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Source: World Health Organization (WHO)
29 April 2014


29 April 2014, Gaza – A simple cut, a fall or a bruise means a trip to the hospital for a young boy with hemophilia, as shown in the short video, “Struggling with Hemophilia in Gaza,” launched on April 29, 2014, in Gaza by the WHO office in the occupied Palestinian territory to mark World Hemophilia Day.

Hopefully an infusion with the correct clotting factor will prevent the child from suffering prolonged bleeding or a badly swollen joint. But in Gaza, up to one-third of essential drugs are missing and shortages are chronic due to the Palestinian Authority’s financial crisis and exacerbated by the blockade and Rafah closure. Palestinians with hemophilia often find that the ‘factor’ is not available in sufficient quantities, or must be kept in reserve to treat hemophilia patients in urgent cases. An alternative treatment, cryoprecipitate, is used by the Ministry of Health when the needed factor is unavailable, but it can mean difficult side effects for patients. Complications of inadequate treatment can be for the Ministry: expensive referrals, and for the patient: joint replacement surgery, amputation, paralysis, as well as being house-bound, impoverished, and suffering psychological impact.

There are 117 hemophilia patients in Gaza, one-half are children and all are males, and about 350-400 patients in the West Bank. Most cases are classified as moderate or severe based on the degree that clotting factors are missing in their blood; moderate cases are treated when there is bleeding, usually after trauma, while severe cases should receive regular prophylactic treatment of the missing factor to avoid life-threatening bleeds, such as from any head trauma.

Dr. Mahmoud Daher, WHO head of the Gaza sub-office, stated, “The financially-strapped Palestinian Ministry of Health has 523 drug items on its essential drug list, necessary for treatment at primary and secondary health care levels in the West Bank, and 480 drugs on the Gaza essential list, which it is pledged to provide but chronically falls short due to the financial crisis.” Drugs that are expensive, have limited suppliers, serve smaller patient groups, have cheaper --- even if less effective --- alternatives, or are not immediately ‘life-saving’ are most often missing. But particular drugs are life-lines for certain groups of patients, and shortages have profound impact on quality of life, meaning unnecessary suffering, prolonged illness, long-term disability or endangered lives.

Patients with Hemophilia A, the most common form, require Factor VIII, and Hemophilia B patients require Factor IX, but patients may be missing any of the 13 clotting factors and require accurate diagnosis and periodic testing, often unavailable. While one unit is only USD 0.44, one bleeding episode may require 2,000 units of the Factor, according to the Palestinian Society for Bleeding Disorders.

Contact: Walaa Ammar, WHO Gaza office: 08-282-2033

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