Gaza’s humanitarian emergency continues to worsen as winter hits

Since the summer, Medical Aid for Palestinians (MAP) has been reporting on Gaza’s humanitarian emergency. People in Gaza have suffered a decade of declining living standards since Israel’s imposition of blockade and closure in Gaza in 2007. This year, the crisis has been exacerbated by severe electricity shortages, medical shortages and barriers to medical referral, creating a humanitarian emergency in Gaza.

New data from the World Health Organisation (WHO) and received by MAP’s team in Gaza highlight the continuing deterioration of the situation, particularly with regards to healthcare.

Hospitals in Gaza continue to suffer severe electricity shortages, with blackouts for 18-20 hours per day meaning heavy reliance on backup generators to power equipment and services. According to the WHO, energy fluctuations have damaged 150 medical machines, and is threatening the ability to collect, store and transport blood.

Protracted reliance on generators meant only for emergency backup means that these vital power sources are rapidly burning through fuel stocks, with emergency UN funding only available to sustain current levels of usage until the end of February 2018. What is more, generators are frequently breaking down, and maintenance, repair and replacement of units is challenged by the ‘dual-use’ list maintained by Israel which restricts the entry of vital parts.

The electricity crisis and funding shortfall is also affecting other basic hospital services. This week catering services stopped at eight Ministry of Health hospitals in Gaza due to financial debts. It is believed cleaning services may also be suspended this week, threatening infection control and the safety of patients.

November saw the first major delivery of medication from the Ministry of Health in the West Bank to Gaza since February, and medical shortages still remain at crisis levels. As much as 38% of essential medications are now entirely out of stock, with an additional 5% at less than a month’s supply (‘zero stock’). Particularly affected are: cancer drugs (37% zero stock); medications for emergency departments and intensive care (48% zero stock); and medicines to treat blood disorders (27% zero stock). In addition, 30% of medical disposables were reported to be at zero stock last month.

With such severe impediments to healthcare inside Gaza, it is essential that patients are able to move freely to other areas of the occupied Palestinian territory (oPt) – such as East Jerusalem – where care is available. Yet in October, 45% of patients’ applications to the Israeli authorities for permission to exit Gaza for treatment elsewhere were unsuccessful.

The WHO has warned that “2017 is likely to see the lowest approval rate for patient applications to exit Gaza since they began documenting rates in 2006, with an average of only 54% of patient applications accepted from January to October 2017”. Compared to the permit granting rate of 92% just five years ago, this highlights an ever-tightening closure of Gaza, its devastating impact on the right to health of Palestinians, and Israel’s ongoing abrogation of its humanitarian duties as the occupying power.

The WHO has also highlighted the restrictions to referral presented by reduced financial coverage by the Ministry of Health in Ramallah: “In the month of October, a total of 1661 referrals were approved by the MoH. The number of referrals approved in October still represents less than 80% of the average monthly referrals of the first quarter of 2017”

The WHO report quotes Gaza’s only child psychiatrist, Dr Sami Awedeah, explaining the additional impact of the electricity crisis on the mental health of Gaza’s population:

“As psychiatrists, we can see that the electricity situation is provoking patients, worsening their symptoms and delaying their recovery. Many people suffering from depression or posttraumatic stress disorder (PTSD) find it difficult to sleep in complete darkness. It triggers deep anxiety and this can have a knock-on impact on their health. There are some patients, particularly those suffering from Obsessive–compulsive disorder (OCD), who need to wash their hands excessively. But without electricity, they have no access to water. This means that basic activities, such as washing hands and flushing the toilet is not possible. As a result, OCD patients are suffering extreme relapses”.

Amid this ongoing emergency, the WHO also highlighted the vital work being done by MAP’s team in Gaza to help save lives:

“MAP-UK has implemented 8 blood donation campaigns to enhance the preparedness for emergencies at Shifa Hospital; procured and released 7 types of emergency drugs and 3 types of medical disposables; conducted one neonatal life support training targeting MoH neonatal and obstetric health professionals; and supplied the MoH laboratories with 3 types of infection control items”

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Resolving Gaza’s protracted humanitarian crisis requires diplomatic action. Governments, including the UK, must work to ensure that international humanitarian law is strictly adhered to in the oPt, including helping to end Israel’s 10-year closure of Gaza, which the International Committee of the Red Cross considers “collective punishment imposed in clear violation of Israel's obligations under international humanitarian law”.

Please help us call on the UK to raise Palestinians’ right to health at Israel’s upcoming Universal Periodic Review at the UN Human Rights Council in January.

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