Situation in the OPT – WHO Health Inforum newsletter (01 October 2003)

Health Inforum News 

Volume 2, No.36, 01 October 2003

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

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In this Issue:

· Shortage of contraceptive pills in MoH family planning clinics in Gaza

· Launching of EMAP II,

· UNRWA protests Israeli action in Qalqilya Hospital

· Developing Nutrition Protocols in Palestine

· Pharmaciens Sans Frontières – Comité International, Report on MOH medicines transportation

· New Publications: A Psychosocial Assessment of Palestinian Children July 2003

· Upcoming events in the MoH

Shortage of Contraceptive Pills in MoH Family Planning Clinics in Gaza

The Family Planning Health Services were established in Gaza Strip more than 10 years ago. Contraceptives were made available to the Ministry of Health (MoH) and most of the relevant non-governmental health organizations in Gaza through the supplies available at MoH stock as well as through the European Women’s Health and Family Planning project through the end of the year 2002.

Currently, there is a shortage of supplies of contraceptives for the coming 6 months.  The MoH is thus looking for assistance in overcoming this shortage.

Below is the list of contraceptives needed for the MoH and NGOs for six months and the estimated prices in US$.

For more information, please contact Dr. Dina Abu Shaban, Director of Women’s Health Department,  Ministry of Health , Gaza

Telephone 08-2822889,

 Email: whddgaza@p-I-s.com

Launching of EMAP II

USAID continues to provide emergency medical assistance

 The United States Agency for International Development Mission’s to the West Bank and Gaza (USAID/WBG) is pleased to announce that on September 26, 2003,  USAID/WBG formally approved a $7,950,000 Follow-On Program to its Emergency Medical Assistance Program (EMAP) which ended September 30, 2003.  The aim of the Follow-On Program (EMAP II) is to ensure continuation of essential support services to the Palestinian health care system during such difficult times.  EMAP II went into effect on September 30, 2003 and will last until March 31, 2005.  As was the case with the original EMAP, EMAP II will be implemented by CARE International, mainly in cooperation with Johns Hopkins University (JHU) and the American Near East Foundation (ANERA).

The decision was taken after careful deliberation and extensive consultation with Ministry of Health staff and donor partners.  USAID/WBG opted for a Follow-On Program to EMAP, mainly on the basis of the recognized effectiveness of the EMAP program.

EMAP II consists of the same broad categories of intervention as the original EMAP: (1) procurement support; (2) operational support through sub-grants; (3) emergency care training; and (4) health information gathering through surveillance.  Within these same broad categories, new adjunct activities have been included, based on lessons learned under the original EMAP. The aim of these adjunct activities is essentially to ensure greater sustainability of the program’s outcomes and to maximize the program’s impact on actual health care practices.  By doing so, EMAP II can be considered a transitional support program, rather than purely an emergency support program.

UNRWA Protests Israeli Action in Qalqilya Hospital

Amman – The United Nations Relief and Works Agency for Palestine Refugees (UNRWA) has protested to the Israeli military concerning  a serious breach of both the United Nations’ immunities and international humanitarian law, taking place at its hospital in Qalqilya in the West Bank.

On Wednesday, 24 September, Israeli troops entered the UN-run hospital and made the medical staff leave their patients and duties and lie on the floor.

Israeli soldiers searched the hospital room by room and doors were kicked in by the troops, some locked doors were shot open. A number of windows were broken. The troops prevented the hospital Director and other staff from using their telephones to contact UNRWA’s field headquarters.

UNRWA has complained to the Israeli authorities concerning this serious disruption to its medical operations, which is contrary to the international Conventions governing the treatment of the United Nations.  It is also a complete breach of the Geneva Convention and its protocols, which accord hospitals special protection during conflicts. Hospitals may not be targets of military operations under the Convention, and the excuse of ‘military necessity’ is specifically ruled out.

UNRWA’s medical staff was unable to care for their patients in the hospital during the Israeli army’s presence in the building. The intrusion of the soldiers into all areas of the hospital, including the surgical theatre, carried the serious risk of cross-contamination of sterile areas. It is likely that key areas of the hospital will be out of operation until they can be rendered sterile.

