Health situation in Gaza - 16 January 2009
Overview
This is the 16 January update on the health sector situation since Israel launched its military offensive in Gaza on 27 December.
- 760 tons of medical supplies reached Gaza via Rafah. Halt to in-kind donations requested to ease overwhelming of Central Drug Store.
- Administrative building, emergency and ambulance station at Al-Quds Hospital totally destroyed in the 15 January attack.
- At least 40 000 people displaced.
- No mains electricity supply to Gaza city today. All hospitals in Gaza city functioning on back-up generators.
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 and affected
According to the Palestinian Ministry of Health (MoH) on 16 January at 13:00, at least 1133 people have been killed since 27 December. Approximately 5200 Palestinians have been injured, including at least 1552 children and 652 women . WHO has not been able to independently verify these details. 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.
UNRWA’s Gaza City warehouse was completely destroyed in a 15 January attack. All supplies, which are critical to UNRWA operations to support 70% of Gaza's population, have been destroyed.
OCHA reported that up to 100 000 people have been displaced. UNRWA has established at least 40 emergency shelters for the displaced, providing bread and drinking water to all shelters, as well as tinned meat to Gaza's three southern districts. The exact number of people who have fled their homes in Gaza remains unclear.
As of 14 January, approximately 500 000 people have no access to running water, and the rest of the population only receive water for a few hours two to three times per week.
CASUALTIES TO HEALTH PERSONNEL
Since 27 December 2008, 13 health personnel have been killed and 22 injured while on duty, according to the MoH health information centre in Gaza.
DAMAGE TO HEALTH FACILITIES
On 16 January, there were no new reports of health facilities being damaged. To date 16 health facilities and 16 ambulances have been damaged or destroyed since 27 December.
Al-Quds Palestinian Red Crescent Society (PRCS) Hospital in south Gaza City remained closed 16 January after being hit by Israeli fire a day earlier. 40 patients who were evacuated have been brought to Shifa Hospital. About 200 people who had been seeking refuge in Al-Quds Hospital were evacuated to an UNRWA shelter. The attack destroyed the hospital's pharmacy and administrative buildings. The emergency and ambulance station was also destroyed. The hospital's roof, top floor and a corridor all suffered damage.
At Al Wafa Rehabilitation Hospital in east Gaza City, staff continue to provide health care despite the facility being damaged on 15 January in a separate attack. Damaged was sustained to the eastern wall of the Geriatric building, which was housing 20 patients at the time of the attack. They remain in the building. The rehabilitation building was not directly hit. The hospital's 52 beds are all occupied, eight by patients on life-support machines. Many patients in the centre are quadriplegics who have suffered a harrowing experience over the last 24 hours.
ELECTRICITY AND FUEL SUPPLY TO HEALTH CARE FACILITIES
All Gaza City hospitals were functioning solely on generators 16 January after electricity was cut to the entire city after power lines were damaged. Fuel supply in Gaza City hospitals is around 50% of storage capacity, which can ensure about 3-4 days of electricity if generators continue working non-stop.
HOSPITAL BED CAPACITY AND OCCUPANCY RATE
Shifa Hospital ICU remains overwhelmed. Some patients were evacuated but the ICU is functioning at virtually full capacity due to the low evacuation rate of patients through the Rafah Crossing and extra patients presenting to the ICU from Al-Quds Hospital. Shifa Hospital is trying to keep its bed occupancy rate below 75% to allow space for urgent and emergency cases.
REFERRALS AND EVACUATIONS OUTSIDE GAZA
On 15 January, 33 patients were evacuated through Rafah. Since 27 December, 413* patients have been transferred through Rafah, most for injuries and some for chronic conditions, according to the MoH. As of 12 January, at least 242 patients who had been referred through Rafah have been sent for treatment in Egyptian hospitals, and 79 have been admitted to hospitals in other Arab states and also to Belgium. At least 21 of the referred patients have since died, according to the MoH.
As of 16 January, 20 chronically ill patients who have submitted requests for evacuation through the Erez Crossing were still awaiting Israeli approval to cross. Israeli authorities have granted permits for the seven of the 20.
The Palestinian Referral Abroad Department remains closed due to the conflict primarily because staff are not presenting to work.
*(The reason for this sharp increase in the number we were reporting until now, is that it seems hospitals in the South of Gaza were referring without coordinating with other organization and so WHO was not informed about these until recently.)
MEDICAL SUPPLIES
A huge volume of medical supplies, 760 metric tons, donated by different States has entered Gaza via Rafah in the last two days. WHO has no information about the content of these supplies. WHO also coordinated the crossing of two truckloads of medical supplies through Karem Shalom on 16 January and a third on 15 January through the same crossing. All three truckloads contain medical supplies from Physicians for Human Rights.
PRIMARY HEALTH CARE CENTRES
PHC services were not functioning 16 January due to the weekend. The 1O PHC clinics converted to emergency evacuation centres continued to work. Of 56 MoH-managed PHC centres and two NGO-run centres serving the MoH, 37 were functioning with major interruptions on 15 January.
WHO remains concerned about management of chronic disease patients and public health in Gaza Strip. 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 3 January.
The childhood vaccination program had virtually ceased between 27 December and 13 January, but due to WHO and UNRWA assistance has resumed in parts of the Gaza Strip. Reduced vaccination coverage could result in outbreaks (for example for measles, polio, and hepatitis), a risk increased by Gaza's high population density and dire living conditions.
PHCs working as emergency centres in the Gaza Strip:
- North Gaza: Shuhada’a Jabalia centre
- Gaza: Zaytoun clinic, Shiekh Radwan clinic
- Middle Zone: Nusierat old clinic, Shuhada’a Nusierat centre, Old Buriej clinic, Dier El Balah clinic
- Khan Younis: Bany Suhalia clinic
- Rafah: Shuahada’a Rafah centre, Tal Al Sultan centre
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. A WHO Emergency Operational Plan for the Gaza Crisis has been launched seeking US$13.3 million for a range of urgent health interventions.
NGOs and doctors have been asked to coordinate with WHO in Rafah and Jerusalem, as well as the MoH Operations Room in Ramallah, on the planned deployment of health personnel into Gaza to ensure that the specialities being offered are actually needed by health services there.
NGOs and doctors have been asked to coordinate with WHO in Rafah and Jerusalem, as well as the MoH Operations Room in Ramallah, on the planned deployment of health personnel into Gaza to ensure that the specialities being offered are actually needed by health services there.
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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