Sélectionnez votre langue
Gaza: Waiting for treatment
21 November 2018 – Rami, 40, sits in the hospital bed stretching his right leg with a piece of white fabric to avoid stiffness in the joints. He cannot walk. He has a severely comminuted right femur fracture caused by the gunshot injury he received in October, during the mass demonstrations in the Gaza Strip. Rami’s leg is temporarily stabilized with an external fixator. But to stimulate bone growth and avoid long-term disability he needs a circular frame that is currently unavailable in Gaza.
Due to the chronic shortage of medicines and medical equipment, even the largest Gaza hospital, Shifa, cannot provide Rami and many other patients with much-needed health services.
Since 30 March 2018, over 24 000 Palestinians have been injured in Gaza during the Great March of Return demonstrations. The mass influx of casualties has disrupted an already fragile health system. In the hospitals, trauma patients are prematurely discharged to make room for new patients.
The Ministry of Health and Palestinian Red Crescent Society’s 10 trauma stabilization points (TSPs), supported by WHO, have helped to substantially reduce the burden on the overloaded hospitals. At the TSPs, set up throughout critical zones in Gaza, wounded patients receive life-saving care close to the point of injury. Almost 50% of the injured patients are treated at the TSPs and immediately discharged.
Still, since the end of March, over 12 000 injured patients have been transferred for treatment to hospital. Initial screening found that at least 460 Palestinians will need long-term limb reconstruction, which requires up to seven surgeries and extensive rehabilitation for up to two years. As the screening continues, this number is expected to grow.
Confined to bed, Rami has been waiting for treatment for over a month now. A father of six, he is almost crying: “My leg is not fixed well, and I can feel it’s moving. I need a proper fixator for my leg to heal. If I am disabled, I won’t be able to support my family.”
“If we do not receive a circular external fixator for Rami as soon as possible we will offer him a referral for treatment outside Gaza,” says Dr Mahmoud Matar, an orthopedic surgeon at Shifa hospital. But to receive health care abroad, Palestinians must apply for Israeli security permits. The approval rate for those injured in demonstrations near the fence is significantly lower than the overall approval rate. Only eight out of 52 applications were approved in October.
Another option for Rami is to go undergo complex surgery in Gaza, but that might result in deformity, limping and persistent pain.
“Do you know what is the hardest feeling is for me as a doctor?” Dr Matar says. “To be unable to serve the patients. It is an internal disaster. Every time I can’t provide needed care for my patients, I feel like a criminal.”
With generous support from donors, WHO and its partners are procuring life-saving medicine, medical equipment and disposables for the hospitals in Gaza. Still, the needs are growing and the response takes time and resources. To date, there is a gap of US$ 20.8 million to cover emergency health needs in Gaza until the end of the year.
WHO’s emergency health support for trauma management in the occupied Palestinian territory is funded by generous donations from the European Union, the UN Central Emergency Response Fund and oPt Humanitarian Pool Fund. In 2018, WHO and its health cluster partners require US$ 43.8 million to support health needs in Gaza, of which approximately 53% is currently funded.
WHO Special sitiuation report, Gaza, occupied Palestinian territory, 7–20 October 2018
A paramedic evacuating an injured child from field. Credit: PRCS.9 Palestinians were killed and 1306 were injuredby Israeli forces during the reporting period from the 7 to the 20 October, according to the Ministry of Health.
Eight Palestinians, including one child, were killed during the demonstrations, while the ninth was killed due to an Israeli attack, which took place on 7 October.
Out of the total 1306 injured, 62% (815 people) transferred to Ministry of Health hospitals or NGO health facilities, including 168 children and 35 females. The remaining 38% (491) were treated and discharged directly from the trauma stabilization points.
Out of the total 815 injured people referred to a hospital, 16 were critically life threatening (1%), 299 moderate (23%), 470 mild (36%), and the remaining 30 were unspecified cases due to limited data collection.
Since the starts of the mass demonstrations, a total of 23 573 people have been injured, of which 5652 were live ammunition gunshot injuries (23%).
Full report:
WHO Special sitiuation report, Gaza, occupied Palestinian territory, 7–20 October 2018
World Mental Health Day in the occupied Palestinian territory: “How is your Mental Health?”
A social media campaign on mental health, led by the Sharek Youth Forum, aims to draw attention to the issues young Palestinians face and the challenges of growing up in the occupied Palestinian territory.10 October 2018 – WHO, in collaboration with the Palestinian Ministry of Health, the European Union (EU) and the Sharek Youth Forum, today launched a campaign to raise awareness about mental health to mark the occasion of World Mental Health Day, which takes place on 10 October every year. The campaign focuses on young people and mental health in a changing world.
Young Palestinians are leading two campaigns to draw attention to the issues they face and the challenges of growing up in the occupied Palestinian territory. They want to begin a conversation in the West Bank and Gaza about what young people can do to grow up healthy and resilient in the face of social difficulties.
