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Source: World Health Organization (WHO)
1 August 2004




Health Inforum News
Volume 3, No.51, 1 August 2004
__________________________________________________________________________________________________
Welcome to the fifty-first issue of the Health Inforum Newsletter.
Quote of the month
    To be or not to be isn't the question. The question is how to prolong
    being. ~ Tom Robbins ~
CONTENTS

Health News
• Rafah Border Crossing
• Measles Campaign
• Neuro Surgery in the Gaza European Hospital
• IDF fired at Nasser Hospital in Khan Younis

Reports
• WHO health situation report on Beit Hanoun
• MOH- Annual book “Health Status in Palestine 2003”

Projects
• 24 hour emergency service to 7 villages North-west of Jerusalem cut off from the rest of the West Bank.

Casualties & access incidents
During last July: 64 deaths and 210 injuries
According to Palestine Red Crescent Society PRCS, during the month of July 2004, the total number of deaths and injuries reported in the West Bank and Gaza Strip was 70 deaths and 251 injuries.
While during the same period, there were 28 incident of delay for ambulances (46hrs delays) and 5 cases were totally denied to access.


HEALTH NEWS

Rafah Border Crossing
From 18th July to 6th August Rafah border crossing has been closed. The Rafah terminal is the only point of passage for Palestinians traveling abroad, and from abroad to reach their homes in the Gaza Strip. Lacking the financial resources or permits to return to Egypt and reluctant to leave their places in the queue, thePalestinian travelers, on their way back, have been forced to stay in the terminal until it opened.

Severe overcrowding and lack of sufficient toilets and washing facilities createdmajor public health concerns. Forced to sleep on the floor in the severe heat,people have started to developed diarrhea and skin diseases, one pregnantwoman went into labor while at the terminal, two others had a miscarriage.Emergency food and water rations have been distributed in response toincreasing arrivals.

Medical teams have made more than 1700 medical consultations in a mobileclinic set up at the terminal. Approximately 58 people waiting in the terminalhad returned from medical treatment in Egypt. Twenty-three of these patientswere hospitalized in nearby hospitals while they were waiting for the terminal toopen. Furthermore, to all those patients in need of receiving medical careabroad, the possibility to leave has been denied.
Health Inforum /WHO published a report on the on Access to Health Servicesfor Palestinians in Gaza Strip including Rafah border.

Measles Campaign
According to the MOH, the total number of immunized children in Gaza strip is169,923. During the measles campaign, launched in June 28, 2004 by theMOH, with UNICEF support, 99.4% of the targeted children have beenvaccinated against measles and administrated a dose of Vitamin A. The MOHreported that there have been no adverse reactions to the vaccine and to thevitamin. Most of the remaining children are living in areas under curfew in BeitHanun. In order to achieve all the targeted children (from 9 months to 5 yearsold) a UNRWA mobile team will visit all isolated areas in order to reach thosechildren living under curfew that could not be vaccinated.

Neuro Surgery in the Gaza European Hospital
In July 25, 2004, the local medical staff of the Gaza European hospital, incooperation with a neurologist from the German Hammer Forum Organization,performed 65 complex neuro surgeries aimed to stabilize the vertebral column.They also provided medical treatment and counseling to about 600 Palestinianssuffering from problems in the vertebral column.
In a press release, the German neurologist emphasized how this cooperation iscrucial to help those Palestinian patients who else way would need to bereferred abroad.

IDF Fired at Nasser Hospital in Khan Younis
In July 23, 2004, at mid night, the IDF fired at Nasser Hospital in Khan Youniscausing physical damage to the building and to the electricity wires in two rooms. The ministry of health reported that the source of the fire was from Al Mawassi area close to Ghoosh Kateef settlement. One patient who was in one of the targeted rooms was shot in his hand.

REPORTS

WHO health situation report on Beit Hanoun
29 June - 05 August 2004
From June 29, 2004 to August 4, 2004, an extensive military operation by the Israeli Defense Forces (IDF) took place in Beit Hanoun, North of Gaza Strip.

No humanitarian crises developed in the central area of the town, whilst for the people leaving in some peripheral areas, under continuous curfew, there was the need to cope with a severe lack of access to essential goods, including food, water and medical care.

Access to primary health care centers for the residents of the central area has been roughly maintained during the incursion. However, for the people living in the isolated areas, there has been a total lack of access to these centers.

Access to secondary care, in the district hospitals of Jabalia and Beit Lahia, has been possible only through coordination with the IDF, resulting in complex procedures and, especially for the patients living in the isolated areas, in severe delays.

The local health system worked reasonably well, coping with the crisis and the increased burden for the services, through the activation of several preparedness measures such as decentralization of staff, extension of working hours, provision of drug stocks, coordination of emergency care and referral system.

No epidemics have been registered during the crisis. However, during the national measles campaign, only about 85% of the targeted children in Beit Hanoun were covered. The 15% of missing children were those living in the areas under curfew.

According to MoH sources, throughout the incursion, the total number of fatalities among Palestinians is 18 and the total number of injuries is 133. No fatalities were reported among Israeli Forces.
Full report available at: www.healthinforum.org
************************************

MOH-Annual Book “Health Status in Palestine 2003”
The Ministry of Health, through the Palestinian Information Center (PHIC), will publish soon its annual report “Health Status in Palestine 2003”.

