{"id":208209,"date":"2009-01-22T00:00:00","date_gmt":"2019-03-12T19:31:51","guid":{"rendered":"https:\/\/www.un.org\/unispal\/?p=208209"},"modified":"2019-03-12T19:31:51","modified_gmt":"2019-03-12T19:31:51","slug":"auto-insert-208209","status":"publish","type":"document","link":"https:\/\/www.un.org\/unispal\/document\/auto-insert-208209\/","title":{"rendered":"Gaza: communicable disease risk assessment – WHO report"},"content":{"rendered":"
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\n\t\t\t\tCommunicable Diseases Working Group on Emergencies, WHO headquarters\n\t\t\t\t<\/div>\n
\n\t\t\t\tCommunicable Disease Surveillance and Response, WHO Regional Office for the Eastern\n\t\t\t\t<\/div>\n
\n\t\t\t\tMediterranean, WHO Office for West Bank and Gaza\n\t\t\t\t<\/div>\n
\n\t\t\t\tDisease risk assessment and interventions<\/strong>\n\t\t\t\t<\/div>\n
\n\t\t\t\tGaza Strip<\/strong>\n\t\t\t\t<\/div>\n
\n\t\t\t\tJanuary 2009<\/strong>\n\t\t\t\t<\/div>\n
\n\t\t\t\t© World Health Organization 2009<\/strong><\/span> <\/span>All rights reserved.<\/span>\n\t\t\t\t<\/div>\n
\n\t\t\t\tThe designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement.\n\t\t\t\t<\/div>\n
\n\t\t\t\tThe mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.\n\t\t\t\t<\/div>\n
\n\t\t\t\tAll reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use.\n\t\t\t\t<\/div>\n
\n\t\t\t\tFor further information, please contact: cdemergencies@who.int<\/strong>\n\t\t\t\t<\/div>\n
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Acknowledgements<\/strong><\/span><\/p><\/div>\n
\n\t\t\t\tThis communicable disease risk assessment was produced and edited by the unit on Disease Control in Humanitarian Emergencies (DCE), part of the Epidemic and Pandemic Alert and Response Department (EPR) in the Health Security and Environment Cluster (HSE) of the World Health Organization (WHO), and supported by the WHO Regional Office for the Eastern Mediterranean and the WHO Office for West Bank and Gaza.\n\t\t\t\t<\/div>\n
\n\t\t\t\tThe communicable disease risk assessment was contributed to and reviewed by the Communicable Diseases Working Group on Emergencies (CD-WGE) at WHO headquarters. The CD-WGE provides technical and operational support on communicable disease issues to WHO regional and country offices, ministries of health, other United Nations agencies, and nongovernmental and international organizations. The Working Group includes the departments of Epidemic and Pandemic Alert and Response (EPR), the Special Programme for Research and Training in Tropical Diseases (TDR), Food Safety, Zoonoses and Foodborne Diseases (FOS), Public Health and Environment (PHE) in the Health Security and Environment (HSE) cluster; the Global Malaria Programme (GMP), Stop TB (STB), HIV\/AIDS and Control of Neglected Tropical Diseases in the HTM cluster; the departments of Child and Adolescent Health and Development (CAH), Immunizations, Vaccines and Biologicals (IVB) in the Family and Community Health (FCH) cluster; Injuries and Violence Prevention (VIP) and Nutrition for Health and Development (NHD) in the Noncommunicable Diseases and Mental Health (NMH) cluster; Security and Staff Services (SES) in the General Management (GMG) cluster; and the cluster of Health Action in Crises (HAC) and the Polio Eradication Initiative (POL).\n\t\t\t\t<\/div>\n
\n\t\t\t\tThe following people were involved in the development and review of this document and their contribution is gratefully acknowledged:\n\t\t\t\t<\/div>\n
\n\t\t\t\tGiuseppe Annunziata (HAC\/ERO); Maurizio Barbeschi (HSE\/EPR); James Bartram (PHE\/WSH); Eric Bertherat (EPR\/ERI); Sylvie Briand (EPR\/GIP); Amina Chaieb (EPR\/ARO); Yves Chartier (PHE\/WSH); Claire Chauvin (DGR\/POL); Meena Cherian (EHT\/CPR); Alya Dabbagh (FCH\/IVB); Mahmoud Daher (WHO West Bank and Gaza); Ousmane Diouf (HTM\/HIV); Pierre Formenty (EPR\/BDP); Albis Gabrielli (HTM\/NTD); Celine Gossner (HSE\/FOS); Alexandra Hill (PHE\/WSH); Stephane Hugonnet (EPR\/ERI); Anthony Laurance (Acting WR, WHO West Bank and Gaza); David Meddings (NMH\/VIP); Shanthi Mendis (CHP\/CPM); Marc Van Ommeren (NMH\/MSD); Fernando Otaiza (EPR\/BDP); Salah Ottmani (HTM\/STB); Jules Pieters (HAC\/ERO); Aafje Rietveld (HTM\/GMP); Cathy Roth (EPR\/BDP); Irshad Shaikh (EHA\/EMRO); Katja Schemionek (WHO\/EMRO); Nadia Soleman (EPR\/ARO); Peter Strebel (FCH\/IVB); Jos Vandelaer (FCH\/IVB); Steven Wiersma (FCH\/IVB); Zita Weise-Prinzo (NMH\/NHD)\n\t\t\t\t<\/div>\n
\n\t\t\t\tEditing support was provided by Penelope Andrea and Ana Estrela (HSE\/EPR).\n\t\t\t\t<\/div>\n
\n\t\t\t\tContributions to previous risk assessments from the following focal points have also been incorporated: Bernadette Abela-Ridder (HSE\/FOS); Andrea Bosman (HTM\/GMP); Claire-Lise Chaignat (PHE\/WSH); Pascale Gilbert-Miguet (GMG\/SES); Lulu Muhe (FCH\/CAH).\n\t\t\t\t<\/div>\n
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1. Context<\/strong><\/span> <\/strong><\/span><\/p><\/div>\n

