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Source: World Health Organization (WHO)
31 January 2006

Health Inforum News
Volume 5, No.67, Dec05-Jan06
Welcome to the Sixty seventh issue of the Health Inforum Newsletter.
of the
    He who has health, has hope; and he who has hope, has everything.
    ~Arabian proverb~

Health News
• Dead birds buried in a Palestinian village near Nablus
• Excluded a Suspected case of Avian Influenza in Jerusalem
• Haaretz: IDF cantonizes West Bank, sealing in Palestinians
• International Pledging Conference on Avian and Human Pandemic
Influenza in Beijing - China
• ICRC latest activities in oPt
• 37th anniversary of the Palestinian Red Crescent Society

Referral abroad of patients from Gaza Strip: monitoring after disengagement December 2005.

Casualties & access incidents
During December, there were 9 episodes of ambulance delay with a total of 9 hours, and 5 cases of denied access.


Dead birds buried in a Palestinian village near Nablus
During the first week of January, estimated 80,000 birds have been buried in a trench in Kherbit Tana land, a Palestinian agricultural village 8 km east of Beit Furik village, Nablus, near Mikhora settlement. Available information suggests that the birds have been dumped by Israeli settlers.

According to an OCHA field assessment, the trench is approximately 7 meters wide and 30 meters long. Clear evidence of recently buried chickens includes feathers scattered around and carcasses of chickens clearly visible approximately 30 centimeters from the surface. In some areas plastic sheeting is visible around the edge of the trench. The stench of decomposing flesh is very strong and offensive.

Information – still not official – from the Israeli Ministry of Health excluded that these birds are infected with Avian influenza virus. The birds would have died of Newcastle virus, that is endemic in the country, and is not dangerous for human health. However, Palestinian Ministry of Health is concerned that the Newcastle disease, an highly contagious and killing disease among poultry, will affect the economics of Kherbit Tana village residents that are depending on agriculture and birds breeding as main source of living.

A joint field visit by the Palestinian Ministry of Health and Israeli Civil Administration took place to directly assess the site, to guarantee that appropriate measures to ensure the safety of population and environment in the area are taken. An official report on this visit will be released soon. The Israeli civil administration sent an apology to the Palestinian Authority for the incidence.

Excluded a Suspected case of Avian Influenza in Jerusalem
January 16th, 2006, a 34 years old man from Sour Baher village, near Jerusalem, was admitted to Hadassah University Hospital, Ein Karem as he developed flu symptoms after some of his chickens had died in the previous few days.

The man has been kept in isolation while has been tested for possible avian flu. The Director of Public Health Services of the Israeli Ministry of Health, Dr. Alex Leventhal, informed that the results of the man’s blood test are negative for avian flu and that the chickens died from the Newcastle disease, an animal infection that is endemic in the country but it is not dangerous for human health.

Haaretz: IDF cantonizes West Bank, sealing in Palestinians
For a month now, since the second week of December 2005, the Israel Defense Forces has severed the northern part of the West Bank from other sections, and prohibited residents from traveling toward Ramallah and southward areas.

The ban applies to some 800,000 people, residents of the TulKarm, Nablus and Jenin provinces. Until January 2nd, the ban applied just to residents of Jenin and TulKarm. Since then, it has been extended to residents of Nablus area. For more information click

International Pledging Conference on Avian and Human Pandemic Influenza in Beijing - China
18 January 2006 -- The International Pledging Conference on Avian and Human Influenza in Beijing has generated major pledges. Speaking at the conference, WHO Director-General, Dr LEE Jong-Wook underscored the areas requiring urgent international and national actions to fight avian influenza and prepare for a pandemic and described the WHO strategy including:

• Reducing people's exposure to the virus
• Strengthening the early warning system
• Intensifying rapid containment operations
• Building capacity to cope with a pandemic, and
• Coordinating global scientific research and development.

The Donors countries have pledged $1.9bn to fight the Avian flu worldwide. The funds will be largely spent on health and vet services aiming to prevent the H5N1 virus mutating and spreading from human to human. The deadly H5N1 strain of bird flu has killed at least 79 people, mainly in Asia, since 2003. All human cases were in close contact with infected birds and there has been so far no confirmed case of human-to-human transmission.

