Health situation in Gaza - 14 January 2009
Overview
This is the 14 January update on the health sector situation since Israel launched its military offensive in Gaza on 27 December.
- On 13 January, missiles destroyed the PHC clinic (for maternal and child health) of the Near East Council of Churches in Al-Shuja’ia area.
- 20 additional patients expected to be evacuated via Rafah.
- Monitoring and surveillance of water quality has not been carried out since the central public health laboratory closed on 4 January due its proximity to open conflict area.
- At least 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
Casualties
According to the Palestinian Ministry of Health (MoH) on 14 January, at least 1011 people have been killed since 27 December, including at least 85 women and 311 children. 4650 Palestinians have been injured, including 1552 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. OCHA reported on the 13 January that growing pockets of the population in Gaza are trapped in their homes. 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
Since 27 December, 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
On 13 January, missiles destroyed the PHC clinic (for maternal and child health) of the Near East Council of Churches in Al-Shuja’ia area.
Shelling on 4 January damaged and forced the closure of the administrative building of the Palestinian Red Crescent Society (PRCS) in Tal El Hawa, near Al Quds Hospital, WHO learned on 14 January.
The MoH health information centre in Gaza reports that since 27 December:
- 15 ambulances have been damaged
- 13 health facilities have been damaged through direct or indirect shelling
Ambulances were stuck 13 January in Jurdiek, in east Gaza City, and Khozaa, east of Khan Younis, while attempting to evacuate patients and could not leave because of intense conflict.
Damage to hospitals:
Dorah Paediatrics Hospital was again directly hit 13 January while eight patients and medical staff were inside. No information is available on the impact to emergency services. Dorah hospital has been closed since 8 January except for emergency services due to its proximity to an open conflict area and damages sustained.
ELECTRICITY AND FUEL SUPPLY TO HEALTH CARE FACILITIES
All health care facilities are receiving 12-16 hours of electricity supply. Hospitals have received some fuel. On average all MoH hospitals and the Central Drug Store have 40-50% of their fuel storage capacity. UNRWA and WHO are working to ensure hospitals are receiving enough fuel.
HOSPITAL BED CAPACITY AND OCCUPANCY RATE
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
All 18 patients were evacuated 13 January through the Rafah Crossing. The number of patients evacuated through Rafah since 27 December is 266, most for injuries and some for chronic conditions.
Another 20 were en route to Rafah for evacuation 14 January. The Egyptian Red Crescent Society is expected to send 25 ambulances to collect the patients.
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 still waiting to cross Erez. None exited 14 January. The Palestinian Referral Abroad Department remains closed.
MEDICAL SUPPLIES
No information available on the WHO medical supplies that entered 14 January.
PRIMARY HEALTH CARE CENTRES
WHO remains concerned about public health including sanitation and water quality in Gaza while waste management has not been assured and garbage is not collected. Monitoring and surveillance of water quality has not been carried out since the central public health laboratory closed due its proximity to open conflict area on 4 January. 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:
Of 58 PHC centres managed by the MoH, 37 were functioning (with major interruptions) as of 14 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 has dramatically declined since 27 December, according to the director of PHC. About 40% 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.
There have been improvements in staff attendance although it remains low in Gaza city at 30% in functioning PHC centres:
- Rafah: 95-100%
- Khanyounis: 95-100%
- Middle zone: 95-100%
- Gaza: 30%
- North: 60%
UNRWA PHC centres:
UNRWA reopened two PHC centres on 12 January. Three out of 18 remain closed.
COORDINATION
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.
Contacts
WHO West Bank and Gaza
Ms. Chiara Stefanini
Health and Human Rights Officer
Email: cst@who-health.org
Tel.: + (972) (0)2 540 0595 – Mobile: + (972) (0)54 717 9024
WHO Regional Office for the Eastern Mediterranean
Mr Altaf Musani
Regional Adviser
Emergency Preparedness and Humanitarian Action
Email: musania@emro.who.int
Tel.: + (202) 26 76 50 25 – Mobile: + (201) 02 58 58 22
WHO Headquarters, Geneva
Paul Garwood
Communications Officer
Health Action in Crises
Tel.: +41227913462 - Mobile: +41794755546
Email: garwoodp@who.int
Old Nablus Road – Sheikh Jarrah POBox 54812 – Jerusalem 91547 Tel: +972 2 540 0595 Fax: + 972 2 581 0193 Email: info@who-health.org
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