Emergency declared in Gaza medical centres
Statements from Physicians for Human Rights- Israel and WHO, news from Al Jazeera.
Children injured by an Israeli airstrike, Gaza city, July 09, 2014.
The military offensive is worsening the ongoing crisis in the health system in Gaza
Serious shortages in medical equipment and pharmaceuticals, fuel shortages and reports of damage to medical installations, medical teams and emergency rescue vehicles.
Physicians for Human Rights- Israel
July 10, 2014
The continued offensive is causing a deterioration of the already inadequate health system and may lead to its collapse.
In light of the state of severe crisis in the Palestinian Health System – defined by the Palestinian Ministry of Health as the gravest situation since the closure of the Gaza Strip in 2007 – hospitals are facing great difficulties in treating the rising numbers of injured – over 500 so far. In view of this situation the Ministry of Health of the Gaza Strip declared a state of emergency on 8.7.14 within which all non-urgent scheduled operations have been put on hold; the state of alert in all medical institutions has been raised and holidays of all hospital workers have been cancelled.
According to officials in the Gaza Strip there is a worsening shortage of medical equipment required for the functioning of the hospitals. From the information which has reached Physicians for Human Rights – Israel (PHR-IL) from the drug administration officials in Gaza, there is a shortage of 471 kinds of expendable medical supplies, including bandages. In addition, the supplies have run out of about 30% of basic drugs – 122 different pharmaceuticals – including anesthetics and intravenous infusion products.
Medical personnel in Gaza report their severe distress directly to PHR-IL. So, for example, the “Shifa” Hospital – the largest hospital in the Strip, which has treated over half of the injured from the start of the offensive – has started to use their emergency supplies which are expected only to last a further three days. From Information provided to PHE-IL by medical staff working at the “Alodda” Hospital in Jabaliya we have learnt that due to equipment shortages hospital teams have been forced to improvise to find alternatives for basic materials. Teams in operating rooms have had to use ordinary thread from seamstresses, which are not sterile in place of purpose made sterile medical sutures. The workers further reported that the threads were manually sterilized to avoid infection.
In addition, over recent days PHR-IL has received reports of damage to medical buildings, including hospitals and clinics as well as to medical personnel. The European Hospital in Khan Younis was hit twice during the last few days from the aerial bombings nearby. The hospital spokesperson informed PHR-IL that the explosion which took place yesterday (9.7.14) near the hospital caused the damage causing the injury of 17 people within the hospital itself, with women and children included in those injured. The hospital reported that the plaster ceilings in the intensive care department, pediatrics department, the hospital entrance and waiting room, have all collapsed. Other departments, including internal medicine, cardiology and pediatric surgery were filled with broken glass after the windows and glass doors were shattered. In the light of the damage the hospital was forced to evacuate the Pediatrics Department of Children and close all outpatient clinics.
The Palestine Red Crescent Society reports that last night at 21:30 the emergency rescue center and ambulance services department in Jabaliya which serves a population of around 350,000 was also hit by an aerial bombing nearby. It was also reported that 12 medics and volunteers were injured. Nine of these were treated and returned to their activities while three needed to be hospitalized. Three out of eight ambulances were damaged and had to be removed from operation. Due to the damage the center has had to close its services. Partial services for the residents are being supplied from Gaza city.
In addition, yesterday (9.7.14) the PMRS organization, a voluntary health organization operating in Gaza, reported that the organization’s Medical Center, located in Beit Hanoun was damaged by heavy bombardments carried out nearby. During the last night, there were reports received at PHR-IL different reports that the civil emergency line (101) that allows summoned rescue teams had been cut off.
In addition to the crisis in the health system and the damage to medical centers there is also an ongoing severe shortage of diesel needed to operate generators in Gaza’s hospitals. More than two weeks ago, Palestinian Ministry of Health warned that fuel reserves are dwindling and are approximately at 20% of the fuel levels required. The shortage of diesel fuel also affects the movement of ambulances which need diesel. In light of these shortages, the Gaza Health Ministry ordered to reduce by 50% the movement of ambulances. Since that time there has been an increasing lack of diesel and there is fear of even more serious damage to the functioning of the health system in Gaza.
Damage to hospitals and medical centers or adjacent aerial bombing threatens the lives of medical staff and the patients themselves, violating the medical neutrality and ignoring the special protection afforded to these teams due to their status and vital role. Also, this damage leads to a state of lack of basic security while staying in medical institutions. There is concern that this violation, if it continues or worsens, would hamper the ability of medical teams to offer aid and save lives.
PHR-IL calls for the State of Israel to stop the military offensive and to avoid at all costs any direct attack on or near the facilities and medical infrastructure and to avoid any attacks on medical and rescue teams and patients: “Out of concern for the lives and welfare of all residents of the area we make a heartfelt and resounding call – stop the fire and stop the incitement. Do not bring before us more victims that require treatment. Put the lives, health and rights of all human beings at the head of your concerns. Do not continue on our behalf with this operation causing further destruction and revenge. It is time to devote the resources and energies that are being directed to war and killing to finally end the occupation and to establish a different vision”.
Lital Grosman, PHR-IL spokesperson: 052-3112136 / 054-6995199
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Palestinians carry an injured man outside the Nasser Hospital in Khan Younis, in the southern Gaza Strip, on Tuesday, July 8, 2014. Photo by Abed Rahim Khatib /Flash90.
WHO appeals for urgent funds to prevent the collapse of health services in occupied Palestinian territory
Statement from World Health Organisation, Regional Office for the Eastern Mediterranean
July 10, 2014
Jerusalem – The recent escalation of violence in the Gaza Strip raises concern about the ability of the Government and the Ministry of Health of the occupied Palestinian territory to cope with the increased burden of medical emergencies on the health system, given the high levels of shortages of medicines, medical disposables and hospital fuel supplies, and rising health care debt.
