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Source: World Health Organization (WHO)
15 September 2003




Health Inforum News
Volume 2, No.35, 15 September 2003
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Welcome to the thirty-fifth 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:
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MoH: Violations against civilians and heath workers from 29 September 2000 to 30 July 2003



MoH Will Soon Publish its Annual Report on Health Status for 2002

Highlights:
MoH report shows that, despite the very difficult circumstances that the Palestinian people face, health staff in all governorates, PHC institutions and hospitals managed to continue practicing their duties in this challenging environment.

Dr. Riyad Awad, the Director of HMIS, indicated that the team worked on this report from January 2003 to June 2003. This represents is the ninth such report since the MOH has took on responsibilities.

Population Size and Demographics:

Regarding population and demographic structure, the report showed that the mid-year population of Palestinians living in the West Bank (including Jerusalem) and Gaza Strip was estimated at 3,464,550. Out of this number 46.5% were less than 15 years of age. The Crude Birth rate was 27.2 per 1000 population, compared to 46.5% per 1000 population in 1995. People of 60 years and above constituted 4.6% of population. At birth, males constituted 105.7 per 100 females. The density rate was about 3,505 inhabitants in Gaza Strip and 380 inhabitants in West Bank per one square kilometer. The total number of deaths in OPt was 10,805. Crude death rate was 3.1 per 1000 population in 2002, in comparison with 4 per 1000 population in 1995. The infant mortality rate was 23.3 per 1000 live births and neonatal mortality rate was 15 per 1000 live births, while the stillbirth rate was 6.5 per 1000 live births.

Mortality: The leading cause of death was cardiac disease at 19.4%. Other causes of death-included accidents with 12.5%, prenatal 11.7%, cardiovascular 9%, cancer 8.2% and hypertension 6% of total deaths in 2002. The leading causes of death for children under 5 years are conditions in the prenatal period with a proportion of 56.6% and congenital malformations with a proportion of 16.1% of total death. The leading causes of death for children aged 1-4 years were congenital malformations with a proportion of 17.3% and accidents, with a proportion of 19.7% of total death. The leading causes of death for people aged 5-19 years were accidents with a proportion of 50.2% and malignant neoplasm with a proportion of 6.0%. The leading cause of death among people aged 20-59 years was accidents with a proportion of 31.6%. The leading causes of death among people aged 60 years and above were heart disease with a proportion of 29.6% and hypertension disease with a proportion of 10.7% of total deaths.

Women’s Health The proportion of the total population consisting of women of childbearing age was 22%, and the maternal mortality ratio per 100,000 live births among women aged 15-49 years was 13.8 (21.8 in GS and 7.8 in WB). The total fertility rate was calculated at 3.85 (4.8 in Gaza Strip and 3.3 in west Bank). About 92.5% of births took place in health institutions and 7.5% at home in OPt (14% in WB). Cesarean deliveries constituted 15.1% of total deliveries. The coverage rate of TT for pregnant women was 30%. Family planning programs showed a steady increase in the number of FP clinics. The report showed that the current use rate of contraceptive methods was 51.4% of currently married women.

The average rate of women who use contraceptive pills was 71.9%, while the average rate was 13.4% for using each of IUDs and condom of total contraceptive methods.


Access and Health Incidents

PRCS Health Incidents Report (30 August-12 September, 03)

(07:45): A PRCS ambulance, on its way to transport a woman in labor to Sebastia village, was stopped by Israeli soldiers at Beit Eba checkpoint. Soldiers at the checkpoint searched the ambulance and checked the IDs of the medics. The soldiers ordered one of the medics to get out of the ambulance and told the driver to leave the area, but the driver refused. The soldiers at that point ordered the driver to park the ambulance on the side of the checkpoint. Ten minutes later, two soldiers came and started shouting verbal abuse at the driver and commanded the ambulance team to sit on the ground for 20 minutes. Finally, and after coordination with ICRC, the ambulance was allowed to pass.

Tubas, 30 August 2003 (10:00): At the entrance of Tubas, Israeli soldiers stopped a PRCS ambulance transporting an elderly patient back to his house from Jenin Hospital. Three Israeli soldiers ran towards the ambulance, shouting at the crew to turn off the engine and to get out. When the soldiers reached the ambulance, they started to kick the ambulance. One of the soldiers dragged the driver out of the ambulance and another soldier hit one of the medics with his gun while shouting at him. One half hour later, the ambulance was allowed to pass.

Gaza 6 September 2003 (13:00): The EMS station at Jabalia received a call concerning an injured person located in the eastern part of Jabalia. Immediately, a PRCS ambulance was dispatched to the area, but the ambulance couldn’t reach the injured person due to Israeli Army tank fire. The driver called the station and requested ICRC coordination to pass the area. Meanwhile the injured person who was later identified as a 17 years old male youth, called the PRCS emergency 101 number from his own mobile and asked for help. The youth managed to inform the EMS that he was shot in both legs. The ambulance crew at the scene began giving the youth directions on how to stop the bleeding.

