Situation in the OPT – WHO Health Inforum newsletter (1 June 2003)

 

Health Inforum News 

Volume 2, No.28, 1 June 2003

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Welcome to the twenty-eighth edition of the Health Inforum Newsletter.

In our ongoing efforts to provide useful information to the whole of the health community, we continue to welcome any comments or suggestions you might have to help us improve this newsletter.

In this Issue:

· Fifty-Sixth World Health Assembly (23 May 2003): Free Access to Health Facilities should be guaranteed in the oPt

· Appointment of the “WHO” Director-General

· MoH: Strategies for Nutrition Programs in Palestine.

· Health Sector Bi-weekly Report, Number 11 (27 April 2003)

· CARE International continues the delivery of Medical Kits, Pharmaceuticals & Medical Disposables to Health Stakeholders

· Gaza: Local and International Health Institutions Condemn Israeli Restrictions Imposed on their Movements

· PRCS Health Incidents Report (17-23 May, 2003)

· MÉDECINS DU MONDE-GREECE IN THE PALESTINIAN TERRITORY ___________________________________________________________________

Fifty-Sixth World Health Assembly (23 May 2003): Free Access to Health Facilities should be guaranteed in the oPt

Dr. Kamal Al Sharafi minister of Health chaired the Palestinian delegation to the World Health Assembly in Geneva (19- 25 May).

Ministry of Health presented the difficulties and obstacles the Palestinians faced and the deterioration of health conditions due to the violation of basic human rights that is implied in the denial of medical services including patients, health workers and ambulances that represent violations of the Fourth Geneva Conventions and the UN laws.

The World Health Assembly published a resolution entitled Health conditions of, and assistance to, the Arab population in the occupied Arab territories, including Palestine (calls upon the WHO Director-General to take immediate steps to guarantee the free movement of health workers, emergency services and patients, and the provision of medicines and medical supplies to Palestinian health facilities. Member States also requested the establishment of a fact-finding committee to assess the deterioration of the health situation in the occupied Palestinian Territory. For more information, please visit www.healthinforum.org

Appointment of the “WHO” Director-General

On 21 May, Dr Jong-Wook Lee was elected as the next Director-General of WHO. A medical doctor and national of the Republic of Korea, Dr Lee has worked in WHO for nearly 20 years. In his speech to the Health Assembly, Dr Lee announced that he would undertake a major expansion of WHO's Global Outbreak Alert and Response Network to identify and respond to future disease outbreaks. Dr Lee begins his five-year term on 21 July 2003.

MoH: Strategies for Nutrition Programs in Palestine

Preliminary results from a nutrition assessment carried out recently during June 2002 by both local and international researchers indicate a significant rise in malnutrition over the last two years, including a worrying increase in the number of malnourished children in Gaza and the West Bank.

While 13.2% of all children under five are chronically malnourished (moderate and severe stunting) – suffering the effects of under nutrition and disease over a long period, fully 9.3% are currently acutely malnourished (moderate and severe wasting) – suffering from grossly inadequate food intakes and/or disease. These rates have risen from 7.5% and 1.4% respectively in 2000. An additional 12.9% are mildly wasted and at risk of becoming acutely malnourished soon if their existing food and nutrition environment does not improve. By all nutritional measures the situation is most serious in Gaza.

One of the more alarming findings of the studies is that the rate of anemia in Palestinian children under 5 has reached 19.7 percent (moderate and severe); and the rate for non-pregnant Palestinian women of childbearing age is now 10.8 percent.

Worldwide, iron-deficiency anemia is one of the main causes of women dying during childbirth. In children, anemia is associated not only with increased morbidity and mortality but also with impaired physical and cognitive development. In adults, iron-deficiency anemia is associated with decreased work capacity and reduced productivity. The associated effects therefore compromise current and future development for the individual, the local community and for the nation.

Further concerns arise from the study’s market survey. This reveals declining availability of high-protein foods such as fish, chicken, and dairy products amongst both wholesalers and retailers in both the West Bank and Gaza. Although serious dislocation in the trade of such food products were primarily due to border-closures, check-points, curfews and military conflicts, there is another, growing, major factor: more than half the Palestinian population surveyed reported selectively reducing their food consumption, and hence the demand for such foods, for reasons more to do with lack of money than with curfews and physical access to food. This decline in effective demand is itself a result of the restrictions on economic activity and access to employment imposed during the current political and security situation.

Accordingly, a quick, efficient intervention plan is needed to stop the deterioration in general nutritional status. Immediate practical steps are needed to support the most vulnerable groups in the Palestinian community.

In the light of the current nutrition situation, rapid strengthening of all efforts and available and potential resources within the Ministry of Health, non-governmental organizations, and international organizations will be a good start to limiting the effects of the current crisis.

In addition, this document is an action plan for linking various current and pipeline interventions in order to maximize their positive impact on the nutritional status of the Palestinian community, currently deteriorating due to the effects of the political situation. This document also indicates programs that may need to continue for some time in order to mitigate the continuing nutritional stresses faced by our population.

