Impact of the Hermetic Blockade on the Gaza Strip
29 August 2006
Deterioration of Health Conditions in the Gaza Strip due to the Blockade
The hermetic blockade over the Gaza Strip imposed by Israeli Occupation Forces (IOF) continues to have catastrophic effects on the health conditions of the civilian population. Health institution, including hospitals and primary health care centers, are suffering from a severe shortage in the supplies of medication and medical supplies necessary for the healthcare needs of the civilian population, especially patients suffering from chronic conditions. The situation deteriorates further and threat to the lives of civilians escalates due to the lack of electricity to run these institutions. It is noted that IOF destroyed 45% of the Gaza Strip power supply. Furthermore, the lack in fuel caused by the limited amounts allowed into the Gaza Strip threatens to worsen the energy situation by rendering power-generators useless or of limited use. In addition, patients who require treatment abroad are threatened by the closure of border crossings and the inability to travel to the West Bank, Egypt, or Israel for treatment.
The overall health situation deteriorated further due to the inability of municipalities and village councils to provide basic services to the population, especially environment-related services such as sewage and garbage disposal and the provision of clean drinking water. These services are adversely affected by the energy crisis and by the lack of chlorine for drinking water. IOF has banned the entry of chlorine to the Gaza Strip through Al-Mentar (Karni) crossing for weeks. Thus, water utilities have been rationed, with wells working on partial capacity, greatly reducing the amount of water reaching the civilian population in homes and institutions. It is noted that some areas receive water only 4-6 hours over a 5-day period. Medical sources indicate that there has been an increase in a number of illnesses over the past two months due to the lack of water. These include fever, diarrhea, and skin ailments.
The psychological suffering of the Gaza Strip population continues with IOF sonic booms and artillery shelling of populated areas. Women and children are the most vulnerable to the psychological effects of the aggression. More children are suffering from decrease in concentration, fear, and enuresis.
The closure of the Gaza Strip border crossings affects the performance of the health sector for a number of reasons:
– Shortage of medication and medical supplies: Some medications for chronic and serious cases such as cancer, epilepsy, and kidney failure have been exhausted, which places the lives of thousands of civilians at risk;
– Difficulty in referring cases to hospitals in the West Bank, Egypt, and Israel: IOF have imposed severe restrictions on entry of Gaza Strip patients to Israeli hospitals. Only 4 patients are allowed passage each day. This is a significant reduction from the rate of 20 per day one month ago and nearly 50 per day three months ago. The Ministry of Health was forced to redirect tens of cases to Egyptian hospitals. However, the closure of Rafah International Crossing since 25 June 2006 has affected the freedom of movement of these patients, and exposed them to serious complications in their health conditions;
– Due to the hindrances facing the health sector, there is legitimate concern over the spread of epidemics. Hospital statistics indicate that there is an increase in fever, diarrhea, and skin ailments among children compared with the same period last year;
– Gaza Strip municipalities and rural councils were unable to run garbage collection trucks due to the lack of fuel. This threatens to cause epidemics and diseases;
– The energy crisis has led to hindering the work of drinking water pumps and sewage disposal stations. The limited work of these vital installations places the health of the civilian population at risk, and threatens to cause epidemics and diseases;
– The energy crisis has caused irregularities in the work of hospitals. There is genuine concern that the persistence of this situation will cause hospitals to be unable to perform their duties.
Deterioration in the conditions of patients in Shifa Hospital in Gaza City:
Shifa Hospital is the largest Palestinian hospital, and is located in Gaza City. It provides healthcare to most of the population of the Gaza Strip, especially critical cases. The hospital has 600 beds and employs 1,400 medical and non-medical staff. Dr. Jum’a El-Saqqa, the Public Relations Director of the hospital, informed PCHR’s fieldworker of the severity of the health situation due to the closure and the energy crisis. The fieldworker obtained two lists of the medications and medical supplies that have run out. The first list contains 54 types of medication; and the second list contains 107 types of medical supplies.
The three main sections of the hospital all suffer from lack of essential medication for critical cases and basic medical supplies, such as diabetes test sheets. Dr. Husam Judeh from the hospital’s kidney diseases department stated that the closure has negatively affected the maintenance of the dialysis machines. There are 21 machines in the department serving nearly 160 patients a week. Nearly 80% of the patients undergo three dialysis procedures a week. In addition, the department receives 60 patients daily, which require supplies, equipment, and human resources to work three shifts. The work rate at the Shifa kidney department is one of the highest in the world.
The department also treats 19 children, each requiring 3 dialysis procedures weekly. But due to the lack of medication required for the procedure, (relatively) non-critical cases receive 2 procedures per week only. This forced reduction places the lives of these children at risk, and threatens to cause a deterioration of their conditions.
The staff at the department complained of the sudden cutting off of power during dialysis procedures. The power outage threatens to cause agglutination of the blood, a serious threat to the lives of patients. A number of patients informed PCHR’s fieldworker that they suffered health complications due to power outages during dialysis.
Ismail Awad Mohammad Shabat (52) from Beit Hanoun stated, “Nearly six months ago, medical exams indicated that I need to undergo a dialysis procedure 3 times a week. Since then, I’ve suffered greatly with these procedures. Sometimes we cannot get the required medication. Other times the machines aren’t functioning and need maintenance. Every time we are told that there is no medication and no spare parts for the machines because of the closure of the border crossings. Since June 2006, I’m facing unprecedented health risks. The most serious threat is that of power outages during dialysis, which requires 4 hours. Power outages occurred several times during my procedures, the last being on Sunday, 6 August 2006. The outage caused agglutination in my blood; and I passed out.”
A physician in the artificial kidney department at the hospital informed PCHR’s fieldworker that agglutination during dialysis occurs despite the availability of power generators in the hospital. The power goes out for a few minutes for the duration between the power outage from the main source and the operation of the generators. These few minutes are enough to cause agglutination, and expose patients to dangerous health complications. The department repeatedly requested a “uninterrupted power supply” machines for the dialysis machines to overcome the brief power outage. However the financial crisis of the Palestinian government and ministry of health prevents the fulfillment of this demand.
The neonatal care unit at the hospital suffers from a shortage of incubators. At the time of preparing this report, there were 33 incubators and 36 neonatal cases. The situation is expected to escalate with an expected increase in premature birth due to fear and anxiety of pregnant women caused by the overall security situation, including the bombardment of populated areas. In addition to the lack of incubators, the neonatal care unit suffers from shortage in medical disposables.
Gaza Strip hospitals and healthcare centers suffer from a severe lack of modern medical equipment necessary for treating critical and complicated cases, as well as diagnostic equipment for the early detection of diseases. Since the start of the Israeli occupation of the Gaza Strip, IOF have enshrined a primitive healthcare system that provides primary healthcare services only, and relies on referrals to Israel for advanced medical care. Hospitals in the Gaza Strip lack many facilities for the early detection of diseases, especially cancer and blood diseases. In addition, these hospitals lack the facilities to treat these diseases. As a result, physicians are unable to correctly diagnose patients; and are forced to rely on transferring them abroad for medical examinations.