According to the custody tribunal that deals with illegal migrants, active TB has been identified in 12 refugees who were held at Ketziot, and the percentage of refugees with active TB among all TB patients in Israel has doubled from 14 percent in 2006 to 28 percent in 2008. Nevertheless, the health and interior ministries allow the refugees to move to other parts of the country without conducting a chest x-ray that would identify the disease, and without other essential tests. The head of the Tuberculosis and AIDS department in the Health Ministry, Dr. Daniel Shem-Tov, testified before the tribunal in May that the lack of testing and vaccinations as mandated by the Health Ministry constitutes "a danger to public health." In July 2007, the Interior Ministry ordered the construction of a tent site to house African refugees who had infiltrated Israel from Sinai. The encampment was intended as a temporary solution until the refugees could be sent back to Egypt, or released in Israel if it was determined that they were eligible for asylum. Since that time, some 5,000 refugees from 25 African countries have been held at Ketziot. Tuberculosis is an airborne infection transmitted via the human respiratory system, which the Health Ministry defines as a "dangerous infectious disease." In 2006, some 1.7 million people died of TB worldwide, mostly in Africa. Over the past few years some 400 new cases of TB have been identified annually in Israel. The custody tribunal, which hears the cases of people present illegally in Israel, including the refugees held at Ketziot, determined that a series of tests and vaccinations be carried out on all detainees before their release from the facility. TB tests were to be administered so that detainees could be treated if necessary. Based on recommendations of public health experts and the Health Ministry's legal department, the tribunal also ordered vaccinations, including for children, against bacterial meningitis and polio. However, Haaretz has learned that the refugees are being released without undergoing the tests since the bodies responsible for them - the Health Ministry, Interior Ministry and Prisons Service - are passing off the responsibility for funding and implementation. According to information received by the tribunal from the Prisons Service and Health Ministry at the end of July, 22 cases of TB have been discovered at Ketziot so far this year, 12 of them not in need of medication. Four of the refugees have active TB, and were transfered to the Prisons Service's medical facility at the Nitzan Prison. The tribunal determined that the rate of active TB among inmates at Ketziot (four cases out of 3,000) is 13.3 times greater than the ratio in 1997 that led Israel to reestablish medical facilities for eradicating the disease and give it the status of a "dangerous and infectious" disease. The tribunal's decision ordering the tests and vaccinations contained sharp criticism of what it termed ongoing failures by the health and interior ministries in not testing thousands of African refugees, although the health ministry itself determined in September 2007 that such testing of Sudanese refugees was essential to protect public health. "Despite the significant rise in the number of active TB patients among the refugees, the Health Ministry is responding late to events and is not providing the solutions that show the epidemic has been stoped," the tribunal stated. Copies of the tribunal's decisions were given to the heads of the health, interior and justice ministries and the heads of the Prisons Service. The tribunal's judges, attorneys Dan Libreti, Yossi Maimon and Tomer Karmi, also said the Health Ministry was acting "clumsily." They stated that because in the case of TB, "a few cases are enough to declare a state of emergency," there was "no reasonable explanation why the Health Ministry had not acted with all due speed to check every individual being held at Ketziot." According to the tribunal, on March 31 the Interior Ministry and Israel Defense Forces decided on a "spontaneous release" of detainees from Ketziot to make room for new infiltrators. Those released did not undergo any medical tests before being allowed to move to Israel's population centers. The tribunal said the Interior Ministry was allowing "massive and unmonitored releases" without "good judgment with regard to the welfare and health of the public." The tribunal also said the "main challenges to ensuring public health in Israel, and particularly in controlling TB, were not medical but political and administrative." In July 2007, the Interior Ministry ordered the construction of a tent site to house African refugees who had infiltrated Israel from Sinai. The encampment was intended as a temporary solution until the refugees could be sent back to Egypt, or released in Israel if it was determined that they were eligible for asylum. Since that time, some 5,000 refugees from 25 African countries have been held at Ketziot. Tuberculosis is an airborne infection transmitted via the human respiratory system, which the Health Ministry defines as a "dangerous infectious disease." In 2006, some 1.7 million people died of TB worldwide, mostly in Africa. Over the past few years some 400 new cases of TB have been identified annually in Israel. The custody tribunal, which hears the cases of people present illegally in Israel, including the refugees held at Ketziot, determined that a series of tests and vaccinations be carried out on all detainees before their release from the facility. TB tests were to be administered so that detainees could be treated if necessary. Based on recommendations of public health experts and the Health Ministry's legal department, the tribunal also ordered vaccinations, including for children, against bacterial meningitis and polio. However, Haaretz has learned that the refugees are being released without undergoing the tests since the bodies responsible for them - the Health Ministry, Interior Ministry and Prisons Service - are passing off the responsibility for funding and implementation. According to information received by the tribunal from the Prisons Service and Health Ministry at the end of July, 22 cases of TB have been discovered at Ketziot so far this year, 12 of them not in need of medication. Four of the refugees have active TB, and were transfered to the Prisons Service's medical facility at the Nitzan Prison. The tribunal determined that the rate of active TB among inmates at Ketziot (four cases out of 3,000) is 13.3 times greater than the ratio in 1997 that led Israel to reestablish medical facilities for eradicating the disease and give it the status of a "dangerous and infectious" disease. The tribunal's decision ordering the tests and vaccinations contained sharp criticism of what it termed ongoing failures by the health and interior ministries in not testing thousands of African refugees, although the health ministry itself determined in September 2007 that such testing of Sudanese refugees was essential to protect public health. "Despite the significant rise in the number of active TB patients among the refugees, the Health Ministry is responding late to events and is not providing the solutions that show the epidemic has been stoped," the tribunal stated. Copies of the tribunal's decisions were given to the heads of the health, interior and justice ministries and the heads of the Prisons Service. The tribunal's judges, attorneys Dan Libreti, Yossi Maimon and Tomer Karmi, also said the Health Ministry was acting "clumsily." They stated that because in the case of TB, "a few cases are enough to declare a state of emergency," there was "no reasonable explanation why the Health Ministry had not acted with all due speed to check every individual being held at Ketziot." According to the tribunal, on March 31 the Interior Ministry and Israel Defense Forces decided on a "spontaneous release" of detainees from Ketziot to make room for new infiltrators. Those released did not undergo any medical tests before being allowed to move to Israel's population centers. The tribunal said the Interior Ministry was allowing "massive and unmonitored releases" without "good judgment with regard to the welfare and health of the public." The tribunal also said the "main challenges to ensuring public health in Israel, and particularly in controlling TB, were not medical but political and administrative."

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