The World Health Organization (WHO) and the Palestinian Ministry of Health are calling on local and international donors to support the Ministry in coping with the current, difficult situation in the occupied Palestinian territory, especially in the Gaza Strip, that is affecting the health and welfare of Palestinians.
Since 6 July, attacks on the Gaza Strip have caused at least 80 deaths (17 children; 16 women) and have injured more than 570 (120 children; 170 women). A hospital, three clinics and a water desalinization centre in a refugee camp have also been damaged. More airstrikes and missile attacks are likely.
The Palestinian Ministry of Health has reported that they are unable to maintain adequate medicine stocks due to chronic outstanding debts, which now total more than US$ 253 million (New Israeli Sheqel 874 million). Of the debt, US$ 105 million is owed to pharmaceutical suppliers and US$ 148 million to private Palestinian medical referral centres. East Jerusalem hospitals are struggling due to US$ 57 million in unpaid referral services, especially the Augusta Victoria hospital, which receives 70% of cancer referrals from the Gaza Strip and 40% of West Bank cases for chemotherapy and radiotherapy. By the end of June, Ministry central drug stores reported that 27% of essential medicine items were at zero stock in the West Bank and at 28% in the Gaza Strip. Both areas also noted that half of medical consumable items were at zero stock.
The situation in the Gaza Strip is most critical as additional factors are aggravating the situation. The Ministry of Health has only 10 days of fuel reserves to power hospitals during the frequent breaks in electric power from main lines. Half of government health workers have not received their salaries in recent months, and some can no longer afford to report for work. Ministry hospitals have stopped all elective surgeries in the past week to save resources and are trying to cope with urgent ones. This means that only urgent, life-saving operations are being carried out; operations such as orthopaedic reconstructive surgeries and cholecystectomies are being postponed until next year. A physician in Shifa hospital, on duty for 24 hours, said, “We are working in a terrible situation. I did not have the necessary materials to stitch my trauma patients today and had to improvise.”
The WHO Regional Director for the Eastern Mediterranean Dr Ala Alwan said, “We faced a similar situation in 2008–2009 and in 2012 in the Gaza Strip when stocks were low and medicines were urgently needed. Today, the West Bank is also affected by shortfalls in budget and medical supplies. The response and preparedness of the health sector is at very low level, and we are concerned about a possible collapse of health services. We are making an urgent appeal for US$ 40 million to support the Ministry of Health in providing essential supplies for health care sufficient for six months, which will guarantee basic preparedness, and US$ 20 million for referral debts to the East Jerusalem hospitals.”
This appeal is being coordinated with the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA). The refugee agency has expressed similar concern about the situation of medicines and the East Jerusalem hospitals. WHO is continuing to work with the Ministry of Health to coordinate humanitarian aid from donors, including facilitating the entry of medicines into the Gaza Strip.
Palestinian girl injured by Israeli airstrike in the northern Gaza Strip. Undated, published 10th July, 2014. Photo by APAimages/REX
As Israeli assaults kill dozens of Palestinians, doctors say they don’t have what they need to help treat the wounded
By Fares Akram, Al Jazeera America
July 08, 2014
Dr. Ayman al-Sahbani rushed to attend to eight people, including two children, in the emergency ward of Al-Shifa hospital. With most suffering from shrapnel wounds, the injured came to Gaza’s primary and largest hospital after an Israeli airstrike hit eastern Gaza City.
“Thank [God] their injuries are minor,” Sahbani, the head of the hospital’s emergency services, told Al Jazeera.
As Israel continues to pound Gaza with airstrikes — carrying out 50 bombings overnight Monday and more throughout the day on Tuesday — Sahbani expressed concern about the capacity of the territory’s hospitals to attend to the many injured.
As of late Tuesday, at least 27 Palestinians had been killed in the Israeli bombardment. More than 130 others were wounded, according to Palestinian officials.
All 12 beds in the hospital’s intensive care unit were occupied on Tuesday.
“Most of those people here have medical referrals and were supposed to be receiving treatment at outside hospitals,” Sahbani said.
“Now we can’t get them out, and we can’t find a space for new patients if the airstrikes intensify.”
He added that the closure of smuggling tunnels between Gaza and Egypt — the main lifeline through which medical supplies were brought into Gaza during Israel’s last major offensive, in November 2012 — and the closure of the Rafah border crossing have exacerbated the problem.
“[In 2012] we were sending critical patients day by day to Egyptian hospitals, aid was coming from Arab and other solidarity groups, foreign doctors were coming to help us, fuel was available,” Sahbani said.
“All that has gone.”
Gaza also suffers from a shortage of medicine and medical supplies, Gaza’s Health Ministry spokesman, Ashraf al-Qedra, told Al Jazeera. Gaza is completely missing about 30 percent of essential drugs, while 15 percent of the remainder is expected to be exhausted within days of an Israeli assault, he said.
“The medical services are in a very critical situation that we have never reached during the [Egyptian-Israeli] siege,” Qedra said, adding that the ministry is running “extremely short” on items like gloves, urine catheters and other medical equipment.
Qedra said the ministry has appealed to the Palestinian consensus government, which was formed last month, to help.
“We are surprised that the government has not reacted so far to rescue the health care system,” he said.
The persistent fuel crisis in Gaza, which leads to frequent electricity cuts, also puts patients at risk, especially those who rely on incubators and dialysis machines, and are admitted to emergency departments.
“In the past, we used to have a crisis in one field, not crises on all levels like today,” Sahbani said.