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Source: World Health Organization (WHO)
1 September 2004




Health Inforum News
Volume 3, No.52, 1 September 2004
__________________________________________________________________________________________________
Welcome to the fifty-second issue of the Health Inforum Newsletter.
Quote of the month
    Health is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity. ~World Health Organization, 1948~
CONTENTS

Health News
• Nablus under curfew
• Medicines and vaccines shortages in MOH - West Bank (July-December 2004)
• UN calls on Israel to ensure respect for International Standards concerning prisoners
• Polio campaign in Rafah and El Mawasi area
• Health coordination meeting in Salfit District
• WHO activities on Mental health / August 04
• An administrative detention order for a paramedic
• International Committee of the Red Cross (ICRC) conducted four-war surgery seminars in oPt
• Palestinian-Israeli Conference on Diabetes held in Tulkarem
• IDF fired at an European Gaza Hospital ambulance
• IDF attacks Palestinian Medical Relief Committee
mobile clinic in Gaza
Reports
• Nutritional Assessment of the West Bank and Gaza Strip, 2003
Projects
• Providing psychological support for Palestinian women and children in the Gaza Strip
Casualties & access incidents
During last July: 64 deaths and 210 injuries
According to the Palestinian Health Information Center, during the month of August 2004, the total number of deaths and injuries reported in the West Bank and Gaza was 49 deaths and 601 injuries.
While during the same period, there were 25 incident of delay for ambulances (29hrs delays) and 6 cases were totally denied access

HEALTH NEWS

Nablus under curfew
Israeli army imposed a curfew on the Old city of Nablus (around 35,000 population) for ten days starting from August 16th, 2004. During this period two Palestinians were killed and 149 were injured. Access to health services including movement of ambulances was restricted. There have been shortages of medicines for chronic patients.

Medicines and vaccines shortages in MOH - West Bank (July-December 2004)
MoH has recently published its needs of pharmaceuticals in West Bank &Gaza for the coming six months till the end of 2004. There are serious shortages of about 163 item of medicine. Also, the MoH is particularly concerned about the fact that the whole budget for EPI vaccines needed for the year 2005 is not covered. For the list of needed drugs, please visit www.healthinforum.org

UN calls on Israel to ensure respect for International Standards concerning prisoners
On August 27, thirteen United Nations agencies operating in the oPt expressed their concern about the hunger strike that more than 2,900 Palestinian prisoners and detainees have joined. For more Information, Please visit www.healthinforum.org

Palestinian-Israeli Conference on Diabetes held in Tulkarem
On Friday, 6 August 2004, Physicians for Human Rights-Israel organized a conference on diabetes in Tul Karem, as part of its Specialist Clinic project. The Palestinian Medical Association in Tul Karem hosted the meeting. 120 Palestinian physicians attended the conference, which included lectures by both Israelis and Palestinians.The event began with a speech by the governor of TulKarem, the Palestinian organizers and Prof. Zvi Bentwich who sits on the Board of Directors of Physicians for Human Rights-Israel.

Polio campaign in Rafah and El Mawasi area
In August 8, 2004 a polio immunization campaign targeting children under 5,was carried out by MoH and UNRWA in Rafah district, in the Gaza Strip,including the whole El Mawasi area. This campaign has been conducted yearly since 2002, when a wild polio virus was found in a sewage sample in Rafah, and will be repeated in 2005. This modality is consistent with WHO polio eradication policy.

Breastfeeding campaign
In the first week of August, MOH and UNRWA carried out a campaign supporting breast feeding, with UNICEF funds. The campaign has been launched in Gaza strip, in coincidence with the international week of breastfeeding. A breast feeding national committee on breast feeding promotion has been established within the Promotional and Educational Department of the MoH. The national committee conducted a workshop to train the health care providers on the critical importance of breast feeding for children’s and mother’s health.

Health coordination meeting in Salfit
WHO/Health Inforum held on 25 August 2004, a district health meeting in Salfit (60,000 population). This district is located in the north of the West Bank and is currently experiencing severe movement constraints,including access to health services, due to the construction of the wall and to the checkpoints. MoH, International organizations and several NGOs participated in the meeting, that will be hold on a monthly basis.

