WHO Report: Estimating Trauma Rehabilitation Needs in Gaza using Injury Data from Emergency Medical Teams

30 July 2024

©WHO – Estimating Trauma Rehabilitation Needs in Gaza using Injury Data from Emergency Medical Teams (Page 9)

Interpretation and implications

– Major injuries requiring ongoing rehabilitation are likely to constitute 25% of the total number of injuries, or at least 22 500 people (as of 23 July 2024).

– Currently available rehabilitation services do not come close to meeting the enormous surge in needs. Even if previous services are re-established, a massive scale-up of rehabilitation effort is already required.

– Major extremity injuries constitute the main rehabilitation need, with an estimated range of 13 455 to 17 550. Although data does not allow disaggregation, the majority are likely to be lower limb injuries, including complex fractures with peripheral nerve injuries.

– It is reasonable to expect that there are between 3105 and 4050 limb amputations, though some anecdotal reports indicate this number may be higher. As with extremity injuries, the majority are likely to be lower limb injuries. At present, there are no operational prosthetic and orthotic services in Gaza. A scale up of long-term prosthetic services is needed – in careful coordination with existing providers who are already planning surge capacities. 10 Estimating Trauma Rehabilitation Needs in Gaza

– There are likely be around 2000 spinal cord and severe traumatic brain injuries – though MDS coding means there is a low confidence in the number. All patients with life changing injuries are placed at significant risk by the severe disruption of rehabilitation and other post-acute services. This is particularly true of patients with spinal cord injury and traumatic brain injury, who are at increased risk of life-threatening complications while displaced and will face challenges (along with their families) in any evacuation. Accessible accommodation for those with complex injuries is required, along with inpatient step-down care for those who cannot be safely discharged.

–  Despite challenges with estimations, the number of burn injuries requiring rehabilitation is likely to be at least 2000. Displacement is also likely to contribute to a persistent surge in burn injuries with risk of fires in tented communities, changes to cooking methods etc. Specialised burn rehabilitation services are needed.

– The number of people with injuries requiring assistive products far exceeds the amount of equipment provided and in the pipeline based on reporting on the Health Cluster Dashboard. Partners are reporting stocks of essential assistive products such as wheelchairs and crutches are exhausted. Many people with disability who have been displaced will also require new or replacement products.

– This huge surge in rehabilitation needs occurs in parallel with the destruction and disruption of essential rehabilitation services that these patients require. Acute rehabilitation services are severely disrupted along with all other hospital services. All three dedicated inpatient rehabilitation services have been damaged or destroyed. Remaining primary health care and community level services are frequently paused or rendered inaccessible due to fighting. Much of the rehabilitation workforce is also displaced, while secondary sources report 39 physiotherapists killed by 10 May.

– This technical note relates only to new injuries, but tens of thousands of Palestinians in Gaza with pre-existing conditions now also lack access to essential rehabilitation services and assistive products that they depend on to maintain their health, independence and access to other critical services.