The intention is to encourage forward thinking for the longer-term protection of vulnerable groups as well as effective coordinated interventions during the current crisis. It is unusual to undertake this planning process during a crisis, and it must be stressed that whereas the components of the strategy listed below might be undertaken sequentially in other circumstances, all components now require major work simultaneously and immediately in order to reverse the current nutritional crisis. Each of the strategic components outlined establishes internal priorities, and is open for review and updating as the situation develops.

Overall goals:

· To mitigate and treat malnutrition in vulnerable groups, especially young children and their mothers.

· To arrest the current deterioration in the health and nutritional status of the population and ensure adequate nutritional status subsequently.

To be addressed by the following strategic elements:

1. Develop a strategic plan for work on nutrition programs.

2. Managing malnutrition

3. Communication strategy for behaviour change

4. Support and encourage breastfeeding, complementary and infant feeding.

5. Appropriate micronutrient supplements for vulnerable groups especially young children and pregnant women.

6. Appropriate food fortification, in addition to encouragement for consumption of micronutrient- rich foods.

7. Develop protocols and guidelines for areas of work related to food and nutrition.

8. Capacity building for health personnel and for staff in other sectors on relevant topics related to food and nutrition

9. Support for relevant applied research in areas related to food and nutrition.

10. Strengthen the monitoring and nutrition surveillance system for all the above.

11. Advocacy for protecting households suffering from prolonged food shortage.

For more information, please visit www.healthinforum.org

Health Sector Bi-weekly Report, Number 11 (27 April 2003)

This issue highlights food security, particularly in the Southern West Bank and in households with children under 5 years of age variations within West Bank. We also look at the function of health facilities in Jenin over the past year.

Health Service Delivery:

The last several Health Sector Bi-weekly Reports have reported on the challenges that the Ministry of Health, UNRWA and NGOs have faced in providing health services since the escalation in emergency situations that occurred in April 2002, and the successes that they have had in overcoming those challenges. In this report, the challenges that have been overcome, and the challenges remaining for health service delivery in Jenin will be highlighted.

In the year since the April 2002 military actions took place in Jenin, health service delivery facilities in that District have faced and, in many cases, have overcome a number of challenges to their operations. From mid-May to mid-June of 2002, the first reporting period, 6 facilities, 4 run by the MoH, 1 by a local NGO, and 1 by an international NGO (INGO).

For more information, please visit www.healthinforum.org

CARE International continues the delivery of Medical Kits, Pharmaceuticals & Medical Disposables to Health Stakeholders

Emergency Medical Assistance Project (EMAP): The goal of the USAID-funded EMAP is to sustain and strengthen the healthcare system in the West Bank and Gaza in this time of crisis by providing medical equipment, supplies and technical assistance.

Pharmaceuticals to MoH

Table No. 1 shows the EMAP Project distribution of Pharmaceuticals and medical disposables to Ministry of Health (21-20 May 2003)

Table No. 2 shows the EMAP Project distribution of Pharmaceuticals, Medical Equipments during 16-30 May 2003, classified by clinic name, level, delivery date and cost.

Gaza: Local and International Health Institutions Condemn Israeli Restrictions Imposed on their Movements

Local and international health institutions working in the Gaza Strip and West Bank districts, 27 May 03, condemned the Israeli restrictions imposed on their movements recently.

The institutions, during a large protest procession held, yesterday in Gaza City called for an end to such practices that form violations to the principles of international law and human law.

The procession that began with doctors wearing their white uniforms, ambulances and a large number of workers in the Ministry of Health and other national and international health institutions began from Al-Shifa Hospital in the city heading towards the headquarters of the UN Special Representative in the PNA territories in the city.

PRCS Health Incidents Report (17-23 May 2003)

Nablus, 22 May 2003 (16:35): An ambulance on its way to transport a patient to Rafedia hospital was stopped by Israeli soldiers at a flying checkpoint between Beit Wazan checkpoint and Quseen checkpoint. The soldiers detained the ambulance for an hour and a half. After checking the IDs of the staff and the patient, Israeli soldiers refused them permission to pass. The team was forced to turn back to the station.

Nablus, 21 May 2003 (14:20): Israeli soldiers at Quseen checkpoint refused to permit an ambulance to transport a child from Deir Sheriff Village to a hospital in Nablus.

Nablus, 21 May 2003 (02:20): Israeli tanks at Jordan Street refused to let an ambulance pass, the ambulance was returning to the station after treating a patient. The ambulance waited till the tanks left the area. Finally, the ambulance passed and returned to the station. The ambulance was detained for three hours and a half.

Nablus, 20 May 2003 (09:00): At Za’atara checkpoint, Israeli soldiers detained an ambulance transporting patients for one hour.

Tulkarem, 23 May 2003 (19:00): An ambulance stopped at Al Taybeh checkpoint while responding to a call to pick up an injured man in an accident from Kefir Jammal Village. The ambulance was permitted to pass being searched and staff ID cards checked. The ambulance was detained for thirty minutes.