Access and Health Incidents

Palestine Red Crescent Society Health Incidence  (13-26 September 2003)

Nablus, 13 September 2003 (02:57): The PRCS Emergency Medical Services (EMS) station in Nablus received a call about an injured person at Al-Nasser Street. An ambulance was dispatched to the area, but on arrival the Israeli soldiers denied the crew access.  The ambulance was then obliged to take an alternate route, which took 45 minutes. Finally, and only after ICRC coordination, Israeli soldiers allowed the crew access to reach the house where the injured person was located. The crew transported the 82-year-old male with no vital signs to Rafidia Hospital with a gunshot wound to the neck where he was declared dead.

Nablus 16 September 2003 (15:00):  A PRCS ambulance was on its way to Al- Watani Hospital to transport a patient from Howwara village. During the transport, the crew received a call about another patient in critical conditions at a clinic in Howwara village. They proceeded to the clinic but at the Howwara checkpoint, Israeli soldiers denied the crew access because, according to the soldiers, the patient in the ambulance was carrying an ID from A’warta village. After coordination with ICRC the ambulance was allowed to pass after being detained for one hour. Unfortunately, by the time the ambulance passed the checkpoint, the doctor on call at the Howwara clinic had already notified the EMS station that the critical case patient had died.

Nablus 17 September 2003 (03:40):  A PRCS ambulance was on its way to transport a patient to the old city in Nablus, after receiving a call of an injured person in the area. The Israeli soldiers stopped the ambulance 100 meters away from the injured person and denied its access. At 04:25; the ambulance took an alternate route through Hatteen Street and found the injured person bleeding on the ground.  He was transported to Rafidia Hospital with gunshot wounds on the neck and hips.  

Nablus 17 September 2003 (03:40):  A PRCS ambulance was on its way to transport an injured person  from the old city in Nablus. Israeli Army jeeps and tanks at Al-Saha gate stopped the ambulance and denied its access. The ambulance took another direction through the green mosque street but couldn’t pass because Israeli tanks had blocked the area. The ambulance was detained for 50 minutes, before Israeli soldiers ordered the crew to leave the area.         

Qalqilia, 20 September 2003 (16:10):  A PRCS ambulance transporting two patients from Ramallah to Qalqilia was stopped by Israeli soldiers at the Yetshar settlement intersection. The soldiers detained the ambulance for two and one half hours. During the detention period the driver and the patients’ companions were ordered out of the ambulance and left standing under the hot sun. Finally, the ambulance was denied access and was obliged to take another route through the Za’atara road to reach Qalqilia.

Nablus, 20 September 2003 (16:20): A PRCS ambulance transporting a patient to Ramallah hospital was stopped by Israeli soldiers at Yetshar checkpoint. The soldiers searched and then detained the ambulance for two and one half hours. The driver tried to call the Nablus EMS station to inform them of the situation but was prohibited by the soldiers. The ambulance was allowed to pass but without the patient. However, the driver refused the soldiers’ order and was eventually allowed to pass with the patient.

Bethlehem, 21 September 2003 (08:55): A PRCS ambulance transporting two patients from Al-Hussein Hospital (Bethlehem) to Augusta Victoria Hospital (Jerusalem) was stopped by Israeli soldiers at the Gilo checkpoint. The soldiers proceeded to check IDs and search the ambulance, which took fifteen minutes. The soldiers then denied the ambulance access without giving a reason. Due to the serious condition of both patients, the crew called the EMS dispatch and requested ICRC coordination. Thirty minutes later, the Israeli authorities denied ICRC coordination. The soldiers at the checkpoint then gave the ambulance crew the choice to either pass with only one of the patients or return back. The crew was forced to choose between two patients in serious condition.  After a total of forty-five minutes delay, the ambulance was allowed to pass with one patient. The kidney dialysis patient remained behind.

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

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

E-mail: pressoffice@palestinercs.org

A Palestinian Child Returns after Undergoing Heart Surgery in London

Abdul Raheem Abu Hamra, a 3-year-old Palestinian child from Gaza, returned from London after  successfully undergoing  open heart surgery.  The operation was carried out  by Prof. Magdi Ya’koob and financed by the Chain of Hope UK Association.

Dr. Sami Abu Dalfa, Director of Al-Dorra Pediatric Hospital of the MoH said that the child was suffering from a complicated congenital anomaly of the heart (Tricuspid Artesia and Pulmonary Artesia).  The operation (Fountain Operation) was complex and lasted many hours.  This kind of operation is made possible through  the cooperation protocol that has been established between the MoH and the Association.  Dr Abu Dalfa added that other cases will be sent to London in order to undergo open heart surgery in  November.

