One year after the summer war in Gaza and stalled reconstruction of war damage, violence escalated sharply in late September following confrontations in Jerusalem. The protests continued in October, with largely youth participation, and triggered clashes with security forces in most Jerusalem neighborhoods but also throughout the West Bank to the highest level in 10 years. Many of the alleged attackers were killed by police or security forces at the scene. Human rights organizations have called for official investigations.
In Gaza protests occurred in early October in the restricted border area and were met by retaliatory fire by Israeli security forces.
From October 1 to October 19, 42 Palestinians were killed, 28 in the West Bank and 14 in Gaza (Palestinian Ministry of Health). Those killed include 10 children and 18 youth aged 18-20 years. More than 1,500 persons have been treated in West Bank and Gaza hospitals for injuries (Palestinian Ministry of Health). There is no data for the number of injuries treated in primary care clinics or in the field, although the Ministry of Health reported more than 3500 persons were treated for tear gas inhalation.
In Gaza 14 civilians were killed and more than 360 were injured. Most of the casualties occurred when protests in the restricted border area near the fence turned into clashes with security forces.
The UN Relief and Works Agency for Palestinian refugees reported that from October 1 to 9, Israeli forces made 45 incursions into refugee camps. One refugee camp resident, a 13-year-old child on his way home from school, was killed and 180 were injured, 50 by live ammunition. The injured included 20 children.
In addition to existing checkpoints at the entrances to Jerusalem, cement barricades were established by Israeli security forces on October 14 at the entrances, and within, eight East Jerusalem neighborhoods affecting the movement of 150,000 residents, including health access. The East Jerusalem hospitals reported that severe traffic jams have created delays in access for medical staff and patients which has disrupted the operations of the six hospitals. Three of the barricades are at the entrances to East Jerusalem hospitals and surround Makassed hospital from all directions. The time required for transfer of patients and medical supplies between the hospitals has tripled. Palestinian Ministry of Health referrals or Gaza cancer patients are particularly affected by the checkpoints at hospitals which hospital officials report are delaying care.
Medical access for the injured is also a concern in light of the large number of ambulances prevented from reaching the wounded or delayed, as well as the injuries of ambulance crews while in service, as reported by the Palestinian Red Crescent Society (PRCS). The PRCS spokesperson reported on October 19 that of the 136 incidents of damage and injury or delayed or denied access involving their ambulances, one-third occurred in occupied East Jerusalem.
HEALTH NEEDS, PRIORITIES AND GAPS
The majority of injuries have been treated in the public sector hospitals, which has driven down medical stocks that have already been in short supply. The MoH issued lists of 45 essential medications, including antibiotics, IV fluids and surgical drugs, and of 45 basic medical consumables, such as infusion sets, syringes and gloves, as being in short supply in its West Bank hospitals, with stocks sufficient foar less than one month. In Gaza, the MoH reported zero stock at 31% of essential medicines (cancer therapies, 48%; immunosuppressants, 46%; cardiac medications, 38%) and 40% of medical disposables (hearing and dental supplies, 95-100%; cardiac catheterization, 83%; ophthalmology, 72%). About $5 million is required to fund one month of critical medical supplies for the Ministry of Health in the West Bank and Gaza.
Makassed Hospital in East Jerusalem has been treating most of the injuries that have occurred in the surrounding neighborhoods, as well as most referrals from the Palestinian Authority (PA) Ministry of Health to the six specialty hospitals in the East Jerusalem Hospital Network, despite suffering from the accumulation of substantial outstanding reimbursements for services delivered in 2015.
A delegation of 10 specialist physicians from Gaza with trauma expertise traveled to the West Bank on October 19 to assist Ministry of Health staff in two main MoH hospitals in Ramallah and Nablus.
PUBLIC HEALTH CONCERNS
Mental health issues, especially for adolescents and youth as the age groups most vulnerable by recent violence, have been highlighted by mental health experts for special attention from health providers.
The use of tear gas in densely populated neighborhoods is a concern for the elderly and for those with respiratory conditions. A 65-year-old woman reportedly died before being able to reach hospital after tear gas was used in her barricaded Jerusalem neighborhood.
WHO continues to provide the MoH technical assistance through its country cooperation programming, as well as humanitarian support through the coordination activities of the Health and Nutrition Cluster, and support for information needs of the MoH and donor coordination of emergency donations. The Palestinian Minister of Health participated in an emergency session of the Health Cluster on October 19 to give a status report about the health situation in the West Bank and Gaza. WHO Head of Office in the oPt also spoke to the group of more than 50 health partners, calling for the protection of citizens, and appealing for keeping health workers, ambulances and health facilities out of the violence.
Dr. Gerald Rockenschaub, Head of Office WHO occupied Palestinian territory
Advocacy Unit: emacopseadv@whoint +972-2-540-0595