The intensity of bombings in the Israeli military operation “Protective Edge” makes it extremely dangerous for the population — and for Médecins Sans Frontières/Doctors Without Borders (MSF) medical teams — in Gaza to move around. As of today, hospitals in Gaza are managing to cope with the influx of wounded arriving. However, the new crisis is aggravating an already fragile health system heavily affected by chronic shortages and structural weaknesses.
An average of 10 bombings per hour makes it practically impossible for MSF teams to continue with their regular medical activities, or to evaluate where the most urgent needs are. In two days alone, there have been more strikes than in all eight days of Israel's 2012 military operation in Gaza, Pillar of Defence.
The air strikes are in retaliation for rockets being launched from Gaza into Israel. “Rockets fired from Gaza are capable of reaching areas such as Tel Aviv, Jerusalem and Haifa, and are a real threat for the Israeli population”, says Tommaso Fabbir, head of mission for MSF in Gaza and the West Bank. So far no deaths have been reported on the Israeli side.
Access to healthcare is a challenge
In Gaza, health authorities have reported more than 80 deaths, including 30 women and children, and over 600 wounded. On Thursday night, the bombing of one house killed eight people, including five children.
“In the first few days, people received [a text message] to warn them that an attack on their building was imminent. But today, this does not seems to happen systematically,” says Nicolas Palarus, MSF project coordinator in Gaza.
Last Thursday,12 patients living close to the MSF post-operative clinic were able to receive their treatment. But most regular patients live in the south of Gaza strip, and MSF's teams have been unable to reach them.
Several health structures, including the European hospital, have been damaged by nearby strikes. The streets of Gaza are completely empty, as people only leave their homes in case of an urgent need.
“With only five to eight hours of electricity per day, water shortages and the difficulty of getting hold of basic living supplies, daily life for the population is like living under siege,” says Palarus.
Due to fuel shortages, only 50 per cent of ambulances are able to circulate. MSF is in daily contact with local health authorities, and has visited two hospitals: the Al Shifa hospital in Gaza City and Khan Younis hospital in the south of Gaza strip.
"Even before now, the hospitals in Gaza were suffering from chronic shortages of medicine and disposables. So this crisis is weakening an already precarious system,” says Palarus.
MSF teams have received authorization to donate emergency medical supplies to Nasser Hospital. In Shifa hospital, health officials informed MSF teams on Friday that the situation was still manageable despite some drug shortages.
The Rafah border crossing, between the Gaza Strip and Egypt, has opened occasionally and for very specific reasons. On Thursday, only 11 patients were transferred to Egypt, and another four patients crossed on Saturday. It appears that only those people having an international passport are authorized to cross the border. A medical team coming from different Arab countries has been waiting to enter Gaza, so far without success.
“It is indispensable that the wounded and the sick needing to be evacuated be able to do so through Rafah and Erez border crossings, and the medical teams and humanitarian convoys be allowed to enter. This is a legal obligation of Egypt and Israel, and vital for the population in Gaza,” says Fabbri.
Update: July 10, 2014
Israel launched a military offensive (Operation Protective Edge) in Palestine this week, in response to rockets launched from Gaza into Israel. Bombings are still very intense, with an average of 10 strikes per hour across the Gaza strip. A reduced MSF team has been able to re-open its post-op clinic in Gaza City this morning, and a dozen patients have so far come for their follow-up treatment.
As of today, Gaza hospitals are still able to respond to emergency needs, but pre-existing shortages of drugs and disposables could cause the situation to worsen. MSF has proposed donations and HR support. An MSF surgical team is on stand-by in case a ground operation is launched.
Update: July 9, 2014
Last night, more that 80 rockets were launched from Gaza into Israel (some reaching population centres near Tel Aviv, Jerusalem and Haifa). The Israeli Defence Forces responded with strikes against Gaza. Official figures put the number of deaths at 25, with 180 wounded, all Palestinian. Violence is also on the rise in the West Bank.
Since 2010, MSF has run a post-surgery clinic (dressings and physiotherapy) in Gaza City, where 80 per cent of the patients suffer from severe burns. Our teams also run a specialized hand surgery in Nasser hospital, and provide intensive care training to medical and paramedical staff at Nasser and Al-Shifa hospitals.
MSF teams are currently on stand-by. They are preparing dressing kits to be distributed directly to patients once movements can be renewed. So far, hospitals in Gaza are able to cope and are not overwhelmed. MSF has proposed donations of medical material and medicines and is prepared to respond to any emergency needs by reinforcing its medical team with additional surgical capacities if the context allows. In the West Bank, an MSF team is providing psychological first aid to people affected by violence. It receives referrals for specialized psychiatric needs from other organizations.
MSF in Gaza
MSF has been working in Gaza for over 10 years. The MSF clinic in Gaza City specializes in post-operative care (dressings and physiotherapy), in particular for burn patients. In Nasser hospital in Khan Yunis city, south of Gaza, MSF organizes training for medical and paramedical teams working in intensive care, and provides specialized training in hand surgery. MSF has two surgical teams ready to enter Gaza and help Palestinian hospital staff.