The State of Gaza Strip Border Crossings

26 November to 24 December 2008

Summery

 

This report reviews the critical deterioration in the humanitarian conditions of approximately 1.5 million Palestinian living in the Gaza Strip.  Gaza civilians have continued to sustain suffering due to the continued closure imposed by the State of Israel, which affects all aspects of life in the Gaza Strip.  The suffering of Gaza civilians increased after 70% of Gaza bakeries were forced to shut down due to a lack of flour and cooking gas (used to operate the majority of Gaza bakeries).  For the second consecutive month, Israel has intensified the closure of the Gaza Strip via the total closure of all Gaza’s border crossings, including those dedicated for the movement of civilians and for the movement of goods.

 

Consignments of food, medicine, fuel and basic needs, including aid to UNRWA , were totally banned.  Flour and wheat have completely run out from Gaza  flourmills.  Gaza Power Plant was completely shut down due to a lack of industrial fuel, and due to continued disruptions in the lines supplying Gaza with power from Israel and Egypt, plunging all the cities and refugee camps in the Gaza Strip into darkness for more than 16 hours per day.  In addition, hundreds of thousands of civilians suffered from water shortages, including drinking water and water for domestic uses, for several days due to the power cuts.  In view of an incredible increase in the price of basic goods and the scarcity of basic needs, civilians in Gaza struggle to ensure their basic needs; a struggle compounded by poverty and unemployment (80% and 60% respectively). All Gaza’s economic and productive sectors, including the industrial, agricultural, and services sectors, were completely incapacitated due to the total closure imposed on Gaza border crossings and the ban on imports and exports. 

 

The Following is a summary of the most significant developments in the Gaza Strip during the reporting period:

·           Israel has imposed more restrictions on Gaza’s border crossings and imposed ban on the delivery of all consignments of food, medicines, fuel and civilians’ basic needs.  Israel has continued to impose a ban on all exports from Gaza.  

·           The main concern of 1.5 million people living in the Gaza Strip has continued to be focused on getting their minimal basic needs of food, medicines and water; including drinking water and water for domestic uses. Water has been in short quantities due to cuts of power.  

·           For the second time in a single month, the UN Relief and Works Agency for Palestine Refugees (UNRWA) was forced to suspend its food aid program and close all its distribution centers for five days because Karm Abu Salem (Kerem Shalom) crossing was closed for its food aid supplies.  It should be noted that UNRWA distributes it food aid to approximately 750,000 refugees in the Gaza Strip who mainly depend on UNRWA aid. 

·           This dramatic situation has seriously impacted on Gaza civilians’ health.  Civilians have been denied access to their needs of food and of drinking water. 

·           Gaza’s bakeries and flourmills have been badly affected.  27 bakeries in Gaza and the majority of Gaza’s flourmills have been shut off due to power cuts, a lack of cooking gas used to operate bakeries, and due to a shortage of wheat and flour.  Gaza civilians faced significant difficulties trying to get bread, which is a basic staple food in Gaza.  Thousands of civilians were forced to stand in queues in front of bakeries for long hours to get reduced number of loaves. 

·           Israel has reduced fuel quantities delivered to Gaza to dangerous levels.  The delivered quantities of fuel did not meet minimum required levels.  During the reporting period, only 29.52% of the amount of industrial fuel required to operate Gaza Power Plant, 1.43% of Gaza’s daily needs of Benzene, 3.94% of diesel and 8.8% of cooking gas were allowed to enter Gaza. 

·           Up to the publication of this report, the only power plant in Gaza is still shut down completely due to a lack of industrial fuel (supplied via Nahal Oz crossing).  During the reporting period, only 2,996,320 liters of industrial fuel were supplied to Gaza Power Plant.  This quantity, which forms 29.5% of Gaza needs of industrial fuel for the reporting period, was enough to operate the plant for only 9 days during the 29-day reporting period.

·           During the reporting period, Israel has continued to impose a tight closure on all Gaza’s border crossings.  Israel partially opened al-Mentar (Karni) crossing for limited hours for five days.  Karm Abu Salem (Kerem Shalom) crossing was completely closed for 21 days, while it was partially opened for eight days to allow the delivery of very limited quantities of humanitarian aid.  Sofa crossing remained completely closed throughout the 29-day reporting period. 

