Important funding sources -- including the governments of the United States, Canada and the European Union -- are withholding money from the Palestinian Authority because its new political leadership is affiliated with Hamas, said Dr. Tawfiq Nasser, AVH chief executive officer. Many world leaders say Hamas is a terrorist organization. "One thing that was not realized is that the Palestinian Authority as the government is the largest service provider," Nasser said in a March 31 interview with the ELCA News Service. "Palestinian civil society is completely dependent on services that are provided by the government."

The funding boycott has put the hospital "in a difficult position," Nasser said.

Since the beginning, the Palestinian Authority (PA) has been the main provider of civil service in Palestine, running a large number of schools, hospitals, clinics, and many other social and civil services. The PA contracted LWF/AVH to provide a variety of health services to the population.  The hospital has been providing, on a monthly basis, about 1700 medical procedures such as dialysis, radiation, chemotherapy, endoscopy and head-neck treatments.

The blockage of the funds will put in danger the life of the patients who are currently under treatment as it is the only source of treatment they can access

Nasser explained that AVH has a significant contract with the Palestinian Authority insurance program that provides catastrophic care coverage. Because funding for that program has been stopped, the insurer went bankrupt, he said.

The result is the hospital has no insurance entity to bill for services, yet patients need treatment. "It's very unethical and illegal to stop the treatment of these patients," Nasser said. "On the other hand we are officially informed that their insurer cannot pay the bills. So what do you do?"

In addition to the financial problem, Palestinian access to the hospital, which has always been a difficult, has been reduced, creating what Nasser called "a near-impossible situation."

AVH could not meet its payroll for the past two months, and some staff, including physicians, have left, Nasser said.

The hospital expects to lose about $296,000 per month in insurance funds, Nasser said. The Action by Churches Together appeal seeks a total of $1.4 million for six months to keep the hospital functioning, he said. The funds are needed very soon, Nasser warned.

"I think that if we don't get this aid between now and (the next) two to three weeks, then the hospital will be in a position where we cannot treat patients," he said. "The window we have now is about three weeks at max, and then the hospital will start going through a serious situation of collapse."

If the hospital can secure the funds, Nasser said he and his staff will have some time to figure out how they can secure funding for the future.

"My main worry, as a person who is trained in the biomedical/clinical field and also is responsible for the hospital management side, is that I don't interrupt services," Nasser said. "If we reach a point where we are interrupting services and we are refusing to treat patients, we create a near-disaster situation."

Nasser is also concerned about the effect of the hospital's financial situation on the outcome of an LWF tax case with the State of Israel. 

During the last three years, the hospital has responded to the critical emergency situations that have resulted from the Israeli/Palestinian conflict as well as providing care for large numbers of patients from the West Bank who cannot access their usual health providers.

AVH was already facing the possibility of paying hundreds of thousands of dollars in taxes to the State of Israel. In court proceedings in 2002 Israel sought to void a long-standing tax exemption the LWF has had for its humanitarian and health care activities in the region since 1966.

Israel won the case in 2002. The LWF appealed the verdict to the Israeli Supreme Court, and the next court date is in May. LWF leaders are concerned the hospital's future may be jeopardized if the LWF loses the appeal. Nasser also believes that if the hospital cannot operate because of the current funding emergency, it could lose the tax case.

In remarks to the ELCA Church Council meeting in Chicago April 1, the Rev. Mark S. Hanson, ELCA presiding bishop and LWF president, said the "very viability" of the hospital is at stake because of the loss of funds and the pending tax case. He said the hospital situation must be resolved immediately for the sake of the Palestinian people.