Qalqiliya, 21 May 2003 (09:25): An ambulance was detained for an hour at a temporary checkpoint beside Deir Sheriff Village. The ambulance was on its way to transport a patient to Al-Watani hospital in Nablus.

Qalqiliya, 18 May 2003 (15:30): Israel soldiers refused passage to an ambulance transporting patients, to Qalqiliya from Nablus. The ambulance was forced to turn back and take an alternative long route.

Jericho, 17 May 2003 (10:55): On the way back to Jericho, after transporting a patient to Beit Jallah hospital, an ambulance was stopped by Israeli soldiers at the intersection between Al-Maqased hospital and Al-Augusta Victoria Hospital. Israeli soldiers searched the ambulance and took the crew’s IDs, confiscating their mobiles. The soldiers made the crew to take boxes of medicine out of the ambulance, and then threw the boxes on the ground. After forty minutes the soldiers allowed the ambulance to pass.

Bethlehem, 22 May 2003 (09:30): An ambulance was detained by the Israeli Army at a flying checkpoint before Gilo checkpoint, while on its way to transport a patient in critical condition to AL-Augusta Victoria hospital in Jerusalem. After checking the IDs of the ambulance crew and searching the ambulance, the patient was also removed from the ambulance; the ambulance was detained for forty-five minutes. When the ambulance reached Jerusalem, beside Damascus Gate, an Israeli police vehicle stopped the ambulance. The soldiers searched and checked the IDs of the crew and the patient, threatening the crew that they would be arrested if they return to Jerusalem; the ambulance was detained for another fifteen minutes.

Bethlehem, 18 May 2003, (12:00): An ambulance at the Cantor checkpoint on its way back from transporting a patient to a Jericho ambulance, was detained for forty five minutes. Israeli soldiers refused permission to the ambulance to pass, but the ambulance waited. Israeli soldiers verbally abuse the staff and one of them on his hands, as the soldiers commanded them to leave the area, but they refused. Finally the soldiers allowed the ambulance to pass.

Gaza, 22 May 2003 (21:30): EMS at Gaza station received a call from Al-Maqased hospital to transport a patient from the city of Beit Hanoun. After coordination with ICRC, an ambulance was stopped by Israeli tank, which denied access to the ambulance in to the city. The soldiers detained the ambulance for two and half hours without allowing them to return to the station.

Gaza, 19 May 2003 (16:00): At the Al-Jamarek area intersection, an Israeli tank detained to an ambulance on its way to transport injured people to Beit Hanoun. The ambulance was detained for three hours, and then the ambulance was eventually allowed to pass.

For full text see <<http://www.palestinercs.org/IHL_Refrence_Text.htm>>

MÉDECINS DU MONDE-GREECE IN THE PALESTINIAN TERRITORY

Médecins du Monde-Greece has been active in the Palestinian Territory intermittently since 1996 with a number of diverse humanitarian medical support programs financed by ECHO, the Greek Ministry of Foreign Affairs, and MDM-Greece proper funds. Cooperating with local NGOs, the Palestine Red Crescent Society and the Ministry of Health, MDM-Greece focused on humanitarian support in terms of food items, blankets, medicines, consumables, medical equipment and surgical interventions at hospitals in Gaza, Bethlehem, Jenin, Hebron, Ramallah and Jerusalem.

Since September 2002, MDM-Greece implemented two concurrent projects in collaboration with the PNA Ministry of Health. The first was funded by the Greek Ministry of Foreign Affairs and effectively upgraded primary health care in Jaba’a, an isolated and neglected village situated between Qalandya to the north and Hizma to the south. MDM-Greece inaugurated the local Primary Health Care Center with donations of medical equipment, a mini laboratory, medicines and furnishings and the Ministry of Health supplied the clinic with a full time nurse, and part time physician and lab technician.

ECHO funded the second project. The Blood Bank at Ramallah Governmental Hospital, and subsequently at Rafidiah and Jenin Hospitals, were supplied with equipment needed to enhance their technical capacity from blood collection to blood screening and to improve the environment for donors.

Physicians, technicians and nurses working in blood banks or relying on their services will be invited to a series of regional workshops that will cover topics such as clinical uses of blood and its components, quality control and management. Training booklets are currently available from MDM-Greece. Pamphlets and posters promoting voluntary blood donations have been distributed throughout the West Bank.

As well, a mini laboratory was procured for a rural health care center in Aurura, Ramallah thus enabling the staff to detect early signs of nutritional deficiencies or parasitic infection.

During this project, a medical information system was designed for use at the Ramallah Governmental Hospital Blood Bank. The database is unique in that it tracks not only donors, but the recipients of blood products and keeps an up-to-date inventory of the blood supply.

MDM-Greece anticipates that the database currently in use at Ramallah Governmental Hospital will become part of a network linking more blood bank facilities in the region.

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: healthinforum@undp.org , www.healthinforum.org,

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