Situation in the OPT – WHO Health Inforum newsletter (01 July 2004)

---

 

Health Inforum News 

Volume 3, No.50, 1 July 2004

__________________________________________________________________________________________________

Welcome to the fiftieth issue of the Health Inforum Newsletter. 

CONTENTS

Health News

· Minister of Health call WHO to send a Fact Findings Committee

· WHO: Opening of Pilot Community Mental Health Centers in the West Bank and Gaza

· Measles Campaign Updates

· UNRWA released its  Annual Report of the Department of Health 2003

· Demographic and Social Consequences of the Separation Barrier on WB (June28, 04)

Reports

· Impacts of Construction the Wall in AL-Ram area

· Mumps Outbreak in Nablus – UNRWA Health Department report /WB

Casualties  & access incidents

During last June: 42 deaths and 377 injuries, including 20 deaths and 101 injuries reported in Gaza Strip

Requests

Medicines shortages in MOH – West Bank (June 2004)

---

HEALTH NEWS

 Minister of Health call WHO to send a Fact Findings Committee

Dr. Jawad El Tebi, Minister of Health, called the World Health Organization to send a Fact finding committee to investigate the deterioration in the health and economic situations in oPt as a result of closures and the construction of the separation wall where was considered by The World Health Assembly in the last annual meeting last May. The minister also asked all the humanitarian and medical international organizations to continue their crucial role in offering the help to the Palestinians and to be prepared for any crises

WHO: Opening of Pilot Community Mental Health Centers in the West Bank and Gaza

As part of the strategy development of the health sector, the World Health Organization and  the Ministry of Health have been implementing a Community Mental Health  project, in the West Bank and Gaza, for the past year, funded by the European Commission Humanitarian Office (ECHO).  

As part of this project, the construction and equipping of 3 pilot Community Mental Centers have now been completed. The opening ceremonies of these Centers will take place in July, as follows: July 13th in Albireh/Ramallah; July 15th in Hebron;  and July 29th  in Gaza.

For More Information: www.healthinforum.org 

Measles Campaign Updates

According to the UNICEF, the total number of immunized children in oPt reached to 364,116 (146,384 in Gaza and 217,73 children in West Bank).

The main centers of immunization have all the required amount of the vaccines. A number of health centers are supplemented weekly while other stable and mobile clinics are supplemented daily.

So far the campaign, which was originally planned to last three weeks, has managed to immunize almost 78% of the targeted children in the first week, which is a clear success.

UNRWA released its Annual Report of the Department of Health 2003

The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) published recently its Annual Report of the Department of Health for the year 2003, the report comprises of the following chapters:

1. Demographic and epidemiological profile of the Palestine refugee population.

2. Programme management.

3. Programme of emergency humanitarian assistance in the occupied Palestinian territory.

4. Medical care services.

5. Health protection and promotion.

6. Disease prevention and control.  

7. Environmental health services.

For more information:

 http://www.healthinforum.net/files/misc/Unrwa_annual_report.pdf

Demographic and Social Consequences of the Separation Barrier on WB (June28, 04)

PCBS has published lately a report on the effect of the Separation Barrier on the West Bank.

Some findings on its effect on health were:

· Reduced access to health services, for both patients and health personnel.

Health problems, including deaths, because of long waiting times (or closures) at gates and checkpoints.

· A total of 2,323 persons (402 families) had been displaced "due to the separation wall". This number of displaced households represents 0.8% of the population living in the affected areas.

REPORTS

Impacts of Construction the Wall in AL-Ram area

Al Ram area, is currently the Palestinian gateway between Jerusalem and Ramallah. Though construction of the wall first began in the area last February, in the last month, the Israelis have marked a heightened pulling up roads, blocking access and tightening their grip on Al Ram.

The Wall's construction in Al Ram, as in other areas will result in the division and separation of Palestinian communities, including schools, places of work, land, medical facilities and family.

Health Inforum, visited Al Ram village with Physician for Human Rights Israel .

Main findings:¹

Description of Al-Ram Wall:

The wall will be located on the Jerusalem- Ramallah main road (starting form Dahiyat Al Bareed  junction all the way up to Qalandiya checkpoint), its length will 2.5 Km with a height of 4.5 meters.

This construction is going on the opposite side of the road if you are going toward Ramallah, so the road became one way and the other side is blocked, so people are going 2 extra kilometers bypass through Al Dahiya to pass a road that was supposed to be 200-400 meters.

Population:

Al Ram population is 65,000 according to the Council; around 60% of them are holding Jerusalem IDs.

Area:

The area of Al Ram (including Dahiet Al-Bareed) is 25,000 Dunoms.

By finishing the wall, all Al Ram will be an enclave and will have one exit through Jaba’ village.

Impacts of the Wall construction:

Health:

· There are four main health centers subcontracted by Israeli Sick funds to serve the Palestinians who are living in Al Ram and holding Jerusalem IDs (around 35,000 population), these centers may be closed when the wall is completed.

· These centers offer Primary health care services and some specialties.

· Secondary health care is not available in that area; Patients (Jerusalem ID holders) are using Jerusalem hospitals as a referral system.

· There are no emergency health services in the area.

· There are no ambulance services and fire station services, if these services will be able to get to the area either from Jerusalem or Ramallah, it will be with a big delay.

· A trip to the doctor in Jerusalem will become a full-blown journey; it will take between 1-2 hours instead of 15 minutes.

