Situation in the OPT - WHO Health Inforum newsletter (15 October 2003)

Health Inforum News

Volume 2, No.37, 15 October 2003

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Welcome to the thirty-seventh edition of the Health Inforum Newsletter.

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In this Issue:

· Rafah Humanitarian Crisis

· Due to the strike in Israel, no entry for medicine from West Bank to Gaza

· PRCS Health Incidents 04 – 10 October 2003

· Detention of UHCC’s ambulance for more than three hours at Howara Checkpoint

· Press release, Médecins du Monde,

· ICRC News

· Palestinian Physicians Syndicate launched EMED Program

Rafah Humanitarian Crisis

According to Palestine Red Crescent Society PRCS, the Israeli invasion of Rafah on 9-11th October 2003 resulted in the following:

* 8 deaths and 80 wounded; * * 107 homes completely destroyed, leaving 187 families homeless.

* 20 homes partially destroyed, leaving 35 families without safe shelter.

* The destruction of the water and sanitation network, in addition to electricity and phone lines.

* Many streets dug up by the bulldozers, causing difficulty in reaching casualties and families requiring assistance.

Due to the strike in Israel, no entry for medicine from West Bank to Gaza

Due to the general strike in Israel, the Karni checkpoint to the Gaza Strip has been closed for over one month (with the exception of a few days during which it was temporarily opened), meaning that the entry of crucial medicines has been blocked. After coordination with the Israeli side, some drugs and pharmaceuticals were allowed to enter Gaza via Erez industrial zone to the north of Gaza for short periods. However, this was true only in the case of drugs coming from Israel or imported by Israeli companies.

Regarding drugs coming to Gaza from the West Bank, the long-standing agreement between the Israeli and the Palestinian sides states that shipments must be transferred via Tarqumia checkpoint in the south of the West Bank. Previous to the strike, at Tarqumia checkpoint pharmaceuticals were inspected by personnel from the Israeli Ministry of Agriculture, who put their stamp on the stock, then transferred it to Gaza. Without this stamp the stock cannot pass out of the West Bank. Since the general strike in the Israeli services includes workers of the Ministry of Agriculture, the transfer of drugs and pharmaceuticals from the West Bank to the Gaza Strip has now become impossible. As mentioned, drugs coming from Israeli sources are not affected.

Influenza Vaccines also are affected

3000 doses of Influenza vaccines for the oPt have been stuck at Ben-Gurion airport in Israel since 27 September 03.

According to Dr. Abed Al-Jabar Alteibi, Director General of Primary Health Care Department in Gaza, the delay in the reception these vaccines will seriously affect the target group.

These shipments of vaccines are funded by USAID and facilitated by UNICEF and WHO.

				Access & Health Incidents
				

PRCS Health Incidents 04 – 10 October 2003

PRC Khan Younis, 5 October 2003 (18:30): The Emergency Medical Services (EMS) station received an emergency call concerning a woman suffering from pregnancy complications in East Rafah. The ambulance crew requested ICRC coordination at 20:00 o’clock. However, the ambulance couldn’t reach its destination because Israeli Army tanks were blocking the area. Then Israeli soldiers began shooting at the ambulance and it was obliged to return to the EMS station. A second attempt for ICRC coordination with the Israeli Army succeeded, but only on the condition that the woman and her family walk to a pre-determined location carrying a flashlight in order to meet up with the PRCS ambulance. When the medics began to walk to meet the woman, Israeli soldiers again started shooting at them. The medics immediately returned to the ambulance and remained near the area till 23:30. Unfortunately, they were unable to transport the women and the ambulance returned to base.

In addition to the above, the following table lists incidents of denial and delay of access during this reporting period.

Date	Location	Delay (Minutes) or Denied Access
6/10/2003	Hebla Separation Gate/ Qalqilia	60 minutes
8/10/2003	Showaika gate/ Tulkarem	60 minutes
8/10/2003	Al-Kafryat/ Tulkarem	90 minutes
8/10/2003	Flying checkpoint	20 minutes
4/10/2003	Al-Hammra/ Jenin	90 minutes

For more information please contact Press Office at: phone: +972 2 240 6515/6/7

E-mail: pressoffice@palestinercs.org

· Detention of UHCC’s Ambulance for more than three hour at Howara Checkpoint

While returning to Nablus after carrying patients to Ramallah, a UHCC ambulance was kept waiting along other 6 ambulances for more than 3 hours at Howara Checkpoint, on to 12/10/2003 from 7:00 p.m. till 11:00 p.m. No apparent reasons were given for such detention.

Press release… Press release… Press release… Press release… Press release…

13th October, 2003

Médecins du Monde,

Object : Denial of access to medical care in Rafah (Gaza Strip)

Médecins du Monde, a medical humanitarian organisation, works in the Gaza Strip alongside the emergency service of the Palestine Red Crescent Society (PRCS) through a team of emergency doctors. Since the start of military operations carried out by the Israeli Army in Rafah on Thursday 9th October, the team affirms restrictions imposed on the PRCS ambulances present to bring medical aid to the injured, and to treat the sick and injured in the most appropriate medical facilities available in the Gaza Strip.

