Only Specialist Medical Clinic for Asylum Seekers in Israel Due to Close Over Lack of Funding

Volunteer clinic in south Tel Aviv set to close after Health Ministry declines to take over funding. Patients will be able to obtain tests and other medical care elsewhere, but at a considerably higher cost

The Terem specialist clinic in south Tel Aviv, October 22, 2018
Ofer Vaknin

The only clinic in Israel that provides specialist medical testing and treatment for asylum seekers at a nominal fee will be shutting down within a month, as the Health Ministry declined to take over funding of it, Haaretz has learned.

The company that has been operating the clinic, Terem, said the project has been run with volunteer staff since it opened in 2010. A second Terem clinic, which provides emergency medical care in the same building near the Central Bus Station in south Tel Aviv and which receives major Health Ministry funding, will remain open.

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For its part, the Health Ministry acknowledged the importance of the volunteer staff of the specialty clinic and noted that it was opened because the state healthcare law does not provide for coverage of people without legal resident status in the country.

The ministry expressed regret over the impending closure of the specialist clinic, but added that it provides the entire budget for the emergency clinic at the Central Bus Station, which it said also provides a range of other services, including well-baby care, psychiatric treatment and treatment for tuberculosis, AIDS and chronic diseases such as diabetes and high blood pressure and medical care for victims of sexual assault.

The Terem children's clinic in Tel Aviv Central Bus Station, October 22, 2018
Ofer Vaknin

South Tel Aviv has the largest concentration of asylum seekers in the country, mainly from Sudan and Eritrea.

Among the services provided by the specialist clinic that is due to close are blood tests, vaccination, ultrasounds, out-patient medical services, including surgery, abortions, cardiac care and psychiatric services. When the specialist clinic shuts down, all non-emergency cases will be sent to other clinics staffed by volunteers or to hospitals.

The Terem specialist clinic is the only place where asylum seekers who have no legal status in Israel can obtain essential diagnostic services such as X-rays and fetal monitoring at a nominal charge.

The clinic also provides services in the fields of orthopedics, physiotherapy, dermatology, neurology and gynecology. It handles almost 1,000 patients a month.

The Health Ministry has agreed to continue funding the adjacent emergency clinic, which treated 36,500 patients in 2016, at a cost of about 4 million shekels ($1.4 million) a year. Overhead involved in running the specialist clinic is about half a million shekels a year.

Orel Ben Ari, the manager of the specialist clinic, issued a letter on Sunday in which he said the clinic would be closing over differences regarding its function and importance.

“I am very sorry about the expected harm to patients and the likely burden on hospitals, but the Health Ministry’s failure to recognize the services granted at the clinic (beyond emergency services) does not enable it to continue,” he wrote.

For many patients, the decision means that they will lose continuity of care and a loss of essential medical services for a nominal fee. They will be able to obtain tests and other medical care elsewhere, but at a considerably higher cost. A battery of blood tests that cost 40 to 70 shekels at the specialist clinic, for example, would run around 400 shekels at a private lab. Ultrasound scans costing asylum seekers 125 shekels would cost about 400 shekels, while pregnancy monitoring would cost about 280 shekels per visit. The specialist clinic offered the service at no charge or a token fee.

The organization Physicians for Human Rights (PHR) operates another volunteer clinic, but it has been sending patients for testing at Terem’s speciality clinic because it is the only clinic that offers the services at a reduced fee. Pregnancy monitoring could pose a particular problem when the specialist clinic closes, as the fees involved elsewhere could lead women to forgo the medical care.

PHR said the Health Ministry is neglecting care for asylum seekers and urged that the issue be addressed in a systematic fashion. Dr. Zoe Gutzeit, the director of the migrant and refugee program of PHR, said the Health Ministry told a session of the Labor, Welfare and Health Committee that the solution to the problem is a health insurance program for asylum seekers.