International Committee of the Red Cross (ICRC) conducted four-war surgery seminars in oPt
The health department of the ICRC, in cooperation with Palestinian MoH, completed in August 2004 four seminars on war surgery. The targeted professionals are surgeons, anesthetists and resident doctors working in Hebron, Bethlehem and Ramallah hospitals. The second seminar was in Nablus with participants from Jenin, Tulkarem, Qalqilya, Salfit and Nablus hospitals. Two seminars were held in Gaza City (for the North of Gaza Strip) and Khan Younis (for the South of Gaza Strip). In all, around 200 participants attended the seminars the lecturers were from MOH , with the participation of two ICRC surgeons specialized on war wounds.

Union of Health Work Committees
In August 15, 2004 the Union of Health Work Committees (UHWC), in coordination with the local authority of Beit Hanun, announced its plan to build a new health center in the western part of Beit Hanun, including a primary Health Care clinic and a women’s Health Clinic. Furthermore, UHWC will implement a medical relief project in Gaza that will include the provision of medical supplies to NGOs in Gaza strip. The personnel employed for the project will be Rafah residents. The project is funded by the Unity of Protestant Churches of Netherlands (UPCN).

WHO activities on Mental Health
During August, WHO carried out several activities on Mental Health in West Bank and Gaza:
• Opening of new Community Mental Health Centers
• Anti stigma radio and TV campaign
• Visits of consultants on Mental Health and Psychiatry and in-service training
• Training in Scotland of Palestinian mental health staff
• Task Force Meeting on mental health training plan
To read more about these activities, please visit www.healthinforum.org

Middle East Council of Churches
A hemoglobin screening program started in Daraj and Shejaeia Middle East Council of Churches (MECC) clinics in Gaza district in February and April 2004, respectively. The project aims at assessing the risk factors associated with iron deficiency in children aged 1-5 years. Those children who will be identified as anemic, will receive iron supplementation and their mothers will also receive iron and will be given relevant educational material. The project is implemented by the MECC staff.

IDF fired at an European Gaza Hospital ambulance
In August 17, 2004, some IDF located at Abu Holly check point in the northern part of Khan Younis fired at an European Gaza Hospital’s ambulance while it was waiting at the checkpoint, damaging to the front glass of the car. The ambulance driver was injured in his eye. The Ministry of Health reported that, previous to the fire, the ambulance had been waiting for more than two hours in a place visible to the IDF.

IDF attacks Palestinian Medical Relief Committee mobile clinic in Gaza
IDF fired at Palestinian Medical Relief Committee (PMRS) mobile clinic on 31st August, 2004 at noon, whilst waiting at the Abu Holi junction checkpoint in Gaza Strip. Two of the six health workers in the ambulance,were injured: Doctor Wafik al Abadilah, shot in his right thigh and the driver Subhei Madi ,was shot in his hands and his leg and now in the Nasser Hospital in Khan Younis for surgical intervention.
For more information www.phr.org.il

REPORTS

Nutritional Assessment in West Bank and Gaza Strip, 2003
Care International carried out in 2003 a Nutritional Assessment in West Bank and Gaza Strip,. This assessment came as a follow-up of that conducted in 2002, and will be published soon.

Background:
A national anthropometrics assessment of children ages 6-59 months had been undertaken in 2002 by Al Quds University and Johns Hopkins Bloomberg School of Public Health funded by US Agency for International Development (USAID) and sub-granted through CARE International’s Emergency Medical Assistance Project (EMAP1). This nutritional assessment had revealed:
• An alarming prevalence of global acute malnutrition in the Gaza Strip (13.3%);
• A global chronic malnutrition prevalence of 17.7% in the Gaza Strip and 7.9% in the West Bank;
• Decreased energy, iron, vitamin A, and zinc intakes in large percentages of the preschool population
The follow up research carried out in 2003 in children 6-59 months by Care International searched the following:
• The prevalence of acute and chronic malnutrition in the Palestinian population of preschool children one year after intensive food aid;
• Sub-populations of preschool aged children that may be vulnerable to acute and chronic malnutrition;
• The quality of food consumption for preschool children in terms of macro and micronutrients with a comparison with 2002;
• Critical food security indicators that can be quantified and the extent to which they affect food consumption;
• The current level of food assistance and the degree to which that assistance is targeted appropriately;
• The links between nutrition and quantified food security indicators.