·           Rafah International Crossing Point was closed to Gaza civilians for 27 days, while it was partially opened for two days to allow approximately 1,000 Gazan civilians, mostly patients returning from treatment in Egypt and civilians returning from pilgrimage in Saudi Arabia, to return to Gaza.

·           Beit Hanoun (Erez) crossing remained completely closed throughout the reporting period for Gaza civilians wanting to travel to Israel or to the West Bank for commercial, religious or familial purposes. 

·           Israel allowed a limited number of Gaza patients with very serious conditions to access hospitals in the West Bank and/or Israel via Beit Hanoun crossing.  The average number of patients permitted to cross Beit Hanoun crossing dropped to 16 patients per day, representing a decrease of 20% compared to the first quarter of 2008, and a decrease of 68% compared to the same period last year. 

·           Health conditions in the Gaza Strip deteriorated due to power cuts which seriously affected the effective operation of hospitals, including al-Shifa Hospital in Gaza city the European Hospital in Khan Younis, and other medical facilities.  Dozens of electrical medical apparatuses became useless. The medicine and medical supplies crises aggravated.  100 items of medicines and medical supplies are reported to be in short quantities.  Those most severely affected include patients with blood, heart and kidney diseases, and chronically sick children. 

·           All units at al-Shifa Hospital, particularly the Pediatric Intensive Care Unit, were seriously affected due to continued power cuts.  This situation threatened the lives of patients and babies.  Workers in these units have been forced to reprogram patients’ monitoring devices several times a day as there has been insufficient electricity to operate the monitoring units on a continual basis.

·           Three patients, including two women, died due to the continued closure of crossings.  So far, 50 patients, including 17 women and 10 children, have died as a result of being prevented from traveling for treatment outside of Gaza, hindering their travel for treatment or as a result of shortages of medication inside Gaza. 

·           Living conditions in the Gaza Strip have continued to deteriorate and rates of poverty and unemployment have continued to aggravate due to almost collapse of all Gaza economic sectors resulting from the closure of crossings and the ban on the importation of raw materials. 

·           Some 900 prisoners from Gaza Strip have been denied family visitation rights for more than 15 months. 

·           The following are the most significant developments at Gaza border crossings during the reporting period:

 

Rafah International Crossing Point

 

During the reporting period, Rafah crossing was completely closed for 27 days, while it was partially opened for one way traffic on 1 and 2 December 2008.  During the partial opening, approximately 520 Gazan civilians stuck on the Egyptian side, mostly patients; students and Gazan families residing abroad, were allowed to return to Gaza.  Since 12 June 2007, Rafa crossing has been completely closed for 534 days. 

 

During the total closure of Rafah crossing, the Egyptian Authorities allowed a very limited number of Palestinian civilians, mostly political leaders and patients returning from treatment, to cross the crossing as follows:

 

–             On 28 November 2008, 95 Gazan civilians, mostly patients and their companions, were allowed to return to Gaza.

–             On 29 November 2008, 10 persons from UNRWA were allowed to leave Gaza via the crossing.  Also on the same day, 29 Palestinians who are all patients and their companions were allowed to return to Gaza. 

–             On 6 December 2009, 13 Palestinians, including three political leaders from the Islamic Jihad movement and 10 persons from UNRWA, were allowed to return to Gaza via the crossing. 

–             On 13 December 2008, 43 Palestinians, mostly patients and their companions, were allowed to return to Gaza via the crossing. 

–             On 14 December 2008, 42 Palestinians were allowed to return to Gaza.  On the same day, a body of a Palestinian patient, Ahmed Abu ‘Amra, who died while receiving treatment for heart disease in Egypt was allowed to be transferred to Gaza via the crossing. 

–             On 15 December 2008, 40 Palestinians were allowed to return to Gaza via the crossing. 

–             On 17 December 2008, 15 Palestinians, mostly patients and their companions, were allowed to return to Gaza via the crossing. 

 

 

 

 

Beit Hanoun (Erez) Crossing

 

·           Israel completely closed Beit Hanoun crossing to Gaza civilians throughout the 29-day reporting period. 

