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Gaza: Health System in Collapse

By Miriam Garfinkle, Judith Deutsch, Reem Abdul-Qadir, Joanna Santa Barbara

May 5, 2008

Qusai Issa, a four-year-old child in Gaza, died on February 2, 2008 from a neuroblastoma, a childhood cancer that needs to be treated aggressively and quickly. According to Physicians for Human Rights-Israel (PHR-Israel), Qusai was initially treated in Egypt in 2007 and then referred to Israel where the appropriate treatment was available. After a wait of twenty days, the Israeli hospital at Tal Hashomer treated him and released him in good condition. He was told to return one week later for continued care. However, Qusai’s family was denied permission to leave Gaza on “security grounds”. His family applied four times and each time they were turned down. Only when PHR-I became involved was he finally given permission to exit Gaza to receive care in Israel after an eighty day delay. At that point he was so ill that treatment was not considered possible. He returned to Gaza the same day and died 5 days later.

The extremity of suffering in Gaza is little known in the West. Underlying the health emergency is the Israeli military’s destruction of Gaza’s basic infrastructure and Israel’s closure of all Gaza’s borders. PHR-I has accused the Israeli army of “deliberately delaying its responses to requests to allow seriously ill Palestinians from Gaza to enter Israel for life-saving or urgent hospital treatment.” Amnesty International reports that “dozens of people refused passage out of Gaza for medical treatment have died in the past few months.” Many who have died from injuries or illness are unable to receive adequate care in Gaza due to the lack of supplies and equipment, or like Qusai they are not allowed to leave Gaza in time for urgent care.

The Israeli blockade is extensive and has led to the collapse of the health system. Even basic medical care is increasingly impossible to deliver. Shifa Hospital closed its operating room in Gaza City due to an inadequate supply of anesthetic on April 17, 2008. Ambulance services are severely limited due to the lack of fuel. According to the World Health Organization, 105 of 460 essential medications are no longer in stock in Gazan pharmacies. Reduced electricity supply and lack of fuel for emergency generators disrupt the functioning of equipment for acute care services – incubators for newborns, heart monitors in intensive care and dialysis machines for kidney patients. Over two hundred deaf children at the Atfaluna Society for Deaf Children are no longer able to use their hearing devices because batteries cannot pass through the blockade.

The current siege falls on a people already devastated by war and by the economic sanctions imposed in 2006. Poverty is a primary determinant of health. The effects are well documented. Seventy per cent of nine month old infants are now anemic and 13-15% of Gaza’s children are stunted in growth due to malnutrition. Dr. Eyad El-Sarraj, the highly respected director of the Gaza Community Mental Health Programme, eloquently speaks of the deep suffering caused by war and poverty, of the humiliation brought about by occupation. Deprivation is now so severe that Oxfam recently stated that the “Gaza economy is no longer on the brink of collapse – it has collapsed.” In 2007, 95% of factories in Gaza were closed. 85% of people living in Gaza are forced to depend on humanitarian aid for securing their basic needs. As of late April 2008, UNRWA, the sector of the UN responsible for the Palestinian refugee population, was unable to deliver food to 650,000 people in Gaza for 5 days in a row due to fuel shortages. The UN reports that the water utility is inoperative due to “Israel’s restrictions on fuel imports and prohibitions on the import of materials and necessary spare parts.” (reported in Ha’aretz May 4, 2008)

Last week, and only with EU pressure, Israel allowed twenty cylinders of anesthetic into Gaza while blocking another twenty-three cylinders. On April 29, 2008, Palestinian and Israeli human rights groups jointly issued an urgent call to “cease restrictions on Gaza’s fuel supply and stop the unprecedented harm to Gaza’s humanitarian needs.”

Israel’s blockade is in clear contravention of international law and constitutes collective punishment of a civilian population. This cannot be tolerated. Israel, the occupying power of Gaza and the West Bank, must ensure, by law, that all people of Gaza and the West Bank have access to medical care to the same extent as any other resident of Israel.

Early in 2006 James Wolfensohn, the former World Bank president and Special Envoy for Disengagement to the U.S. Foreign Relations Committee, warned in strong words against this kind of treatment of the people of Gaza: “The collapse of health services and the education system, which addresses the needs of one million children, would be a failure for the new government and would have tragic consequences for the Palestinian people. This should not be permitted under any circumstances.” This has been permitted, leading to the predicted results. Now Canada must join with other international voices to demand an immediate end to this siege. Silence is the inhumane option.

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