It is also worth mentioning that two children, Ahlam Hamad and Malak Keshta, from Gaza Strip, returned last s week from Switzerland after undergoing successful open heart surgery.  These procedures were organized and covered by Palestine Children’s Relief  Fund (PCRF) in USA.  

Developing  Nutrition Protocols in the oPt

Ard El-Insan is currently working on developing protocols of nutrition throughout a technical consultancy team (Dr. Raghda Al Shawwa, Dr. Adnan Al-Wahaidi, Dr. Najwa Rizkalla and Mrs. Dina Al Sharif), funded by the MARAM project (Healthier Palestinian Families).

According to Ard El-Insan the idea for the above activity resulted  from the absence of effective standardized and nationally adopted nutritional protocols.  The absence of such protocols has been the main obstacle hindering  the effectiveness of past and current  programs related to nutrition..  The necessity of developing integrated and well-adopted national nutrition protocols thus remains a serious concern to health professionals and decision makers.

The output of this consultancy will be the development of nutritional protocols, which will be validated at the national and international levels.

The technical content of the developed protocols will address the following areas:

1. Breastfeeding

2. Infant feeding counseling

3. Growth monitoring

4. Maternal nutritional health.

Ard El-Insan has asked for the contributions of different providers and professionals to achieve this important and significant task, by providing  materials (protocols/ guidelines/ policies, scientific papers or publications) relevant to maternal and child health nutrition.

Care International Deliveries of Medicines

USAID, through Care International, has delivered the medical kits listed below during  the period 6th -18th September 03.

The following table shows deliveries of Medical Kits as of the 8th September 2003.

· Medical kits

In addition,  the following table shows the delivery of Medical Commodities from September 13th   2003 to September19th 2003 .

Pharmaciens Sans Frontières – Comité International,  Report on MOH Medicines Transportation

Pharmaciens Sans Frontières – Comité International (PSFCI) is financed by ECHO (European Community Humanitarian Office). They began  their activities with the MoH on the 31st of May 2003, in order to distribute pharmaceuticals from the central pharmacy store in Ramallah to different districts in the West Bank.  Recently, they published their report on drug distribution for the MoH

PSF CI implemented  drugs management rules in the following Primary Health Care facilities:

1. Qalqilya: Health facility of Jayyus;

2. Bethlehem: Central PHC and Health Facilities of Beit Fajjar, Hussan, Tuqu;

3. Nablus: Central PHC and Health Facilities of Asira ash  shamalya, Huwara and Qabalan;

4. Hebron: Central PHC and Health Facilities of Yatta, Bani Naim and Sair

5. Ramallah: Central PHC and Health Facilities of Arura, Beit Rima, Deir Jarir;

6. Jerusalem: Central PHC (dispensary room) and Health Facility of Qatanna;

7. Jericho: Central PHC;

8. Salfit: Central PHC;

Drugs management rules consist of the following:

– Storage of drugs on shelves with labels on the  front of each item;

– Management of drugs in alphabetic order according to   generic name, galenic form and the proximity of the   expiry  date (FIFO);

– Separation of expired drugs;

– Identification of  unused items or large quantities;

– Narcotics separated and locked;

– Cool medicines in fridge.

To read the full detailed report covering the period from  31 May to 23 August 2003. Please visit Health Inforum web portal http://www.healthinforum.net/files/misc/PSF_report.doc 

New Publications:

A Psychosocial Assessment of Palestinian Children July 2003

As the Israeli-Palestinian conflict continues, reports of trauma amongst Palestinian children have multiplied.

In order to provide a better understanding of the psychosocial well being of Palestinian children, the following assessment was undertaken by Save the Children-US and the Secretariat of the National Plan of Action for Palestinian Children (NPA), , in collaboration with Save the Children-Sweden. Funding was provided by the United States Agency for International Development (USAID).

For more information please visit Health Inforum web portal www.healthinforum.org 

Upcoming Events in the MoH

· Palestine Children’s Relief Fund (PCRF) in USA reports that a plastic surgery delegation, headed by Dr. Henrico Roberto, will visit the Gaza European Hospital starting at Nov. 28th 2003, for one week.

· PCRF reported that a Dutch cardiac surgery delegation, headed by Dr. Paul Chuff, will visit the country during the period of  the 17th to the  23rd Oct. 2003.   The team will perform heart operations for children who have cardiac problems.    

FOR MORE INFORMATION

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