
- Cancer patients are regressing because they miss chemotherapy appointments and medicines, so the funding crisis is directly worsening health outcomes.
- The collapse follows three years of reduced international aid and disrupted tax transfers from Israel, meaning the fix is as much political and financial as medical.
Background
The Palestinian Authority provides public services, including healthcare, in parts of the occupied West Bank under long-standing arrangements in which Israel collects customs and tax revenues on its behalf and transfers them periodically. Those transfers, alongside international donor support, have been central to PA finances and a recurring point of friction between the two sides. Since October 2023, Israel has maintained widespread road closures and checkpoints across the West Bank, and the article describes settler attacks on Palestinian communities, all of which have compounded the economic decline and made it harder for patients and staff to move.
The article notes that even during the second Intifada, drug supply at Beit Jala was not a problem, which underscores how far the current shortages go beyond previous crises.
Key Perspectives
Hospital staff at Beit Jala: Doctors and nurses are working on half salaries with whatever drugs are available. Atwan described the situation as a disaster, while dialysis unit physician Iyad Dari said the problem is not a lack of staff.
Patients: An older cancer patient said a checkup now costs 200 shekels (about $65), and described doctors and cleaning staff doing their best each month "but they aren't provided with anything." Patients from surrounding villages must weigh whether to travel to the hospital at all.
Critics and skeptics: The article offers no reported response from Israeli authorities, and it is unclear how a checkpoint regime that blocks staff and patients will ease even if funding returns. The deeper question is whether the PA can sustain services while its revenue base, tax transfers and donor aid, remains unstable.
What to Watch
- Whether Israel resumes regular transfers of tax receipts to the Palestinian Authority.
- Whether international donors restore aid after three years of decline.
- Whether checkpoints such as Nabi Yunis at Halhul stay closed and settler activity in the area escalates, further restricting movement for staff and patients.