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

Health Inforum News 

Volume 2, No.21, 15 February 2003

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– In this News Letter:

– New Health Coordinator in West Bank and Gaza Strip

– No Health without Mental Health.

– ESSPII World Bank Project.

– PRCS Health Incidents (February 1-14) -Newly Posted:

A report by Physicians for Human Rights-Israel

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"Improving of local capacities and strengthening information and advocacy are cornerstones of WHO strategy in the oPt." 

By: Dr. Ricardo Sole Arques the New "WHO" coordinator 

I would like to convey my salutations to the Health community while I am taking office as WHO's Health Coordinator in West Bank and Gaza. I see this new post as a challenging opportunity, and also as a big responsibility.

In my professional career as an international health worker I have been through complex and difficult situations, both at field practitioner level and at planning and policy maker levels. I participated actively in the health sector reform in my country (Spain) during the eighties, and I have been involved in different responsibilities in conflict situations around the world in the last 10 years, like the Balkans, Afghanistan, Colombia, and in some African countries, like Niger, Mali, Burundi and Angola. In the region I was involved in Lebanon in 1996 and I have been following closely the evolution of the crises in the Near East.

I think that the International Community has an obligation towards the Palestinian people, and I am convinced of the commitment of WHO towards the improvement of the health conditions in the Palestinian Self Rule Areas. The good health indicators and the high level of education of the Palestinian people are universally acknowledged. Of course, health is the result of many factors, and the political constraints are currently possibly the most relevant health hazard for the Palestinian people. I hope that my experience in the health sector and in complex emergencies will be an added value to the effort of WHO in the current situation in the oPt.

I count on keeping a close collaboration with the Health community in order to achieve the goals we are aiming, which can only come as the result of a joint and strong will from all involved. Improving of local capacities and strengthening information and advocacy are cornerstones of WHO strategy in the oPt.

The region is facing troubled times. You can count of my commitment and dedication and, with the contribution of all of you, we will be able to see the end of the tunnel while building the basis of an adequate health system in the context of a healthy society, the one the Palestinian people undoubtedly deserves.

Health Infield 

NO HEALTH WITHOUT MENTAL HEALTH 

War has a severe mental impact on the population. Security and survival becomes a major issue for individuals and the society. In this process the services of vulnerable groups, as people with mental illnesses, may decline.

In order to protect the values of a human civil society and to open gates for a development of the services in the future it's important also to support the vulnerable groups during war and crises.

World Health Organization Emergency and Humanitarian Action's program for West Bank and Gaza has, in collaboration with the Palestinian Authority's Ministry of Health and international organizations, started a Reorganization of Services and Coping with Crises project.

The project will support and implement a community mental health development, improve the conditions and patients- & human rights of patients with mental illnesses. The impact of the present war situation on the minds of the general population and on people with mental illnesses also requires network activities, empowerment programs and support, integrated in the community and with the local services. The preparation of a long term strategic plan for mental health services and organization should continue on behalf of the Ministry of Mental Health as part of formulating a National Health Policy.

The new project will continue the work of the earlier started WHO Mental Health Program, supported by the Ministry of Health and French and Italian organizations.

The present conditions are reflected in human minds and human minds guide the actions people take. There is no health without mental health and peace is a prerequisite for health.

The Emergency Service Support Project (ESSPII) has been declared effective on January 13, 2003. 

This project will be on a grant basis for US$ 25 million from the World Bank, and we will secure more funding in co-financing. The support is going to be for three ministries: MOH, Education and Higher Education and Social Affairs. The support to the MOH will be US$ 13,450,000.

The objectives of the project are to mitigate the deterioration of basic social services brought about by the ongoing conflict and its negative effects on economic activity and Government revenue.

The support to the MOH will cover the following operating budget items:

(i) Essential Drugs and Medical Consumables (Grant: US$7.10 million). 

This subcomponent will finance the procurement of essential drugs, vaccines, laboratory and blood bank materials and other medical consumables, allowing for retroactive financing back to September 1, 2002.

(ii) Non-medical Recurrent Expenditures (Grant: US$4.10 million). 

This subcomponent will finance non-medical costs of operating and maintaining of health facilities, including communication, fuel, water and electricity utilities, rent for health facilities, cleaning services, cleaning materials, transportation, linen, uniforms and stationary.

