PARIS, January 3, 2010 (WAFA)- One year after Israel launched its military offensive against the Gaza strip and the people of Gaza are still suffering from severe physical and psychological wounds, Médecins Sans Frontières (MSF) said in a report .
The three-week-long military operation “Cast Lead” which started on the 27th of December 2009, involved raids, intensive aerial bombing and a crushing land offensive. The war ended 22 days later, on January 18, 2009, and took a heavy toll on the whole Gaza strip. Nearly 1,300 Palestinians were killed (including 900 civilians, 300 of whom were children) and 5000 others were injured.
For MSF volunteers and doctors, the people of Gaza were left with not just severe physical wounds and disabilities, but rather emotional scars that will most probably stay with them for the rest of their lives.
“Beyond the humanitarian crisis and the despair left behind by the war, MSF has been witnessing on a daily basis through its medical activities an ongoing crisis of human dignity. This is a different kind of crisis where more than one million women, children and men are losing their freedom to a decent and normal life” said Jean-Luc Lambert, MSF head of mission for the Palestinian Occupied Territory.
“1,5 million people are physically trapped. And what we are witnessing is indiscriminate violence against civilians who have no way out. It is a population deprived of the right to work and right to movement. And as a direct consequence there will be a decrease of self esteem and an augmentation of psychological disorders,” Lambert added, noting that those who were injured during the offensive not only have to struggle for recovery from their wounds and disabilities but rather are facing the overwhelming task of rebuilding their lives and homes with what little means they have left.
From MSF's perspective, the situation in Gaza continues to deteriorate more than a year after the Israeli military operation. The Palestinian health sector in Gaza is in a much worse condition because of the continued embargo, which was tightened in January 2008. The blockade prevents any post-war reconstruction today.
According to recent statistics, the military offensive and the blockade led to the current dilapidated living conditions of the people of Gaza strip. The majority of the population lives under the poverty line. They can hardly rebuild their homes because of the lack of income and the drastic restrictions on movements of goods and people imposed by the Israeli authorities. The lack of common understanding between the Palestinian Authority in Ramallah and the Hamas administration in Gaza has also dealt a blow to the provision of essential services to the people of Gaza already suffering under a suffocating blockade.
Regarding the health sector, most medical equipment is unreliable and the embargo makes it impossible to obtain certain spare parts. Similarly, medical units also face drug shortages.
More than 5,000 people were wounded during the January Israeli military operation. Many are disabled and the only rehabilitation center in the Gaza Strip also finds it difficult to import raw materials and the components required to manufacture artificial limbs. The waiting time for a prosthetic limb extends to mid-2010. Even as the 150 disabled patients, of whom 50 in MSF post operative program, await theirs, unexploded munitions continue to kill and wound 'Two children have been killed and at least three wounded while playing with these weapons,' says Lambert. 'One year later, the children of Gaza are still losing their lives to the war.'
Wounded in Gaza in need of Post Operative care To meet the needs for post-operative care (dressing and physiotherapy), MSF has been working in its three clinics in Beit Lahya, Khan Younis and Gaza city.
A fourth clinic will be open at the beginning of next year in Rafah. Currently more than 450 patients are still under treatment receiving weekly physiotherapy sessions and dressing treatments by MSF medical teams.
During the three-week-war, MSF’s Gaza city postoperative care clinic remained open for patients. Between 5 to 20 patients were treated every day through referral from Al Shifa Hospital. The major difficulty was access as both MSF staff and the patients could not reach the health structures because of the intensity of the conflict.
The intense bombardment and violence had imprisoned the population in their homes,and MSF clinics were empty of patients and the most effective way to assist Gazans at the time was for MSF volunteers to provide first aid. Three expatriates (one French project coordinator, one Australian nurse and one French doctor) with the 60 local volunteers tried to help the wounded. And because many of the injured and sick were trapped in their homes, MSF nurses and doctors carried out home visits whereby consultations and treatment was made available. These home visits enabled 250 patients to receive first aid.
Throughout 2009 MSF doctors and staff carried out over 65000 sessions of dressing and physiotherapy and treated 1,116 patients. MSF has 20 physiotherapists, 4 doctors, 13 nurses in three MSF clinics in the Gaza strip.
Eight mobile teams are currently providing wound management and physiotherapy by daily visits to patients at their homes.
Psychological effect of the war Throughout 2009, a mental health team composed of five psychologists has been providing 3000 consultations to treat the psychological consequences of the Israeli military operation. The psychological effect of the war has been dramatic and thus MSF increased its team of psychologists to deal with the influx of cases. 3000 consultations were carried out by MSF teams during one year in the whole Gaza Strip.
