Israeli Bedouin Women Lack Access to Prenatal Care

The infant mortality rate in Muslim villages, including the Bedouin communities, is 11.2 per 1,000 births, compared to 2.7 per 1,000 births in Jewish communities.

Some 7,000 families live in the Bedouin village of Wadi Naim, one of the largest unrecognized Bedouin villages in the country. The village borders on the Ramat Hovav industrial zone. Many families have more than 10 children. Some 30,000 Bedouin live in the entire area, and after legal aid group Adalah petitioned the High Court of Justice, the court ordered the Health Ministry to open a well-baby clinic in Wadi Naim five years ago. However, two and a half years ago, the clinic closed.

The lack of proper access to prenatal care and preventive attention to infants among Negev Bedouin may partly explain the infant mortality rate in this sector, which is up to 5 times the national average and may be getting worse.

well-baby clinic in the Bedouin village
Eliahu Hershkovitz

Families now have to travel to Segev Shalom, another Bedouin village, 15 kilometers away, for follow-up and inoculations for their infants.

Ataf Abu Rabia, Adalahs coordinator for the south, says that as a result many children are not receiving the usual vaccinations.

Although the Clalit health maintenance organization opens daily in Wadi Naim, for the babies we have to travel and lose a day of work, says Diab Al Danfiri, 45, of Wadi Naim, who has 19 children. For some its inconvenient to travel such a long distance with all the children and wait in line, he says.

The infant mortality rate in Muslim villages, including the Bedouin communities, is 11.2 per 1,000 births, compared to 2.7 per 1,000 births in Jewish communities. In the unrecognized Bedouin villages, including Wadi Naim, the infant mortality rate stands at 12.2 per 1,000 births. The figures come from the Central Bureau of Statistics for 2010, whose data is based on the 2008 census,

A recent report by Physicians for Human Rights indicates that infant mortality rates in Bedouin communities may be worsening. From 2007 to 2009, the infant mortality rate in Muslim communities in the south, including Bedouin communities, was 10.5 per 1,000 births, compared to 2 per 1,000 in Jewish communities in the center of the country. In 2010, the mortality rate of Bedouin babies rose to 13.6 per 1,000, compared to 4.1 per 1,000 in Jewish communities in the south.

The higher birth rate among the Bedouin does not explain the gap. According to Central Bureau of Statistics figures for 1997 to 2000, Muslim families (including Bedouin) with eight or more children had a mortality rate of 11.2 per 1,000, which is more than 90 percent greater than Jewish families with eight or more children, where the mortality is 5.9 per 1,000 births.

There are prenatal programs in some of the Bedouin villages, but Prof. Arnon Wiznitzer, head of the obstetrics and gynecology department at Soroka Medical Center in Beer Sheva, says that some 12 percent of Bedouin women giving birth at Soroka have received no prenatal care at all. The fact that the doctor delivering the baby has no idea of the age or size of the fetus greatly increases the risk of complications, he says.

But, in recent months, doctors have been going giving lectures in the villages of Aroer, Kseifa and Hura, including the subject of birth control. Dr. Zoya Razbargier, who lectures in Bedouin towns for Soroka, says that some 20 percent of Bedouin mothers giving birth are over 40, and are unaware that increased age and multiple births up the risk of birth defects, and they refuse testing of amniotic fluid to make sure the baby is developing properly.

According to Wasim Abbas, head of the Physicians for Human Rights health project in the Arab sector, the program the Health Ministry has been operating for Negev Bedouin since 1995, has had limited success because of the general lack of infrastructure in the region.

Without a comprehensive national program, the gap will remain huge, he says.
The Health Ministry says it lacked the nursing staff to keep the well-baby clinic running in Wadi Naim, and that it is working on an incentive package to encourage nurses to work in the Negev. The ministry said it has enough positions and enough funding but not enough nurses to fill vacancies. The ministry said it hoped to re-open the Wadi Naim clinic as soon as possible, but not before there was a full complement of nurses to staff it.

The ministry also said that 43 percent of deaths among infants up to a year old among the Bedouin result from hereditary conditions and/or birth defects, as opposed to 16 percent in the Jewish population. Other reasons for higher infant mortality rates included poverty, poorly educated and poorly nourished mothers and problems of access to preventive medical care at well-baby clinics and relatively low willingness to undergo recommended tests.

The ministry said the issue was a top priority, and that its director general has allocated special funding to the health of pregnant women and babies in the south. Funding for this purpose was tripled in 2011, the ministry said.