Since Thursday 9th October the Israeli army have carried out military operations in the Rafah refugee camp , in the south Gaza Strip, which have to date caused the death of eight persons (of which two were children) and led to at least sixty others being injured. The ambulances which should assist the victims were unable to reach the « occupied » zone, and were not accorded the protection normal to medical vehicles.

During the night of 10th to 11th October, when an ambulance from the Palestine Red Crescent Society (PRCS) attempted to bring assistance to a patient in the refugee camp, which was under curfew, Israeli forces opened fire as the ambulance crew prepared to leave the vehicle – clearly identified by a flashing light. Prior coordination to reach the home of the patient had been granted by the Israeli army. Since then, absence of protection for the medical staff has totally prevented access for ambulances to the sick and injured inside the incursion zone.

These military operations accompanied by a system of partial road closures result in the Gaza Strip being cut into four parts. Rafah is thus isolated from the rest of the territory. Closure is strictly imposed during the night- time military operations. These conditions have a serious and direct implication on the care of sick and wounded in the most appropriate medical facility. The only hospital able to receive injured in the Rafah area is the Abu Yusef el Najar hospital, which has only 50 beds. In recent days the hospital has had to deal with an influx of injured patients, without even the possibility to transfer some to the nearby hospitals in Khan Yunis (Gaza European Hospital 3km distant and Nasser Hospital at 7km), or to Shifa Hospital in Gaza City 30 km away.

Continued closure of the roads by the Israeli army, and the lack of authorisation accorded the ambulances to transfer patients between hospitals, thereby freeing space in the Najar Hospital of Rafah, constitute major obstacles in the correct treatment of victims due to the ongoing incursion.

Médecins du Monde denounces these obstacles denying aid to the victims and access to appropriate care. Such obstacles constitute violations of International Humanitarian Law, notably the Fourth Geneva Convention concerning the protection of civilians.

Press contacts:

Jerusalem: Blandine Contamin – tel : 972 57 249450

Gaza: Nathalie Godard – tel : +972 (0)57 832 882

Paris: Laure Weisgerber / Annabelle Quenet – tel : 33 1 44 92 14 31

ICRC News:

· Update on Emergency Care Work

In order to improve emergency care skills and to provide emergency staff with updated knowledge, the ICRC, together with Ministry of Health and Palestine Red Crescent Society, organized 8 seminars in the Gaza Strip and the West Bank on Advanced Support for Weapon Wounded.

350 emergency room nurses and emergency medical technicians attended these seminars, which took place in September and October.

In addition to lectures in triage and pre-hospital management, the seminars also provided lectures on International Humanitarian Law, the emblem and rights and duties of the medical mission. A brochure providing brief descriptions of ICRC activities and emblem issues was distributed to all participants.

· Latest Food Distributions In the West Bank And Gaza

Due to military operations, curfews and closures, the Palestinian economy is deteriorating rapidly. More than half of the population lives below the poverty line and unemployment is close to 50%.

The ICRC continues to remind the Occupying Power of its primary responsibilities under the fourth Geneva Convention to ensure that the entire population has access to food and water, medical assistance, employment and education. However, the needs in the occupied territories in all of these areas remain enormous. Therefore, in June 2003, as an exception, the ICRC decided to extend its large assistance programs in urban and rural areas until December 2003.

From 8 September to 5 October, the ICRC carried out the following:

Urban Voucher Program,

18,425 families in Ramallah, Jericho, Nablus, Tulkarem, Bethlehem and Hebron received their six-weekly voucher to be redeemed for essential food and non-food items.

Rural Relief Program

14,118 families in 159 villages in Bethlehem, Nablus, Ramallah, Jenin, Tulkarem, Salfit, Jericho, Hebron and Qalqilya districts received 980 Mt. of flour, 98 Mt. of sugar, 163 Mt. of pulses and 119,020 Lt. of vegetable oil as well as 4,319 hygiene parcels.

House destruction relief program

60 families in the Gaza Strip and 34 in the West Bank, whose houses have been destroyed or damaged, received relief kits containing blankets, hygiene supplies and household items and, if needed, a tent.

H2 assistance program

In the Old City of Hebron (H2), the ICRC distributed food parcels to 1,918 vulnerable families.

Emergency assistance in Gaza

In the Gaza Strip, emergency assistance of food parcels was distributed to 8 families.

Water assistance

In Hebron and Salfit districts, 3,295 truck- loads of 10,000 liters each were distributed and the building of 32 cisterns was completed.

