Health situation in Gaza - 13 January 2009
This is the 13 January update on the health sector situation since Israel launched its military offensive in Gaza on 27 December.
- One paramedic killed 12 Jan.
- 18 additional patients expected to be evacuated via Rafah.
- Dorah Paediatrics hospital again was hit by shellfire on13 Jan.
- 35 520 people displaced in Gaza by crisis.
- All hospitals have 8-12 hours partial power supply.
- MSF Spain in Jerusalem and MSF Belgium in Rafah still waiting to enter Gaza.
International Humanitarian Law requires all medical personnel and facilities be protected at all times, even during armed conflict. Attacks on them are grave violations of International Humanitarian and Human Rights laws. Access to heath is a fundamental human right.
According to the Palestinian Ministry of Health (MoH) on 13 January, 971 people have been killed since 27 December, including at least 85 women and 311 children. 4418 Palestinians have been injured, including 1549 children and 652 women . WHO has not been able to independently verify these details.
*The reason for the high increase in the death count is the identification of many bodies that were previously not identified or found under the rubble or in areas previously not accessible.
OCHA reports that the number of people who have fled their homes in Gaza remains unknown, but is estimated in the tens of thousands, with the majority staying with host families. As of 12 January, UNRWA was operating 38 emergency shelters, with 35,520 displaced people. UNRWA has provided bread and drinking water to all shelters, tinned meat to the three southern districts of Gaza.
CASUALTIES TO HEALTH PERSONNEL
One paramedic was killed on 12 January. Since 27 December 2008, 13 health personnel have been killed and 22 health personnel have been injured while on duty according to reports from the health information centre of the MoH in Gaza.
DAMAGES TO HEALTH FACILITIES
Since 27 December 2008, the health information centre of the MoH in Gaza reports that:
- 15 ambulances have been damaged
- 11 health facilities have been damaged through direct or indirect shelling
Damage to hospitals:
Dorah Paediatrics hospital was again directly hit January 13. There is no information regarding continuity in the provision of emergency services. Dorah hospital has been closed since 8 January except for emergency services due to its proximity to an open conflict area and damage sustained to its infrastructure.
Damage sustained by the Gaza European Hospital on 10 January has not yet been repaired.
El Nasser Paediatrics hospital is still functioning with major limitations due to damage sustained on 10 Jan.
ELECTRICITY AND FUEL SUPPLY TO HEALTH CARE FACILITIES
All health care facilities are now receiving eight-twelve hours of electricity supply. Hospitals have received some fuel supplies. On average all MoH hospitals and the central drug store have 40 -50 percent of their storage capacity of fuel. UNRWA and WHO are working to ensure that hospitals are receiving enough fuel supplies.
HOSPITAL BED CAPACITY AND OCCUPANCY RATE
The Shifa hospital ICU remains overwhelmed. Some patients were evacuated but the ICU is functioning at almost full capacity, with more than 20 out of its total 30 beds occupied due to the low evacuation rate of patients through the Rafah Crossing. Shifa Hospital continues to try to keep the bed occupancy rate below 75% to allow space for urgent and emergency cases.
REFERRALS AND EVACUATIONS OUTSIDE GAZA
30 patients were evacuated 12 January through the Rafah Crossing. Another 18 were on route to Rafah for evacuation on 13 January (7pm). The number of patients evacuated through Rafah since 27 December is 248 (excludes those on route), most for injuries and some for chronic conditions.
Belgian authorities have offered to evacuate to Belgium seven children needing medical care with seven companions; they are en route today to El Arish. WHO is working with the MoH and Egyptian authorities on this issue.
As of 12 January, the Palestinian Health Liaison Officer had submitted 20 requests for evacuation of chronically ill patients through Erez Crossing. Israeli authorities have granted seven permits, but patients are waiting to cross Erez. None exited today 13 January. The Palestinian Referral Abroad Department remains closed.
On 10 January, 203 tons of medical supplies and five new ambulances donated by several donors (Saudi, Jordan Turkey, Qatar, Libya, south Africa, and Arab medical society, Egyptian Sharia Society, Algeria, Morocco) crossed from Rafah into Gaza.
