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Source: World Health Organization (WHO)
15 October 2003




Health Inforum News
Volume 2, No.37, 15 October 2003
__________________________________________________________________________________________________

Welcome to the thirty-seventh edition of the Health Inforum Newsletter.
In our ongoing efforts to provide useful information to the health community, we welcome any comments or suggestions you might have to help us to improve this newsletter. Please help us to distribute this update by forwarding it to your colleagues and friends. If you wish to subscribe, please send an email to info@healthinforum.org

In this Issue:

· Rafah Humanitarian Crisis
· Due to the strike in Israel, no entry for medicine from West Bank to Gaza
· PRCS Health Incidents 04 - 10 October 2003
· Detention of UHCC’s ambulance for more than three hours at Howara Checkpoint
· Press release, Médecins du Monde,
· ICRC News
· Palestinian Physicians Syndicate launched EMED Program


Rafah Humanitarian Crisis

According to Palestine Red Crescent Society PRCS, the Israeli invasion of Rafah on 9-11th October 2003 resulted in the following:


    * 8 deaths and 80 wounded; * * 107 homes completely destroyed, leaving 187 families homeless.

    * 20 homes partially destroyed, leaving 35 families without safe shelter.

    * The destruction of the water and sanitation network, in addition to electricity and phone lines.

    * Many streets dug up by the bulldozers, causing difficulty in reaching casualties and families requiring assistance.



Due to the strike in Israel, no entry for medicine from West Bank to Gaza

Due to the general strike in Israel, the Karni checkpoint to the Gaza Strip has been closed for over one month (with the exception of a few days during which it was temporarily opened), meaning that the entry of crucial medicines has been blocked. After coordination with the Israeli side, some drugs and pharmaceuticals were allowed to enter Gaza via Erez industrial zone to the north of Gaza for short periods. However, this was true only in the case of drugs coming from Israel or imported by Israeli companies.

Regarding drugs coming to Gaza from the West Bank, the long-standing agreement between the Israeli and the Palestinian sides states that shipments must be transferred via Tarqumia checkpoint in the south of the West Bank. Previous to the strike, at Tarqumia checkpoint pharmaceuticals were inspected by personnel from the Israeli Ministry of Agriculture, who put their stamp on the stock, then transferred it to Gaza. Without this stamp the stock cannot pass out of the West Bank. Since the general strike in the Israeli services includes workers of the Ministry of Agriculture, the transfer of drugs and pharmaceuticals from the West Bank to the Gaza Strip has now become impossible. As mentioned, drugs coming from Israeli sources are not affected.

Influenza Vaccines also are affected

3000 doses of Influenza vaccines for the oPt have been stuck at Ben-Gurion airport in Israel since 27 September 03.

According to Dr. Abed Al-Jabar Alteibi, Director General of Primary Health Care Department in Gaza, the delay in the reception these vaccines will seriously affect the target group.
These shipments of vaccines are funded by USAID and facilitated by UNICEF and WHO.

    Access & Health Incidents

PRCS Health Incidents 04 - 10 October 2003

PRC Khan Younis, 5 October 2003 (18:30): The Emergency Medical Services (EMS) station received an emergency call concerning a woman suffering from pregnancy complications in East Rafah. The ambulance crew requested ICRC coordination at 20:00 o’clock. However, the ambulance couldn’t reach its destination because Israeli Army tanks were blocking the area. Then Israeli soldiers began shooting at the ambulance and it was obliged to return to the EMS station. A second attempt for ICRC coordination with the Israeli Army succeeded, but only on the condition that the woman and her family walk to a pre-determined location carrying a flashlight in order to meet up with the PRCS ambulance. When the medics began to walk to meet the woman, Israeli soldiers again started shooting at them. The medics immediately returned to the ambulance and remained near the area till 23:30. Unfortunately, they were unable to transport the women and the ambulance returned to base.

In addition to the above, the following table lists incidents of denial and delay of access during this reporting period.
    Date
LocationDelay (Minutes) or Denied Access
    6/10/2003
Hebla Separation Gate/ Qalqilia60 minutes
    8/10/2003
Showaika gate/ Tulkarem60 minutes
    8/10/2003
Al-Kafryat/ Tulkarem 90 minutes
    8/10/2003
Flying checkpoint 20 minutes
    4/10/2003
Al-Hammra/ Jenin 90 minutes
For more information please contact Press Office at: phone: +972 2 240 6515/6/7

E-mail: pressoffice@palestinercs.org

· Detention of UHCC’s Ambulance for more than three hour at Howara Checkpoint

While returning to Nablus after carrying patients to Ramallah, a UHCC ambulance was kept waiting along other 6 ambulances for more than 3 hours at Howara Checkpoint, on to 12/10/2003 from 7:00 p.m. till 11:00 p.m. No apparent reasons were given for such detention.
Press release… Press release… Press release… Press release… Press release…

13th October, 2003





Médecins du Monde,

Object : Denial of access to medical care in Rafah (Gaza Strip)

Médecins du Monde, a medical humanitarian organisation, works in the Gaza Strip alongside the emergency service of the Palestine Red Crescent Society (PRCS) through a team of emergency doctors. Since the start of military operations carried out by the Israeli Army in Rafah on Thursday 9th October, the team affirms restrictions imposed on the PRCS ambulances present to bring medical aid to the injured, and to treat the sick and injured in the most appropriate medical facilities available in the Gaza Strip.

