The appalling situation that has been prevailing in the Palestinian Territories for months now —primarily in Gaza— has not changed. Below is an update on the human losses, material damage, the Palestinian health system, water and electricity supply problems, and the Doctors Without Borders/Médecins Sans Frontières (MSF) response.

MSF doctors Jean Paul Delain and Mohammed Abu Magaisseeb evaluating conditions in a damaged area, Bayt Lahiya, Gaza. Photo ©Laura Brav / MSF

June 28 marked the launching of the military operation "Summer Rain" by the Israeli Defense Forces following the abduction of an Israeli soldier by Palestinian militants, and the firing of rockets into Israel. By July 18, 2006, 101 Palestinians had been killed in Gaza. Almost half of the dead were civilians, including 18 children, 9 women, and 3 disabled people. An additional 300 people were injured during Israeli attacks and incursions in Gaza.

Civil infrastructure (bridges and government buildings) as well as an electrical supply station in Gaza have also been targeted. The Karni transit point for goods has been randomly opened and closed, and all crossroads have been partially or totally closed. In other words, Gaza has been almost completely isolated.

Health

There are 22 hospitals and 58 primary health centres in Gaza, 22 of which are equipped with electric generators. Twenty-one of these health facilities have been assigned to handle emergencies.

The health personnel have not been paid for five months and living conditions of the staff and their families have been more than difficult. Nonetheless, and despite medical equipment, electricity and fuel shortages, doctors and nurses are still doing their jobs: 75 percent of hospital services are still functional, 12 health units are open 24 hours per day and four are open 12 hours daily. It is difficult, however, to provide all treatment levels. Priority is given to emergency cases.

The living conditions of the population

On average, electricity is available 6-8 hours per day. Electric generators can not easily be purchased in the local market. In Rafah, in the south of Gaza, there was no electricity at all from July 7 to 13.

Water transport in Rafah, Gaza. Photo © Laura Brav / MSF

Water is supplied 2-3 hours a day, but cannot be pumped or stored due to the lack of electricity and fuel. The northwestern part of the Gaza strip has long been disconnected from the water supply network due to the destruction of pipes during an incursion. With every incursion, new water tanks are destroyed and access to wells is made impossible.

The sewage reservoir in the north of the Gaza Strip is full and can not be drained due to lack of electricity and fuel. In some parts of the Gaza, garbage collection has been interrupted for weeks.

MSF intervention

Medical

As a result of the suspension of Western financial aid to the Palestinian Authority, there have been some pharmaceutical stock shortages. Accordingly, MSF has made drug donations to the main hospitals and has placed more specific orders for drugs to treat patients with chronic diseases. Drugs and emergency medical equipment have also been distributed and pre-positioned for hospitals on the frontline that are receiving the wounded. MSF is in close contact with hospitals to respond to any medical needs and human resources requests, and to supply the emergency and intensive care units.

Mental health needs are also significant and despite travel difficulties, patients have been coming to MSF for treatment. The current context of violence and the consequences of incursions and daily bombardments create stress and trauma that have to be taken care of rapidly. Three MSF psychologists have managed to resume their consultations (either at homes and or at mobile clinics).

A new MSF surgeon will join the team to help establish a short- to mid-term cooperative arrangement with hospitals in the area.

Logistics

Water is being distributed to a group of refugees fleeing bombardment of Al-Shoka, an area near the airport. Food supplies are being taken care of by the United Nations Relief and Works Agency (UNRWA), the World Food Program (WFP) and the International Committee of the Red Cross (ICRC).

MSF is also responding to the needs of populations displaced within the Gaza Strip due to incursions, and to those affected by the lack of water and electricity. MSF is particularly active in the areas of the Al Fara towers, where MSF intervened in 2005; in the Bedouin village of Bait Lahiya, located not far from the sewage reservoir and disconnected from the electric supply network; and in the north, where a large number of individual water tanks have been damaged by rocket bursts.

Since June, MSF has been assisting 200 families living in the frontline area in northern Gaza, near a firing zone. The families have been frequently affected by the shooting and shelling. Today, MSF is closely monitoring the situation (number of wounded, demolished houses, people fleeing the area, patients suffering from mental disorders, and people who have received food and equipment) and remains ready to respond to any further needs.