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The Gaza Strip, on the eastern Mediterranean coast between Israel and Egypt has been the setting for a protracted humanitarian crisis. It has a population of 1.5 million with the sixth highest population density in the world, and a very young demographic with 18% of the population under 5 years of age (274 000 children). Recent events have resulted in a severe exacerbation of the chronic humanitarian crisis. <\/p><\/div>\n

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As of 18 January, over 50 896 people had been newly displaced and were residing in 50 shelters organised by the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA). It is estimated that there may be an additional tens of thousands of displaced people, mainly sheltering with host families. As of 18 January, the Ministry of Health of the Palestinian Authority (MoH) reported that 1 300 people had been killed since 27 December, of whom at least 410 were children and 104 women. Over 5 300 were reported injured, including 1 855 children and 797 women. <\/p><\/div>\n

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Vital infrastructure has been severely compromised or destroyed, resulting in lack of shelter and energy sources, sudden deterioration of water and sanitation services, food insecurity, overcrowding and severely curtailed access to health services. Since 27 December 2008, at least 16 health facilities and 16 ambulances have been reported damaged and as of 14 January, 21 out of 57 MoH health facilities and 3 out of 18 UNRWA health facilities were closed (OCHA). <\/p><\/div>\n

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Those facilities that remain operational face a number of challenges, including (i) low staffing levels due to insecurity, especially in Gaza City; (ii) electricity for only a few hours per day from emergency generators; (iii) uncertain supply lines; and (iv) inaccessible health care services for most of the catchment area population, with attendance rates reported to have fallen by more than 50%. <\/p><\/div>\n

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2. Priority health issues<\/strong><\/span> <\/strong><\/span><\/p><\/div>\n

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The risk of excess morbidity and mortality is primarily from traumatic injury or from the discontinuation of treatment for chronic conditions due to poor access to health care services. Diarrhoeal diseases currently represent the most important risk of excess morbidity and mortality from communicable diseases. The priorities below may change should the crisis continue for an extended period. <\/p><\/div>\n

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