(iii) Treatment in Private/Non Governmental Clinics (Grant: US$1.30 million). 

This subcomponent will finance contracts with private/non-governmental medical institutions for providing services that are not available by public facilities in the area.

(iv) Nutrition Services (Grant: US$0.50 million). 

This subcomponent will cover the provision of supplementary milk formulas and iron supplements to public clinics as part of a wider program of addressing the phenomenon of malnutrition amongst children below 5 years of age and lactating mothers.

(v) Hospital Food Contracts (Grant: US$0.50 million). 

This subcomponent will finance the cost of food for hospitals.

PRCS Health Incidents Report (February 1-17, 2003) 

Nablus, 17 February 2003, Mohammad Al Kaabi, a volunteer in the Medical Care Committee was shot in the abdomen by Israeli live ammunition while he was in a UPMRC (Union of Palestinian Medical Relief Committees) ambulance. The incident occurred as, Al Kaabi, 19, was attempting to assist victims of the Israeli attack on civilians in Nablus the day before. Israeli soldiers in a tank shot directly at the ambulance; hitting Al Kaabi in the abdomen. The bullet then exited the ambulance and hit a nearby medical storage facility.

The driver of the ambulance, Firas al-Bakri, was also injured in his hand by shrapnel from Israeli gunfire.

Nablus, 14 February 2003 (8:25 PM): Israeli soldiers at the Howara checkpoint stopped an ambulance that was transporting patients. The soldiers imposed arbitrary searches and commanded the staff to remove the vehicles oil pump. The ambulance was denied permission to pass, and forced to return to Nablus without transporting the patients.

Nablus, 14 February 2003 (10:00 AM): Israeli soldiers at the Howara checkpoint stopped an ambulance that was transporting a woman in labor. The officer in charge asked one of the soldiers to remove the vehicles air filter, but the same soldier misunderstand the officers order and instead told the medics to drive on. However the other soldiers ordered the vehicle back and verbally assaulted the crew. The ambulance was then permitted to pass.

Nablus, 14 February 2003 (2:00 PM): Soldiers at the Shafe Shamron checkpoint stopped an ambulance transporting a patient to Jenin. The vehicle was detained for 1.5 hours.

Nablus, 8 February 2003 (3:30 PM): Israeli soldiers at the Howara checkpoint stopped an ambulance that was carrying three patients. The ambulance was detained for two hours, and forced at gunpoint to return to Nablus.

Nablus, 8 February 2003 (12:30 PM): An ambulance carrying 3 patients was stopped and detained for 3 hours at Al-Mslah checkpoint, searched and staff ID cards checked. The ambulance was stopped again at another checkpoint; Israeli soldiers confiscated the crews ID cards and ordered them to return back.

Nablus, 7 February 2003 (7:30 PM): Israeli soldiers at the Howara checkpoint stopped an ambulance that was transporting a woman from the village of Derestiya to the Rafidya Hospital in Nablus, where she was going to give birth. The soldiers detained the ambulance for 1 hour without providing justification for their actions.

Nablus, 7 February 2003 (10:10 PM): An ambulance in transit between the Nablus and Beta branches of the PRCS was stopped at the Howara checkpoint for one hour. The soldiers entered the ambulance, cut the upholstery of the medics chair in the back of the ambulance, and damaged the stretcher by throwing it out the back of the vehicle. The ambulance was denied permission to pass, and forced to return to Nablus.

Nablus, 7 February 2003 (12:12 PM): Soldiers at the Howara checkpoint stopped an ambulance transporting two patients from the hospital to their homes. The vehicle was detained for 1.5 hours, and copies of the PRCSs Arabic-language publication Balsam were confiscated.

Nablus, 6 February 2003: Two Palestinian nurses were killed by the Israeli helicopters air strikes which hited al Wafa'a and al Amal hospital in eastern Gaza city, the two nurses names are Omar Hasan , 21 years old and Abdel Karim Loubed,

Nablus, 6 February 2003 (11:00 AM): Israeli soldiers at the Howara checkpoint held an ambulance that was carrying a cardiac patient and a kidney patient from the hospital to their homes. The soldiers, kept the ambulance there for 1.5 hours before allowing it to pass.

