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

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Highlights

  • The further reduction in the electricity supply to Gaza has caused a severe impact on the health services, 30 hospitals and 2 health facilities face risk of partial closure as the supply for back-up generators become depleted. An additional 70 primary healthcare facilities are also impacted.

  • Out of the 516 medications on the essential drug list, 177 drugs items (34%) were at zero stock levels in May. In June, 184 drug items (36%) were at zero stock in the Ministry of Health’s Gaza Central Drug Store (CDS). The decrease in the availability of drugs is placing patient lives at risk.

  • Out of the 184 drug items out of stock, 161 items are completely depleted in June (31%).

  • In May, of the 853 medical disposables on the essential list, 270 (32%) were reported at zero stock levels in the CDS Gaza; in June, 271 (32%) were reported at zero stock.

  • WHO has expanded its emergency response by releasing US $ 360,000 from its internal emergency funds to scale up its response and to support health authorities to prevent the further deterioration and collapse of the health sector in Gaza.

Situation Update

Impact of fuel shortages on health

  • Extended power cuts are severely impacting the health sector, and hospitals face the risk of closure as fuel supplies to run back-up generators become depleted. Gaza’s 14 public hospitals and 18 NGO hospitals and health facilities face partial closure, since the start of the sudden increase in power cuts, which began on the 16th April when the Gaza Power Plant closed. In addition, 70 primary healthcare facilities are impacted by the energy shortages.

  • However, the situation has become increasingly serious. On the 21st June 2017, Israel reduced its electricity supply to Gaza. This decision has shortened the daily average of power in Gaza by an additional one hour. Hospitals and health facilities now face up to 18-20 hours of no electricity from the main grid supply.

  • Some of the effects on service delivery include:

    o Reduced sterilization, laundry, cleaning and catering services: down to only five hours per day (during the grid electricity only)

    o Access to desalinated water in hospitals has been reduced to a maximum of 5 hours per day.
    This has a direct impact on infection prevention and control measures

    o Elective surgery waiting lists are increasing by an additional two months

    o Diagnostic services are reduced. MRI, CT scans, X- rays including mammograms are postponed and only take place when there is electricity from the main supply.

    o In Shifa Hospital, Gaza’s major trauma hospital, the MRI scanner has stopped functioning following fluctuations in electricity

    o Over 300 pieces of essential lifesaving medical equipment in public hospitals across Gaza have stopped functioning as a result of the chronic electricity shortages

  • During black-outs, the hospitals rely on fuel donations for generators to provide essential electricity and sustain critical lifesaving services. However the maintenance of these generators presents an additional constraint. The overuse of hospital generators will lead to a shorter life cycle and the need for spare parts, some of which Israel classifies as ‘dual-use’ items. In addition, the constant use of these generators, often for over 20 hours per day, requires skilled medical engineers on-site, who are often overstretched and underresourced. According to the MoH, the capacity of the generators to sustain the services in the hospitals is decreasing. Furthermore, the currently available and pledged fuel donations to sustain lifesaving services are only sufficient to last until October 2017.

  • Without fuel for generators, the situation is immediately life-threatening for 113 new-borns in neonatal intensive care units, 100 patients in intensive care and 658 patients requiring haemodialysis twice or three times a week, including 23 children. Refrigeration for blood and vaccine storage will also be at risk.