Physicians for Human Rights-Israel, Al-Mezan Center (Gaza) and the Palestinian Medical Relief Society (Ramallah)
Emergency Gaza Update 28.
2008 - The health system in Gaza is in a state of collapse - A medical supplies store was bombarded today - Referrals to medical care outside the Gaza strip are suspended Since the start of the Israeli military strikes against the Gaza Strip, true to Sunday, 16:00, 282 dead (including 20 children and 9 women) and about 700 wounded persons (including 130 children and 28 women) have been identified by Gaza hospitals, including more than 100 seriously wounded.
According to local estimates, dozens are defined missing, presumed to be trapped beneath destroyed buildings.
The Palestinian ministry of health in Gaza claims that the number of dead is even higher.
The Gaza health system is in a state of collapse and cannot provide an adequate response to the growing needs.
The closure imposed by Israel on all Gaza crossings, including the total closure of Erez Crossing since last Friday, prevents the evacuation of patients and wounded persons and deepens the human tragedy occurring in the Gaza Strip.
Governmental hospitals full to overflowing Hospitals in Gaza cannot deal with the heavy load of injured people continuing to arrive since Saturday, and today as well.
In the two main hospitals in the Gaza Strip there is a shortage of beds, despite the fact that all wards were evacuated in order to admit wounded people.
As a result, wounded people are filling the corridors of the hospitals.
The endless flow of new wounded and the need for beds has led to a suspension of care for dozens of other patients, including cancer patients, cardiac patients and other chronically ill patients.
These were sent to their homes for the duration of the crisis.
Shifaa’ hospital According to Dr.
Hassan Khalaf, director general of the hospital, true to Sunday at 13:30, 240 wounded people had been admitted to the hospital and the numbers of wounded were continuing to rise hourly.
The majority of injuries were a result of direct hits, of shrapnel and of shock waves, caused by bombardments from the Israeli air force and buildings collapsing on top of their inhabitants.
The hospital has operated in emergency mode since Saturday, and its 12 operating rooms have been working 24 hours a day, with all medical teams on site.
The heavy overload of wounded and the shortage of operating rooms led to the use of four of the wards in the obstetrics departments as general surgical rooms, and the hospital has stopped admitting women for deliveries.
The outpatient clinics in the hospital, and four Intensive Care Units in the burns department of the hospitals are now being used for hospitalization of the wounded from the Israeli attacks.
The European hospital in Khan Younis According to Dr.
Zaki Zakzouk, a senior oncologist in the hospital, 30 seriously wounded people are hospitalized there.
Most of them are suffering from head and neck wounds and are in urgent need of complex neurosurgical procedures.
All these need a pulmonary intensive care unit, but due to the severe shortage of beds in the department, only half are connected to ventilating machines, and others are ventilated manually.
There is also a shortage of type O minus blood.
A shortage of refrigeration rooms and of ambulances is preventing transfer of blood from Shifaa’ hospital.
Nationalisation of private medical centers As part of the attempt to deal with the emergency, private clinics including ‘Almamdawi’, the Red Cross clinic and others, have stopped their regular activities and are now functioning as hospitalization units for the wounded, to which governmental hospitals are now referring patients.
Damage to medical equipment stores Today, 28.
08, the largest medicines and medical supplies store of the ministry of health in Gaza was bombarded.
It mainly serves Shifaa hospital.
The store, located next to the Falastin football stadium was completely destroyed and a large amount of medical supplies was destroyed.
Referrals out of Gaza suspended Erez Crossing has been hermetically closed since the morning of Friday 26.
2008, and the soldiers have been evacuated from the crossing.
Physicians for Human Rights-Israel has been informed that the authorities at the crossing would not longer be handling applications for transfer of patients and wounded persons to medical care outside Gaza, including urgent and lifesaving cases.
This information was confirmed by representatives of the Palestinian Subcommittee for medical referrals, who told us that their attempts to coordinate passage or even communicate with Erez Crossing authorities had failed.