At (19:00) the ambulance was obliged to return back as it received a call from the D.C.O informing them that the Israeli authorities refused ICRC coordination. The following day, 7/9/2003, the station received a call from the D.C.O informing them that a PRCS ambulance could transport the injured person. Finally, the ambulance crew found the body of the 17- years old youth, after he was left bleeding for 18 hours.

Nablus, 11 September 2003 (16:00): A PRCS ambulance, on its way to transport a patient was stopped at the Zattara checkpoint. An Israeli settler standing beside the checkpoint, shouted verbal abuse at the crew and also attempted to throw stones at the ambulance, but the soldiers ordered the crew to leave the area.In addition to the above, the following table lists incidents of denial and delay of access during this reporting period.




Health In Field

Mapping Health Facilities on District Level

In order to properly plan, manage and monitor any public health programme, Health Inforum provides up-to-date, GIS relevant information and makes it available for decision-makers at all levels of the public health system. As every health problem or health event requires a different response and policy decision, information must be available, reflecting a realistic assessment of the situation at local, national and global levels. This must be done with best available data, taking into consideration the changes in the existing health situation and the influences based upon it.

Since June 2002, Health Inforum’s public health mapping programme has been leading a local partnership in the promotion and implementation of GIS to support decision-making for a wide range of public health programmes. West Bank map has been produced including the localities of the health facilities, type of services, level of services, bed ratio, and type of health Provider. Recently Health Inforum has produced the first map of Gaza, which includes the localities of the health facilities, type of services, level of services, bed ratio, and type of health provider.

Hot off the press, health facilities maps per districts are now available from Health Inforum; they are easily printable in A3 or A4 page size.

Health Facilities Maps also available on our website: www.healthinforum.org. In addition, the Health Inforum is distributing those maps for each health stakeholder office, contact us to get your copy.

French Medical Delegation Ends its Visit to Opt

The French delegation of specialists in peripheral neurosurgery ended its stay in OPt last week... During their time here, the specialists performed 18 operations at the Shifa hospital in Gaza, alongside the local medical staff. All operations, which were sophisticated and complex in nature, were a success.

Dr. Lenin Dominique, Professor of Neuro surgery in the University of Nantes in France, headed the French team. The local staff in Shifa hospital in Gaza and Nasser Hospital in Khanyounis participated in the operations, over a period of one week.

The French medical delegation also carried out 80 medical checkups in Shifa Hospital, where 20 of these cases needed surgery. Such operations could not be performed by the local medical staff due to the complexity of the interventions needed. Out of all of the operations, 12 were performed to children under 18 years old, who were wounded in Israeli shootings. Some other operations were done for sciatic nerve injuries or injuries to its branches in the thigh, knee or lower leg. Injuries of the sciatic nerve may lead to muscles paralysis of the upper or lower limbs.

The Ministry of Health presented Certificates of Honor to the head and members of the delegation. MoH expressed gratitude for the efforts of the delegation in performing such exceptional operations, and for their help to the wounded of the Intifada.

Gaza mobile clinic of Medical Relief Committees (MRC) report for August 2003

The mobile clinic of the MRC visited 17 remote locations in Khanyounis and Rafah districts, these places are: Baten El-Smain, Al-Nasser quarter, Ka’ El-Krein, Ma’en, Al-‘Mour, Al- Sharquia, Abu Samour, Al-Siamat and Abu Fsaifis.

During the visits, clinical checkups, laboratory examinations and provision of medicines were offered to 2077 cases, of which 56% were children under 15 years old. In addition; the medical staff gave lectures and health education presentations. Services of MRC are offered free of charge and sponsored by Norwegian Peoples Aid.

The mobile clinic visited also 12 remote locations in Mid-zone, Gaza and North Gaza districts. These locations were: Al-Heker, El-Masha’la, EL-Malalha, AL-Ja’farawi, El-Sika, El-Boura, Al-Moghraga, Wadi El-Arayis, Al-Saiafa, Beir El-Na’ja, Al-Kattaneya and Al-Birka.

Clinical checkups and medicines were offered to 1987 cases, of which 59% were children under 15 years old. The services of mobile clinic were offered in participation with MDMGreece.

ICRC: A seminar on "Advanced Support for Weapon Wounded"

On the 15th of September, the International Committee of the Red Cross, The Palestinian Ministry of Health and the Palestinian Red Crescent Society began a series of seminars on "Advanced Support for Weapon Wounded”. The first of these seminars was held in Ramallah.

Another seven seminars are planned – five in the West Bank and two in Gaza. These seminars are targeted at different types of health providers, including nursing staff and EMTs. The expected total number of trainees is around 400.



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