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Source: World Health Organization (WHO)
1 August 2006



Situation Report on Gaza Strip n.6
18 July - 1 August 2006



Security
The IDF continue their operations in Gaza Strip:
• The IDF continues shelling and missile firing on targets in Gaza Strip.
• The IAF1 attacks on houses are continuing.
• Palestinian militants continue firing at IDF positions and launching home made rockets at the Israeli territory.
• On July 30th, during a demonstration organized by Islamic Jihad, some demonstrators broke into the UNSCO compound ransacking some offices and
damaging cars. Order was restored after the arrival of PA Security Force 17 and police.

Casualties
Since 25 June:
• 179 Palestinians were killed by the IDF; out of them 33 were children less than 18 years old and 23 were females.
• 690 Palestinians were wounded.

Access
• Medical supplies have been imported to Gaza through Karni commercial crossing without major problems during the referring period. Karni crossing has been open only for import.
• Referral of patients abroad has been a serious problem. None of the 300 patients referred to Egypt and Jordan by the MoH during July have managed to leave, as Rafah border crossing has been closed since the 25th of June.
• Referral of patients to Israel - through Erez check point – during the month of July has been only partially limited: 171 patients out of 184 requests (93%) crossed Erez, according to the Palestinian Health Liaison officer. Every patient is examined case by case and only critical patients are authorized to pass, according to the Israeli DCL2. Since the 23rd July, following an attack to IDF outposts in Erez by Palestinian militants, the crossing for patients in critical conditions have been restricted to few hours per day, with a schedule that is changing every day.

Primary Health Care Services
• As a result of the military operation in Beit Hanoun (North Gaza Strip), one PHC center of UNRWA was damaged and closed for two days.
• Lack of power continues and so the need of using generators to sustain regular health care delivery (cold chain, diagnostic equipment, etc). Functioning generators are available in 22 out of 58 PHC facilities. Vaccines were transferred from facilities without generators to the nearest with generators. Limits in availability of fuel has been temporarily overcome by the fuel procured through the Temporary International Mechanism.
• The MoH, within its emergency plan, identified 21 PHC in Gaza Strip to function as emergency centers. Currently, 12 of them are working for 24 hours and other 4 are working for 12 hours per day.
• No reporting of reduction in PHC service delivery. All public health programs including Mother and Child Health, Food Inspection, Health Education, Nutrition Department, surveillance and epidemiology unit are functioning.

Hospital Services
• All hospitals are functioning. Since the state of emergency was implemented in the hospitals, elective surgical operations services were reduced. Consequently hospitals postponed some surgical operations because of shortage in equipments, disposables and power supply. Cases of elective surgeries are transferred from MoH to NGO hospitals in Gaza.
• All MoH hospitals in Gaza Strip have generators; the generator at Al-Nasser pediatric hospital in Gaza city is insufficiently functioning, leading to some
shortages in water supply.
• Hospitals are using electricity from generators to operate the most critical departments as operation theaters, x-ray departments, sterilization of equipments,
etc. The insufficient and fluctuating power produced by the generators provokes malfunctioning of the most sensitive equipment.

Public Health concerns
• Water shortage remains a problem due to lack of power to the water pumps. The CMWU3 is implementing a rotation system to provide households with water.
• The lack of electricity also affects the waste water treatment and disposal. As a result, concern for public health problems from proliferation of insects and leaking of sewage to the underground water was raised by the MoH and the Palestinian Environmental Authority.
• Concern about food safety as a result of interruption of the cooling system at households and industrial level was also raised. Fishing is not permitted due to
siege on the coast, thus aggravating concerns for protein availability.
• The municipal services are affected by the lack of power. The solid waste collection and disposal was reduced during the reporting period
• Drug supply is limited due to the MoH financial crisis: by the end of July 80 items out of 473 were less then 1 month stock, whilst further 80 were less then 3 months stock.
• Referral of patients out of Gaza Strip – particularly those referred to Egypt and Jordan - is severely hampered as a result of tight closures imposed by the Israeli Security Forces on all crossings.

Response
• WHO provided drugs, medical disposables and laboratory reagents to the MoH. WHO continues monitoring the health situation using a standardized monitoring tool and providing information to the stakeholders. WHO is organizing and leading coordination activities in the health sector.
• The EC provided (through the TIM4) fuel to support the health facilities in Gaza Strip. Overall monthly requirements are estimated at 600,000 liters. About 300,000 liters of fuel have been provided so far. TIM also delivered fuel for generators of water wells, booster stations, desalination plants and waste water treatment plants managed by the CMWU in Gaza. Also, through TIM allowances for health staff will be distributed this week, while 300 health staff in Ramallah Hospital already received it. The TIM procedure for procurement of medical supplies (Window 1) has not been finalized yet.
• ICRC provided essential medicines and two war wounded kits to the MoH. ICRC also provided 96 hygiene kits to the displaced families in Ashoka, east of Rafah.
• UNICEF provided two generators to two PHC centers of the MoH. UNICEF also provided 24 baby hygiene kits for displaced families in Beit Hanoun.
• In addition to its operations in Gaza to assist the refugee population, UNRWA established a small first aid clinic for displaced families from Ashoka and is
distributing food parcels and water to the displaced families of Ashoka and Beit Hanoun.
• The government of Qatar sent to the MoH a first shipment of donations of medical disposables.
• The Italian Cooperation is providing drugs and consumables to the MoH central drug stores with a grant of 20,000 Euros.


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1 Israeli Air Force
2 Directorate of Coordination and Liaison
3 Costal Municipal Water Utility
4 Temporary International Mechanism

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