As you all know, I am a great fan of Physicians for Human Rights – Israel (PHR) and an active participator in their mobile clinic that visits the Palestinians in the West Bank weekly on Shabbat, to give free medical advice to the local inhabitants. These visits give us all, doctors and paramedical helpers, the satisfaction of useful work and hopefully make a small contribution to mutual understanding and a better future.

The other night I attended in Tel Aviv a medical conference in my chosen field, diabetes, in order to keep up to date with the latest news and developments in that specialty of medicine. The advances that have been made in the last decade are really most interesting and convincing, and they have changed the current acceptable standard treatment of this deceptively 'mild' disease, with its very serious long-term complications.

Now where does the frustration come in? Of all these modern medications, in all my years with PHR in Palestine, I have not once prescribed these new treatments. Why? Simple, they are expensive. The local Palestinian sick fund does not carry them – they stick with the older proven treatments that can do the job as well, but give more work to the patients.

We from PHR do not carry them with us in the pharmacy on our visits, also because of price, but even more because there is no point in prescribing a new drug for free for one month – as we usually do in our mobile clinic – when the patient cannot continue using them because he cannot afford the unsubsidized price, and has to go back to the old regimen.

So we cannot give our best – a pity.