Since Thursday 9th October the Israeli army have carried out military operations in the Rafah refugee camp , in the south Gaza Strip, which have to date caused the death of eight persons (of which two were children) and led to at least sixty others being injured. The ambulances which should assist the victims were unable to reach the « occupied » zone, and were not accorded the protection normal to medical vehicles.
During the night of 10th to 11th October, when an ambulance from the Palestine Red Crescent Society (PRCS) attempted to bring assistance to a patient in the refugee camp, which was under curfew, Israeli forces opened fire as the ambulance crew prepared to leave the vehicle – clearly identified by a flashing light. Prior coordination to reach the home of the patient had been granted by the Israeli army. Since then, absence of protection for the medical staff has totally prevented access for ambulances to the sick and injured inside the incursion zone.

These military operations accompanied by a system of partial road closures result in the Gaza Strip being cut into four parts. Rafah is thus isolated from the rest of the territory. Closure is strictly imposed during the night- time military operations. These conditions have a serious and direct implication on the care of sick and wounded in the most appropriate medical facility. The only hospital able to receive injured in the Rafah area is the Abu Yusef el Najar hospital, which has only 50 beds. In recent days the hospital has had to deal with an influx of injured patients, without even the possibility to transfer some to the nearby hospitals in Khan Yunis (Gaza European Hospital 3km distant and Nasser Hospital at 7km), or to Shifa Hospital in Gaza City 30 km away.

Continued closure of the roads by the Israeli army, and the lack of authorisation accorded the ambulances to transfer patients between hospitals, thereby freeing space in the Najar Hospital of Rafah, constitute major obstacles in the correct treatment of victims due to the ongoing incursion.

Médecins du Monde denounces these obstacles denying aid to the victims and access to appropriate care. Such obstacles constitute violations of International Humanitarian Law, notably the Fourth Geneva Convention concerning the protection of civilians.

Press contacts:
Jerusalem: Blandine Contamin - tel : 972 57 249450
Gaza: Nathalie Godard - tel : +972 (0)57 832 882
Paris: Laure Weisgerber / Annabelle Quenet – tel : 33 1 44 92 14 31



ICRC News:

· Update on Emergency Care Work

In order to improve emergency care skills and to provide emergency staff with updated knowledge, the ICRC, together with Ministry of Health and Palestine Red Crescent Society, organized 8 seminars in the Gaza Strip and the West Bank on Advanced Support for Weapon Wounded.
350 emergency room nurses and emergency medical technicians attended these seminars, which took place in September and October.

In addition to lectures in triage and pre-hospital management, the seminars also provided lectures on International Humanitarian Law, the emblem and rights and duties of the medical mission. A brochure providing brief descriptions of ICRC activities and emblem issues was distributed to all participants.

· Latest Food Distributions In the West Bank And Gaza

Due to military operations, curfews and closures, the Palestinian economy is deteriorating rapidly. More than half of the population lives below the poverty line and unemployment is close to 50%.

The ICRC continues to remind the Occupying Power of its primary responsibilities under the fourth Geneva Convention to ensure that the entire population has access to food and water, medical assistance, employment and education. However, the needs in the occupied territories in all of these areas remain enormous. Therefore, in June 2003, as an exception, the ICRC decided to extend its large assistance programs in urban and rural areas until December 2003.

From 8 September to 5 October, the ICRC carried out the following:

Urban Voucher Program,
18,425 families in Ramallah, Jericho, Nablus, Tulkarem, Bethlehem and Hebron received their six-weekly voucher to be redeemed for essential food and non-food items.

Rural Relief Program
14,118 families in 159 villages in Bethlehem, Nablus, Ramallah, Jenin, Tulkarem, Salfit, Jericho, Hebron and Qalqilya districts received 980 Mt. of flour, 98 Mt. of sugar, 163 Mt. of pulses and 119,020 Lt. of vegetable oil as well as 4,319 hygiene parcels.

House destruction relief program
60 families in the Gaza Strip and 34 in the West Bank, whose houses have been destroyed or damaged, received relief kits containing blankets, hygiene supplies and household items and, if needed, a tent.

H2 assistance program
In the Old City of Hebron (H2), the ICRC distributed food parcels to 1,918 vulnerable families.

Emergency assistance in Gaza
In the Gaza Strip, emergency assistance of food parcels was distributed to 8 families.