PRIMARY HEALTH CARE CENTRES
WHO remains concerned about public health and public sanitation in Gaza while waste management has not been assured and garbage is not collected in the Gaza Strip. The vaccination program has been seriously interrupted. There have been some attempts to operate in several centres. Reduced vaccination coverage could result in outbreaks, a risk increased by Gaza's high population density and dire living conditions.
MoH PHC centres:
Some of PHC clinic have been re-opened today 13 January:
- Fukhari clinic (Khanyounis)
- Mughraqa clinic (middle zone)
- Johor El Deek (middle area)
Of 58 PHC centres managed by the MoH, only 35 were functioning (with major interruptions) as of 13 January. The 1O PHC centres that have been converted into emergency evacuation centres continue to function. For the geographical distribution of functionality of the MoH PHC centres see Annex 1.
Bani Suhalia clinic (in Khan Younis District) and Shuhada’a Nusierat clinic (in Middle Zone District) are functioning as triage centres to back up hospitals in their respective areas.
- • The use of PHC activities have dramatically declined since 27 December, according to the director of PHC. About 70% of chronically ill patients regularly attending PHC centres have interrupted their treatments and are no longer attending PHC centres. However, antenatal care (ANC) has resumed in all currently functioning PCH clinics.
On average, staff attendance is around 30% in all functioning PHC centers.
As a result:
- Most vaccination programmes (EPI and adult vaccinations) have been interrupted due to closure of clinics, unavailability of electricity or fuel at clinics equipped with generators, movement restrictions affecting distribution of vaccines and lack of staff. Today 13 January, in coordination with UNRWA, the vaccination program increased its capacity to operate to 45-50% in most of areas around the Gaza Strip.
- Dental care has been re-established in 7 PHC clinics out of 28 providing dental care, as follow:
- North Gaza: Shuhada’ Jabalia center
- Gaza: Ramal clinic and Daraj clinic
- Middle zone: Zawayda clinic
- Khanyounis: Bany Suhalia
- Rafah: Shuhada Rafah center
- PHC laboratory services have been halted since military operations began due to lack of electricity, staff and laboratory re-agents.
- Nutritional surveillance has stopped because the main centre is closed as it is located in a risky area.
- School health services are not functioning since schools are closed and staff not reporting to work.
- Preventive medicine is not functioning due to lack of staff.
- Epidemiology department is not functioning since no information is flowing from peripheral facilities, hospitals are overwhelmed with casualties, PHC centres are not fully functional and laboratories are not reporting.
- Occupational medicine is not functioning due to lack of staff.
- Health education and promotion activities have been suspended due to lack of staff.
An additional four MoH PHC clinics have closed during the past two days due to damage suffered during the conflict.
UNRWA PHC centres:
UNRWA reopened two PHC centres on 12 January. Three out of 18 remain closed: the Elshouka and Zaitoun centres were closed after IDF instructed people living in an adjacent building to evacuate prior to bombardment, while a centre in Beit Hanoun was closed due to being in a high risk area.
WHO is coordinating the emergency health response through its offices in Jerusalem, Gaza, Cairo and Geneva, working closely with the Palestinian MoH in Ramallah and with health cluster partners.
WHO West Bank and Gaza
Ms. Chiara Stefanini
Health and Human Rights Officer
Tel.: + (972) (0)2 540 0595 – Mobile: + (972) (0)54 717 9024
WHO Regional Office for the Eastern Mediterranean
Mr Altaf Musani
Emergency Preparedness and Humanitarian Action
Tel.: + (202) 26 76 50 25 – Mobile: + (201) 02 58 58 22
WHO Headquarters, Geneva
Health Action in Crises
Tel.: +41227913462 - Mobile: +41794755546
Old Nablus Road – Sheikh Jarrah POBox 54812 – Jerusalem 91547 Tel: +972 2 540 0595 Fax: + 972 2 581 0193 Email: firstname.lastname@example.org
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