The first campaign is a social media campaign, led by the Sharek Youth Forum in Ramallah in the West Bank, which began on World Mental Health Day with the hashtag #How_is_your_Mental_Health? Several short videos and posters are to be uploaded on Facebook carrying messages from adolescents and experts on mental well-being and healthy lifestyles. The same hashtag will be used in social media activities in Gaza, where a similar awareness-raising campaign will be launched.
WHO and the Palestinian Ministry of Health have also planned a workshop in the coming weeks for the Student Parliament, which represents 34 schools from across the West Bank. The workshop aims to assist these students in developing activities to carry out in schools to raise awareness on mental health and how to protect mental health in the face of everyday challenges. A counselor at each school will oversee the student events and activities. In Gaza, the Ministry of Education and the Ministry of health will provide 200 students with awareness-raising sessions on mental health.
Adolescents are defined by WHO as young people between the ages of 10 and 19 years. For many, this period of transition from childhood to adulthood can be a confusing and difficult time, and so understanding mental health and how to protect mental well-being is crucial.
Dr Gerald Rockenschaub, WHO Representative in the occupied Palestinian territory, stated: “Half of all mental health disorders in adulthood start by age 14, but most cases are undetected and untreated. Teaching adolescents methods to cope with psychological stresses can improve mental health for young people at this critical stage of development. Interventions aim to teach young people a range of skills, including how to handle peer pressure, deal with difficult emotions, resolve conflicts, build bridges with friends and family, develop self-confidence, safeguard themselves from high pressure marketing strategies – including those by the tobacco and alcohol industry – as well as to cope with other stresses like academic competition.”
WHO defines mental health as “not merely the absence of mental illness, but as a state of well-being in which all individuals can realize their individual potential, cope with day-to-day stress, and work productively and usefully in a way that contributes to their local communities.” WHO in the occupied Palestinian territory leads a project called Building Palestinian resilience: improving psychosocial and mental health responses to emergency situations. The project, funded by the EU, carries out activities to promote mental well-being, as well as addressing significant gaps in the development of mental health services – including gaps related to mental health service provision in emergency response – in the occupied Palestinian territory.
For further information, please contact:
Rajiah Abu Sway
WHO, Jerusalem office
Tel: 00972547179037
email:
WHO launches report on the Right to Health 2017, October 2018
October 2018, Gaza – WHO today released its report, Right to Health: Crossing barriers to access health in the occupied Palestinian territory 2017. The report examines obstacles to achieving the highest attainable standard of health for Palestinians living under occupation, including barriers to health access and attacks on health care.
Dr Gerald Rockenschaub, Head of WHO in the occupied Palestinian territory, stated: “Enjoyment of the highest attainable standard of health is a fundamental right of every human being. Today’s report outlines major obstacles to achieving that right for Palestinians living under chronic occupation in the West Bank and Gaza Strip. In 2017, we have seen the lowest approval rate on record for Gaza patients needing access to hospitals in the West Bank, East Jerusalem and Israel. This year we have also witnessed a large number of attacks on health staff, ambulances and facilities, with the sad loss of three health colleagues killed while working to treat people injured during protests in the context of Gaza’s “Great March of Return”. We face major challenges in the health sector across the occupied Palestinian territory, with reductions in funding and a shrinking humanitarian space. This event is an opportunity for us to come together, to reflect on these challenges and to consider strategic actions in the coming months to bring about meaningful improvements for the health of Palestinians.'
The WHO report outlines key indicators for monitoring the right to health in the occupied Palestinian territory, and gives detailed analysis of the barriers to access for some of the most vulnerable Palestinian patients who require permits to access specialized health care. At the same event, WHO launched a book of photo stories on the right to health, which give accounts of individual patients and health workers and the difficulties they face. One story is that of Mohammad, a 7-year-old boy from Gaza with cancer in his right hip, and his grandmother Amal. Amal tells of the financial burden of traveling to East Jerusalem for care:
“I don’t dare to buy anything, but sometimes Muhammed asks to go to the cafeteria to buy a treat. I can only buy him the cheapest things… Much of the money goes on transport... Gaza has no work, no electricity, no water, nothing.”Jamie McGoldrick, the Humanitarian Coordinator and UN Resident Coordinator for the occupied Palestinian territory, stated: “Israel’s restrictions on the free movement of Palestinians and its permit regime has severe consequences for access to health care of an extremely vulnerable group of patients in need of specialist treatments and investigation not available in Gaza or in the West Bank outside of East Jerusalem. A third of these patients are referred for cancer care. A third of these patients are children and young people aged 19 years or under. Three-fifths of these patients faced at least one denial or delay of a permit application in 2017. Collectively we have a responsibility to insist that Palestinians enjoy full and equal rights and have unhindered access to services needed to promote health and wellbeing.”
For more information:contact the Advocacy team:
Related links
Annual report: Right to health
Right to Health photo book: Palestinian voices
WHO video-graphic: the journey of a referral patient from Gaza
