Health Situation in Gaza – 5 January 2009
Overview
This is an update on the health sector situation since the Israeli air strikes started at 11.15 on 27 December 2008.
- Two shells hit 15 metres from Al Awda hospital’s emergency room. A nurse sustained severe head injuries.
- Three mobile clinics were destroyed 5 January. All vehicles are now unusable.
- One paramedic was killed and two injured en route to evacuating a patient and their ambulance destroyed by munitions. This raises total of medical staff killed since 27 December to six and ambulances hit to three.
- All Gaza hospitals continue working on back-up generators for the third consecutive day.
International Humanitarian Law requires all medical personnel and facilities be protected at all times, even during armed conflict. Attacks on them are grave violations of International Humanitarian and Human Rights laws.
CASUALTIES
As of 5 January, the Palestinian MoH had reported 548 deaths since 27 December, of which at least 120 were children and 44 women (30% of all deaths). At least 2550 Palestinians have been injured, of which 1134 are children and women. The MoH reported that since Israel began its ground operation on 3 January, 109 persons have been killed.
On 5 January one Palestinian MoH paramedic officer was killed and two others were injured in El-Hawa area. On a separate incident a nurse was severely injured following the explosion of two consecutive shells 15 metres away from Al Awda hospital’s emergency room.
HOSPITAL FUNCTIONING
Damage to hospitals and ambulances
The ambulance that carried the paramedic officer and his colleagues was hit by munitions. Al Awda hospital emergency room was damaged by the explosion. At the time of shelling, ambulances were bringing in wounded, placing at great risk the lives of the wounded and health personnel. According to Palestinian medical sources, the hospital had received no advance warning.
Similarly, no warning was given before three mobile clinics and one vehicle belonging to the Union of Health Care Committees (UHCC) were hit and destroyed in the morning while parked inside their premises in Gaza City, close to Shifa hospital and to the UNDP building. The mobile clinics had been recently donated by the Spanish Government and had not yet been used.
There are fears of possible attacks on hospitals due to Israel’s allegations that Hamas may be using the hospitals as hide-outs. Shifa hospital staff are fearful of an attack, placing greater strain on already overstretched health personnel.
The Director of El Wafa rehabilitation hospital, Gaza’s only rehabilitation hospital, has received orders from the IDF to evacuate all staff and patients. The Director has refused and everyone remains in the hospital. El Wafa is located in eastern Gaza’s El Sheja’ia neighbourhood.
Windows at the Dorah and Gaza Paediatrics hospitals have not been repaired and are covered with plastic sheeting.
Electricity failure and fuel supply
All Gaza City hospitals have been without electricity since 3 January – 72 consecutive hours – and have been depending on back-up generators. UNRWA and ICRC are working to supply more fuel to keep generators running. Hospitals warn that the generators are close to collapse and they have four more days of fuel, even with services limited to the mere essentials. At the Shifa hospital alone, collapse would have immediate consequences for 70 intensive care unit patients including 30 in the neonatal care. Twelve operating rooms would also be immediately affected, in addition to shutting down the oxygen extractors, refrigerators for blood units and machines for emergency laboratory services. Also, all hospitals would be without heating and lighting.
Health personnel
An ICRC team of emergency surgeons entered the Gaza Strip through the Erez Crossing on 5 January and brought 1000 units of tetanus oxide.
Insecurity, damage to roads and bridges, and fragmentation of the Gaza Strip into zones by the IDF are preventing staff from reaching health facilities. Movement is progressively difficult and dangerous. Movement from one zone to another for health personnel requires coordination with the IDF, which is being dealt with by the ICRC. Staff are working 24-hour shifts to try meet needs, instead of the regular eight-hour shifts. This accumulative situation is placing great strain on health personnel.
Bed capacity and occupancy rate
While stabilized patients are being discharged as soon as possible to free up space in the hospitals, Intensive Care Units (ICUs) throughout the Gaza Strip are overloaded and there is still an urgent need to evacuate patients.
Primary health care centres
Four UNRWA health centres (Maen, Shouka, Zaitoun, Naser) have been closed due to military operations. Its remaining 14 centres are open for emergency services.
The UHCC was due to re-open its primary health care centre on 5 January to support growing health care needs but the destruction of the mobile clinics on 4 January and concurrent damage to the building has prevented its reopening.
Referrals and evacuations outside Gaza
Seventeen patients were scheduled to be evacuated through the Rafah crossing for referral to hospitals in Egypt, Saudi Arabia and Libya, bringing the total of patients evacuated through Rafah to 122 since 27 December.
One patient was evacuated through Erez crossing on 5 January and 12 patients have submitted requests to be refereed through Erez by the Palestinian Liaison Officer. The Referral Abroad Department RAD has been closed since 27 December, but the Palestinian Liaison Officer resumed working from home on 5 January.
Medical supplies
WHO is facilitating the entry of four trucks through Karem Shalom. Only two were allowed in on 5 January and the other two were delayed until 6 January.
Coordination
On 5 January, the Palestinian MoH in Ramallah began activities at its emergency operations room in collaboration with WHO to respond to the health situation. The operations room will provide assessments of requirements (pharmaceuticals, consumables, equipments and spare parts), follow up on the response of international community and address referrals of injured and other patients.
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Contacts
WHO Regional Office for the Eastern Mediterranean
Mr Altaf Musani
Regional Adviser
Emergency Preparedness and Humanitarian Action
Email: musania@emro.who.int Tel.: + (202) 26 76 50 25 – Mobile: + (201) 02 58 58 22
Anne N’zaou Daher Aden
Technical Officer, Information & Communication
Emergency and Humanitarian Action Unit
Email: nzaoua@emro.who.int Tel.: (202) 22765558 – Mobile: +(201) 65 51 31 48
WHO Headquarters, Geneva
Paul Garwood
Communications Officer
Health Action in Crises
Tel.: +41227913462 – Mobile: +41794755546
Email: garwoodp@who.int
Old Nablus Road – Sheikh Jarrah POBox 54812 – Jerusalem 91547 Tel: +972 2 540 0595 Fax: + 972 2 581 0193 Email: info@who-health.org
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Document Type: Situation Report, Update
Document Sources: World Health Organization (WHO)
Subject: Gaza Strip, Health
Publication Date: 05/01/2009