·           The crossing was also completely closed for five days for the limited categories allowed to enter the crossing (members of diplomatic missions, employees of international humanitarian organizations and some patients with serious diseases).  Those who obtained permission to use the crossing were forced to wait for long hours before being allowed to pass, some were turned back, and forced to return the following day.  Individuals were exposed to complex security and permit procedures, tight security measures and sometimes humiliating body searches.

·           Israel completely closed the crossing throughout the reporting period for Gaza traders.  Previously, Israel had allowed very limited number of Gaza traders, averaging 10 traders per day at most, to use the crossing. 

·           Israel has imposed further restrictions on the movement of foreigners and Palestinians working in international humanitarian, relief and development organizations.  Beit Hanoun crossing was completely closed for the movement of these two categories for 15 days.  In addition, Israel completely closed the crossing for the movement of employees of international press institutions for 17 days.  Since 2 November 2008, Israel has reduced the crossing opening hours for these categories from 60 hours to 45 hours per week.  Further, the members of these categories are forced to wait for long hours at the crossing before being allowed to pass, go through very complicated search and security procedures while many of them are not allowed to cross. 

·           Israel denied Gaza Christians access to the West Bank to celebrate Christmas and  New Year’s Day.  According to Palestinian sources, the Civil Affairs Department submitted applications for 1,000 Gaza Christians to get them permits to travel to the West Bank.  However, Israel approved 271 applications only.  The majority of the approved applications are for children and elderly people.  Israel refused all applications submitted by youth.  Those who were approved stated to PCHR that they were waiting, up to the publication of this report, for Israel to allow them to cross Beit Hanoun crossing to the West Bank. 

 

Prisoners’ Visitation Rights

 

Israel have prevented Gaza families from visiting their imprisoned relatives in jails inside Israel since 6 June 2009 when Israel suspended the prison visitation program that is facilitated by the International Committee of the Red Cross.  There are approximately 900 Gazans in prisons inside Israel.  This unjustified denial of familial visitation right is in violation of International Humanitarian Law, especially the Fourth Geneva Convention of 1949.  It should be noted that there are approximately 150 prisoners from Gaza who had already been denied visitation rights prior to the suspension of the prison visitation program.  Israel claim that this denial is linked to security reasons.  

 

 

 

 

Al-Mentar (Karni) Crossing

 

·           During the reporting period, al-Mentar crossing was completely closed for Gaza imports for 24 days, while it was completely closed for Gaza exports throughout the 29-day reporting period.  Israel partially opened the crossing for 5 days to allow the delivery of 137 truckloads of fodder and grains to the Gaza Strip. 

·           Since 13 June 2007, the crossing has been totally closed for 414 days. 

·           This continued closure of al-Mentar crossing resulting in jeopardizing the humanitarian conditions of approximately 1.5 million civilians living in the Gaza Strip. 

 

Gaza Flourmills

 

Mr. Abdul Naser al-‘Ajrami, Head of Bakeries Owners’ Association, told PCHR the following:

 

“The flour that is available in Gaza is enough for three days only.  Shall the ban on the delivery of flour and wheat continue, all Gaza bakeries and flourmills will be shut down by the morning of 28 December 2008 at latest.  There are only 20 bakeries that are still working, with only 100 tons of flour in their stocks.  Ten bakeries have shut down because of the expiry of their stocks of cooking gas although, they have 100 tons of flour in their stocks.  27 other bakeries have shut down due to expiry of flour and cooking gas.”

 

All Gaza flourmills have shut down, except one flourmill.  This flourmill has 400 tons of flour that will be distributed to bakeries throughout four days. 

 

Mr. Ihsan al-Farra, from the Palestinian Flourmills Company which is the largest flourmill in Gaza, told PCHR that:

 

“We completely shut down on Thursday, 18 December 2008 because we ran out of wheat.  Since 5 November 2008, we have been forced to shut down several times.  Before Eid al-Adha, we were forced to shut down for ten successive days, then we started work again after the delivery of limited quantities of wheat – 250 tons – to the flourmill.  This quantity is enough to operate the4 flourmill for a single day.  Our flourmill used to produce between 200 and 250 tons of flour daily.”

