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Amputees - The challenges faced by Gaza-strip amputees in seeking medical treatment [EN/AR/HE]

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The 2014 offensive on the Gaza Strip produced approximately one hundred new amputees among its residents. The end of the war was the start of a new one for the amputees - a battle to cope with the reality of their new life. The new report highlights the difficulties faced by Gazan's amputees on their way to rehabilitation.

The summer 2014 offensive on the Gaza Strip produced approximately one hundred new amputees among its residents. The end of the war was the start of a new one for the amputees—a battle to cope with the reality of their new life. To a certain extent, the story of the amputees - and of those injured in general- is the story of Gaza’s healthcare system and the obstacles it faces.

The Amputation

During the fighting, medical teams were often forced to work in field conditions without suitable equipment. Chaos also reigned in the hospitals due to the heavy workload, the time pressure, the lack of coordination between the various actors and the shortage in resources to provide care. Attacks on ambulances and transfers between the various hospitals meant that many of those injured were not evacuated to hospital in time, which delayed their treatment and caused unnecessary complications. And with wounded individuals prematurely discharged from hospital in order to clear beds for hospitalization, their treatment remained partial and faulty. For all these reasons, many individuals who were injured in the limbs underwent improper limb amputation, which prevents the fitting of an artificial limb without surgery to correct the stump. Such surgery is not available in the Gaza Strip on a permanent basis, and is sometimes performed by medical teams from international organizations.

Fitting Prostheses

The only place in the Gaza Strip where prostheses can be fitted is the Artificial Limb and Polio Center (ALPC), considered to be a central establishment for various rehabilitation treatments. The center makes prostheses, tailors them to patients and fits them. Its services are provided free of charge, and it has indeed treated a number of amputees from the recent war. A rehabilitation physician who visited the center on behalf of Physicians for Human Rights – Israel (PHRI) estimated that the artificial limbs manufactured there, good though they are, were not as good as the ones fitted in Israel, in terms of both quality and two other significant parameters: They were relatively heavy, affecting mobility and ease of operation; and, more importantly, the upper – extremity prostheses were solely cosmetic rather than functional, thereby failing to meet the principal need of the mostly-young amputees to function in a way that will allow their return to a routine in life. Another problem is that amputees from across the Strip have a hard time getting to the center, which is located in Gaza City, and some give up on their treatment there due to the high cost of transportation involved. Furthermore, the center is not part of Gaza’s public health system, and thus not all amputees are consistently referred there for treatment. Artificial limbs can also be fitted in West Bank hospitals, but referrals and funding for those are very hard to obtain from the Palestinian Ministry of Health, not to mention the difficulties involved in crossing over to the West Bank as a result of Israeli policy.

Rehabilitation

After being fitted with prostheses, amputees who have lost their limbs need to undergo a rehabilitation process involving various treatments. These treatments are provided in Gaza at a number of centers, hospitals and clinics operated by various organizations. The central institutions providing rehab services in the Gaza Strip are the Gaza center for prostheses previously mentioned, and the team from Al-Wafa rehabilitation hospital. Al-Wafa used to be the main and largest rehab center in the Gaza Strip before it was bombed during the latest offensive. Following its destruction, the hospital staff relocated to Al-Amal medical center for the elderly. As a result, the Al-Wafa team now has only 35 hospitalization beds at its disposal as opposed to its previous 125.