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Health services close to collapse in Gaza

Statement
7 January 2009

The health services in Gaza, already depleted and fragile, are on the point of collapse if steps to support and protect them are not taken immediately. WHO has called for immediate improvement in the situation to make humanitarian health services accessible by the local people.

To date more than 680 deaths (including about 218 women and children) have been recorded and over 2850 people are reported injured. The dead include 13 medical personnel. Twenty-two more were injured, according to reports from the Palestinian Ministry of Health. The numbers continue to rise and include many civilians.

  • Life-saving medical supplies cannot reach those in need. Life-saving supplies that are urgently needed to treat the injured and to sustain health services continue to pile up at the borders to Gaza. Not enough trucks can get in and distribution inside Gaza is constrained by lack of security and infrastructure.
  • Access to care is compromised. The intensity of the aerial bombardment and ground hostilities (with the cordoning off of Gaza into distinct sectors with restricted movement) is seriously constraining movement of patients, emergency medical services, referrals for care and the health personnel who are critical to effective and efficient functioning and delivery of these services. Medical evacuation of some of the critically injured outside of Gaza is being prevented, not only by lack of security but also by border closure and restrictions on movements.
  • Hospitals are overwhelmed. They do not have enough beds in emergency admissions or intensive care nor operating theatres to cope with the volume of casualties. Current make-shift arrangements to convert other hospital beds into trauma/intensive care beds are also nearing exhaustion of capacity. There have been reports of injured people lying on the ground in health facilities.
  • Health workers are exhausted. Emergency medical services and trauma care teams have been on the job, round the clock, since the aerial bombardment started on 27 December. They are physically exhausted and replacements are urgently needed to sustain the provision of life-saving services to the critically injured.
  • Power failures are a constant risk. All hospitals are relying on generators, some of them round the clock, because mains supplies have been cut. Fuel supplies are running out. A power failure would have catastrophic effects on infection control, blood transfusion, instrument sterilization and basic sanitation and hygiene in hospitals, operating theatres and intensive care units. An increase in life-threatening hospital-borne infections (such as gangrene, septicemia, tetanus, etc.) and complications (such as shock) can also be expected.

WHO has established an emergency operations base in Ramallah, jointly with the Ministry of Health to assist in coordination of the health sector response; advocacy for unfettered access to Rafah; tracking medical donations and relief supplies; and planning for re-entry to Gaza should a ceasefire be reached.

In addition to providing surgical kits enough to care for 5000 persons and emergency health kits for 90 000 people for three months, WHO is coordinating the entry of medical supplies in to Gaza. The Organization is also working with the UN agencies and Red Crescent societies to boost operational capacities on the Rafah border to ensure medical evacuations of critical patients and track medical relief items and donations.

From the operational bases in Gaza, Ramallah and Jerusalem, WHO is strengthening outbreak investigation and control due to food and water-borne diseases. It is advocating that environmental health concerns, including sanitation and hygiene, among displaced populations are addressed. WHO teams are assisting medical personnel in responding to trauma and injuries, and establishing a coordination mechanism to ensure joint assessment of the health needs in Gaza.

According to UNWRA, over 13 000 people have been displaced. Support services for health care, safe water, food, basic sanitation and hygiene for the displaced either do not exist or are very limited. If hostilities do not cease, the numbers of the displaced people can be expected to rise.

For both the displaced population and the general population, there is now a serious risk of outbreaks of communicable disease, such as acute respiratory infections, measles and acute watery diarrhoea, all of which have potential for high mortality among children. Mortality among expectant mothers and newborns can be expected to rise and there will increasingly be cases of unmanaged chronic diseases and psychosocial conditions.

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