· Source: UPDATE N°51, Weeks 37-40, 8 September – 5 October 2003

Care International Deliveries of Medicines

USAID, through Care International, has delivered the medical kits listed below during the period September 27th -October 10th, 03. The following tables shows deliveries of Medical Kits and other deliveries. Medical kits

Clinic Name	Kit Type	Clinic Level	Delivery Date	Total Cost $
Al Zakat Agraba	MED	3	30/9/2003	787
SMA Qabalan	MED	3	30/9/2003	787
PRCS Azmoot	MED	2	30/9/2003	505
Al Zakat Beta	MED	3	30/9/2003	787
Old City Nablus	MED	2	30/9/2003	505
UPMRC Turmos Aia	MED	2	30/9/2003	505
PRCS Silwad	MED	3	30/9/2003	787
UPMRC Synjel	MED	2	30/9/2003	505
SMA Der Debwan	MED	2	30/9/2003	505
PRCS Abu Misha’al	MED	2	2/10/2003	505
PFS Kufor Ein	MED	2	2/10/2003	505
Ateel Society	MED	3	8/10/2003	787
UPMRC Maithaloun	MED	3	8/10/2003	787
UHWC Tubas	MED	3	8/10/2003	787
UPMRC Al Zababdeh	MED	2	8/10/2003	505
Anabta Al Zakat	MED	2	8/10/2003	505
UPMRC Tulkarem	MED	2	8/10/2003	505
UPMRC Al Sileh	MED	2	8/10/2003	505
PFS Yabad	MED	2	8/10/2003	505
UPMRC Jiflick	MED	2	8/10/2003	505
Al Samou Med center Hebron	MED	3	4/10/2003	787
Doura Municipality	MED	3	4/10/2003	787
Dahria Municipality	MED	3	4/10/2003	787
Seir Charitable Society	MED	3	4/10/2003	787
Halhoul Womens Society	MED	3	4/10/2003	787
Tarquomia Charitable Society	MED	3	4/10/2003	787
Beit Omar Charitable Soc	MED	3	4/10/2003	787
Bani Naim Charitable Society	MED	3	4/10/2003	787
Noba Charitable Society	MED	2	4/10/2003	505
UPMRC Idna	MED	3	4/10/2003	787
Shyoukh Zakat Community	MED	3	4/10/2003	787
PRCS Beit Fajar	MED	3	7/10/2003	787
Aknaf Beit Al Maqdes	MED	3	7/10/2003	787
PRCS Al Khader	MED	3	7/10/2003	787
UPMRC Jenin	MED	3	8/10/2003	787
			Total	23,597

· Other Deliveries

Item	Qty	Beneficiary	Delivery Date	Total Cost $
Medical Disposables	9 Pallets	MOH Ramallah	4/10/2003	20,109
Pulse Oxymeter& Medication Trolly	1&2	MOH Ramallah	8/10/2003	5,100
Metronidazol Inj ,500mg	10,200	MOH Ramallah	4/10/2003	11,220
			Total	36,429

Palestinian Physicians Syndicate launched EMED Program

The Palestinian Physicians Syndicate began implementing its Emergency Medicine Educational and Development (EMED) program last Saturday. This is a one-year program that aims to provide training for in-hospital emergency department practitioners — both physicians and nurses. A total of 210 physicians and nurses will benefit from this program, which will be divided into 7 courses, each lasting for 6 days with 30 participants. The program is being implemented by CARE international in cooperation with Johns Hopkins University and Target Medical Services. The technical oversight is provided by the Palestinian Physicians Syndicate and the Palestinian Nursing Syndicate. The USAID funded this programme.

The opening ceremony was held in the presence of the Minister of Health, the Director General of the MoH and the Chairman of the Physicians Syndicate. In his speech, the Minister of Health recognized the efforts made to begin this program, and stressed the importance of these courses. He noted that this training is especially important in the current context of the range of Israeli obstacles to healthcare access — including checkpoints, curfews and closures, in addition to daily incursions and the on-going emergency situation in the region.

It is also worth mentioning that the Palestinian Physicians Syndicate is currently implementing another training program in the field of pre-hospital emergency care for 100 physicians, funded by MARAM project. The Syndicate, through its Scientific Board, is currently finalizing the process of adapting protocols related to pre-hospital emergency care. Dr. Salah Al-Khaldi the head of Scientific Committee of the Syndicate pointed out that the Syndicate runs 198 emergency points scattered in all the Gaza Strip. Physicians serving in these points, who work on voluntary basis, will benefit from the pre-hospital emergency services program as will other physicians from the MoH and other sectors.

FOR MORE INFORMATION

Please feel free to contact us for information at:

Health Inforum, c/o the Italian Cooperation

Sheik Jarrah, East Jerusalem

Tel: 02 532 7447 Fax: 02 532 2904

Email: info@healthinforum.org www.healthinforum.org

Health Inforum posts daily news and announcements concerning health issues on our website: www.healthinforum.org. We welcome your inputs, comments and suggestions.

Situation in the OPT – WHO Health Inforum newsletter (15 October 2003)

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