 

PCHR notes that the last delivery of wheat (1,000 tons) occurred on 14 December 2008. 

 

 Nahal Oz Crossing

 

Israel has imposed severe restrictions on Nahal Oz crossing that is dedicated for the delivery of fuel supplies to Gaza.  The movement of fuel supplies to Gaza via Nahal Oz crossing during the reporting period was as follows:

 

·           Nahal Oz crossing was completely closed for 20 days for the delivery of all fuel derivatives. Gaza has suffered severe shortage of all fuel derivatives, which continue at the time of writing. 

 

 

Fuel supplied to Gaza during the reporting period:

 

Day	Date	Benzene in liters	Diesel in liters	Cooking gas in tons	Industrial fuel in liters
Wednesday	26/11/2008	00	00	129.980	437,420
Thursday	27/11/2008	00	00	00	00
Friday	28/11/2008	00	00	00	00
Saturday	29/11/2008	00	00	00	00
Sunday	30/11/2008	00	00	00	00
Monday	1/12/2008	00	00	00	00
Tuesday	2/12/2008	00	00	00	00
Wednesday	3/12/2008	00	00	00	00
Thursday	4/12/2008	00	00	00	400,000
Friday	5/12/2008	00	00	00	00
Saturday	6/12/2008	00	00	00	00
Sunday	7/12/2008	00	00	00	00
Monday	8/12/2008	00	00	00	00
Tuesday	9/12/2008	00	299,000	187.980	443,900
Wednesday	10/12/2008	50,000	101,000	190.760	422,000
Thursday	11/12/2008	00	00	214.240	450,200
Friday	12/12/2008	00	00	105.370	431,000
Saturday	13/12/2008	00	00	67.950	421,000
Sunday	14/12/2008	00	00	00	00
Monday	15/12/2008	00	00	00	00
Tuesday	16/12/2008	00	00	00	00
Wednesday	17/12/2008	00	00	00	00
Thursday	18/12/2008	00	00	00	00
Friday	19/12/2008	00	00	00	00
Saturday	20/12/2008	00	00	00	00
Sunday	21/12/2008	00	00	00	00
Monday	22/12/2008	00	00	00	00
Tuesday	23/12/2008	00	00	00	00
Wednesday	24/12/2008	00	00	00	00
Total		50,000	400,000	896.640	2,996,320
Daily imports average		1,724	13,793	30.918	103,321
Percent of daily needs		1,43%	3,94%	8,8%	29,52%

 

 

 

 

·           Israel imposed a ban on the delivery of industrial fuel, which is used to operate Gaza Power Plant, to Gaza for 22 days.  Israel opened Nahal Oz crossing for seven sporadic days to allow the delivery of 299,320 liters of industrial fuel.  This quantity is enough to operate Gaza power plant for less than nine days and represents 29.52% of Gaza needs of industrial fuel for the 29-day reporting period; the Gaza strip needs 10,150,000 liters of industrial fuel for the reporting period. 

·           On 19 December, Gaza Power Plant was shut down because its stocks of industrial fuel had run out.  Many neighborhoods in the Gaza Strip plunged into darkness.  Gaza city, where approximately 570,000 civilians live, was the most affected due to the power cuts. 

·           Gaza Electricity Distribution Company (GEDCO) suffered severe shortage of power.  GEDCO was forced to make schedules for the distribution of power to Gaza areas in order to face the shortage of power. 

·           This coincided with winter.  In view of the expiry of cooking gas, Gazans mainly depended on limited power supplies for heating purposes.  This resulted in increasing burdens on the power network in Gaza.  As a result, many transformers and parts of the power network were disrupted. 

·           Engineer Suheil Skeik, GEDCO Director General, said that the power shortage in Gaza, northern Gaza and middle Gaza amounted to 70%.  He explained that power cuts hours reached the peak in Gaza where they registered 16 hours per day.  He added that the increase of power consumption during the winter season escalated the power crisis by increasing burdens on networks and transformers and disrupting them.  GEDCO was unable to repair such disruptions due to expiry of materials required for the purpose.  Israel has continued to impose a ban on the delivery of materials and spare parts required by GEDCO to conduct repairs to power networks.  

