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Source: World Health Organization (WHO)
1 September 2002

Health Inforum News
Volume 1, No.11, 01 September 2002
______________________________________________________________________________________

Welcome to the eleventh edition of the Health Inforum Newsletter. In our ongoing efforts to provide useful information to the whole of the health community, we continue to welcome any comments or suggestions you might have to help us to improve this newsletter. Each Newsletter has had a particular theme. If your organization has an information need that you would like to address, please let us know and will do our best to accommodate your request.

We continue in this issue to deal with the Nutritional Status of the Palestinian people. We will publish the MOH Emergency Plan to prevent the deterioration of health conditions for the Palestinian Children and Women.

Also, we will summarize the main findings concerning nutrition of the Sentinel Surveillance System for Palestinian Households, Health Sector Bi-weekly Report. Number 1, August 5 2002.This was recently released by Johns Hopkins University with CARE International, and ANERA under the Emergency Medical Assistance Project (EMAP) which have partnered with Al Quds University to design and implement a sentinel surveillance system for Palestinian households. In addition, the Maram Project has designed a monitoring system for all health service delivery facilities whether operated by the Palestinian Ministry of Health, UNRWA, or Palestinian NGOs. This integrated set of research activities are intended to collect and report on data related to the impact of the emergency on various aspects of the health sector, every two weeks from June 2002 to September 2003.

You can find a copy of this survey on our website under Situation & Needs Analysis -> Report Library.

In addition, the following news items are also covered:

1. The MOH is the only authority that has the right of Disease Surveillance at the national level
2. World Health Organization activities in the occupied Palestinian territories.
3. Patient’s Friends Society-Jenin, Annual Report
4. A call to update your Information

Palestinian Ministry of Health has taken several steps to deal with Nutritional Status

The Ministry of Health declared the state of emergency in the light of the recent release of the preliminary findings of the “Nutritional Assessment and Sentinel Surveillance System for West Bank and Gaza - 5 August 2002”. The MOH has taken the following steps to prevent the deterioration of health conditions for the Palestinian children and women:

1. The MOH declared the emergency situation in Mother and Child Health Care Centers, Women Health Department, School Health Services & Health Education Department to focus their activities on the community awareness regarding the health, food & diet, and anemia especially among children & pregnant women.

2. The MoH will reactivate the National Council for Nutrition.

3. The MoH will formulate a National Steering Committee including all the related organizations.

4. Formulate a National Nutrition Strategy with participation of the bodies mentioned in 2 & 3 above.

5. Rapid positive response from MARAM and all the NGOs to work with the MoH for the rapid implementation of the strategy.

6. MARAM, CARE International & ANERA will provide the MoH with their needs of Iron & Vitamin Supplements (for one year).

Sentinel Surveillance System for Palestinian Household- Health Sector Bi-weekly Report

The tightening of road closures and the imposition of prolonged curfews results in, restricting the movement of people and goods, continue to degrade the Palestinian public health infrastructure, affecting severely the economy and the population’s access to health care, food, and water, as well as the ability for the health care system to function.

Health Inforum News will focus on the food and water Main Findings, for the detailed report,

Food

A total of 724 out of the 1280 households sampled in the report (56.6 %) throughout all Districts of the West Bank and Gaza reported that the amount of food eaten by household members had decreased for more than one day during the two weeks, a percentage that has remained constant throughout all four rounds of sampling. All 80 households sampled in Bethlehem reported a decrease in food consumption followed by Hebron (83.8 %).

The dire state of the Palestinian economy plays a more important role in the decrease of food consumption than curfew and closures or food availability in the market. Of the 724 households with a decrease in food consumption for more than one day, two-thirds cited lack of money and one-third cited curfews/closures as the reasons. Although the prices for basic food supplies have not changed in the eight weeks of data collection, 469 out of 1280 Palestinian families (36.6%) lack the purchasing power to consistently feed their families. This is supported by two other disturbing trends that have stayed consistent over the last 8 weeks:

· 53 % of 1280 households were forced to borrow money to purchase food during the two-week sampling interval with highest rates in Bethlehem (88.8 %), North Gaza (72.5%), Jericho and Gaza City (70 %).
· 16.9 % were forced to sell assets to buy food. Gaza City (41.3 %) and Khan Younis (32.5%) were the highest for families selling assets for food.

As could be expected, households would be buying less high priced food items such as meat, fish, and chicken, items that also have higher protein contents. Surprisingly though, 32.1 % of all households reported buying less bread, potatoes, and rice, basic, inexpensive staple food of the Palestinian diet. Bethlehem and Hebron districts ranked the highest in percentage decrease of purchased food of each type.

