Dr. Mohamed Shatat is the Head of the Dialysis Department of al-Shifa hospital, located in Gaza City, whose working conditions have deteriorated due to the ongoing electricity crisis, caused by the Israeli siege. “The electricity crisis is very severe in the hospital in general and in particular for the dialysis department, which cannot work without electricity”, Dr. Shatat explains.
Throughout the past months, the already dire electricity provision of the Gaza population has decreased from 8 hours electricity per day to only 3 or 4 hours. The most severe consequences are experienced by hospitals and their patients, and whereas generators can partially compensate the lack of electricity, regular fallouts interfere with treatments. This has particularly negative effects for the dialysis section of the hospital, where an interruption in electricity provision leads to an interruption of the blood cycle rotation. Accordingly, blood is kept within the machine, which leads to coagulation and a waste of blood, lastly contributing to blood shortage and complications that can affect the patient’s overall health. Depending on the patient’s condition, the interruption of dialysis might lead to death.
“The electricity provision from the generators is not constant, which also affects the dialysis devices themselves and can damage them or make them entirely useless. Electronic devices needed to repair the machines are not available in the Gaza Strip and acquiring them from international donors takes 6 to 12 months due to the siege. Consequently, patients in need of treatment cannot get the life-saving treatment they need”, Dr. Shatat elaborates.
With the fallout of machines, the patient’s dialysis is delayed and waiting times increase, which has a strong psychological and social effect on the patients. Furthermore, a high number of patients does not live within Gaza City but has to travel to get to the hospital. “I have a patient who has tried to schedule her dialysis appointment for the afternoon instead of finishing by midnight because she lives in the border area, which can be an unsafe zone at night. It happened before that when she would reach the border area late at night, the Israeli soldiers were shooting at the car from a nearby point of inspection. So, these people risk their lives when they come to us for a delayed treatment”, Dr. Shatat emphasizes.
The hospital currently offers treatments in 5 different shifts, the last being from 11 in the evening until 3 in the morning, which can be very tiring for older patients and patients living further away. The hospital currently has 45 dialysis machines and treats 328 patients. In addition to the electricity problem, several medicines are not available, such as the biotin hormone, a lack of which leads to anemia. In the severest cases, a lack of medical supplies essential for the dialysis treatment can lead to an interruption of the dialysis and lastly to an intervention of the ICRC or other international organizations.
“When the electricity hours were severely decreased, I had a patient whose treatment was interrupted for 3 hours because the generator had no gasoline and the blood started to clot and the patient needed a blood transfer. If this would happen on a regular basis, the patient would die after 2 or 3 days”, Dr. Shatat explains.
One of the patients is called Yasmin Abu Kashef, a 20 years old girl looking much younger than her actual age. She was diagnosed at the age of 15 and suffered from several other health conditions, such as weak growth and kidney stones. She has to come to the hospital for treatment 3 to 4 times per week and the dialysis has a strong exhaustion effect on her. Furthermore, she suffers from kidney failure in the third stage.
“In this case, an implant is no option due to the kidney stones and a surgery will lead to yet another kidney failure. The machine is the soul of the patient, so you can imagine the effect on the patient if it stops working”, Dr. Shatat explains.
“We live in the North of the Gaza Strip, so the regular transportation to the hospital is a high issue for my family. The costs are very high and can hardly afford it, but we don’t have another choice, as there is no treatment for dialysis anywhere in Gaza but in the City. In addition to that, the costs for medicines are very high when the hospital runs out of the required medicine and we have to acquire it somewhere else on our own expenses”, Yasmin’s father, Jehad Abu Kashef, reiterates.
The electricity crisis in the Gaza strip has severe consequences for the humanitarian situation and has led to a deterioration of civilian’s access to basic services, in particular to healthcare and environmental health services, including water supply and sanitation. According to international humanitarian law, Israel as the occupying power is responsible for guaranteeing the occupied civilians’ access to basic services, including electricity, healthcare, and water, and by not doing so is violating international law.