·           The Gaza Strip depends on three sources of power: Gaza Power Plant provides 67-70 MW (34%) Israel provides 120 MW (58,5%) and Egypt provides 17.5 MW (7.5%).  All the fuel used to operate the Gaza Power Plant comes from Israel.

·           Nahal Oz crossing was completely closed for benzene supplies for 28 days, and was partially opened for one day to allow the delivery of 50,000 liters of benzene.  This represents 4.1% of Gaza needs of benzene for the reporting period.  Before Israel’s decision to reduce fuel supplies to Gaza, Gaza used to import 120,000 liters of benzene daily. 

·           Israel closed Nahal Oz crossing for diesel supplies for 27 days.  The crossing was partially opened for two days to allow the delivery of 400,000 liters of diesel; representing 3.94% of Gaza needs for the reporting period.  Before Israel’s decision to reduce fuel supplies to Gaza, Gaza used to import 350,000 liters of diesel daily. 

·           Israel completely closed Nahal Oz crossing for cooking gas supplies for 23 days.  The crossing was partially opened for 6 days to allow the delivery of 896,640 tons of coking gas; 8.8% of Gaza needs of cooking gas for the reporting period.  Gaza needs 350 tons of cooking gas daily. 

 

 

 

Sofa Crossing

 

Israel completely closed Sofa crossing throughout the 29-day reporting period.  All basic goods, including humanitarian aid for UNRWA and the World Food Program (WFP), were banned during the reporting period. 

 

In addition, Israel banned the delivery of goods that had been allowed to enter Gaza following the Tahdiya’ or ‘Period of calm’ that came into force on 19 June 2008.  Prior to the Tahdiya, these goods, which included livestock, fresh fruit juice, gas bottles, wood, and textile cloth had been banned for more than a year.   

 

The construction sector continued to struggle for survival due to continuing severe shortage in all construction materials, mainly cement.  Prices of limited quantities of construction materials available in Gaza markets quadrupled.  Dozens of development projects have been suspended or cancelled as a result, and thousands of construction sector workers have been laid of work.   

 

Imports of aggregate were also banned during the reporting period.  PCHR notes that Israel had permitted aggregate to enter Gaza in limited quantities during October (2008), after a fifteen month ban.  Gaza currently requires approximately 2,500 tons of aggregate per day to fully rehabilitate its construction industry.

 

Karm Abu Salem (Kerem Shalom) Crossing

 

During the reporting period, Karm Abu Salem crossing was completely closed for 21 days and partially opened for eight days.  Since announcing the re-opening of the crossing and adopting it as the main commercial crossing for the Gaza Strip on 18 August, 2008, Israel has closed the crossing for a total of 128 days. 

During the opening days, Israel allowed the delivery of approximately 294 truckloads of foods and medicines for WFP, ICRC and UNRWA. 

 

Israel did not allow the delivery of any imports, including humanitarian aid.  Israel also did not allow the delivery of basic goods that had been allowed to enter to Gaza prior to the closure of the crossing.  It should be noted that during the opening days, the crossing operated below its capacity and that the daily average of allowed truckloads was 11 truckloads. 

 

Right to Health

 

Obstruction of Patients’ Movement and Denial of Right to Receive Treatment

 

During the reporting period, Israel continued to obstruct the movement of dozens of Gaza patients via Beit Hanoun crossing.  Hundreds of Gaza patients requiring urgent treatment in the West Bank and/or Israel have been denied access to treatment.  During the reporting period, due to these restrictions on patients’ movement:

 

 

 

–          Rate of Gaza patients granted permits to access treatment in hospitals in Israel and/or the West Bank dropped to approximately 16 cases per day.  This rate represents a drop by 20% in comparison with the first quarter of the current year when the rate of patients who had been granted permits to access Israel and/or the West Bank for treatment registered 20 cases per day.  During the same period of last year, rate of patients allowed to cross Beit Hanoun crossing registered 50 cases per day.  This means that in comparison with that period, the drop in the allowed cases is 68%.

