alt10 July 2014, Jerusalem –  The recent escalation of violence in the Gaza Strip raises concern about the ability of the Government and the Ministry of Health of the occupied Palestinian territory to cope with the increased burden of medical emergencies on the health system, given the high levels of shortages of medicines, medical disposables and hospital fuel supplies, and rising health care debt.

The World Health Organization (WHO) and the Palestinian Ministry of Health are calling on local and international donors to support the Ministry in coping with the current, difficult situation in the occupied Palestinian territory, especially in the Gaza Strip, that is affecting the health and welfare of Palestinians. Since 6 July, attacks on the Gaza Strip have caused at least 80 deaths (17 children; 16 women) and have injured more than 570  (120 children; 170 women).  A hospital, three clinics and a water desalinization centre in a refugee camp have also been damaged. More airstrikes and missile attacks are likely.

The Palestinian Ministry of Health has reported that they are unable to maintain adequate medicine stocks due to chronic outstanding debts, which now total more than US$ 253 million (New Israeli Sheqel 874 million). Of the debt, US$ 105 million is owed to pharmaceutical suppliers and US$ 148 million to private Palestinian medical referral centres. East Jerusalem hospitals are struggling due to US$ 57 million in unpaid referral services, especially the Augusta Victoria hospital, which receives 70% of cancer referrals from the Gaza Strip and 40% of West Bank cases for chemotherapy and radiotherapy. By the end of June, Ministry central drug stores reported that 27% of essential medicine items were at zero stock in the West Bank and at 28% in the Gaza Strip. Both areas also noted that half of medical consumable items were at zero stock.

The situation in the Gaza Strip is most critical as additional factors are aggravating the situation. The Ministry of Health has only 10 days of fuel reserves to power hospitals during the frequent breaks in electric power from main lines. Half of government health workers have not received their salaries in recent months, and some can no longer afford to report for work. Ministry hospitals have stopped all elective surgeries in the past week to save resources and are trying to cope with urgent ones. This means that only urgent, life-saving operations are being carried out; operations such as orthopaedic reconstructive surgeries and cholecystectomies are being postponed until next year. A physician in Shifa hospital, on duty for 24 hours, said, “We are working in a terrible situation. I did not have the necessary materials to stitch my trauma patients today and had to improvise.”

The WHO Regional Director for the Eastern Mediterranean Dr Ala Alwan  said, “We faced a similar situation in 2008–2009 and in 2012 in the Gaza Strip when stocks were low and medicines were urgently needed. Today, the West Bank is also affected by shortfalls in budget and medical supplies. The response and preparedness of the health sector is at very low level, and we are concerned about a possible collapse of health services. We are making an urgent appeal for US$ 40 million to support the Ministry of Health in providing essential supplies for health care sufficient for six months, which will guarantee basic preparedness, and US$ 20 million for referral debts to the East Jerusalem hospitals.”

This appeal is being coordinated with the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA). The refugee agency has expressed similar concern about the situation of medicines and the East Jerusalem hospitals. WHO is continuing to work with the Ministry of Health to coordinate humanitarian aid from donors, including facilitating the entry of medicines into the Gaza Strip.

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