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World Health Organization (WHO)
31 July 2005
Health Inforum News
Volume 4, No.62, July-August 2005
Welcome to the sixtieth issue of the Health Inforum Newsletter
Life is not merely to be alive, but to be well. ~
Marcus Valerius Martial
• Health Sector Working Group (HSWG) Statement on Disengagement
• Physicians for Human Rights-Israel petition on Palestinian’s treatment abroad
• MoH: 129 patients died at the checkpoints since September 2000
• EMAP II project has closed down last month
Disengagement - Healthcare during withdrawal operations in Gaza
WHO brief, June 20, 2005 (Updated version, July 20, 2005)
Visit to the Separation Wall
Casualties & access incidents
During July, there were 19 episodes of ambulance delay with a total of 20 hours, and 3 cases of denied access.
Health Sector Working Group (HSWG) Statement on Disengagement
The Health Sector Working Group, being the main coordinating body for medical and health aid to the Palestinian population and institutions, welcomes Israeli’s decision to evacuate its settlements and withdraw from the Gaza Strip and parts of the Northern West Bank. It warns, however that closures and other restrictions on freedom of movement imposed as part of the disengagement plan may result in serious harm to the population and may adversely impact the provision of health services.
HSWG asked the Israeli authorities in its statements (August 9, 2005) to undertake substantive measures to ensure that the basic rights of the Palestinian population are respected and to minimize any negative impact that disengagement may have on the provision of services to those in need of medical attention. For more information on the statement please visit www.healthinforum.org
Physicians for Human Rights-Israel petition on Palestinian’s treatment abroad
On 21 July 2005, Physicians for Human Rights-Israel filed a petition to the Israeli High Court regarding the Israeli army’s regulations for Palestinian patients needing to travel from the oPt into Israel or other countries for medical treatment.
Currently, patients’ applications for travel permits are not handled properly, are rejected without a professional medical opinion as required by the regulations, and delays in processing can range from days to weeks - all this, even though many patients’ conditions are very serious and they require immediate life-saving treatments. This situation sometimes causes a worsening of the condition, even to the point of it becoming life threatening.
The two health coordinators from the Israeli Ministry of Health - one in the Gaza Strip and one in the West Bank - handling the requests are not physicians. Significant differences exist between the two with regards to the manner of handling the cases since the regulations are not clearly defined. For more information: www.phr.org.il
MoH: 129 patients died at the checkpoints since September 2000
129 Palestinians patients died on Israeli checkpoints from 28 September 2000 until 15 August 2005, according to the latest reporting of the MOH Information Center. This unfortunate figure has been the consequence of delay or denied access of ambulances through checkpoints in spite of critical conditions of the patients. For more Information: www.moh.gov.ps
EMAP II closed down last month
At the end of July 2005, the Emergency Medical Assistance Program II (EMAP), funded by USAID and implemented by CARE International ended all its components, but the procurement part that will continue until the end of the year. Delivery of pharmaceuticals and disposables is underway, and the Ministry of Health has already received spare parts for its hospitals and equipment for clinics. Also, four oxygen extractors were delivered in Gaza to the hospitals of Durra, Tel Al Sultan, Beit Hanoun and Naser.
The capacity building component of EMAP II supported 12 NGOs in the field of rehabilitation and emergency health care. With the Regional Model Centers and Continuing Medical Education Program (CME) created by EMAP II in the emergency departments in Rafidia, Ramallah, Makassed, Al Shifa, and the European Gaza Hospitals, technical assistance was provided to the staff of those hospitals. In June 2005 the CME coordinators visited Johns Hopkins University, Baltimore, Maryland, USA, and received advanced trained on the management of emergency departments.
A database for injury surveillance has been developed by CARE and Johns Hopkins University, and activated in five hospitals in West Bank and Gaza. The Statistical Information Department of the Ministry of Health will regularly produce injury surveillance reports. For more information please visit www.healthinforum.org
Disengagement - Healthcare during withdrawal operations in Gaza
WHO brief, June 20, 2005 (Updated version, July20, 2005)
Withdrawal operations started in Gaza on 15 August 2005 in 21 settlements. In the West Bank only four northern settlements will be evacuated.
Main challenges during disengagement
• Patient capacity to reach the health facilities of appropriate level of care
• Health workers access to their working place
• Delivery of drugs and medical supply to the health facility
2- Extra burden of traumas resulting from clashes
Preparedness of the health sector for disengagement
1- Service Delivery:
• Pre-positioning of drugs
• Redeployment of staff according to place of residence
• Rescheduling health workers' working days and hours
• Baseline information
• Monitoring during withdrawal according to standard indicators
• Information management and dissemination through Ministry of Health (MoH) website, OCHA and Health Inforum
• Ministry of Health coordination: activation of Operation Room
• Health Sector coordination: MoH weekly meeting with support from WHO, monthly Health Emergency Coordination Meeting
• UN coordination: UN contingency plan, Operational Coordination Group meetings.