–          From the beginning of the reporting period to 21 December 2008, Israel allowed 390 Gazan patients to use Beit Hanoun crossing in order to have access to Palestinian hospital in the West Bank or to hospitals inside Israel.  Earlier, the representative of the Palestinian Ministry of Health in the Civil Liaison Office in Gaza had submitted 300 applications on behalf of patients requiring urgent treatment in Israel or in the West Bank.  These 300 applications are still waiting for Israeli approval.  Patients have sustained great suffering while waiting response to their applications.  The waiting period extended in many cases for several weeks.  Many applications were rejected after long waiting.  

–          Since Israel tightened the closure on the Gaza Strip in June 2007, 50 Palestinian patients, including 17 women and 10 children, have died as a result of being prevented from traveling for treatment outside of Gaza, obstructing their travel for treatment purposes or as a result of shortages of medication inside Gaza.  During the reporting period, three patients, two women and a man, died, as detailed in the following: 

 

1.            On 1 December 2008, Dawlat Abdul Fattah Abdullah Mhanna, 53, from Jabalia Refugee Camp in the north of Gaza, died.  Mhanna had been prevented several times from traveling outside of Gaza for treatment although her health conditions were seriously deteriorated.

 

Abdullah Abdullah Mhanna, 62, who is the husband of the deceased woman told PCHR the following:

 

“My wife began to suffer from colon cancer three years and a half ago.  She had been regularly treated throughout that period.  In last August, her health deteriorated because the cancer spread again.  On 20 August 2008, doctors decided to refer her to the Arab Care Center in the West Bank.  She got a medical referral from the Ministry of Health but the authorities of the Israeli occupation prevented her from crossing Beith Hanoun crossing.  We applied for another medical referral and got it on 6 November 2008.  Heyam, who is the sister of my wife, was supposed to accompany my wife.  My wife and her sister Heyam were informed that they had an approval to cross “Erez”.  They arrived at “Erez” crossing at 10:00 on 6 November 2008 and entered to the crossing area.  Then they were detained by the Israeli intelligence.  They remained detained till 16:00 on the same day (six continuous hours).  Then they were informed that the companion of the patient (her sister) was prevented to pass for security reasons.  They were also informed that the companion had to return to Gaza while that the patient had permission to pass and head to the hospital without companion.  The health conditions of my wife did not allow her to ravel alone.  She needed somebody to assist her and take care of her.  So my wife was forced to return to Gaza with her sister.  Then my wife applied for a new referral and changed the companion.  But she remained waiting for a long time.  Meanwhile, her health seriously deteriorated and she was transferred to Tumors Department at al-Shifa Hospital in Gaza city.  She died on 1 December before getting a response.”

 

 

 

2.            On 26 November 2008, Karima Zuheir ‘Atwa Abu Dalal, 35, from al-Nuseirat Refugee Camp in the middle of Gaza, married and a mother of five children, died because she was prevented from traveling for urgent treatment. 

 

Maher Abdul Razeq Mahmoud Abu Dalal, 37, is the husband of the deceased woman.  He is a municipal employee.  He told PCHR the following:

 

“My wife was detected to have cancer of the lymph glands in 2003.  In March 2006, she had a marrow transplantation operation in the Naser Institute Hospital in Egypt.  She stayed there for four months for medical follow-up.  Then she returned home in February 2007.  She was supposed to return to Cairo after 6 months for medical follow-up.  However, she was unable to travel to Cairo on time because Rafah crossing was closed.  She was transferred to al-Shifa Hospital where she made medical examinations.  It was founded that there were new cancer cells.  Because of the continued closure of Rafah crossing, my wife was referred to the West Bank for treatment.  She managed to travel to the West Bank on 16 July 2008.  She stayed for a month in the Arab Specialized Hospital in Nablus for treatment.  She was informed that she needed another marrow transplantation operation.  When she returned to Gaza, we began to apply for a new referral to the Arab Specialized Hospital for the marrow transplantation operation.  She got a referral on 26 August 2008, and we submitted the referral to the Civil Liaison Office to coordinate for the travel.  The Israeli authorities rejected the application and reported my house to be denied access for security reasons.  We made contacts with many human rights organization inside Israel to assist us.  Four attempts were made, but none of them had positive results.  In the meanwhile, my wife’s health deteriorated and she died on 26 November 2008”. 

