Ahmed
Zourob receives dialysis treatment at Al-Shifa Hospital in Gaza City. Because
of the siege, his level of treatment is inadequate and he can no longer obtain
the medication he needs.

Gaza City, Palestine—Ahmed Zourob is one of the 164
patients who fill the Dialysis Unit at Al-Shifa Hospital in Gaza City everyday.
Like the others, he is here because his kidneys, deteriorated by disease,
cannot adequately perform their function; as with many of the patients here, he
relies on the medical treatment he receives at Al-Shifa to survive. Yet, now under
siege for more than three years and thus unable to provide necessary medication,
plagued with equipment in perpetual disrepair, and confronted with an acute
shortage of electricity, Al-Shifa’s dialysis unit is experiencing its own state
of deterioration. “We have witnessed almost a fifty percent shortage in
the medicine and machines we need to run this unit at its capacity due to the
Israeli occupation and closure, not to mention the problems arising from the
electricity crisis” says Dr. Mohammad Shatat, Deputy Director of
Al-Shifa’s Dialysis Unit, the largest such unit in the Gaza Strip. The consequences,
he says, have been a visible decline in the health and prospects for recovery
and survival of the patients.

Dialysis treatment is not easy under
any circumstances. Patients suffering from chronic kidney failure must spend up
to four hours each treatment attached to a dialysis machine which circulates
the blood from their body through a filtration system to remove toxins and before
returning it to their bodies. In normal conditions, patients receive dialysis
treatment three times a week and are also required to take up to five different
types of medicine, including antibiotics and a combination of  hormones and supplements which protect the
kidneys from further damage and prevent the onset of anemia, Dr. Shatat
explains.

Yet the Israeli-imposed closure has
made dialysis treatment significantly more difficult for the 300 kidney
patients at Al-Shifa and their families. Before the closure, says Dr. Shatat,
the medicine required by the patients was available in the hospital pharmacy
and provided to patients suffering chronic diseases free-of-charge. Now, as a
direct result of the closure, the hospital pharmacy has run out of many essential
medicines, including those required by dialysis patients. Patients and their
families must find alternative sources for the drugs, paying out-of-pocket for
these medicines at artificially high prices in pharmacies outside the hospital,
in the cases in which such the medicine can be found at all.

Ahmed was diagnosed with kidney failure in 2008, and he has
been unemployed for about as long. The closure has worsened Ahmed’s condition
by simultaneously denying him access to the medication he needs through
Al-Shifa and denying him of an economic livelihood that would allow him to
purchase his medication outside the hospital. “Three months ago the hospital
told me that my medicine was no longer available in the hospital pharmacy, but
without a job I cannot afford the medication on my own. I don’t know what I can
do.” Without access to the prescribed medication, Ahmed’s condition has
steadily deteriorated in the past year and he has recently been diagnosed with
anemia.

Under its policy of closure, Israel
has also disallowed the import of medical equipment, including new dialysis
machines and spare parts needed to repair those machines which are no longer
functioning. As a result of inadequate resources, dialysis treatment has had to
be reduced for all patients from three to two times a week, which presents
grave implications for the health of the patients, says Dr. Shatat: “Dialysis treatment
serves the purpose of the kidneys, so it is vital for these patients; if they
fail to receive the required treatment the consequences can be deadly.” Indeed,
four patients from the Dialysis Unit died in April 2009 immediately following
the reduction in treatment.

The entire healthcare sector in the
Gaza Strip suffers from an acute shortage in medicine and medical equipment due
to the Israeli-imposed closure. According to the Palestinian Ministry of
Health, 110 types of medicine and 123 types of medical equipment have run out
in the Gaza Strip during the first six months of 2010; another 76 types of medicine
are expected to run out in the coming three months.

The dire situation in Al-Shifa’s Dialysis Unit caused by the
restriction of goods into Gaza is exacerbated by constant electricity cuts, a
result of the energy crisis effecting the Gaza Strip. For the 1.5 million
Palestinians inside Gaza, constant electricity outages have become just another
burden of daily life. In Al-Shifa’s Dialysis Unit, however, the sudden and
frequent outages which come in addition to the regular electricity cuts place
the patients’ lives and the medical machines at great risk. “When the
electricity goes out during a dialysis cycle,” Dr. Shatat explains, “approximately
300cc of blood is caught outside the body of the patient and cannot be
returned. We have lost several dialysis machines due to sudden changes in
electricity levels, but the risk posed to patients’ lives is much greater.”

Israel permits the entry of only
enough fuel to run the Gaza Power Plant at 45% of the capacity needed to
adequately supply the demand in Gaza. The entire Gaza Strip now experiences
power outages of up to twelve hours a day, disrupting all aspects of the lives
of Palestinians who are already living with hardships caused by the Israeli closure.

Accordingly, Al-Shifa depends on
four generators for its electricity, and they are old and in constant need of
repair. “The generators are meant as backups, not to be run all the time,”
says Dr. Shatat. “Now the generators are used to power all the hospital
wards and so they need repairing. But the Israeli closure makes it very
difficult to obtain the parts we need; we’ve been waiting for a year for
batteries, prohibited under ‘security concerns.’”

Under these difficult conditions,
increasing numbers of patients in Gaza suffering from serious injuries and
diseases are forced to seek treatment outside of the Gaza Strip. Yet the
process for obtaining the necessary permits for transfer from Gaza to hospitals
abroad is long and arduous. Hundreds of patients—including women and children—are
denied each month by Israel under the guise of “security concerns.”
Since 2007, the Palestinian Center for Human Rights has documented the cases of
67 patients who have died because they could not obtain the necessary treatment
in Gaza and were denied a permit to seek medical treatment abroad.