| GAZA CITY–In a land where the pop-pop of guns, the deep booms of artillery and the wail of sirens from emergency vehicles are constant, it is no surprise that medical resources are being exhausted.
And when these are further hindered with border closures and power losses, as it is in the Gaza Strip, the consequences are catastrophic.
Here, in this seemingly lawless setting, a 46-year-old Palestinian, too weak to say his name, is unable to receive treatment for cancer he has in his brain.
Normally cancer patients are sent to Israeli territory or Egypt for radiation and chemotherapy treatments since those are not available in Gaza.
"The situation is very bad due to the border closures," said Dr. Abdel Rahman Barkawi, director general of the Ministry of Health in the Gaza Strip.
Barkawi said Palestinians needing medical treatment in Egypt wait in cars for hours, sometimes days, at the Rafah border only to be turned away.
"The Israeli Defence Forces (IDF) only allow 20 to 30 cars through and 600 cars are turned back," he said. "We are suffering for the last six years."
Control over Gaza was handed over to the Palestinian National Authority last year after 38 years of Israeli occupation; however, the IDF began an offensive there soon after Palestinian militants captured an Israeli soldier at the Karem Shalom crossing on June 25.
Adding to the already aggravated health situation is the power outage–Israel bombed Gaza's main power plant–forcing hospitals to run generators 24 hours a day. For example, Al-Shifaa, Gaza’s largest hospital, has four generators that are consuming about 4,000 litres of fuel a day.
Dr. Baker Abu Safia, who heads the hospital’s emergency department, said the European community gave Gaza about 300,000 litres of fuel, which although in Gaza now, was blocked for ten days at Gaza’s entry points controlled by Israeli authorities.
"This means disaster for us," Dr. Safia said.
When asked why the Israelis would stop the fuel from coming into Gaza,
Dr. Safia said, with his hands motioning at his throat, "They want to strangle us but not kill us."
Generators are meant to be reserved for use in an emergency a few hours at a time and not continuously for months, Dr. Safia pointed out.
"This means they will break down…we haven’t another generator, and if we want to bring a specialist from the West Bank to fix this generator, we can’t," he said.
Keeping vaccines constantly cool–several batches have already had to be destroyed–and trying to keep water treatment plants flowing are just two of the many problems causing a flood of emergency patients, said Ministry of Health’s Dr. Barkawi.
"The number of child patients has tripled, especially the poor," he said. "They come with scabies, skin and abdominal diseases caused by lack of sanitation, contaminated water and decayed foodstuffs due to lack of continuous cooling, particularly in supermarkets."
Creating an even further crunch to the humanitarian crisis is the Israeli decision to withhold Palestinian tax and customs receipts collected for the Palestinian National Authority (PNA). Most of its 145,000 civil servants have not received full salaries for the past seven months. If the municipal sector does not work to help take the sewage from the streets, Barkawi added, disease will become even more widespread, intensified by the region’s heat this time of year, with temperatures hovering around 35 C.
These harsh conditions affect about 1,400,000 people in the Gaza Strip, an area just over half the size of Toronto. Jabalia Refugee Camp north of Gaza City, one of the most densely populated areas in the world with half the residents under the age of 14, could see the gravest health implications. Residents there live in cement block shelters with asbestos roofs.
"You can imagine the extent of the suffering," Barkawi said. "People do not know the situation." When asked how he felt about Canada joining the United States and the European Union in suspending its financial assistance, totalling about US $1 billion in 2005, from the Palestinian Territories in April after their Hamas-led government was elected to power there in February, Barkawi said Palestinians don’t understand this move.
"I detest Hamas," he said. "But the US tells the world democracy is the best way. Then it should respect the government no matter what the results are.
"Most of our people consider Canada our friend. Canada should not follow the U.S."
Hamas is considered a terrorist organization by Israel, the EU and the US, among others, because it has refused to renounce violence against Israel and accept Israel's right to exist.
"We have to hope that honest people of the West help," Barkawi said. "We are helpless people–we need your support." A core concern is that hospitals are running out of their strategically stored medical supplies and medicines, such as penicillin, especially as the severity of injuries soar.
"The wound of the injured patient we received one year ago was simple: gunshot, inlet, outlet, dressing, surgery. We used little alcohol, few medications," Al-Shifaa’s Dr. Safia said from his worn wooden desk on which sits a ‘70s-style plastic PA system that only works when held just so.
"Now we receive more cases with more body destruction: multiple cut wounds, amputations, multiple fractures," he said as an eight-year-old boy named Bilal Abu El Amrain was carried in with an M16 bullet in the left side of his chest. He was shot while playing in East Gaza.
"This means this patient needs more time in the operating room, more time in the intensive care unit, more time in the hospital, a few weeks…a few months. You can imagine the dressings alone needed for this patient. Material that I use for one patient now I before used for 100 patients," said Safia, whose work day starts at 7:30 a.m. and doesn’t finish until 1:30 a.m.
Safia expressed several shortfalls at the tertiary healthcare level.
More than 60 per cent of known cardiac disease can be managed by cardiac catheterization–a test to check heart and coronary arteries–and percutaneous coronary intervention, which involves using a thin flexible tube (catheter), guidewire, and balloon, to open coronary arteries and improve blood flow to the heart. But these materials are not available in Gaza, so painful open surgery is all that is possible.
As well, there is only one vascular surgeon in Gaza. But the oncology department, even with improvements to its diagnostic system, suffers the most, Safia said. "We just don’t have the funding."
Meanwhile, the Palestinian man, with cancer growing in his brain, lies in his Gaza home near his six children, waiting to die.
There are ways to help those suffering in Gaza, one of which includes calling Lifemakers, an organization that takes care of children in Gaza, at 011-970-599-681669 or e-mailing life_makers@lycos.com
Another option is to call the PNA's Ministry of Health in Gaza at 011-972-828-29178.
Goertz is a Calgary-based freelance writer who has made several trips to the Middle East.
* * *
The situation here is complicated, both Jews and Muslims blaming each other for causing decades of death.
As long as Palestinian suicide bombers and the underground terrorist network continue to build arms, the Israelis intend to press on with their operation, including the construction of a security barrier.
At seven metres, it is twice as tall as the former Berlin Wall, and when completed will annex nearly 50 per cent of the West Bank to Israel, enclosing Palestinians into a de facto prison reminiscent of apartheid South Africa.
All buildings, including homes, within 35 metres of the wall, on the Palestinian side, are being razed to the ground, rendering thousands displaced.
The wall cuts Palestinians off from their fields, schools and work. To reach them they cross at checkpoints.
According to the Israel Embassy website, the security fence is working: "A fence has proved its utility in Gaza, where one has existed since 1996, resulting in no successful suicide attacks from Gaza within Israel."
But is the fence really working? Its construction, combined with Israelis building luxurious white condo complexes in Palestinian land, is fuelling more anger not only on the Palestinian side, but throughout the Middle East, resulting in a tit-for-tat fight that may never be solved without neutral international intervention. |
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