The blockade tightens for Gaza's patients

For several years, the UN has warned that Gaza could be ‘unliveable’ by 2020. As people residing there mark ten years under Israel’s blockade and closure of Gaza in June, many would argue that this is already the case.

After a decade of closure, Israel continues to impose restrictions on the movement of people and goods in and out of Gaza. The economy has been severely weakened, to the point that 42% of people are unemployed, and 80% of people are reliant on some form of humanitarian aid to meet their basic needs.

Even the most basic of resources are hard to come by. Many residents contend with 12-16 hours of electricity cuts every single day. A staggering 95% of water in Gaza is unsafe to drink.

Within a decade of suffocating closure, Gaza has also witnessed three largescale military assaults and numerous incursions, resulting in the deaths of more than 3,700 people and tens of thousands of injuries. More than 47,000 people remain homeless nearly three years on from the last major offensive, when their houses were destroyed.

The health sector in Gaza has not been spared the impact of conflict and blockade. 139 hospitals and clinics and 84 ambulances have been damaged or destroyed in conflict, putting medics themselves on the front lines. In total, 39 medical personnel have lost their lives while seeking to provide care to the wounded during attacks.

Gaza’s medical professionals show remarkable commitment to their work in the most difficult of circumstances. But despite their dedication, the blockade and Gaza’s economic woes mean that they lack the resources or equipment they need to provide adequate care to a population of almost two million people.

Hospitals out of reach

With the health sector struggling to cope, it is vital that patients are able to travel to hospitals outside of Gaza. Access to Palestinian hospitals in East Jerusalem is particularly important, as they can provide certain treatments and specialisms – such as heart operations and radiotherapy – unavailable anywhere else in the occupied Palestinian territory.

Last year, over a third of all patients applying to the Israeli authorities for a permit to exit Gaza were either denied or did not receive a response in time for their appointments. Family members seeking to accompany patients to their appointments are also often denied, or face security interrogations at the Erez crossing. The Rafah crossing with Egypt – the only other exit for people in Gaza – remains closed almost year-round.

MAP’s Director of Programmes in Gaza, Fikr Shalltoot, explains the impact of these restrictions:

“The blockade on Gaza is life-threatening for critically ill patients who have to wait days or weeks to get permits to reach their hospitals in the West Bank,” she says. “Unfortunately, sometimes permits come too late.”

Behind each denial or missed appointment is a personal story of a patient for whom care is available somewhere, but that they cannot reach.

“Apart from the pain and anxiety of being ill, patients in Gaza are always stressed and uncertain about the availability of their treatment in the Gaza hospitals,” says Fikr.

“No matter what, patients must be able to access treatment. It’s a basic right for any human being in the world.”

Doctors denied

Medical personnel – doctors, nurses, radiologists and others – suffer the same restrictions on movement as their patients. They are often denied opportunities to leave Gaza to train alongside their peers in other areas of Palestine or abroad, and therefore to improve their skills or learn the latest care techniques.

A decade of blockade has therefore left Gaza largely cut off, not just from the West Bank and East Jerusalem, but from the world. With no political situation in sight, reducing the need for patients to be referred out of Gaza is vital for saving money for the beleaguered health sector and, more importantly, possibly saving lives of patients themselves.

The medicines and equipment MAP provides to Gaza’s hospitals are essential to meeting the immediate needs of sick and injured people. But it is through our training programmes that MAP is able to ensure patients can access high-quality specialist care inside Gaza for years to come, and reduce reliance on an unfair and uncertain permit regime.

MAP partners with a number of institutions in the UK to take expert trainers into Gaza, to provide experience and skills teaching which would otherwise be unavailable. In the past year, this programme has gone from strength to strength.

In 2016, we provided neonatal life support training to 94 medics – doctors, nurses and other staff – to help reduce mortality among Gaza’s youngest residents. Thirty-two medics from Gaza received sterilisation and hospital hygiene training, helping to reduce the rate of infections and improve patient safety. Seventy medics learned Primary Trauma Care techniques, so that they are able to respond to emergencies and crises which are all-too-frequent in Gaza. More than 50 physiotherapists also received training in the latest specialist techniques to help those recovering from injuries and illness.

Thanks to the help of supporters like you, MAP is working to ensure that Gaza’s inspirational medical workforce is able to access the knowledge they need to provide the quality of care Palestinians deserve.

The long journey home to Gaza 

Exiting Gaza is only part of the ordeal medical professionals face when training abroad. Getting back home can be equally challenging.

As the occupying power, Israel has an obligation to ensure free movement of humanitarian personnel. Israel’s frequent denial of exit permits for doctors and medics seeking to travel for training and professional development forces many to exit and return to Gaza through the Rafah crossing with Egypt, which is closed most of the year.

This is the ordeal which faced Marwan*, a Theatre Nurse who was supported by MAP and IDEALS to undertake a fellowship in London in 2016, when returning to Gaza through Egypt:

When Marwan landed at Cairo airport, he was immediately detained. He was interrogated at the airport, his passport and phone were taken from him, and he was kept in a filthy room crowded with 35 other Palestinians and 20 people of other nationalities. He was forced to pay 300 Egyptian Pounds (GB£15) for a 30 second phone call to his wife to let her know what had happened.

Marwan was kept there for 25 hours before being released and allowed to board a crowded bus to the Rafah crossing with 50 other Palestinians. They were questioned and had their luggage searched at three checkpoints along the 15 hour journey. Others on the bus had items stolen from their luggage, and one woman had her phone smashed by a guard when she tried to film this happening.

Finally at the Palestinian border, Marwan was held for a further seven hours before he was eventually allowed to cross, at 2am.

The journey home took 60 hours, an ordeal of constant anxiety, no sleep, and increasing despair.

*Name anonymised to protect identity

This article originally appeared in the Summer 2017 edition of our supporter magazine, Witness.

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