The Palestinian Centre for Human Rights (PCHR) follows up with grave concern the healthcare situation in the Gaza Strip and seriously warns of a catastrophic deterioration that would strike the health care sector in the case of a Coronavirus (COVID-19) outbreak, especially after confirming four coronavirus cases outside of quarantine. PCHR fears the collapse of the already fragile and exhausted healthcare system and facilities in Gaza due to the Israeli- imposed closure on the Gaza Strip for the last 14 years. PCHR confirms that the shortage of medicines and medical supplies, and the electricity crisis resulting from the power plant shutdown after the Israeli occupation authorities banned the entry of fuel necessary for its operation, will disrupt the provision of medical services for at least 2 million Palestinians who live in poor living conditions in the Gaza Strip, which is classified as the most overpopulated area in the whole world.
According to PCHR’s follow ups, on Monday, 24 August 2020, the Government Media and Information Center in the Gaza Strip announced in a press conference four coronavirus cases in persons outside quarantine centers. All four cases come from the same family and live in al–Maghazi refugee camp. As soon as the Ministry of Health and medical staff confirmed the cases, health protocols were followed. The Information Center clarified several measures put in place to maintain public health and safety, including a 48-hour curfew across the Gaza Strip, and suspended work in public and private sectors, and shutdown educational institutions, mosques, markets, wedding halls and clubs, and banned all gatherings in order to contain the virus, identify possible cases and to deal with individuals who had contact with corona cases.
According to sources at the Ministry of Health, , the total number of coronavirus cases detected in the quarantine facilities since 15 March 2020 is 114; 72 recovered, 41 active cases receiving health care services at the isolation hospital, and only one death in the Gaza Strip. The number of people in quarantine facilities is 2210, none show COVID-19 symptoms, distributed at 16 quarantine facilities across all Gaza governorates.
The healthcare facilities in Gaza are already on the verge of collapse due to the Israeli- imposed closure on the Gaza Strip for the last 14 years, exacerbated by the repercussions of the Palestinian internal division and political bickering. All of this has caused a fragile healthcare system in the Gaza Strip, a perpetual shortage of essential drugs and medical devices and insufficient number of specialized health professionals; rendering the system unable to meet the basic medical needs of the Gaza Strip population in normal times. Moreover, health facilities suffer additional challenges due to the shutdown of the Gaza Power Plant since 18 August 2020, after the Israeli authorities banned the entry of fuel needed to operate it on 10 August 2020.
Dr. Ashraf al-Qedrah, spokesperson of the Ministry of Health (MOH) in Gaza City, said that the Ministry suffered a shortage in testing kits for coronavirus before the new cases were discovered. MOH urgently needs more intensive care units, respirators, and coronavirus diagnostic equipment, medicines, medical consumables and protective gear to prepare it to combat coronavirus. Al-Qedrah added that hospitals and medical centers currently suffer from a serious shortage of 45% of the essential drugs list, and 31% of medical consumables, and 65% of laboratory products and blood banking supplies. Al-Qedrah warned that the Ministry would fail to provide its medical services due to the power outage and lack of fuel, stressing that the Ministry needs about 450,00 liters of fuel per month to operate 90 electric generators in hospitals and medical centers in an 8-hour power outage scenario. However, as the power outage reached 16 -20 hours a day, the Ministry needs about 750,000 liters of fuel per month.
PCHR’s fieldworkers reported the effect of power outage for long hours on medical facilities. Mr. Amid Mushtaha, Manager of the Department of Laboratories at MOH, highlighted that the power outage negatively affects laboratories and blood banking supplies and cause failure to carry out the required laboratory tests, indicating that laboratory devices constantly need electricity, specially samples that require storage at -20 Celsius, such as coronavirus testing kits, which exposes them to become damaged. Mushtaha pointed out that the continued power outage and use of electric generators as alternative power source, affects the accuracy of results and might cause damage to devices and electronic pieces, in addition to its bad effect on blood components (plasma and cryoprecipitate) that is stored at minus 80 degrees Celsius; as well as, the inability to separate blood to its essential components or conduct compatibility testing between the patient and the blood unit due power outage.
Dr. Nabil al-Barqouni, General Director of Nurseries Network in Gaza, warned of the repercussions of power outage on 120 newborn babies currently present at nurseries in the Gaza Strip hospitals, pointing out that all of the nurseries available in the Gaza Strip hospitals (seven in total) depend on electric power for their operation. Dr. al-Barqouni also stressed that the continued power outage and use of alternative power sources cause damage to equipment, such as incubators, respirators, and infant ventilators, affecting the lives of the newborn babies, and might cause complications that could lead to death.
Dr. ‘Abdul Salam Sabah, Director-General of hospitals in the Ministry of Health (MOH), said that long periods of power outage will significantly affect the scheduled surgeries in Gaza hospitals; an average of 3,864 operations monthly, ranging from small to medium and large operations. These operations are conducted in 45 surgical operation rooms across Gaza hospitals. Sabah clarified that this poses a risk to patients in the Intensive Care Units (ICU), where bed occupancy rate is (84%), noting that the lives of those patients depend upon medical ventilators. Sabah added that the power outage and fuel shortage greatly affect the hemodialysis departments in the Gaza hospitals, which only have 131 dialysis machines, indicating that 923 patients receive hemodialysis treatment across the Gaza Strip governorates.
In light of the fear of a health sector collapse in the Gaza Strip and the foreseeable inability of the healthcare system to deal with patients in the case of a coronavirus spreads, PCHR:
Stresses that the primary responsibility for providing medical supplies to the Gaza Strip population lies with Israel and it must take all necessary preventive measures available to combat the spread of infectious diseases in accordance with Articles 55 and 56 of the Fourth Geneva Convention of 1949;
Calls upon the international community and WHO to put pressure on Israel and compel it to comply with its obligations, and to allow the entry of medical supplies and equipment necessary for coronavirus medical examination;
Calls upon the international community to immediately and urgently intervene and put pressure on Israel to allow the entry of fuel required to operate the Gaza Power Plant;
Calls upon the international community and humanitarian organizations to provide aid to the health system in the Gaza Strip, including medical supplies to Gaza Hospitals, in order to combat the spread of coronavirus;
Stresses the need for coordination between MOH in Gaza and Ramallah to combat the spread of coronavirus;
Demands MOH in Gaza to disseminate updated information about patients infected with the coronavirus, and how to access health services;
Calls on Gaza authorities to take measures in order to protect public health and safety; and
Calls upon citizens to understand and comply with the measures imposed by the authorities and required by the current circumstances to avoid the spread of the virus.