Health care in the Gaza Strip remains dire, top UN humanitarian officials have warned. Essential drugs, medical supplies and parts, and fuel to power hospital generators are in acute shortage, and travel for patients who are seeking urgent treatment outside the area is restricted.
The same officials have emphasised that the situation could deteriorate further unless Israel eases the restrictions that have curtailed the flow of humanitarian and commercial supplies to meet the needs of the 1.5 million population in Gaza.
The World Health Organization in its latest biannual plan for humanitarian action cautions that chronic situations, such as that in the Palestinian territories occupied by Israel “will continue to deteriorate and will thus require significant resources in 2008-9.”
“I have been shocked by the grim and miserable things that I have seen and heard today, which are the result of current restrictions and the limitations on the number of goods that are being allowed into Gaza,” said Sir John Holmes, the UN emergency relief coordinator during a day long visit to the Gaza Strip.
Sir John, a former ambassador and diplomatic adviser to the former UK prime minister, Tony Blair, in a statement noted that he was shocked by the current restrictions.
The Israeli government increased restrictions on movements in and out of Gaza last June in response to the control of the Gaza Strip by Hamas, the Palestinian group that Israel has declared a hostile entity, and to the indiscriminate firing of rockets from Gaza into Israel.
Filippo Grandi, deputy commissioner general of the United Nations Relief and Works Agency for Palestine Refugees in the Near East, said that the number of trucks passing through Gaza’s borders had fallen from 14 000 to 15 000 in January 2007 to 1800 in January 2008.
The most serious aspect of the crisis was the energy shortage, he said.
Mr Grandi said that the director of the 560 bed Shifa Hospital in Gaza City, Hassan Khalas, had told him that he had “no time to take care of the health of the patients because he was spending all his time looking for fuel . . . Without it, the generators would stop and vital structures, such as incubators for infants, would shut down.”
Sir John Holmes also visited Shifa Hospital this month. He said that the director had conveyed his fears about the potentially disastrous effects of border closures on the dialysis and neonatal wards, which are dependent on regular supplies of fuel and electricity and spare parts for life saving equipment such as incubators and dialysis machines.
According to UN humanitarian officials 10 of the 26 dialysis machines at the hospital have broken down and the hospital is working 24 hours a day to meet the needs of the patients.
“If we have an electricity shortage and we have enough fuel for generators we can overcome [the problem]. But when you have electricity cuts and shortages in fuel this combination is very bad,” said a UN health expert closely monitoring events in Gaza.
Dorothea Krimitsas, a spokeswoman for the International Committee of the Red Cross, said that hospitals are experiencing unreliable and insufficient fuel supplies. Ambulance services have also been disrupted because of the fuel shortages, she noted.
Because of electricity blackouts, she said, some hospitals in Gaza have electricity for only eight hours a day, and most have to resort to generators. During 10-16 February, five hospitals in Gaza had only sufficient fuel to last one or two more days.
In such circumstances non-urgent surgery is suspended, she noted, adding that the irregular supply of electricity also adversely affected equipment.
The Red Cross is providing eight hospitals with essential medical supplies, surgical equipment, and spare parts for maintenance of operating theatres and medical and electrical equipment; helping with medical referrals to Israel; and providing vegetables and dairy products.
WHO and other relief groups have also been providing Gaza with drugs and other medical needs.
The availability of drugs in Gaza in December decreased to 105 out of 416 essential items, according to a WHO assessment.
Mr Grandi told reporters in Geneva that as a result of the stringent measures about 22% of patients seeking medical treatment outside the area had been refused. In some cases, this “can cause deaths,” he said.
Reuters news service reported that in one case on 14 February, an ambulance carrying a 67 year old Palestinian woman who had had a stroke was refused access at an Israeli military checkpoint, and she died.
A WHO report on the health sector in the occupied territories for December 2007 to January 2008 says that seven patients died in Gaza “either at home or at a Palestinian hospital after lack of timely access to the required referral health services.”
This includes four patients with critical conditions, including a 13 month old girl with kidney failure who died after admission to hospital in Israel was delayed, and two patients who died after they were denied border crossing at Rafah.
The tough measures were challenged by 10 Israeli and Palestinian human rights groups before Israel’s Supreme Court, but the court rejected the petition.
The UN High Commissioner for Human Rights, Louise Arbour, has stated that “collective punishment” is prohibited by international humanitarian law.
A spokesman for the Israeli embassy in Bern, Switzerland, Uri Rothman, said that Israel still provides Gaza with about 70% of its electricity capacity, but noted that there had been a reduction in fuel supplies and also some electricity.
He said that Israel was committed to its humanitarian obligations “and will not allow hunger in Gaza.” He blamed Hamas for the problems and added “first and foremost Israel has an obligation to protect its citizens.”