Selection from the executive summary:
• The prevalence rate of anemia among pregnant women was 37.6% in Palestine; 44.2% in West Bank. Anemia among infants aged 9 months was 40.5% (46.5% in GS vs. 37.2% in WB).
• MOH warns the international communities and organizations from re-emerging of infectious diseases that threaten not only Palestinian infants and children but also children in all neighboring countries and regions as known infectious diseases do not recognize borders or checkpoints.
• There was deterioration in mental health indicators, where patients' visits to the mental health clinics increased by 20.3%. A noticeable increase was seen in epilepsy, schizophrenia, mental retardation, nocturnal enuresis, and affective disorders. In addition, there was an increase in neurosis cases among population, with a percentage of 11.9%.
• Due to the high unemployment rate and border closures, public revenues from taxation and health insurance have been dried.
• The decline in economic activity is likely to continue affecting various aspects of the health care delivery system. A substantial proportion of the MOH budget comes from the Palestinian National Authority and due to dry in public revenues from taxation and health insurance; the Ministry’s budgetary support was reduced.
• The postulated MOH expenditure was 108.6 million US$ in 2003. The estimated expenditure of MOH in 2003 was 98.5 million US$, therefore, a deficit of 9.4 million US$ was reported in 2003.

Main health indicators for the oPt for the year 2003:
For the full executive summary of the report, please visit www.moh.gov.ps or Health Inforum website www.healthinforum.org 

PROJECTS

Project Title: 24 hour emergency service to 7 villages North-west of Jerusalem cut off from the rest of the WestBank.
Location: The MoH-PRCS Primary Health Care Clinic in Biddo village, being central in location to all the othervillages was chosen to have the emergency center.
Project starting: 1st of August 2004, it was inaugurated on August 4th, 2004.
Project Duration: One year
Donor: The Italian Cooperation
Project budget: USD114, 114.00
Implementing Agency: Palestinian Ministry of Health, Palestine Red Crescent Society with the contribution andsupport of the seven Local neighborhoods Councils and from the Italian NGOs, UCODEP and COSPE.

Background:
The people living in the villages North-West of Jerusalem face tremendous difficulties and movement restrictionsmainly because of the villages’ geographic location: being close to Jerusalem and surrounded by Israelisettlements. Also, with the proposed route of the ‘separation wall’, Israel would further be isolating this area,cutting it from any connection with the nearby Palestinian cities.

The result of the Israeli restrictions will be an almost complete disruption of social and economic life. More than35,000 people living in seven villages, Biddo, Beit Surik, Al Qubeibeh (Emmaus) Qatanna, Beit Anan, BeitDuqqu, and Beit Ijza will also be denied access to emergency services.

Objective:
To open an emergency center that would be open 24hours a day, 7 days a week for a pilot period of six months, in order to face the access problem to emergency services.

Implementation:
The Centre will function in three shifts. In addition to the morning shift (Shift A from 8.00 – 14.30, where MoHpersonnel works), two additional shifts are introduced (Shift B 14:30 – 22:30, personnel financed by the Localcouncils, and Shift C 22:30 – 08:00 personnel financed by the PRCS). The PRCS/MoH will be responsible forrunning the centre.

The main activities involved prior to opening the Centre are as follows:
CASUALTIES & HEALTH INCIDENTS

According to the Palestine Red Crescent Society (PRCS), during the month of July 2004 the total number ofdeaths and injuries reported in the West Bank and Gaza Strip were 70 deaths and 251 injuries.
During the same period, there were 28 incidents of delay for ambulances (46hrs delays) and 5 cases weretotally denied access.
The following diagram shows the number of incidents according to areas and delay or D/A on checkpoints:



The above diagram shows:
• In Nablus, Huwwara checkpoint still has the biggest number of ambulance incidents where therewere 7 incidents with a total delay of 690 minutes, which means almost 1:35 hr delay per incident.
• The same applies to Beit Hanoun, with an average of 1:30 hr delay per incident.




• The diagram shows that more than ¼ of the incidents are represented by denial of access.
• In May, there have been big numbers of incidents due to the invasion of Gaza strip.
• By comparing the (No. of delay incidents) with the (delay hours), we see that for eachincident it takes an average of one hour of delay, besides the cases that were totally denied of access. This delay increased in July as it reached to be 1:35 hr per case.



FOR MORE INFORMATION
Please feel free to contact us at:
Health Inforum, c/o Italian Cooperation/ Sheikh Jarrah, East Jerusalem, Tel: 02 532 7447, Fax: 02 532 2904
Health Inforum, c/o WHO Jerusalem office/ Sheikh Jarrah, East Jerusalem, Tel: 02 5400 595, Fax: 02 581 0193
Health Inforum, c/o WHO, Gaza office, Al-Bayed building, Al-Halbi Str. Tel: 08-2822033, Fax: 02-2845409
Email: info@healthinforum.org
Health Inforum posts daily news and announcements concerning health issues on its website: www.healthinforum.org.

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