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19 jan 2009

Health situation in Gaza - 19 - 20 January 2009

Picture
Overview This is the 19-20 January update on the health sector situation since Israel launched its military offensive in Gaza on 27 December.

  • Emergency status continues at health facilities
  • Post-ceasefire assessments underway to evaluate immediate health needs and damage to health facilities.
  • Immunization and antenatal care resumes with a normal average of attendance.
  • UNRWA and UNICEF dedicated to raise immunization coverage within the Gaza Strip.
  • 34 health facilities have been damaged since 27 December. More may be discovered as areas become accessible again due to the cease-fire.
  • WHO coordinates delivery of 3 trucks of supplies.
  • Electricity supplies improved at health facilities.
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.

  • OCHA: Situation in Gaza Strip (as of 18 January 2009)

EMERGENCY STATUS

All MoH hospitals have declared that the emergency status declared on 27 December with the beginning of hostilities remains intact following the two cease-fire declarations, as many injured patients are still hospitalized.

CASUALTIES and AFFECTED

According to the MoH on 19 January at 16:00, the number of people killed in the Gaza Strip since 27 December was approximately 1300, including 410 children and 104 women. Approximately 5300 people have been injured, including 1855 children and 795 women*.
(*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 reports that 44 out of the 50 emergency shelters established to accommodate the displaced people are still in place for 46 000 displaced people.

HEALTH PERSONNEL

Since 27 December 2008, 16 health personnel have been killed and 22 injured while on duty, according to the MoH health information centre in Gaza.

Since the cease-fire, most health personnel have been reporting to work regularly and working for one ore two continuous shifts, each shift for 12 hours.

DAMAGE TO HEALTH FACILITIES

Since 27 December, 34 health facilities (8 hospitals and 26 PHC clinics) have been damaged or destroyed in direct or indirect shelling.

Of the 8 damaged hospitals, two were not functioning as of 20 January. The 8 are:

  • Al Dorah Hospital – damaged on 3 occasions – 3, 12, 13 January (functioning only for emergency cases)
  • Gaza Pediatrics Hospital – damaged 3 January
  • Al Awda Hospital – damaged 5 January
  • Gaza European Hospital – damaged 10 January
  • El Nasser Pediatrics Hospital – damaged 10 January
  • Al-Quds PRCS Hospital – damaged twice 4, 15 January (not functioning)
  • Al Wafa Hospital – damaged 15 January
  • Al-Fata Hospital – damaged 15 January (not functioning)

Of the damaged PHC clinics, 20 were identified between 17 and 19 January after staff were able to inspect areas previously inaccessible due to insecurity. The number may increase as all sites are visited.

WHO is investigating the extent of damages to these health facilities. For a preliminary assessment please see "ANNEX 1: Health facilities damaged/destroyed since 27 December."

  • ANNEX 1: Health facilities damaged/destroyed since 27 December
    pdf, 50kb

PRIMARY HEALTH CARE CENTRES

26 PHC clinics have been damaged or destroyed since 27 December (23 MoH, one UNRWA, two NGO).

Most of the MoH PHCs reportedly remain functional despite the damage (50 of 56). Of the six that remain closed, five were severely damaged and one was shut due to its close proximity to a high-risk area. For a detailed list see "ANNEX 2: Functionality status of 56 MoH clinics."

Immunization, antenatal care and management of chronic diseases services have been fully resumed in the 50 functioning MoH PHC clinics. Laboratory and dental services have been partially resumed. Health education and promotion services have recommenced in all the functioning PHC clinics. Internal referrals between PHC clinics and hospitals have been resumed for only severe cases.

Most health personnel have returned to work since the cease-fire, according to the director of the PHC directorate. But some are still supporting hospitals and have not returned to their PHCs.

Related public health measures being carried out include:

  • Collection of water samples 20 January that were sent to Gaza’s central Public Health Lab for routine analysis 21 January.
  • The MoH’s epidemiology department is strengthening the communicable diseases surveillance system among PHC clinics to avoid any communicable disease outbreak.

Also, 15 of UNRWA’s 18 PHC centers are fully functioning. Immunization services began 18 January at the UNRWA displaced people’s shelters. UNRWA is working with UNICEF to immunize all children in Gaza.

ELECTRICITY AND FUEL SUPPLY TO HEALTH CARE FACILITIES

Electricity supply improved during 19-20 January as nearly 90 000 liters of industrial gas were emptied from the filling depot at the Nahal Oz Border Crossing. Some hospitals received electricity for 8-12 hours while others received it for 12-18 hours.

MEDICAL SUPPLIES

3 trucks of medical supplies and consumables donated by Italian Cooperation to WHO, WFP, and UNRWA entered Gaza on 20 January through Karem Shalom.

COORDINATION WHO

Gaza held a health coordination meeting in Gaza City – WHO premises – on 19 January. 20 organizations participated, including UN agencies and INGOs. The main topics discussed were coordination of donations entering Gaza, and the post-crisis concerns and actions.

WHO is undertaking a needs and health facilities assessment that will be coordinated with Health Cluster partners. NGOs and doctors have also been asked to coordinate with WHO in Rafah and Jerusalem, as well as the MoH Operations Room in Ramallah, before deployment of health personnel into Gaza to ensure that the specialties being offered are needed by health services there.

WHO is coordinating the emergency health response through its Jerusalem, Gaza, Cairo and Geneva offices with the MoH in Ramallah and Health Cluster partners. A WHO Emergency Operational Plan has been launched for a range of urgent health interventions.

  • WHO Emergency Operational Plan
    pdf, 96kb
  • ANNEX 2: Functionality status of 56 MoH clinics
    pdf, 30kb
  • Situation report in PDF format
    pdf, 470kb

A chance to breathe… …

people are out on the streets. Some shops are open. I have so much I want to write for you, and I’m just too tired and have no concentration.

Somehow it’s got to be 11pm already, so I think maybe I should go and sleep. But then there will just be more to write about tomorrow… the world just keeps turning, huh.

I want to convey some of the cautious hope I am seeing. But instead it seems like the enormity of these last days has hit me.

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