Independent Appeal: A vital lifeline for patients from the West Bank

Dr Haitham al-Hassan is smoking his tenth cigarette of our meeting and drinking the blackest of black coffee. "We are in a desperate position," he says. "One day we can't do catheterisation because we have run out of tubes. The next day we can't do X-rays because we have run out of film. Some 60 per cent of my budget has disappeared in the past year."

Dr Hassan is not a doctor in the Third World; he is the director of al-Maqassed Hospital, in East Jerusalem, the largest medical centre for sick Palestinians, and he is struggling to stop his service falling apart.

He shows me an empty general surgery ward, the lights dulled, the beds fresh and waiting for patients desperate for treatment. "This ward has been closed for a year. We can't afford to keep it open," he says.

The majority of patients who make it to the Maqassed are Palestinians from the West Bank who need the specialist treatment they can only receive here. The Palestinian Authority usually pays for their care, but since the election of Hamas earlier this year, the authority's funds have been frozen by Israel and the international community. "We have lost half a million dollars a month," Dr Hassan says. "But at the same time, our number of patients has massively increased because the boycott has brought the medical services on the West Bank to the brink of collapse. We have an increased burden and slashed resources - a disastrous combination."

At every step, there is evidence of a hospital stuttering to a halt. A nurse explains they have run out of sterilised gowns for the operating room. "We have to wait two hours in between each operation while the gowns are sterilised," she says. "We are losing a huge amount of operating time."

The consequences of the military occupation lie bleeding in every ward. In intensive care, we find a patient who was mangled in a car crash. His accident happened just 20 minutes away on the West Bank - but he was detained at the Israeli checkpoints for three hours. "His kidney has been damaged, his lung was seriously damaged," Dr Hassan says, reading through the medical notes. The patient had to be transferred to a new ambulance at the checkpoint, "which is why he has dead muscles. This man will be disabled all his life because he had to wait so long for treatment."

It is, the doctor adds, "an everyday occurrence" for patients to suffer more serious injuries or die because they have been held at checkpoints. "A half-hour delay can kill. Now a three-hour delay is common."

For three months this year, the staff at the Maqassed Hospital went without pay. "We cannot afford to buy drugs in bulk any more," Dr Hassan says, "so we have to buy piece by piece, which is 30 per cent more expensive."

He explains this as we enter the neonatal unit, the only place where Palestinian babies weighing less than 600 grams can be treated. A tiny infant who could fit into my hand is silently kicking the air from her incubator. "Is she a terrorist?" Dr Hassan asks under his breath. This ward has only been able to stay open, he explains, because the hospital is receiving financial support from, among others, the Welfare Association, one of The Independent's three Christmas charities. Unimaginably small babies are being kept alive in incubators bought by the charity.

"The Welfare Association has rescued us," Dr Hassan says as he watches a mini-baby scheduled for cardiac surgery the next day, "with a project that improved the administrative capacity and services of the six Palestinian hospitals here in East Jerusalem. We have saved a fortune we can now use on patients."

They have upgraded an operating theatre and installed a new sterilisation unit. They pay for the doctors here to receive specialist training. "We have set all this up," says the Welfare Association's director, Caroline Qutteneh, "but now they need the money to keep it going." For that, says Dr Hassan, "we need more help."

* Israel said yesterday it will renew attacks against Palestinian rocket-launching cells in Gaza, threatening to destroy a shaky, month-long ceasefire. The decision came after a Palestinian rocket seriously wounded two Israeli teenagers in southern Israel.