I was interested but disappointed to read your interview with Cathy Gritzner on setting up a health service in Palestine (News Focus, 25 June).

Since leaving the NHS in 1992 I have been working in Gaza on a Department for International Development project. I find Ms Gritzner's experience very different from my own.

The United Nations Relief and Works Agency for Palestinian Refugees in the Near East operates several community based healthcare centres in the refugee camps, the towns and in Gaza City. All offer good maternal and child healthcare, which includes family planning services that advise on and readily supply all forms of contraceptive devices. It is unclear what Ms Gritzner's objective was to 'smuggle' condoms into the Strip. Professional healthcare workers might find her actions inappropriate and irresponsible. Surely there is a duty on any individual or agency supplying contraceptives to also provide correct and appropriate instruction in their use.

Until 1994 healthcare and nurse education in Gaza and the West Bank were controlled by the Israeli civil administration. Since the transfer of these services to the Palestinian authority there have been immense improvements. Currently, there are three nurse-training institutions in Gaza. All have close links with local and international universities and all are fervently working to provide nurse education at international levels such as those defined by the European Union.

The situation in Gaza and the West Bank is unusual and requires a unique, sensitive and appropriate approach. If we hope to improve such situations through our professional contribution, it must be done in a committed manner that embraces healthcare needs, cultural realities, environmental and political circumstances. To transfer models of care such as those of the UK could be considered contrary to good developmental practice as they require immense financial resources, which the Palestinians cannot presently generate. Such financially dependent services which cannot be sustained when international donations cease have the potential to create only more problems.

Anne Hauzar

Project adviser

Gaza College of Nursing