OPT/Gaza: Responding to urgent medical needs of choked-off Strip

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As a result of the closure imposed on the Gaza Strip since 5 November, medical facilities are once more running out of essential supplies. This has dire consequences for the health of the Palestinian population. Katharina Ritz, the ICRC's head of mission for the occupied Palestinian territories, talks about the humanitarian situation and the organization's efforts to respond to the most urgent needs.

How is the population of Gaza affected by the closure of the Strip?

The situation for civilians in Gaza is dire. One of our main concerns is the serious impact the closure is having on the population's health. Hospitals are running out of even the most basic items and medicines are lacking. There is a lack of pain killers for severe pain, specialized antibiotics and anaesthetics. Mothers and fathers in Gaza told our staff that they are worried about what could happen if they have to take their children to hospital. Moreover, as fuel become scarce, rolling power cuts that are particularly felt in the North of the Strip and Gaza City, are severely affecting hospitals, which experience serious disruptions in the functioning of their equipment.

Even if a bit of humanitarian aid trickles in, it is not enough to cover the most basic needs of the people in Gaza. Everyday of complete or nearly complete closure creates new needs.

For the past year and a half, the situation has deteriorated day by day and when the crossing points close completely it creates an even more precarious situation.

Crossings should be opened immediately, so that essential commodities to cover the basic needs of the population can get through. We urge the Israeli authorities to make this happen in order to give the population access to medicines and food.

How can hospital doctors and nurses cope with a situation where they are running out of many basic medicines?

The hospitals and emergency rooms are coping as best they can and are trying to use other medicines that are still in stock. For instance, medical staff try to cope by using the next best solution which is not always a good one - for example, if they need tubes for a medical procedure, they will use a tube size smaller or bigger than the appropriate one. In cases of severe pain they have to revert to painkillers that are less effective.

Even before this current closure, the health care system was already very fragile, in particular due to an already serious disruption in the import of medical supplies and the ongoing strike of health workers in Gaza. In addition to that, the number of patients allowed to get treatment outside of the Gaza Strip has dropped to the lowest levels of 2008. The sharp decrease was already felt in September, when less than 400 people were able to leave the Strip for treatment, compared to about 1,000 in previous months.

What can the ICRC do in this situation?

For the first time since the tight closure imposed on 5 November, on 17 November the ICRC was allowed to get one truck of badly needed medical supplies into Gaza. Among the most needed items, we provided surgical instruments and plaster. Two more trucks full of supplies, including intravenous fluids, are still waiting for authorization from the Israeli authorities to cross into the Strip. Currently, medical supply into the Gaza Strip is below the minimum required. To ensure that sufficient emergency stocks are in place, approximately nine truckloads of medical supplies for hospitals are needed every month.

Whenever nothing at all gets into the Strip, we do have an emergency stock of medicines and material in Gaza in order to help treat casualties such as war wounds, but these items cannot help treat all patients, for instance paediatric and obstetric cases and patients with chronic diseases, such as cancer, diabetes or cystic fibrosis. Emergency stocks are designed to cope with emergency medical needs and should remain available for that purpose only. They do not and should not cover the basic medical supply needs of the population.

The ICRC repeatedly reminds the Israeli authorities of the severe humanitarian consequences of the closure and of its obligations, under international humanitarian law (IHL), to the population living in the Gaza Strip. In particular, and as far as possible, they must ensure that the basic needs of the population are met. Concretely, there is an obligation to ensure that the 1, 5 million people living in Gaza have access to food, water and medical supplies. In addition, Israel has an obligation to allow and facilitate humanitarian aid. The ICRC recognizes Israel's right to take measures to ensure the security of its population. However, these measures must respect the relevant rules of IHL and the measures' security benefits must be proportional to their negative humanitarian consequences.