Visit to the Gaza Strip to better understand the challenges facing health system, February 2015
10 February 2015, Gaza City − Today the United Nations Humanitarian Coordinator for the occupied Palestinian territory (oPt), Mr James W. Rawley, and the head of the WHO office in oPt, Dr Gerald Rockenschaub, visited the Gaza Strip to see the critical challenges currently facing the health system.
The delegation visited Al Qubba Primary Health Center in East Gaza, a severely damaged clinic which can no longer provide health services, and Al Rahma clinic which is accommodating its own clients as well as those of Al Qubba. The directors of both clinics briefed the visitors.
The delegation then visited Al-Shifa hospital where they visited the medical departments and were briefed by officials of the Ministry of Health on the difficulties of delivering basic services in Gaza, and especially during the summer 2014 crisis. Representatives from UNFPA, UNRWA, Medical Aid for Palestine, Palestinian Medical Relief Society and UNICEF described the challenges faced by UN agencies, local and international NGOs in the health sphere.
At a press conference later, Mr Rawley highlighted the role of the Humanitarian Coordinator in supporting the health sector, and the role of the WHO office in closely monitoring chronic and emerging issues critical to the provision of adequate health services in Gaza.
Gaza’s health crisis
“The blockade is a structural problem for the Palestinian health sector and a barrier to free access, control over resources and planning, and economic and educational opportunities, required for a well-functioning health system,” was a key WHO message.
Patients’ access to Egypt has been reduced by 85% since 2011. While over 2,000 patients from Gaza were identified to be in need for specialized medical referral services in hospitals in Egypt in 2014, less than 600 of those patients were able to access their care due to the closure of the Rafah border.
18 000 patients seek access to referral services through Erez crossing, mostly to Palestinian hospitals in the West Bank including East Jerusalem, but also to Israeli hospitals and 18% experience problems in access.
Chronic shortages in essential medicines have been averaging 30% over the past 5 years, and up to 50% in medical disposables. During the summer 2014 attacks on Gaza, foreign drug donations bridged gaps temporarily, but for 2015 the Ministry of Health in Gaza to date has only 6% of its required budget for medicines.
The damage to the power infrastructure and the long-term fragility of power supply and grids is a constant concern for the 22 public and non-profit hospitals in Gaza who provide life-saving care. Back-up systems and other coping mechanisms are insufficient alternatives to a reliable power supply.
The total cost of required investment in health infrastructure for the relief, early recovery and reconstruction phases in the health sector following the Gaza crisis is estimated to be USD 218 million. Only a fraction of these needed funds have been raised so far.
The health system is also negatively affected by internal problems that are a result of the political-financial situation in the West Bank and Gaza, seen most urgently in the current health workers salary crisis. 50% of the Ministry health workforce in Gaza began a partial strike in late January to demand full payment of their salaries. Contracted hospital services for cleaning and food catering have also threatened imminent strike due to long-standing non payments. The crisis has already caused disruption in health services, curtailing elective surgeries, shortening work hours of clinics and leading to overcrowding of patients seeking care. An urgent solution is required to maintain continuity of health services, while a longer term process is developed to ensure a sustainable solution for the health workforce.