“Many people in Gaza lost a child, a parent, another relative or a friend. Israel's military operation left thousands of homes partly or totally destroyed. Gazans witnessed a trauma situation and they need to speak about it. The war worsened the daily life. When you are invaded by an anxiety, the daily life is a burden. By short therapy we try to give a breath of fresh air to the families. We work with the mother or the father on the symptoms in order to try and heal the scars of the war”, describes Michèle Gaborit, an MSF clinical psychologist.
“More than half of our patients are children”, adds Michèle Gaborit, an MSF clinical psychologist. “One year after the war, the children have still being suffering from anxiety, lack of concentration, intrusive memories, bed wetting, fears. The war has injured men, women and children in their flesh but also in their mind. During one month, there was no safe place in Gaza. One year after the war, the wounds are still open.”
In the aftermath of Israel’s military operation on Gaza the destruction has been visible everywhere. Neighborhoods were turned into rubble. Schools, kindergartens, hospitals and fire and ambulance stations were damaged by the non-stop shelling.
Livelihoods were systematically destroyed, particularly in January. Many small companies, both factories and shops, and private homes were razed or seriously damaged. The United Nations estimates the total cost of this destruction at $139 million.
Today, 75 per cent of the Gaza population – more than 1.1 million people – relies on food aid.
Part of MSF’s intervention in the Gaza strip has a social component. A social worker assesses the social needs of the patient of the mental health project and the patient’s family. The kind of social support given by MSF includes, food parcels like oil, beans, rice and non food items like blankets, plastic sheeting, plastic chairs, school uniforms and transportation. The social worker networks with other agencies offering social support and will refer the patients if appropriate.
An important addition to the MSF post operative program was the inclusion of microbiology program. MSF organized for a laboratory technician to visit Gaza and assess the private laboratory of P M R S (Palestinian Medical Relief Society).
Training was conducted to increase the capacity of PMRS laboratory regarding diagnostic tools of infection. An agreement was formalized and MSF made donation of reagent materials. Follow up evaluation and workshop is scheduled for early 2010.
This is a very important addition to our support to the Health structures as the resistance to antibiotics is very high in Gaza and the timely and efficient laboratory testing of cultures allows for correct prescription and overall better management of those patients who present with infected wounds.
MSF teams have over the past year been working in close collaboration with front line hospitals such as Al Shifa by providing drugs (consumables, fluids) and emergency kits to treat wounds and burns in the whole Gaza strip. They also deliver drugs to the public hospitals and to shelters schools.
MSF donated 11,000 Euros of emergency drugs supply to hospitals and clinics during the Israeli military operation to help the overburdened facilities cope with the flow of patients.
MSF emergency teams, among them experienced surgeons and a cargo freight of 21 tons of medical materials, entered Gaza after the outbreak of the hostilities. Amongst the injured are many disfigured or disabled cases in need of secondary surgeries. In the immediate days following the three weeks military operation MSF opened an emergency surgical facility by setting up inflatable tent to cater for the influx of trauma cases.
Two operating rooms with eleven beds have been set up under medical inflatable tents in the center of Gaza city. This emergency and post emergency intervention lasted from January 09 up to July 09. MSF treated 362 patients and performed 518 surgeries – primarily surgery (80%) and orthopedic (16%). These included removal of external fixators, skin grafts and flapping, shrapnel removal, release A total of 1553 surgical consultations were also conducted in the duration between January to July 2009.
After the war in Gaza, MSF doubled its staff and increased its capacities to adjust to the needs of the people and fill and the gaps identified in the local health structures following an influx by the wounded.
Speaking out about the indiscriminate bombings On Friday, January 16th, MSF held press conferences in Jerusalem and Paris to decry the dire humanitarian situation currently affecting civilians trapped in Gaza, and demanding that all parties to the conflict respect medical teams attempting to reach these people.
Dr. Christophe Fournier, President, MSF International Board: “This bloodshed of civilians must end. Médecins Sans Frontières today expresses its outrage that so many civilians have died and that aid workers cannot save more lives.
The Gaza population continues to be victimized by indiscriminate gunfire and bombing. Medical workers lack access to the wounded and few victims can reach a hospital.”
Dr. Marie Pierre Allie, President, MSF France: “ We are afraid that more civilians will be killed and wounded and that hospitals will be bombed. It is critical that all parties to the conflict respect civilians, first aid workers, health facilities and humanitarian aid workers. This has not been the situation up to now. Humanitarian law applies in all conflicts and must be respected by all—including states.
“This extreme violence is striking a trapped, imprisoned population. We are told that the population is warned before every attack, but people have nowhere to flee, nowhere to take refuge. In more than 40 years of work in conflict situations, MSF has rarely faced such levels of violence against civilian populations. Whether in Somalia, the DRC, or even Darfur, none of those wars produced so many deaths in so little time. Our goal is not to establish a hierarchy of war horrors, but to denounce the cynical way in which Israel is carrying out its military offensive, with no respect for civilians. “This yawning gap between such admirable intentions and actual risks is unacceptable.”