 

3.            On 1 December 2008, Ahmed Mahmoud Ali al-Zrei’i, 55, from Deir al-Balah in the middle of Gaza, died due to shortage of medications required for his treatment. 

 

Mahmoud Ahmed al-Zrei’i, 21, is the son of the deceased civilian.  He told PCHR the following:

 

“My father had been suffering from Parkinson’s disease (disease in the central nervous system) since 2005.  He was required to take medications regularly.  Doctors prescribed Dopicartan, which is an Israeli drug.  My father’s health improved with this drug.  In beginning 2007, the drug became to be in short quantities in Gaza pharmacies.  Shortly later, the drug ran out from Gaza.  Thus my father’s health began to deteriorate and he was forced to take another similar drug.  But the new drug caused him health troubles and inflection in the throat.  We tried to take him abroad for treatment, but doctors told us that his health was seriously deteriorated and that his disease caused him atrophy of brain cells.  He had epileptic seizures and then he was referred to the psychiatry department in al-Naser Hospital in Gaza city.  His health continued to deteriorate till he died on 1 December 2008.”

 

Catastrophic Deterioration of Conditions in Hospitals and Healthcare Centers

 

Further deteriorations have continued to affect the health sector in Gaza because of the tight siege.  Hospitals and healthcare centers were seriously affected.  They were unable to ensure their medical needs and their ability to provide medical services to Gaza civilians was affected. 

 

 

Munir al-Bursh, Director General of the Pharmacy Department, stated to PCHR that 105 medicines and drugs and more than 225 items of medical supplies completely ran out from the medicine stores of the Ministry of Health.  Within one month at most, dozens of  medicines and medical supplies will completely run out according to the statements of al-Bursh. 

 

Bassam al-Mohammadein, Director General of the Maintenance Department in the Ministry of Health, explained that many medical apparatuses in Gaza hospitals are disrupted.  He said that the maintenance of these apparatuses is impossible because of the Israeli impose ban on the delivery of spare parts to Gaza.  He also explained that Israel confiscated some medical apparatuses.  Al-Mohammadein said that Israel has continued to prevent taking medical apparatuses’ spare parts and other medical tools to be repaired in specialized companies outside of Gaza.  As a result, dozens of medical apparatuses were disrupted, mainly kidney dialysis machines, respirators, supervision apparatuses and USP apparatuses used by the Artificial Kidney Unit at al-Shifa Hospital.  The following illustrates the most significant deteriorations affecting health conditions and medical services and that are caused by the continued imposition of tight siege:

 

·                 Eight months ago, Israel confiscated spare parts of the CT system at the European Hospital in Khan Younis.  As a result, the CT system in the Hospital was completely disrupted.  In addition, the electronic board of the CT system at al-Shifa Hospital in Gaza City was disrupted.  As a result, the System is partially used for very serious cases. 

·                 Severe shortages of spare parts resulted in the shut down of main power generators at al-Shifa Hospital and at the European Hospital.  This jeopardized the lives of patients in these hospitals.  It should be noted that certain departments at al-Shifa Hospital and at the European Hospital do not have access to power because the hospitals use low capacity powers that can not supply power for all the departments. 

·                 In Naser Hospital in Khan Younis city, surgeries have been suspended due to shortage of operations’ lamps.  Doctors were forced to conduct some operations using bad lightening. 

·                 Surgeries have been suspended in the Abu Yousef al-Najjar Hospital due to shortage of spare parts used for air conditioners in operations rooms and due to disruption of some medical apparatuses that do not have alternatives. 

·                 In Beit Hanoun Hospital, surgeries were suspended due to incapacity to replace the Antistatic PVC in the operations department. 

·                 Surgeries have been suspended in al-‘Oyoun Hospital due to shortages of Anesthesia devices and spare parts for sterilization equipment, especially heaters.  It should be noted that all Gaza hospitals have begun to suffer shortages of Anesthesia devices and spare parts for sterilization equipment. 

·                 Primary Care Centers are suffering from shortages of spare parts used for refrigerators that are used to keep vaccines.  This shortage may result in decomposing vaccines.  