Water assistance
In Hebron and Salfit districts, 3,295 truck- loads of 10,000 liters each were distributed and the building of 32 cisterns was completed.

· Source: UPDATE N°51, Weeks 37-40, 8 September – 5 October 2003

Care International Deliveries of Medicines

USAID, through Care International, has delivered the medical kits listed below during the period September 27th -October 10th, 03. The following tables shows deliveries of Medical Kits and other deliveries. Medical kits
Clinic Name
Kit Type
Clinic Level
Delivery Date
Total Cost $
    Al Zakat Agraba
MED
3
30/9/2003
787
    SMA Qabalan
MED
3
30/9/2003
787
    PRCS Azmoot
MED
2
30/9/2003
505
    Al Zakat Beta
MED
3
30/9/2003
787
    Old City Nablus
MED
2
30/9/2003
505
    UPMRC Turmos Aia
MED
2
30/9/2003
505
    PRCS Silwad
MED
3
30/9/2003
787
    UPMRC Synjel
MED
2
30/9/2003
505
    SMA Der Debwan
MED
2
30/9/2003
505
    PRCS Abu Misha’al
MED
2
2/10/2003
505
    PFS Kufor Ein
MED
2
2/10/2003
505
    Ateel Society
MED
3
8/10/2003
787
    UPMRC Maithaloun
MED
3
8/10/2003
787
    UHWC Tubas
MED
3
8/10/2003
787
    UPMRC Al Zababdeh
MED
2
8/10/2003
505
    Anabta Al Zakat
MED
2
8/10/2003
505
    UPMRC Tulkarem
MED
2
8/10/2003
505
    UPMRC Al Sileh
MED
2
8/10/2003
505
    PFS Yabad
MED
2
8/10/2003
505
    UPMRC Jiflick
MED
2
8/10/2003
505
    Al Samou Med center Hebron
MED
3
4/10/2003
787
    Doura Municipality
MED
3
4/10/2003
787
    Dahria Municipality
MED
3
4/10/2003
787
    Seir Charitable Society
MED
3
4/10/2003
787
    Halhoul Womens Society
MED
3
4/10/2003
787
    Tarquomia Charitable Society
MED
3
4/10/2003
787
    Beit Omar Charitable Soc
MED
3
4/10/2003
787
    Bani Naim Charitable Society
MED
3
4/10/2003
787
    Noba Charitable Society
MED
2
4/10/2003
505
    UPMRC Idna
MED
3
4/10/2003
787
    Shyoukh Zakat Community
MED
3
4/10/2003
787
    PRCS Beit Fajar
MED
3
7/10/2003
787
    Aknaf Beit Al Maqdes
MED
3
7/10/2003
787
    PRCS Al Khader
MED
3
7/10/2003
787
    UPMRC Jenin
MED
3
8/10/2003
787
Total
23,597



· Other Deliveries

Item
Qty
Beneficiary
Delivery Date
Total Cost $
    Medical Disposables
9 Pallets
MOH Ramallah
4/10/2003
20,109
    Pulse Oxymeter& Medication Trolly
1&2
MOH Ramallah
8/10/2003
5,100
    Metronidazol Inj ,500mg
10,200
MOH Ramallah
4/10/2003
11,220
Total
36,429


Palestinian Physicians Syndicate launched EMED Program


The Palestinian Physicians Syndicate began implementing its Emergency Medicine Educational and Development (EMED) program last Saturday. This is a one-year program that aims to provide training for in-hospital emergency department practitioners -- both physicians and nurses. A total of 210 physicians and nurses will benefit from this program, which will be divided into 7 courses, each lasting for 6 days with 30 participants. The program is being implemented by CARE international in cooperation with Johns Hopkins University and Target Medical Services. The technical oversight is provided by the Palestinian Physicians Syndicate and the Palestinian Nursing Syndicate. The USAID funded this programme.

The opening ceremony was held in the presence of the Minister of Health, the Director General of the MoH and the Chairman of the Physicians Syndicate. In his speech, the Minister of Health recognized the efforts made to begin this program, and stressed the importance of these courses. He noted that this training is especially important in the current context of the range of Israeli obstacles to healthcare access -- including checkpoints, curfews and closures, in addition to daily incursions and the on-going emergency situation in the region.

It is also worth mentioning that the Palestinian Physicians Syndicate is currently implementing another training program in the field of pre-hospital emergency care for 100 physicians, funded by MARAM project. The Syndicate, through its Scientific Board, is currently finalizing the process of adapting protocols related to pre-hospital emergency care. Dr. Salah Al-Khaldi the head of Scientific Committee of the Syndicate pointed out that the Syndicate runs 198 emergency points scattered in all the Gaza Strip. Physicians serving in these points, who work on voluntary basis, will benefit from the pre-hospital emergency services program as will other physicians from the MoH and other sectors.


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