WHO Special Situation Report: Gaza, occupied Palestinian territory (July to August 2017)

Situation Report
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  • The continued 20-22hour electricity cuts are placing an increasing burden on hospitals and primary healthcare clinics across Gaza. With funding for fuel from the humanitarian pooled fund, released by the UN Humanitarian Coordinator, and from WHO resources, lifesaving services have been sustained. This has directly reduced the mortality risk of 452 newborns, 400 intensive care patients and 658 patients requiring haemodialysis twice or three times a week.

  • Out of the 516 medications on the essential drug list, 204 drug items (40%) were at zero stock levels in August. 190 drugs, which are considered to be critical and life-saving, are at less than one month’s supply in Gaza, out of which 46 drugs are completely depleted.

  • WHO has recently secured US $1 million from the Central Emergency Response Fund (CERF) to replenish hospitals with life-saving medical equipment that has stopped functioning due to the electricity crisis.

Situation Update

Impact of fuel shortages on health

  • As of June 2017, the prolonged electricity cuts have extended to at least 20-22 hours per day, affecting the entire population. This has dramatically undermined the provision of critical health care services at hospitals, primary healthcare clinics, blood banks and the storage of vaccination. In particular, this has jeopardized the functionality of the 14 public hospitals in the Gaza Strip, which are the main source of secondary care to 90% of Gaza’s population. The complete collapse of the health sector is being prevented by targeted humanitarian interventions, initially through funds released by the UN Humanitarian Coordinator and then by WHO on an emergency basis.

  • So far, the funding from the humanitarian pooled fund, released by UN Humanitarian Coordinator and the resources released by WHO have prioritised the most critical health services, such as ICU’s, operational theatres, emergency departments, maternity wards and neonatal intensive care units. Essential fuel supplies have sustained these critical services and reduced the risk of preventable mortality of 452 new-borns in the six neonatal intensive care units, 400 intensive care patients and 658 patients requiring haemodialysis twice or three times a week, in addition to supplying fuel for the refrigeration of blood and essential blood products used in the hospitals and for vaccine storage in the MOH healthcare facilities.

  • Whilst critical departments in Gaza’s hospitals are coping with the electricity crisis, primary healthcare clinics (PHCs) are forced to close early due to the lack of available electricity. Many PHCs are rationalising fuel by reducing or stopping diagnostic services. The impact on PHCs has been visible even at UNRWA’s primary healthcare clinics. As patients turn to UNRWA facilities when MOH clinics are closed, there has been a noticeable increase in the number of patient consultations in UNRWA primary healthcare clinics since the onset of the fuel crisis. UNRWA health clinics are now consuming an additional 25,000 litres of fuel every month to cope with the electricity shortages and the increasing patient demand.

  • Hospitals are coping with the limited fuel by reducing services such as sterilisation services, elective surgeries, and diagnostic services, cleaning and catering. WHO has been following the waiting list for elective surgery, using ENT (ear, nose and throat surgery) as a key indicator. In 2016, the average waiting period for an elective surgery in ENT was 12 months. In comparison, the waiting period for an elective surgery in ENT has now increased to a 14-month waiting period. This increase is a direct result of the electricity shortages. Elevated waiting times for surgeries can lead to further complications in patients. Chart 1 (illustrated below) shows the increasing trend in waiting time for elective surgeries since the electricity crisis in June 2017.