Arafat's Illness

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Yasser Arafat's gaunt, fragile appearance during last weekend's inauguration of an emergency cabinet for the Palestinian Authority has raised a flurry of speculation over the state of the 74-year-old leader's health. Palestinian officials on Wednesday denied rumors that Arafat had last week suffered a mild heart attack and explained that Arafat has been suffering from a bad case of the flu or an intestinal infection. But according to a source inside the compound, the recent working diagnosis is that Arafat is suffering from stomach cancer. Al-Jazeera TV reported Wednesday that two teams of doctors, one from Jordan and the other from Egypt, arrived in Ramallah Wednesday to treat Arafat. Abu Dhabi TV reported on Thursday that following their examination of the Palestinian leader, the Egyptian doctors "expressed concern" about the state of his health. Neither report specified his condition.

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The prognosis for stomach cancer patients depends on the stage at which the cancer is diagnosed and treated, and the size and location of the tumor. Whatever the state of the cancer, however, such a diagnosis poses a major challenge to both Israel and the Palestinian Authority, which could require some nimble refereeing by the Bush administration.

The most immediate crisis would involve the need to treat Arafat's condition. The Ramallah compound in which Arafat has been holed up for the best part of two years is hardly the most conducive environment for invasive surgery. It would, in theory, be possible to erect a surgical suite at the compound, but hospitalization would certainly be preferable from a medical standpoint. Israel has until now insisted that if Arafat leaves his compound, he'd be on a one-way ticket out of the West Bank. And each new terror attack brings renewed public and political pressure on Sharon to make good on his cabinet's in-principle decision to expel the Palestinian leader. But Arafat has vowed to go down fighting against any attempt to remove him from the compound, and the Bush administration has restrained Israel from carrying out the threatened expulsion, on the grounds that such a move would be "unhelpful" to the pursuit of stability. The Palestinian leader's new condition, however, could raise uncomfortable choices for Israel, the Palestinians and the Bush administration.

If Arafat's condition proves to be terminal, the Palestinians will be forced to answer the long-deferred question of succession, and the running debate in Washington and Jerusalem over the prospects for pursuing a peace agreement without the aging Arafat will have been settled. The question of Arafat's succession is complicated by the fact that his power derives from the three separate offices he holds: Palestinian Authority president, PLO chairman and leader of the Fatah movement. The PA constitution requires that if the president is incapacitated, his post would be temporarily filled by the Speaker of the Palestinian legislature. However, the Speaker's position is currently vacant, following Ahmed Qureia's resignation from it in order to become prime minister. Following Thursday’s meeting of the Palestinian legislature at which Arafat’s appointment of an emergency cabinet was rebuffed, Qureia reportedly signaled Arafat that he no longer wants the position.

Rather than a simple transfer of the mantle of power from one uncontested national leader to another, Arafat's passing would likely open a protracted period of power struggles and realignments in Palestinian politics — and it appears unlikely that all three of his positions would be filled by a single successor. The immediate implications for any peace process will be uncertain, although the Israelis and the Bush administration have long insisted that breaking Arafat's grip on the Palestinian national movement is a prerequisite for progress.