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World Health Organization (WHO)
31 December 2008
Health Situation in Gaza - 31 December 2008
This is an update on the health sector situation since the Israeli air strikes started at 11.15 on 27 December 2008.
WHO is working with the Palestinian Ministry of Health (MoH) and international and local organisations to coordinate assistance to the health sector.
WHO has held three meetings with health partners in Jerusalem, Gaza and the MoH in Ramallah. It was agreed information on drugs and supplies donations be shared with WHO and MoH Ramallah to assess on-going needs.
One paramedic and one doctor were killed in an air strike while trying to evacuate casualties in the Northern Gaza Strip.
There are some constraints to achieve reliable figures about casualties. The MoH information centres were unable to track all records. Some people were rushing to bury dead bodies without notifying health authorities. The MoH reported about 390 fatalities, out of them there are records of 305 fatalities. WHO is trying to double check the remaining number of fatalities. Among the fatalities are 34 children. The MoH also reported about 1700 injured, including 260 children. The Rafah border was open to evacuate patients and transfer of medical supplies. The MoH reported that since 29 December, 46 injured were evacuated and today another 15 are scheduled to be evacuated.
Gaza has 27 hospitals, 13 of which are managed by the MoH with a capacity of about 1500 beds. Private and NGO hospitals have about 500 beds. MoH hospitals were overwhelmed by the initial influx of patients. They switched to emergency mode, discharging non-urgent patients whenever possible (some to NGO hospitals). Emergency and operating rooms are under intense pressure but most have sufficient beds so far. The medical teams are working on a 12-hour shift basis. A WHO team regularly visits the hospitals.
PRIMARY HEALTH CARE FUNCTIONING
The MoH manages 56 primary health care (PHC) centres in Gaza St, 24 of which are assigned to work as emergency centres. The MoH has deployed many staff members from PHC services to work in hospitals. Two PHC centres (Al Atatra clinic and Jabalia Martyrs clinic) were damaged and stopped working while two others are not functioning because of their proximity to risky areas.
UNRWA manages 18 PHC centres in Gaza, 16 of which are functioning. The Maan and Zaitoun centres are closed due to being located in risky areas. UNRWA maintains all basic services including maternal and child health, vaccination, non-communicable diseases and outpatient services. UNRWA has assigned 4 centres to act as emergency and evacuation centres. These are working in two shifts, while third shift of medical staff operates on-call. All UNRWA PHC are supplied with 2 months stock.
The MoH mental health teams are functioning with full capacity. Surani clinic operates until 11am, after which its staff undertake field visits to hospitals to carry out crisis intervention activities with wounded and traumatized people. All mental health facilities are open to beneficiaries until 11am daily.
Due to the current situation, the Gaza Community Mental Health Programme has suspended all its activities within the Gaza Strip, including mental health and psychosocial activities delivered through three mental health centres. The programme’s main building suffered serious damage on 27 December during intensive shelling of a nearby police station.
Although the situation of drugs and medical consumables has been stabilized to cope with injuries, some shortages of consumables and medical equipment remain in Gaza hospitals. WHO is working closely with MoH staff in Ramallah and Gaza to assess the needs and coordinate responses.
At least 12 trucks of medical supplies have been delivered to Gaza during the last few days. Four (4) truckloads were scheduled to arrive 31 December with supplies from CARE and UNFPA. The trucks experienced delays at Betunia and Kerm Shalom crossings and were delayed to 1 January 2009. ICRC is making further substantial deliveries in coming days and WHO is providing 50 surgical kits and 9 inter-agency emergency kits (funded by Norway and the HERF), which are due to arrive in the next few days. Substantial volumes of supplies from other donors are in the pipeline.
There is a risk that these supplies could overwhelm Gaza’s storage and delivery capacity and be far in excess of requirements, while leaving some essential needs unmet. Agencies were requested to support WHO coordination efforts by:
Correcting and updating the details of planned deliveries on the relevant spreadsheets:
Consulting WHO and the MoH on further planned donations and deliveries.
The information should be sent to Munia Abu El Hawa,
054 802 2753 and to the International Cooperation Department of MoH:
The MoH in Ramallah has decided not to refer any cases to Israel although it is understood that exceptions were made for several cases 31 December. One patient coordinated by UNRWA has also been referred for treatment through Erez. Egypt opened the Rafah border for patients to exit. WHO was informed that 46 injured patients had passed through Rafah until the morning of 31 December and 15 more will be allowed out during the day.