Physicians for Human Rights-Israel Medical Delegation to Gaza February 17- 18, 2011
Day one: Thursday, February 17th
9 am: After about an hour delay at Erez Crossing filling out necessary paperwork, PHR-Israel's four-member medical delegation entered Gaza.
10 am: PHR-Israel's delegation was greeted by the Minister of Health, Basem Na'im, Dr. Muhammad Kashaf, Director of International Cooperation in the Ministry of Health, Dr. Hassan Khalaf, Deputy Minister of Health, Dr. Nasser abu Shaaban, Director of Human Resources, and Dr. Yusef Mudalal, Head of Office at the Ministry of Health. Following an exchange of information regarding supplies missing from local hospitals and overall challenges, the delegation set out for the European Hospital in Khan Younis, where they were welcomed by senior physicians and the Director of the Hospital. PHR-Israel's physicians examined 15 patients, most of who require surgeries that could not be carried out during this visit because of the lack of time and equipment needed to perform operations of the spine.
Repeated appeals by the heads of three refugee camps to provide care to patients suffering from advanced orthopedic and neurosurgical problems led PHR-Israel's delegation out of the main hospitals and to an "improvised" clinic organized in a building on the main road connecting the Maghazi, Al Bureij, and Nuseirat Refugee Camps. PHR-Israel doctors examined 70 patients, many of whom had never seen a physician, nor received treatment.
Case Study: Mr. Hamed, a patient in his 50's had been suffering from a slipped disc, causing severe pain and pressure on his spinal cord. MRI imaging showed signs of a spinal cord injury and Mr. Hamed was referred to undergo surgery in Egypt. Though his surgery was meant to improve his condition, Mr. Hamed was admitted to hospital immediately upon his return to Gaza, as he began experiencing speech problems and weakness in all four limbs. PHR-Israel's met Mr. Hamed at his bedside and after examining him determined that the problems were a result of two metal fixtures improperly implanted between two vertebrae in his spinal cord. Two doctors from PHR-Israel's medical delegation, Dr. Yassin and Dr. Masalha, together with a local physician, Dr. Abu Hadrus, determined that the patient required urgent back surgery in order to prevent full paralysis of all four limbs. In order to carry out this procedure however, a specific microscope is needed, as well as a specialist who can carry out the surgery. PHR-Israel pledged to try to apply for access for an affiliated doctor to carry out the procedure and to try to get a hold of a microscope needed for the operation.
Our delegation identified 15 patients whose conditions they believe could improve if given access to proper treatment. PHR-Israel will take action to get the proper supplies into Gaza so that during their next visit, they will be able to carry out the necessary surgeries.
8 pm: PHR-Israel's delegation made its way to Al-Shifa' Hospital in Gaza City to examine 10 patients, most of who were women in need of joint replacement procedures. These procedures will hopefully be carried during the next visit of the delegation.
10 pm: The delegation met with Dr. Samir 'Ismail, Deputy Dean of the Faculty of Medicine at Al Azhar University, Dr. Mufid Muhallti, Deacon of the Faculty of Medicine at the Islamic University, and Nasser abu Shaaban, Director of Human Resources in the Ministry of Health. The delegation and their hosts discussed options for developing the health sector by way of certifying new medical staff, whether through actual conferences and workshops, or via video conferencing. All expressed doubts that long distance learning would be an efficient way to train new medical students and wondered about the possibilities of making hands on seminars available in Gaza or in Israel to Gaza's medical community. All agreed that they would continue exploring ways of initiating certification seminars for medical students.
1 am: PHR-Israel's delegation met with Mr. Muhammad Daher, a local representative of the World Health Organization, who briefed us on the current state of health systems in Gaza.
Day two: Friday, February 18th
8 am: PHR-Israel's delegation gave a presentation to approximately 20 Neurologists and Internists. Dr. Masalha presented on Epilepsy and new methods of treatment, while Dr. Burat spoke about new treatments for Alzheimer's disease.
Following the presentation, the delegation met with the local representatives of the Health Work Committees, Dr. Yusef Musa and Dr. Khaled abu Taha, both surgical orthopedists, to explore the possibility of carrying out orthopedic surgeries and procedures at the hospital during a subsequent PHR-Israel visit.
12:30 pm: PHR-Israel's delegation made its way to the Gaza-Erez Border Crossing.
=A7 Buildings and roads damaged during Operation Cast Lead (2008-9) are still in a state of disrepair because of the ongoing ban on the entry of construction materials.
=A7 People spoke a lot about poverty, unemployment, and sewage beginning to flow through the streets. In place of cars, the delegation saw hundreds of horse and donkey-driven wagons transporting good. This is due to the lack of spare parts for cars or and the lack of fuel.
=A7 The Ministry of Health in Gaza reports a lack of 180 crucial drugs, (out of a list of 480 drugs) to treat cancer and medical problems in the fields of nephrology and chronic diseases. Fever reducer for young children, was not available during the entire month of January. Also, new drugs are not currently available. 159 out of 470 spare parts to fix medical equipment are not currently available in the Strip. Certain medical supplies used in Operating Rooms or Emergency Rooms are not available. The only CT machine available in the Nasser Children's hospital has been out of service for months.
=A7 All through January, it was not possible to carry out blood tests because of a lack of equipment in hospitals.
=A7 Above all, the Ministry of Health mentioned the lack of physicians and specialists in the fields of Neurology, Neurosurgery, Nephrology, Spinal Surgeries, Oncology, and more, as major problems preventing the development of the Palestinian health system and the daily treatment of patients. In addition to ongoing problems regarding medical education and training inside Gaza, it has been increasingly difficult for medical students to leave Gaza to do their residency in the West Bank, or elsewhere, because of the ongoing closure.
=A7 There are power outages in Gaza for 8 hours a day, causing a near-full dependency on generators. At the same time, there are not enough generators to sustain the needs of the hospitals.
=A7 Since the unrest in Egypt began at the end of January 2011, Rafah Crossing has been closed. Patients waiting on the Egyptian side will be allowed to re-enter Gaza beginning on the 19th of February, but until further notice, patients will not be allowed to pass through.
The delegation witnessed the extremely challenging circumstances facing patients and medical staff, especially pertaining to the needs of Gaza's new generation of medical professionals to train and engage in research. In light of our visit, alongside our case-intake and advocacy activities, PHR-Israel will continue to seek entry into Gaza in order to carry out surgeries and procedures, will look into new coordination with with local organizations and Israeli Hospitals to find proper training solutions for young medical staff, and identify needed equipment to carry out many specialized procedures.