HIGHLIGHTS
- WHO, health cluster partners and UN agencies have started field work for damage and needs assessments and recovery plans
- Health sector regains partial functionality for most of health facilities (although 58% damaged)
- UN Flash Appeal prepared for Gaza's major recovery needs
- Donor's reconstruction and recovery conference scheduled for October
Situation update
The health sector is continuing to work to recover following the damages to health facilities, and lack of access for staff and patients during the period of July and August. More than 90% of health facilities are operating although some are with limited services due to damage. With the exception of 5 Ministry of Health clinics which were destroyed totally, all other MoH clinics and all UNRWA clinics are reported to have opened for patients in the past week, including six primary health care clinics that had been closed for security reasons throughout the hostilities. Challenges remain due to the long-standing shortages of electricity, essential medicines and medical supplies.
Of the 90 UNRWA schools which were being used as shelters for displaced persons, 64 have been evacuated as families have returned to their homes, or moved to the homes of relatives, rented accommodations or transferred to other shelters. The former shelters are being prepared for students for the start of the UNRWA academic year in Gaza delayed to start on September 14. UNRWA reported that 26 shelters are still in use and sheltering 60,506 displaced persons; each shelter has a medical point for service provision, monitoring and referrals.
Hospitals
As of September 3, out of 32 hospitals, 3 remain closed and another 3 hospitals reopened with some staff in other locations and with limited services.
Primary health care
Preventive health concerns are being addressed by health service providers conducting tracing of children who have missed their scheduled vaccinations during the past 2 months.
There has been improved reporting from the disease surveillance system. In addition, the early warning system which monitors 13 common communicable diseases is being utilized by MoH and UNRWA for the surveillance of diarrheal disease, typhoid, mumps, scabies, impetigo, acute respiratory infections, polio (acute flaccid paralysis), meningitis ( aseptic, meningococcal,other bacterial meningitis), food poisoning, measles, infectious hepatitis, cholera and others. No increase in communicable diseases has been detected..
Assessments
Findings based on data collection from the health sector rapid assessment will illustrate the scope of the damage to the health system and enable partners to identify priority needs for short, medium and longer term interventions.
The Ministry of Health conducted its own needs assessment for submission to the Ministry of Planning for a 100-day recovery and rehabilitation plan. The assessment estimates that US$42 million will be needed to support full health service operations, including medical supplies, referrals, short-term repairs of damages and equipment, ambulance replenishment and psycho-social interventions in the next 3 months, and a total of $100 million over the next 2.5 years for longer term interventions such as more extensive repairs and construction and new equipment.
Damage to health facilities and closures (see Annex)
Following the ceasefire, health providers could assess the status of all health facilities, including those that had been closed due to lack of access. Eight additional clinics were found to have suffered some damage.
Of the 32 hospitals and 97 primary health clinics that were monitored for damage and closures since July 7, 17 hospitals and 58 clinics reported damage ranging from broken windows to total destruction.
One hospital and 7 clinics were totally destroyed: the Wafa Rehabilitation NGO hospital, 5 Ministry of Health primary health clinics (Shajaiiyeh, Gaza city, Juhr al Deek, Khuza'a and Khan Younis), the NGO clinic (Palestinian Red Crescent) Khalil al Wazir health center in Gaza city, and the Palestinian Medical Military Services' Hijazi clinic.
Several other clinics were heavily damaged and will need major rehabilitation. Several Health Cluster partners are providing stationary PHC services where health facilities have been destroyed and mobile clinics continue to provide services in marginalized areas.
The Ministry of Health reports a total of 47 ambulances were damaged, of which 14 were completely destroyed and 33 were partially damaged. 21 of the ambulances were operated by PRCS, 22 by MOH and 4 by the Palestinian Military Medical Services.
Public health concerns
- Continuation of medical care for injured persons discharged from hospitals and who require home care and outpatient follow up.
- Referrals and access to specialized treatment for patients with non communicable diseases, including genetic conditions, orthopedic problems, cancer and neurological conditions, will likely remain below average, both within Gaza and to outside hospitals, as priority will be given to follow-up treatment for casualty patients
- The unexploded weapons in urban and rural areas represents a public health hazard, especially for children. UNMAS has begun clearing the ordnance but the work will likely take months.
Health needs, priorities and gaps
- Specific needs assessments for vulnerable persons. There are plans for health assessments for elderly (HelpAge) and for disabilities (Handicap International).
- Continuity of care and management of chronic, life-threatening non communicable diseases (cardiovascular disease, diabetes, cancer and chronic respiratory disease) in view of challenges due to ongoing shortages of medications, both during and after the current emergency.
- Improvement in coordination for foreign medical teams (FMT) to ensure matching of expertise to needs, entry coordination procedures, best placement and quality of care.
WHO action
Health Cluster and working groups: During the emergency, the Health Cluster was re-activated by the Interagency Standing Committee. Weekly coordination meetings have been conducted by WHO and the Palestinian Ministry of Health as co-chairs.
- Three health working groups have been convened in Gaza:
- Mental Health and Psychosocial Services working group in Gaza, coordinates aid to the mental health sector and coherency of interventions;
- Foreign medical teams coordination working group, led by International Medical Corps (IMC), with the aim to develop guidelines for entrance of foreign teams. The FMT group met and agreed to the procedures for accepting and coordinating the arrival of FMT, and to ensure they respond to a need. Procedures include presenting medical credentials to the MoH, receiving authorization to practice, and having an agreed upon place and time slot with an establish medical facility;
Disability working group, with international and national services providers, held an ad hoc meeting in Gaza to discuss needs concerning interventions for persons with disabilities.
As part of the rapid assessments, WHO assessed the impact of the crisis on the health system and health status of the population, including damage to health infrastructure, the degree of functionality of health facilities and the availability of human resources at the health facilities. Together with its partners, WHO led the health component of the Multi-Cluster Assessment (MIRA), and is currently leading a joint health cluster rapid health sector assessment.
Resource mobilization
A total of US$ 12.6 million in essenital medicines and medical supplies have been received by the health sector in Gaza since July 7 to help meet the needs of this emergency, with of the donations destined for Ministry of Health hospitals. A revised flash appeal is being issued.
Contact:
WHO West Bank and Gaza Country Office
Contact: Dr. Mahmoud Daher
Tel: +972-598944650
daherm@whoint.
Download Document Files: https://unispal.un.org/pdfs/WHOSitRpt_Issue11.pdf
Document Type: Situation Report, Update
Document Sources: World Health Organization (WHO)
Subject: Armed conflict, Casualties, Closure of institutions, Gaza Strip, Health, Living conditions, Population, Security issues
Publication Date: 07/09/2014