Nablus, 6 February 2003 (11:30 AM): An ambulance carrying 4 patients home from the Rafidya and Al-Watani hospitals was stopped at the Howara checkpoint. The ambulance turned around since the Israeli soldiers did not allow it to pass through the checkpoint, saying that the checkpoint was closed.

Nablus, 4 February 2003 (9:00 AM): An ambulance was detained by the Israeli Army at the Shafi Shamron checkpoint while on its way to pick up a cardiac patient from the village of Sebastiya. After checking the IDs of the ambulance crew and searching the ambulance, one of the soldiers permitted the ambulance to proceed. Immediately, another soldier stopped the ambulance at gunpoint, forcing it to remain at the checkpoint for 3 hours.

Nablus, 3 February 2003 (09:00 PM): Israeli soldiers at the Jordan Street checkpoint stopped an ambulance at gunpoint, and forced it to turn back. The ambulance was attempting to carry a child with heart disease from her home in the Balata Refugee Camp to a hospital in Nablus.

Jenin, 1 February 2003 (08:00 AM): An Israeli Army jeep halted an ambulance at gunpoint before the Beit Eba and Quseen checkpoints. The ambulance, which was carrying 4 patients, was detained for 2.5 hours. When the ambulance driver refused to make the patients leave the ambulance, he was beaten in the face and abdomen, while an Israeli soldier held a gun to his head. The soldier threatened to shoot the driver if he did not make the patients leave the ambulance. As a result, a cancer patient and an elderly male cardiac patient were removed from the ambulance, and forced to find transportation to the hospital in a private car.

Tulkarem, 6 February 2003 (04:25 PM): PRCS received a call from the Israeli Army, requesting that an ambulance pick up an injured person from the Al-Kafreyat checkpoint. Upon arrival at the checkpoint, the ambulance crew was told to leave and the soldiers claimed responsibility for treating the wounded man. Later in the day, PRCS received another call from the Israeli army asking them to pick up the corpse of the man who had died at that same checkpoint.

Tulkarem, 6 February 2003 (12:45 PM): An ambulance carrying two injured persons was held at the Quseen checkpoint for 1 hour. One of the two patients was in critical condition after being shot in the head with a rubber bullet fired by and Israeli soldier. No reason was given for detaining the ambulance.

Tulkarem, 3 February 2003 (06:40 AM): An Israeli tank stopped an ambulance that was carrying a dialysis patient. The ambulance was held for 35 minutes, and then forced to turn around. The reason given by the soldiers was that the condition of the patient was not critical enough to warrant a trip to the hospital.

Hebron, 1 February 2003 (08:45 PM): PRCS ambulance was forced to maneuver through 7 road blocks in order to reach a cardiac patient in Yatta. The response time for this call should have been 15 minutes but because of the blockades it took 40 minutes and when the medical team reached the patient he had died.

Ramallah, 5 February 2003 (12:10 AM): An ambulance transporting a pregnant woman from Surda to Ramallah was held at the Surda checkpoint for 30 minutes. Israeli soldiers searched the vehicle while the woman was in active labor.

Gaza City, 6 February 2003 (11:50 PM): An EMS ambulance was forced to turn back while attempting to respond to a call near clashes in the area of the Al-Wafa Hospital. As the ambulance reached the scene, an Israeli tank fired shots in the direction of the ambulance forcing it to turn back without reaching the injured.

For more information please contact Press Office at: E-mail: pressoffice @palestinercs.org PRCS Website: www.palestinercs.org 

Newly Posted: A report by Physicians for Human Rights-Israel

"BLOCKED" A Visit to the Villages of Salem, Deir al Hatab and Azmut

"The physical roadblocks are installed in addition to staffed checkpoints. The techniques used to create roadblocks are varied – concrete blocks, high earth embankments, concrete walls, deep ditches, and ditches into which sewage has been diverted, so that they cannot be crossed even on foot (see below). A sick person who manages to cross sewage ditches and makeshift embankments on foot may then encounter a couple of soldiers preventing access to the city. The same patient cannot be evacuated by ambulance, since ambulances are unable to cross ditches of a depth of 2-3 meters or climb embankments 5 meters high. In such circumstances, the concept of "emergency evacuation" has become meaningless".

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