VZCZCXYZ0001
OO RUEHWEB

DE RUEHJM #1852 1291526
ZNR UUUUU ZZH
O 091526Z MAY 06
FM AMCONSUL JERUSALEM
TO RUEHC/SECSTATE WASHDC IMMEDIATE 1977
INFO RUEHXK/ARAB ISRAELI COLLECTIVE IMMEDIATE
RHEHNSC/NSC WASHDC IMMEDIATE
RUEATRS/DEPT OF TREASURY WASHDC IMMEDIATE

UNCLAS JERUSALEM 001852 
 
SIPDIS 
 
SENSITIVE 
SIPDIS 
 
NEA FOR FRONT OFFICE; NEA/IPA FOR WILLIAMS/GREENE/WAECHTER; 
NSC FOR ABRAMS/DORAN/LOGERFO; STATE PASS TO USAID/BORODIN; 
TREASURY FOR ADKINS 
 
E.O. 12958: N/A 
TAGS: PHUM EAID EFIN KWBG IS
SUBJECT: AUGUSTA VICTORIA HOSPITAL TO DENY CARE TO 
PALESTINIANS ABSENT FUNDING 
 
REF: JERUSALEM 1697 
 
¶1.  (SBU) Summary:  In a May 4 meeting with EconOffs, CEO of 
Augusta Victoria Hospital (AVH) Tawfiq Nasser warned that AVH 
would be forced to deny "catastrophic care," such as 
pediatric dialysis and oncology treatment, to Palestinians 
due to a lack of funding.  AVH, together with St. John Eye 
Hospital and Al-Makassad Hospital, provide over USD 750,000 
in medical services to about 6,000 Palestinians referred by 
the PA and UNRWA per month.  These hospitals have 
traditionally relied on reimbursements from the PA, but are 
facing financial pressures because of the PA's inability to 
make the payments.  Nasser added that he had briefed 
Washington officials on this problem during an April visit. 
End Summary. 
 
Getting down to the numbers 
--------------------------- 
 
¶2.  (SBU) According to Nasser, AVH is the only hospital in 
East Jerusalem or the West Bank that is able to provide 
chemotherapy and pediatric dialysis.  The PA had agreed with 
AVH on a monthly fixed payment of USD 322,000, including 
oncology treatments in order to cover the costs of PA 
referrals (reftel).  Presently, the PA owes AVH USD 1.5 
million and has not made a payment since February.  Treatment 
for Palestinians accounts for 40 percent of AVH's budget: 20 
percent is paid by UNRWA and 20 percent is part of the PA's 
contractual obligation.  AVH's underlying institution -- the 
Lutheran World Federation -- informed Nasser that AVH should 
start contingency planning should the PA default on its 
obligations.  Nasser said that this meant that AVH would have 
to begin denying care to patients in one to two months if 
funding does not materialize. 
 
¶3.  (SBU) Nasser said that drugs account for 70 percent of 
its expenses.  The hospital spends USD 200,000 to 250,000 per 
month for dialysis and oncology treatments, 
gastrointestinology, and endoscopy procedures.  The majority 
of drug suppliers are Israeli firms that contract out to 
Palestinian agents.  Even though USD 1 million is owed to 
drug suppliers, Nasser said he was unable to approach the GOI 
to ask for their assistance given the political sensitivities. 
 
UNRWA confined to reimburse AVH only for refugees 
--------------------------------------------- ---- 
 
¶4.  (SBU) UNRWA has a contractual agreement to reimburse AVH 
for tertiary services provided to refugees and, according to 
Nasser, is unable to expand its mandate (reftel).  (Note: 
While all Palestinians are eligible to purchase insurance 
from the PA, PA employees are required to enroll in the PA 
insurance scheme.  End Note.)  Nasser said AVH had discovered 
that Palestinians, looking for a lower co-payment, apply for 
both UNRWA and PA health insurance, complicating AVH's 
billing system.  (Note:  Palestinians pay a 30 percent 
co-payment under the UNRWA insurance and a 10 percent 
co-payment under the PA insurance.  End Note.)  He urged that 
the PA should revamp the system to avoid inconsistencies in 
the healthcare sector, particularly since there is no common 
database to track insurance coverage. 
 
AVH shuttle service 
------------------- 
 
¶5.  (SBU) Nasser noted that AVH has four daily shuttles to 
Hebron, Abu Dis, and the north of the West Bank.  Nasser said 
that this busing system, called "Hope and Health Across the 
Wall," was designed to facilitate the travel of West Bank 
patients for care at AVH in East Jerusalem.  He estimated 
that it costs AVH USD 290,000 per year to run the shuttle 
service, although some of the costs are defrayed by payments 
from the staff. 
 
Comment: 
-------- 
 
¶6.  (SBU) Helping AVH meet its unfunded costs would be an 
ideal use of donor humanitarian funds, since AVH is one of 
the few non-PA MOH providers of catastrophic care to West 
Bank Palestinians.  End Comment. 
WALLES