In the fourth round interval of data collection, a general increase in the percentage of households reporting decreases in the amount of food was observed in all specific types of food on the survey. Sixty-two percent reported decreases in the amount of food in the last two weeks, 72.2% reported decreases in meat, fish and chicken, 42.5% decreases in bread, potato and rice, 49.1% decreases in milk and milk products, and 70.9 % a decrease in fruits and vegetables.

Water

A cumulative 44.7% of households (since data collection began) reported water interruptions in two weeks preceding the survey, with the highest percentages in Jericho 88.5% and Gaza City 83.8 %.

Eighteen clinics throughout the West Bank and Gaza have experienced decreases in water supplies since 31 May due primarily to one or more of the following factors:

· Damage to the public/municipal water system (6);
· Damage to the facility of water tank(s) (2); and/or
· Non-delivery of purchased water (8).

The interruptions in water supply at the facility level have affected clinical services and the availability of drinking water for both patients and staff. In a number of clinics, cleaning and housekeeping services, essential to infection control, have also been affected.

Other news:

World Health Organization activities in the occupied Palestinian territories

In the context of the current emergency WHO continues to be involved in a number of initiatives:

· The emergency operations room for the health sector (HART, now renamed Health Inforum) is continuing to strengthen coordination in support of the Palestinian health authorities and service providers by collecting and sharing up-to-date information about the humanitarian health situation and the emergency response. Health Inforum is now setting up a Discussion Board on the website to stimulate an open dialogue and debate around health issues in the Palestinian territories. It is a way to allow as many people as possible to share in discussions about important issues.
· Emergency Coordination meetings, chaired by WHO, are taking place in Ramallah at the Public Health Laboratory every two weeks, curfews permitting, to share information and problems encountered among organizations involved in the emergency health response.
· Over 100,000$ worth of rodenticides and pesticides for the emergency environmental health program are currently being delivered to the MoH. These are for controlling diseases like leishmaniasis, West Nile fever, foot and mouth disease and diseases induced by rodents and flies which are becoming increasingly likely in the present situation in which garbage disposal services are completely disrupted.
· Coordination work is continuing within the established structure of the Health Sector Working Group where WHO acts as the Secretariat. A Health Sector Working Group meeting took place in Gaza on 10 July. The Ministry of Health (MoH) outlined its new strategy of decentralization, in response to the curfew regime in the main West Bank cities.
· WHO is actively involved in the preparation of the incoming Health Sector Review (HSR) promoted by the European Commission. MOH, Palestinian NGOs and local stakeholders are being contacted to establish a Steering Committee, which will guide the activities of the HSR and support the team of experts carrying out the exercise.
· A household/health facility survey is being planned. Its inception is expected within the next few days. The pre-test of the survey will take place on September 9 and September 12.
· A Mental Health technical assistance program to the Ministry of Health, whose start had been kept on hold for sometime, is now being revived and five Palestinian professionals are in the process to travel to Trieste, Italy, for a six-month training program.

MOH is the only authority that has the right of Disease Surveillance at the national level

The Palestinian Ministry of Health published a statement concerning the deterioration in the Palestinian health status due to the Israeli incursion in the Palestinian territories. The curfews, the subversion and destruction of the Palestinian infrastructure, splitting the Palestinian governorate, impeding the movement of medical teams and ambulance vehicles, destroying water and sewage water pipe network, affected badly the health status which endangered and threatened the health of the Palestinian Population with the risk of outbreaks of certain infectious diseases, particularly, Shigellosis, Salmonellosis, Typhoid and West Nile Fever. For more information refer to Health Inforum website.

Patient’s Friends Society-Jenin, Annual Report 2001

Patient’s Friends Society continues providing health services to the people in Jenin District and expanded its activities and is planning for future projects to achieve its goals in providing good health services in Jenin, especially in remote and rural areas, where no other health services are provided by taking care of patients, especially the poor ones. PFS does its utmost to provide better primary health care services for Mothers and Children. It also works on improving the quality of the Mother and Child health services.

The full report is on Health Inforum website: http://hart.itcoop-jer.org

A call to update your Information

Health Inforum is dedicated to update its information and database on regular basis to be up to date in order to enhance the cooperation and coordination within the health sector.

We call all our partners, the Palestinian non-governmental organizations, the International organizations, the donors, UN agencies to update their information by looking to our website (Contacts and links) and revise the information regarding their organizations, if there are any changes concerning the activities or contacts, please email the right information to hart@undp.org

WEBSITE:

Health Inforum posts daily news and announcements concerning health issues on our website: Http://hart.itcoop-jer.org. We welcome your inputs, comments and suggestions.

FOR MORE INFORMATION

Please feel free to contact us for information at:
Health Inforum, c/o the Italian Cooperation
Sheik Jarrah, East Jerusalem

Tel: 02 532 7447 Fax: 02 532 2904
Email: hart@undp.org Http:// hart.itcoop-jer.org


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