• UNSCO Operation Room and DSS coordination through Area Security Management Team meetings.
For the full report please visit www.healthinforum.org
Health Inforum opened a special window on its web page which includes health activities, emergency plans and preparedness related to MoH, UN and other local stakeholders.
Visit to the Separation Wall
A visit to the affected areas by the wall in Qalqilya, Jerusalem and Bethlehem was conducted on Sunday 24th and Monday 25th of July 2005 in response to an invitation from the International Cooperation Department (ICD)of the Ministry of Health. Health Inforum participated during the two days, with other international agencies
Participants from WHO, UNICEF, UNRWA, Merlin and representatives from the MoH International Cooperation Department, the governor office, the municipality and the local press - in addition to the director of the Primary Health Care district office and his staff - all went to a field visit to Beit Amin, Azzun Atma, Al Dhaba and Ras Atiya villages in Qalqilya.
The Separation Wall reaches up to 12 -13 meter height, with a width of 3 meters. In order to build the wall, agricultural lands were confiscated. The land that has been left without damage can be accessed by farmers only after obtaining a permit. This permit has proved to be almost impossible to get, so lands have been neglected and plantations are being damaged for lack of care.
In Qalqilya, over 7,000 people have left their residencies and 600 shops have been closed as a consequence of the economic crisis provoked by the Wall.
The Wall is cutting Qalqilya into many enclaves, and the entrance to each enclave is through a gate that should open from 6 am to 6 pm. However, the opening hours are irregular.
Effect of the wall on access to health services
Qalqilya have 17 primary health care facilities, (11 MoH and 6 NGO), one MoH emergency hospital, which limited specialized care, and one hospital managed by UNRWA which serves only the refugee population.
Access to the hospitals for patients coming from several villages is heavily restricted as the hospitals are located in Qalqilya city.
Difficulties for medical staff to reach the health clinics to provide services to patients and to monitor the activities.
Four villages (Arab Al Ramadien, Ras Attira, Ras 'Atiya, 'Azzun Atma) are totally isolated between the Wall and the Green Line, and they are cut off from getting any medical services even in case of emergency.
The immunization program could be affected, especially in the capacity of maintaining an effective cold chain as vaccines are kept for several hours under the sun before reaching their destination.
In some areas, the increased time to reach the health facilities - up to 1.5 hours after it used to be less than 10 minutes – could deter the people to seek health care when needed.
Houses located near the Wall face major problems in winter as soldiers close the rain-release tunnels that pass through the Wall, causing flood back of water into the houses.
Sewage of surrounding settlements end up in some villages lands.
The main water wells in Qalqilya have been confiscated
Participants from WHO, CARE International, Italian Cooperation, MDM France and the local invitees from the governor office and municipality of Abu Dis participated to the visit.
Some isolated villages around Jerusalem have PHC clinics but some health professionals face problems in reaching their working place in the health center, to conduct school health visits and environmental inspections (Beit Iksa, Bedo, Qubebeh, Qatanah, Beir Nabala, Beit Hanina At-tahta, Al Shaikh Saed).
Other isolated villages do not have PHC clinics and have difficult access to nearby clinics and to hospitals (Nabi Samoel, Beit Suriq,Beit Igza, Beit Duqqo, Jadira, Jeeb, Qalandia Albalad, Rafat, Kufur Aqab, Samir Amis, Qalandia Camp, Záem and Arab Aljahaleen).
Participants from WHO, MDM France, UNRWA shared the visit.
Projected Wall is not built yet, only a small part of it is already finished. The Wall will totally separate Bethlehem from Jerusalem, and the connection will be through a gate.
Concerning health services, Bethlehem depends on Jerusalem hospitals for referral care, and the Wall already hampers the capacity of Bethlehem residents to access these services. When the health problem would require more than one day of hospitalization, patients and their accompanying family members will be considered as illegally staying in Jerusalem.
CASUALTIES AND HEALTH INCIDENTS
During July 2005, there were 19 episodes of ambulance delay (for a total delay of 20 hrs). In 3 cases the access was totally denied, according to PRCS. The following diagram shows the total number of ambulance incidents by area, the time of delay and the episodes of denied access (D/A) at the checkpoints:
This diagram shows the variation from July 2004 to July 2005:
FOR MORE INFORMATION
Please feel free to contact us at:
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
Health Inforum, c/o Italian Cooperation/ Sheikh Jarrah, East Jerusalem, Tel: 02 532 7447, Fax: 02 532 2904
Health Inforum posts daily news and announcements concerning health issues on its website:
Zenaida Tablante/DPA/NY/UNO on 21/06/2005
Date and time
21/06/2005 03:57:19 PM