·                 All Gaza hospitals are suffering shortages of spare parts required for laundries and driers used for washing and drying cloth and sheets used for patients’ beds and in operations rooms.  In addition, irons were disrupted due to shortage of spare parts.  Some hospitals face problems to transfer their laundries to other hospitals for cleaning. 

·                 Also due to shortages of spare parts, many lifts were also disrupted in Tal al-Sultan Hospital in Rafah, the European Hospital in Khan Younis, Beit Hanoun Hospital and Naser Hospital in Khan Younis.  As a result, patients have been carried by their relatives to upper floors.  Many patients fell down to the stairs while being carried to upper floors. 

·                 The power cuts severely affected the medical services at the al-Aqsa Martyrs Hospital in Deir al-Balah city.  In addition, the Hospital has suffered severe shortage of medicines and medical supplies.  According to data made available by the Hospital  to PCHR, during the reporting period, many healthcare services that the Hospital offers to civilians in middle Gaza were suspended several times.  On Thursday, 18 December 2008, the different departments in the Hospital remained without power for two hours, and for four hours on Saturday, 20 December 2008.  The main board that nourishes alternative power generators and that works when power is cut had been disrupted.  All the medical devices were disrupted, including electronic devices in the intensive care unit and supervision devices used to supervise the health of newborns in the nursery unit.  The Hospital was forced to delay dialysis provided for approximately 54 kidney failure patients.  Further, the Hospital suffers severe shortage of different medical supplies and tools, including Exchange Blood Trays in the pediatric extensive care unit.  The Hospital was force to transfer many patient children to the al-Naser Children Hospital in Gaza city.  The intensive care unit in the al-Aqsa Martyrs Hospital suffers shortages of central lines required for patients with cardiac diseases, sterilization bags, medical cords, medical nylon bags, ray films, permanent urinary catheters, 10% glucose solutions, saline solutions, support splints and gypsum.  In addition, the Hospital is still suffering from severe shortage of cooking gas used for sterilizing medical tools.  The Hospital is also suffering from shortages of many necessary medicines, including medicine used for dissolving blood clots; medicines used for pancreas diseases and penicillin-water.  These medicines have been unavailable for approximately five months. 

 

In view of the data and documentation reported, PCHR calls upon the international community, particularly the High Contracting Parties to the Fourth Geneva Convention relative to the protection of civilians in times of war, to:

 

1.               Exert effective pressure on Israel to compel them to open all Gaza crossings, those used for commercial purposes and those used for civilian movement, to enable the Gaza civilian population to enjoy contact with the oPt and the outside world, and also to enable them to enjoy their basic civil and political rights, as well as their economic, social and cultural rights.

2.               Promptly and urgently intervene to open Rafah International Crossing Point for those who want to leave Gaza, including hundreds of patients who require treatment abroad, students enrolled in international universities, holders of residency permits in foreign countries, and other humanitarian cases, and for those who are stranded in Egypt to be able to return to Gaza if they wish.

3.               Promptly and urgently intervene to ensure respect for the provisions of International Humanitarian Law and International Human Rights Law, in order to put an end to the deterioration of living conditions taking place across the Gaza Strip.  

4.               Compel Israel to restrain from collective punishments of the civilian population of the Gaza Strip, including tightening and restricting the closure of the Gaza border crossings.    

5.               Remind the State of Israel of its obligations towards the civilians of the Gaza Strip, as the Occupying Power, as regards article 55 of the 1949 Fourth Geneva Convention that stipulates: ” To the fullest extent of the means available to it, the Occupying Power has the duty of ensuring the food and medical supplies of the population; it should, in particular, bring in the necessary foodstuffs, medical stores and other articles if the resources of the occupied territory are inadequate. The Occupying Power may not requisition foodstuffs, articles or medical supplies available in the occupied territory, and then only if the requirements of the civilian population have been taken into account”. The High Contracting Parties to the Fourth Geneva Convention have a duty to commit to their obligation under article 1 of the Convention that provides for ensuring the implementation of the provisions of the convention by the State of the Israeli military occupation, in order to ensure protection to the Palestinian civilians of the Gaza Strip.