Gaza: a health care system impeded - MÃ©decins du Monde

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A doctor’s tale from the eye of the stormI remember that Saturday like it was yesterday, and I guess I will never forget it. The first attack started around 11.20 AM: around thetime of the prayers, when the schools ended and when the children crowd the streets of Gaza. I was in a training with MDM-F whenwe heard the first bombing. One time, two times,… six… ten…. And all along we heard the noise of the warplanes… From our tallbuilding, we could see dozens of columns of dark, black smoke. And every minute, a new column appeared. For the first 30 minutes,we thought they were isolated attacks, but later that day, when it did not stop, we understood it was the war.Our mobiles were off, no one had network and we could not connect with our relatives nor with our base in Jerusalem. I took theresponsibility of sending the trainees home. Each one of us needed to feel safe, with our families and children.I reached my house in Khan Younis after a big traffic delay since the roads were congested due to the panic. But I reached it safely thoughbombs were hitting more frequently. I joined my wife and my four children, they were frightened. Few minutes later, the Red Crescenthospital of Khan Younis called me: Every doctor of Gaza was called in. My wife was terrified; she did not want me to leave. “You have justarrived with us”, she begged. But I had to go.24-long hours of unrest followed. Casualties, wounded and burnt victims were rapidly coming in and started flocking the hospital.Electricity and water were often cut, sometimes for 3 days in a row. Hospital devices were relying on generators. I saw the family of somepatients in need of an artificial respirator, pumping manually to provide air to the wounded, until electricity would come back.Intensive Care Units (ICU) and ER rooms of the main hospitals were overcrowded… Maternities were converted into ICU and chronicpatients sometimes sent home to make space for urgent cases.Every three days, I had to take a 24 hour shift at the hospital. The two other days, I simply stayed at home, confined with my family,tirelessly watching the tragic news on TV… On the third day, 5 members of my family were killed, including a 7 year-old boy. And it wenton at this rhythm until the end of the war: hearing airplanes, drones and missiles, recognizing their specific sounds, ensuring the children’s‘safety’ away from doors and windows, sleeping scared… Listening to the unfolding tragic news, hearing about the losses within families,visiting and treating the countless wounded, the widows, mourning, grieving, and treating the wounded at the hospital…After a couple of days, humanitarian assistance arrived in the Strip. There were many donations: drugs, equipment, ambulances. But itdid not solve everything. Drugs were near their expiry date and generally had a short shelve life. Materials were useful but often old orrequiring spare parts that were impossible to purchase in Gaza. As for ambulances, 15 new vehicles were not very useful, when - becauseof the closure- fuel became scarce.Dr. Ahmed Abu Teir is a surgeon from Gaza.He has been working with MDM-F since 2002where he is currently the medical base manager© Pauline Beugnies I MDM FranceGaza city, one year after the « Cast lead » operation. The Abed Rabbo neighborhood has been badly destroyed during the military operation.Today, the material needed to rebuild homes and infrastructures is cruelly missing.
GAZA: A CONTEXT JEOPARDIZING THE DEVELOPMENT OF THE HEALTH CARE SYSTEMAt the time of commemorating the one-year anniversary of operation “Cast Lead”, the situation for 1.5 million Palestinians in the GazaStrip is getting increasingly worse. Yet, the latest Israeli attack must be viewed in the wider context of the increasing isolation andimpoverishment of the Gaza Strip.The high demographics of the Gaza population- the most densely populated area in the world-inevitably causes a lot of pressure to beexerted on the health sector. It must respond not only to the current contextual challenges resulting of the blockade and the previous war,but also to the increasing demands for health services resulting from a rapidly increasing population.SOCIO-ECONOMIC PROFILE OFTHE GAZA STRIPTotal population1.416.539 people (including 69% of refugees)Population density4.500 inhabitants per km2(France: 93,59 hab./km2)One year after the end of the offensive, many of the primary health careimprovements that have been previously achieved are now at risk. Socioeconomicaldeterminants and environmental factors, compounded by the currentemergency situation have increased the demand for health services, which donot meet current domestic resources capacities or substantial internationalresources.Fertility rate6 (Egypt: 3.5)Life expectancy73 yearsAverage family size6.5Age structureAround 45.5% of the populationis under age 15Unemployment rate65%Dependence ratio1:8.5(one working person sponsors 8.5 persons)The Al Atatra clinic where MDM-F works has been destroyed during last year’s attacks. Sincethen, MDM-F has been renting a house nearby, until it the initial centre will be rehabilitated.Today, few families whose houses have been destroyed still live in tentsin front of the medical centre.© Pauline Beugnies I MDM FranceThe impact of the Israeli blockade on Gaza© Pauline Beugnies I MDM FranceThe water sewage system has been badly impacted by theWar. Today, the sewage is being discharged into the sea.The ongoing two year-and-a-half Israeli blockade on Gaza has negativelyimpacted the human rights of the citizens in the Gaza Strip, including the right tohealth. Since then, healthcare for people in Gaza has dramatically deteriorated attwo levels: the provision of health services inside Gaza and access to treatmentoutside Gaza.As a direct result of the blockade, Gaza’s economy has all but collapsed,unemployment and poverty have sky-rocketed and essential public infrastructuresuch as health, water and sanitation networks have deteriorated at an alarmingrate, while basic foodstuffs, fuel and medical supplies have been in short supply.Since June 2007, Israel has been imposing restrictions on the movement ofgoods and people at Gaza’s border crossings. People, including those in needof medical attention, have not been able to get out, while most of raw materialsneeded for rehabilitating and re-building health facilities are denied to enter theterritory.
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Gaza: a health care system impeded - MÃ©decins du Monde

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