12 September 2017
Last month, Medical Aid for Palestinians (MAP) announced that Gaza should be considered a ‘humanitarian emergency’. The deterioration of healthcare, and the inability of many patients to get out for treatment elsewhere, means that Gaza is now unliveable for many patients.
A Special Situation Report released last week by the World Health Organization (WHO) underscores the seriousness of the situation, outlining how electricity shortages, diminishing stocks of medication and barriers to medical referrals out of Gaza have put lives at risk over the last two months.
With 20-22 hours of electricity cuts per day, hospitals and clinics in Gaza have had to cut back on all but the most critical services. Sterilisation, cleaning, diagnostics and catering have all been cut back. The number of elective surgeries have also been reduced. This is evidenced by a two-month rise in the average waiting time for elective ear, nose and throat (ENT) operations compared to the average in 2016.
For the majority of the time when mains electricity is unavailable, hospitals rely on generators meant only for temporary use. These require a constant supply of fuel to continue working, and their overuse is causing them to degrade rapidly. Repairing them is often difficult as the import of spare parts is restricted by Israel, who considers them to have a potential military “dual use”.
Switching to-and-from generator electricity also causes voltage fluctuations, which has damaged life-saving medical equipment, including a CT scanner at Nasser Hospital.
Power outages pose serious dangers to critically-ill patients, including around 400 intensive care patients and 452 new-borns in neonatal intensive care units (NICUs). These NICUs are also facing severe overcrowding which is making adequate monitoring and infection control impossible.
Vital medical supplies are also running out in Gaza. The Ministry of Health in Gaza maintains a list of 516 essential medications, 40% of which are now at “zero stock”, meaning less than a month’s supply in stock at the Central Drug Store.
Delving deeper into this data, the seriousness of these shortages is clear. The majority of depleted items (180 out of 516, or 35% of the total list) are completely depleted. The Ministry of Health categorises medications into immediately life-saving drugs (“Category A”) and medications which are not immediately life-threatening, but shortages of which can cause complications or risk patient mortality if they are unable to access it for more than one month (“Category B”).
190 “Category A” drugs – which includes emergency medications, anaesthetics, antibiotics and medications used to treat thalassaemia, haemophilia – are at “zero stock”, almost a quarter of which (46) are now completely unavailable.
The WHO highlights four groups of patients particularly affected by these shortages:
One third (34%) of medical disposables – including “stents” used to open blocked arteries in cardiac catheterisation operations – are also at “zero stock”.
The suffocating barriers to free movement for patients in Gaza also continued through July. With a healthcare emergency unfolding in Gaza and adequate treatment often unavailable, many patients are referred out to hospitals in the West Bank and East Jerusalem, or abroad. To get to these appointments, most patients must pass through the Israeli-controlled Erez crossing, particularly as the Rafah crossing with Egypt is closed most days, and does not offer patients a route to hospitals elsewhere in the occupied Palestinian territory.
Nevertheless, in July 2017 Israel granted permits to just 57% of those patients to applied, meaning almost half were either denied outright or did not receive a response in time to attend their appointments.
The majority of patients referred out of Gaza for treatment must obtain financial coverage from the Ministry of Health in Ramallah, in the West Bank. In July, only half of these requests were granted.
In total, this meant that two out of every five Gaza patients were denied or delayed access to healthcare outside of Gaza in July.
The results of these barriers can be catastrophic for seriously ill patients. The WHO reported on the sad case of Yousef Zourub, a 22-year-olf man from Rafah with a genetic disorder called Gaucher disease, who was denied exit for care:
“Yousef Zourub … had complications following a severe episode of pneumonia that required advanced surgery outside Gaza. He had an appointment at Makassed Hospital in East Jerusalem on 16th July 2017. Three permit applications were submitted for him for three consecutive hospital appointments. On 26th March Yousef’s application was pending and he lost his hospital appointment on that date. His application was also delayed for another appointment on 5th May. Following his application for the appointment on 16th July, Israeli General Security Services requested that Yousef attend for security interrogation at Erez. The appointment for security interrogation came too late and Yousef died on 16th June 2017 at the European Gaza Hospital.”
With such serious challenges to the provision of healthcare, the WHO said targeted humanitarian interventions are preventing “the complete collapse of the health sector.”
The WHO list some of these interventions in their report. UNRWA has secured USD $2 million of funding for emergency fuel to keep generators running at hospitals and health facilities in Gaza. The WHO has also secured USD $1 million to replenish essential life-saving equipment damaged by the electricity crisis, and delivered emergency health supplies such as surgical kits and pharmaceuticals.
MAP’s response is also highlighted in the report: “MAP has started the procurement of over US $140,000 for essential lifesaving items and infection control materials for the neonatal intensive care units in Gaza. In addition, MAP has continued to bridge the gap for essential drugs items that are at zero stock.”
If you would like to support this vital work, please consider making a donation to MAP today.
MAP is also campaigning for an end to the restrictions and barriers to Palestinians’ health and dignity, and this year is calling on the UK Government to do more to help bring Israel’s 50-year occupation of the West Bank, including East Jerusalem, and Gaza – and the 10-year blockade of Gaza – to an end.
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