Summary of findings:
The following table summarizes the prevalence of global acute and chronic malnutrition, in children ages 6-59 months in West Bank and Gaza.


The findings indicate that:

• The prevalence of GAM was very high in August 2003 in both West Bank and Gaza Strip; however, Bethlehem, Qalqilya, Deir al Balah, and Khan Younis had the highest prevalence;

• In the Gaza Strip the prevalence of GCM in 2003 was lower than in 2002 ( from 17.5% to 12.7%)

• Children registered as refugees were statistically more likely to be chronically malnourished than non refugees (12.4% versus 9.4).

• Among refugee children, chronic malnutrition prevalence was higher in Gaza Strip compared to West Bank (13.2% versus 10.6%).

• In 2003, in refugee children acute malnutrition was less prevalent than in 2002 ( 3.9% compared to 9.6%). Also chronic malnutrition was lower in 2003 than in 2002 (12.4% vs. 15.1%)

For more Information, Please visit www.healthinforum.org

PROJECTS
Project Title: Providing psychological support for Palestinian women and children in the Gaza strip

Location: Three districts of Gaza strip: Gaza city, North Gaza and Middle Zone.

Project duration: Two years

Donor: The International Relief Fund for the Afflicted and Needy, IRFAN- Canada

Starting Date: 22nd May 2004

Project Budget: US$ 190,340

Implementing agency: Ard El Insan (AEI)

Background:
Psychological problems amongst children and women severely affect their overall well-being and currently represent a great challenge to health personnel dealing with maternal and child health care. The existing restless life style and the cumulative daily suffering of Palestinians has been incriminated as a major cause for increased psychological problems amongst children and women.

During the daily attendance of mothers with their children, AEI has found that growth delay, malnutrition and repeated illnesses were often attributed to the poor psychological status of mothers and children themselves.

Psychological problems and disorders are noticeably increasing in Gaza strip in the last few years. Hence, the need of such a project had been resulting from an increase in the problem size, in addition to lack of adequate facilities required for responding to these growing problems.

Objective:
To help families and communities to cope with stress in order to prevent psychological problems and trauma,especially amongst children, in the Gaza strip.

Implementation:
The targeted areas is: Gaza, Wady El Salga, El Mugraga in the Middle Zone and El Izba and Beet Hanoun in the north district.

With the assistance of Gaza Community Mental Health Program (GCMHP) a team for psychological support consisting of 4 psychologists, 4 health workers and one psychiatrist is established. For this purpose, local qualified personnel are recruited and trained to provide counseling to children, women and families in both AEI and in the community. Also the AEI staff will be trained by GCMHP.

Home visits are carried out by the team in order to identify children with psychological problems and to counsel the families on how to deal with them.

School visits to provide health education to the teachers on mental health issues as a part of the treatment cycle are also carried out.

Lectures, workshops and summer camps are organized, in order to provide families, teachers and students with information and counseling tools to be used for detection and management of psychological and mental health problems.

Activities:

CASUALTIES & HEALTH INCIDENTS

According to the Palestinian Health Information Center (MOH), during the month of August 2004 the total number of deaths and injuries reported in the West Bank and Gaza Strip was 49 deaths and 601 injuries.

During the same period, according to PRCS, there were 25 incidents of ambulance delay (29hrs delays) and in 6 cases access was totally denied.

The following diagram shows the number of incidents and delay or D/A on checkpoints according to areas:


The above diagram shows:

• The diagram shows that more than 1/5 of the incidents are represented by denial of access.

• In May, there has been a big number of incidents due to the invasion of Gaza strip.

• In August, there was a reduction of hours of delay, although the incident number is relatively high. By matching the No. of delay incidents with the n. of delay hours, we see that each incident takes an average of one hour of delay, besides the cases in which the access was totally denied.




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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