The United Nations bird flu coordinator, Dr. David Nabarro, mentioned that veterinary services around the world are not strong enough to effectively monitor bird flu outbreaks and cull poultry flocks and warned that significant resources are immediately needed to strengthen these services.

ICRC latest activities in oPt
In cooperation with the Palestinian Ministry of Health, the International Committee of Red Cross (ICRC) held 2 seminars on case management of trauma, in Ramallah and Gaza, for 51 Palestinian medical staff. In Gaza, Mawasi area, ICRC launched a project to rehabilitate 126 fishing boats. This project follows an assessment indicating that fishermen are one of the groups most affected by the second Intifada, in terms of income.

37th anniversary of the Palestinian Red Crescent Society
The Palestinian Red Crescent Society (PRCS) celebrated in December 26th, 2005 its 37th anniversary. PRCS was and still acts as Ministry of Health and Social Affairs for the Palestinians of the Diaspora, especially in Lebanon, Syria and Egypt. Since its establishment in 1968, PRCS has continuously been providing services to the Palestinian people, both in times of calm and during emergencies.


Referral abroad of patients from Gaza Strip: monitoring after disengagement
December 2005.

WHO/Health Inforum report

Access to specialized health services outside Gaza Strip continued to be monitored by Healthinforum, during December 20051.

Access through Erez
During the period 1 – 31 December, referral abroad for in-patient and out-patient care was requested for 758 patients, out of which 742 (98%) received the permit and could leave trough Erez. 16 patients did not receive the permit, on the basis of unspecified security reasons. Each patient has been accompanied by one person, mainly a family member.

Urgent patients could leave by ambulance through a "back to back" transfer. In December, the daily number of ambulance transits ranged from 0 to 8 per day. The waiting time at the checkpoint took from 2 to 24 hours.

Patients crossed Erez during all days of December 2005, despite the closure of the checkpoint to Palestinians from 6th to 11th and from 16th to 31st of December.

Figure 1: Access of patients through Erez during 1-31 December, 2005

Figure 2: Weekly percentage of patients who crossed Erez (out of the total requests) during the period 15th August – 31st December, 2005

Access through Rafah

All patients have been able to cross Rafah border during this period, according to the mentioned sources. The number of patients with a MoH request for referral abroad who crossed Rafah border was 3341. Male patients in the age group 18 – 40, if holding a MoH referral request, did not need the permit released by the Egyptian Authority that is normally requested to males of this age group.

Urgent patients are transported to the border by a Palestinian ambulance and then transferred to an Egyptian ambulance with a “back to back” system, to continue in the Egyptian territory.2 The transferal procedure is done in the Palestinian territory for both departure and arrival. The time for the back to back procedure has taken 5-30 minutes, compared to 2-8 hours before the disengagement period. The number of urgent patients leaving Gaza to Egypt through Rafah border by ambulances was 39, in addition to 61 patients who returned from Egypt.

Rafah crossing opening hours were 5 hours per day (11 am – 4 pm) during the period 1st – 19th December and have been extended to 8 per day (8 am – 4 pm) during the period 20th – 31st December.

1 The source of reported data is the Health DCO Coordinator of the Ministry of Health and the Director General of Rafah border crossing.
2 Only cases crossing Rafah who were holding the documents for medical referral released by the Palestinian Ministry of Health have been recorded as patients, whilst people seeking medical care abroad who did not hold the referral documents have been recorded as normal passengers.


During December 2005, there were 9 episodes of ambulance delay (for a total delay of 9 hrs). In 5 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 November 2004 – November 2005:

Al-Bireh, 13/12/2005, 14:30 PM: A PRCS ambulance was stopped and denied access by the Israeli soldiers at Kalandiya checkpoint, while on route to transport a woman in labor from the checkpoint to hospital. The crew tried to cross the checkpoint in an attempt to administer emergency medication to the woman in labor, but the soldiers prevented them and threatened the emergency medial technician using their weapons. When the woman was almost ready to give birth, her accompany carried her, crossed the checkpoint and delivered her to the PRCS crew. The crew immediately began to assist the woman who delivered her baby within a couple of minutes inside the ambulance. Its worth mentioning that this is not the first incident in which women in labor denied access to hospitals and delivers at the above mentioned check point. For more information click

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

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