Health services continue despite damaged facilities

40 per cent of hospitals and clinics forced to close

During the 50-day Gaza emergency, 75 health structures (17 hospitals and 58 clinics) were damaged to varying degrees and 44 facilities were closed at one time due to damage or for security reasons, limiting access to health services to almost half of the population. Nevertheless, following the ceasefire, only four of the 32 hospitals monitored by the Ministry of Health (MoH) and WHO remain closed.

At the height of the conflict in early August, 40 per cent of hospitals and clinics were forced to close their doors (10 of 32 hospitals and 34 of 75 clinics), predominantly in the northern and eastern areas of the Gaza Strip where military activities were intense. At least three hospitals and seven clinics were totally destroyed and have not yet reopened.

The material losses to the health sector have been preliminarily estimated at over $5 million, but a more detailed assessment is currently underway. All health providers were exposed to damage (see table below).

Some of the most serious damage will have a long lasting impact. The closure of two specialized hospitals resulted in the loss of 140 patient beds (six per cent of total bed capacity in Gaza) at a time when hospitals were overwhelmed with casualties:

• The greatest loss has been the total destruction of the only medical rehabilitation centre, Al Wafa Hospital, which had recently installed modern rehabilitation equipment in its seven-floor new building for persons with disabilities.
• Mohammed Al Durra Hospital, one of only three pediatric hospitals in Gaza, has been closed since 25 July due to debris from nearby explosions.

Health providers have been resourceful in relocating health services. Two damaged hospitals, Al Wafa and Balsam, and at least one clinic (in Khuza’a) have been relocated to other sites, and the Beit Hanoun hospital (MoH) has admitted inpatients to undamaged sections of the hospital. Almost all of the damaged centres reported broken windows and doors, but some also had moderate to serious structural and roof damage, with penetration or collapse of exterior walls.

The current challenge for the health sector is to improve the quality of care for patients who require further surgery, rehabilitation or medical care on an outpatient or referral basis. These objectives are being pursued amid shortages of medical supplies and electricity and mounting debts by the MoH that have prevented salary payments to many health workers.

Sustainable Solutions for Energy and Water[1]

A number of long-term options to address Gaza’s energy and water crisis are currently under consideration, all of which are dependent on progress in the political situation. For the energy crisis, these include the import of an additional 150-300 MW of cost-efficient electricity from Israel; to re-convert the GPP to operate on natural gas, for which it was originally designed, and supply it with natural gas from the gas fields under the Gaza sea; and/ or increase imports of electricity from the Arab Regional Grid.

Short to medium-term interventions under consideration for Gaza’s future water quality and supply include an increase in annual water imports from Israel and the building of shortterm low-volume (STLB) desalination plants. Proposed long-term interventions include the completion of planned sewage treatment plants to enable about 40 per cent of the recovered water to bereused for irrigation of fodder and fruit trees, while the remainder would recharge and rehabilitate the underlying Aquifer. Another long-term option is to build a large desalination plant, although this alternative faces multiple challenges that reduce its feasibility.

* This article was contributed by the UN’s World Health Organization