Of the hundreds of wounded, PHR-Israel has the full details of 25, all of whom are suffering from serious injuries and must be urgently referred to external advanced medical centers: 14 of these are unconscious in the ICU at Shifaa hospital and are in immediate danger of their lives.
Seven others suffer severe orthopedic injuries and are in danger of losing limbs.
Four others suffer from internal injuries.
All tried to apply to Erez crossing for permission to exit Gaza and all failed so far.
Jordan has declared its willingness to admit wounded people, but in order to access Jordan, patients must receive an exit permit from the Israeli authorities to exit via Erez Crossing.
Rafah crossing Despite the declaration of the Egyptian government according to which it would open Rafah crossing to the wounded, no wounded people have been evacuated via this crossing, for several reasons: • Political disconnection between the Hamas government in Gaza and the Egyptian Government due to the Israeli attacks prevent proper coordination between Egypt and Hamas.
Egypt claims that Hamas is preventing the passage of patients to Egypt through Rafah.
• The severity of the cases: dozens of wounded people are not transferred to Egypt due to the severity of their condition.
The majority of these are head injuries and internal injuries.
Most are unconscious and are in need of artificial ventilation and a medical team to accompany them on ambulances to advanced medical centers in Cairo, a six hour journey from the Rafah Crossing, Doctors in Gaza fear that many of the wounded may not survive the journey.
• Shortage of ambulances: As already reported by PHR-Israel in detail on 22.
08, only half of Gaza’s 58 ambulances are functional.
The remaining ambulances are working full time since Saturday and cannot be spared.
The Israeli military is issuing threats to civilians Many patients have phoned PHR-Israel over the past 24 hours, reporting that during the night they had received recorded threats over the telephone.
The first recorded message ordered them to leave their homes due planned bombardments.
The second message warned that anyone aiding militants or hiding arms would be exposed to bombardments.
Appeals for humanitarian assistance Today Israel enabled the opening of Kerem Shalom crossing for entry of some humanitarian goods.
However, according to the Palestinian ministry of health in Gaza, these supplies are not sufficient.
Due to the severe shortage of medical supplies and medicines (105 sorts of medicine, 225 types of medical items and 93 types of laboratory supplies are missing), as detailed by PHR-Israel on 22.
08, PHR-Israel and PMRS today received an urgent appeal from the Gaza Ministry of Health for transfer of medical supplies.
Among the supplies asked for are basic sterilization equipment, clothing for medical teams, needles, dressings, anaesthetics, catheters, medical gases, oxygen, monitors and medicines.
The overall value of necessary supplies requested from PHR-Israel is half a million US dollars.
PHR-Israel is working to find funding sources and to coordinate transfer of the supplies.
PMRS has initiated an emergency call to support First aid, ambulances services, Individual relief and rehabitation of injured people the call is for 1 million$ Summary The current attack found the health system in Gaza in a state of near-collapse due to the blockade imposed upon it for the past year and a half, as well as previous closures.
Even before this crisis the system was working in a severely restricted manner.
Now it must handle wounded people who are in need of complex care by expert professionals, which in the current situation it cannot provide.
Targeting of civilians and/of medical facilities is a breach of international humanitarian law.
The targets chosen by the Israeli military include also clearly civilian installations.
As occupying power currently in effective control of the area, Israel, which is currently carrying out a massive military operation in the Gaza Strip, must bear responsibility for the wounded of the attack, enable their access to hospitals able to care for them, respect medical neutrality of related facilities and allow entry of all necessary medical supplies for hospitals to be able to handle the wounded people.
For further details contact: Ran Yaron, PHR-Israel, 0547 577696 ranyaron@phr.
il; Bahia Amra, Palestinian Medical Relief Society, 0599407847 bahiaamra@hotmail.
com; Mahmoud Abu Rahma, Al Mezan Gaza, 0599609310, mahmoud@mezan.