¹Al Ram Mayor, Mr. Sarhan Al Salaimeh.

Education:

Students will be cut from their schools since most of them are learning in schools in Jerusalem.

Economy: 

Since Al Ram town is considered the linkage point between the west bank and Jerusalem for its location. It is the major trade market that connects Israeli traders with Palestinian ones. Also most of the Jerusalem ID holders in the town are working in Jerusalem or in Israel.  The wall will affect the economical situation very badly and it will add more unemployed workers.

Mumps Outbreak in Nablus – UNRWA Health Department Report /WB

An outbreak of Mumps erupted in Nablus UNRWA Camps. Where the first case reported from Asker camp on December 12th, 2003. It extended to nearby Balata camp and Camp No.1 and then to Fara'a, Tulkarim and sporadic cases were reported from Noor Shams.

To bring this outbreak under control, UNRWA Health Dept. took the following measures.:

– Up to date Health education campaign: For the staff through training and latest educational materials. For the community through focus group discussions, volunteers recruitment and investments of public places and media for announcement of educational materials.

· School survey to follow up all students and their vaccination status.

– All practical measures that should be taken in case of outbreak have been established; simple definition of the disease to catch all cases, line-listing (including: patient's name, sex, date of birth, resident, address, date of onset, date of diagnosis, occupation, school or kinder garden, symptoms, immunization status, date of immunization, complications if any), mapping of cases, and hypothesis.

– To confirm the diagnosis: Intensified efforts were exerted to detect the underlying cause for the parotid gland swelling through the surveillance of the presenting clinical picture and to confirm it by laboratory investigation:

· 31 serum samples were collected and sent to the Public health laboratory for serological studies. The results showed that IgM for mumps were negative in 24 samples, equivocal in six samples, and positive in one only. While IgG were positive in 28 samples, negative in two samples and equivocal in one sample only.

· Ten samples of urine, blood stool and parotid gland fluid cultures were negative for bacteria and viruses.

· Nasopharyngeal Aspirates and Parotid gland biopsies were obtained from six patients for histo-pathological and viral molecular studies. Histo-pathological examinations showed a viral infectious process is the main feature. The nasopharyngeal aspirates samples were negative for influenza A, B viruses, adenovirus, and Respiratory synsecial virus (RSV) by molecular PCR, Para-influenza by Shell Vile and by electron-microscopic examinations. Four of the six nasopharyngeal aspirates were positive for mumps by RT-PCR, in addition, four of the six biopsies were positive for mumps virus by RT-PCR

· Serum samples are subjected to sequence analysis of the gene.

· Still we are waiting for the final results of sequence analysis and neutralization of the virus

Epidemiological Data : up to July, 4th, 2004 were: The total number of cases reached 1984 cases, 49.8% of cases reported from Balata camp, 41.3% from Asker camps, 4% from Fara’a camp, and 2.3% from each of Tulkarem and camp No.1. The ages mostly affected was 6 years (15.2%), 12 years (10.2%) and 13 years (9%) respectively, while the age groups mostly affected were 11 to 15 years (41.3%) and 6 to 10 years (30.7%). Male affected more than females (male to female ratio was 1.26). 75% of cases received MMR single dose at age of 15 months. Complication rate was 1.6%, mainly Orchitis

CASUALTIES & HEALTH INCIDENTS

According to Palestine Red Crescent Society PRCS, during the month of June 2004, the total number of deaths and injuries reported in the West Bank and Gaza Strip was 42 deaths and 377 injuries, including 20 deaths and 101 injuries reported in Gaza Strip.

While during the same period, there were 37 incident for ambulances (30hrs delays) and 9 cases were totally denied to access.

The following diagram shows the number of incidents according to areas and delay on checkpoints in minutes:     

The above diagram shows:

· In Nablus- Huwwara checkpoint, it has the biggest number of ambulances incidents where we have 12 incidents with a delay of 670 minutes, which means almost 1 hr delay per incident.

· The same is applied in Hebron –Al Rama, it shows an average of 1 hr delay per incident.

· Ambulances entry to Jerusalem is so difficult, there were 2 cases, one of them was totally denied of access and the other one had a delay on 4.5 hrs.

· In the first diagram on the left, it shows that more than ¼ of the incidents generally been denied of access.

· In May, there were a big number of incidents due to the invasion to Gaza.

· By comparing the 2 diagrams, mainly the number of incidents with delay hours, we see that for each incident it takes an average of one hour of delay, besides the cases that were totally denied of access.

Requests

Medicines shortages in MOH – West Bank (June 2004)

Ministry of Health has published lately its needs of pharmaceuticals in West Bank for the coming six months.

If you are interested to respond to these needs, please contact the MOH directly or contact us on:

Phone: +9722 532 7447

Fax: + 9722 532 2904

E-mail: info@healthinforum.org 

FOR MORE INFORMATION

Please feel free to contact us at:

Health Inforum, c/o Italian Cooperation/ Sheikh Jarrah, East Jerusalem, Tel: 02 532 7447, Fax: 02 532 2904

Health Inforum, c/o WHO Jerusalem office/ Sheikh Jarrah, East Jerusalem, Tel: 02 5400 595, Fax: 02 581 0193

Health Inforum, c/o WHO, Gaza office, Al-Bayed building, Al-Halbi Str. Tel: 08-2822033, Fax: 02-2845409

Email: info@healthinforum.org   

Health Inforum posts daily news and announcements concerning health issues on its website: www.healthinforum.org.