Gaza 2009 ErikFosse LOWRES

dignityinstitute.dk

Gaza 2009 ErikFosse LOWRES

Gaza 2009

Professor Erik Fosse MD

Rikshospitalet, University of Oslo


Gaza facts

• Governed by Egypt

1948-1967

• Occupied by Israel

1967-2005

• Israel still controls borders,

airspace, harbours

• Size: 360 square km

41 km long 6-12km wide

• Population 1.5 mill

• Mean age 17 years

• 80% under WHO poverty

definition after blockade


Recent history

• Election January 25 2006

• Hamas got 42.9% of votes and 74 of 132 seats in parliament

• In April USA, European countries including European Union and

Norway cut off direct aid to the Palestinian authority beacuse Hamas

would not renounce the use of violence.

• Autumn 2006 Coalition government was formed between Hamas and

Fatah

• Norway acknowledged the coalition government, but no other country

• All Hamas members of government arrested by Israel

• January 2007 fighting in Gaza between Hamas and Fatah

• 14. June 2007 Hamas gained full control of Gaza strip

• Fatah created an all Fatah government on the west bank which was

announced the legitimate government by Arab states, US and Europe

• Israel immediately closed all borders

• 23 January 2008 Hamas broke the barrier to Egypt, closed after 12

days

• Tunnels became the only way of smuggling goods and weapons


Effects of the blockade

• All goods production stopped 2006

– Small industry

– Vegetable, fruit and flower export

• Stop in building material import 2007

• Stop in medical equipment

• Stop i grain import, all mills closed

• Stop in electrical power supply

• Stop in fuel

• Poverty increased

• Health care shortage

– Health care controls

– Maternity control

– Chronic illness

– Psychosocial support

• Deficiency disease increased

• During autumn 2008 no western

journalists or humanitarian aid residents

were allowed into Gaza

• No protection of the people


Breadline, Gaza January 2009:

5-6 hours waiting to maybe get some bread

"It's an atrocity what is being perpetrated as punishment on the people in Gaza.

It's a crime... I think it is an abomination that this continues to go on,".

Former president Jimmy Carter to Haaretz 19th april 2008


The attack started 27th December 2008


The Shifa hospital

• Main university hospital

• 546 beds

• 406 MDs

• 278 nurses

• 1011 employees

Total tear of the brachial artery-Interposition of vein graft


Wednesday 31/12 Burial of a doctor

killed while working in an ambulance


Reception area


Reception area-employees and

volunteers


Rtg avd 1 CT 4 Rtg lab


Innleggelse av thoraxdren


Triage møte 3. januar


TRIAGE

T1: Immediate treatment

T2: Delayed treatment

T3: Minimal treatment

T4: Expectant treatment

Areale for T3

60% av pasientene


Invasion started Saturday 3/1

Bombing of the Ibrahim al Maqadma mosque in Beit Lahiya

Ambulances and civillian cars lining up with patients


Patients are coming


Saturday 3/1 Bombing of the

Ibrahim al Maqadma mosque in

Beit Lahiya, chest injury


Sunday 04/01 Bombing of the vegetable

market- surgery in the OR corridor


Two patients in each OR


Tuesdag 6/1 Bombing of al Fakhora –

UN school in Jabalya camp


The heroes


DIME weapon injury?


Kompresjon av karskade


Thorakoabdominalskade


Phosphorous bombs at school in Beit Lahiya

Foto: Omar Barghouti


MoH daily statistics

Statistical office phoned all hopitals at 4 pm.

All injured or dead that could be

identified by name, age and gender were

registered


Killed pr. 180109

Total number of killed: 1300

410 children


Injured pr 180109

Total number of injured: 5300

1855 children< 18 years, 795 women, 2650 men


Consequences of the war

February 8th

• More than 5300 people injured, mostly civillians

• More than 1430 people killed, 431 (32%) children

210 female

• 12 ambulances destroyed

• 11 ambulance personell killed

• Public buildings destroyed (ministries, all police

stations, schools, 42 mosques)

• Al Quds hospital bombed and burned down 9/1

• UN main storage bombed

• More than 4000 buildings totally destroyed

• More than 20 000 buildings severely damaged


Shifa hospital


The war on Gaza 2009:

Situation for the civilians

Special situation in Gaza

Densely populated

Demography (Very young population)

Nowhere to run

No “Civil defense”

Weakened infrastructure

Weakened health

Several accumulated trauma

The war

Targets: The Civilian population?

Ambulances were targets

Overload to the hospitals

Limited supplies to hospitals

Weapons

Difficult evacuation out of Gaza

Security for international organizations

No western journalists

Mo western witnesses

Psychosocial factors: Terror


Witness and medical professional


Lancet editorial

www.thelancet.com Vol 373 January 17, 2009

We find it hard to believe that an otherwise internationally

respected, democratic nation can sanction

such large and indiscriminate human atrocities in a

territory already under land and sea blockade. The heavy

loss of civilian life and destruction of Gaza’s health

system is unjustified and disproportional, despite rocket

attacks by Hamas. The collective punishment of Gazans

is placing horrific and immediate burdens of injury and

trauma on innocent civilians. These actions contravene

the fourth Geneva Convention.

We are disappointed by the silence of national medical

associations and professional bodies worldwide in

response to this destruction and dislocation of health

services. Their leaders, through their inaction, are

complicit in a preventable tragedy that may have longlasting

public-health consequences not only for Gaza,

but also for the entire region. ■ The Lancet


Consequence of the war concept

• War is terror

• War creates terror

• Causes severe destruction of the civillian

society

• Invites extremism


The attack on Gaza

• Was a humanitarian

cathastrophe for the

palestinians

• Was moral cathastrophe for

Israel

• A political solution can only

be achieved through

negotiations with all parties


IDF December 28th 2008:

”We hit 90 % of the intended targets”

32% of injured and killed were children

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