For many patients in Gaza’s besieged north, order evacuation Walking south from a hospital bed is tantamount to a “death sentence.”
That is A scathing assessment from the World Health Organization October 14, 2023.By then, four hospitals Has ceased operation Destruction caused by Israeli bombs in northern Gaza.
In addition to the direct damage caused by the current conflict, 1,400 Israelis and more than 2,800 Palestinians killed The first 10 days of fighting – this will have a significant and undoubtedly long-term impact on Gaza’s health system.
as a Palestinian global health expert I have worked with medical professionals in Gaza and I know that even before the recent escalation of violence, the state of health services in Gaza was poor.For decades, doctors and hospitals have also had to cope with inadequate and scarce resources. The devastating impact of 16 years of lockdown imposed by Israel, in part Coordination with Egypt.
The system is completely overwhelmed
The most pressing problem in Gaza is those seeking aid due to bombings ordered by Israel after Hamas militants attacked their people.one anticipated ground attack This will only further create the risk of more civilian casualties.
Hospitals in Gaza have completely at a loss.in a only 2,500 hospital beds The population exceeds 2 million.it forces hospitals to care for patients in corridors and nearby streets. People injured in explosions are receiving horrific treatment without the basic knowledge of: Gauze dressing, antiseptic, IV bag, and pain medication. Those who suffer from traumatic injuries do not receive adequate care, leading to increased rates of infection and amputation.
Things could get worse soon.Hospitals in Gaza forced to work, according to UNOCHA No electricity, using fuel to run generators to keep life-saving equipment running. The United Nations estimates that this fuel could be depleted at any time due to Israel’s sweeping siege of Gaza.
The situation has raised fears that, in addition to the large number of bomb victims, Gaza’s health services will soon have to Responding to disease outbreaks.Although evacuation routes are open, patients with urgent health needs, such as dialysis or chemotherapy, are ordered to leave and travel to southern Gaza to safer ground also bombed.
A century of underfunding
The current damage to Gaza’s health system is clear. But Gaza’s health care system was already under pressure even before the latest bombing. In fact, decades-old policies have left it unable to meet the basic health needs of Gaza residents, let alone respond to the ongoing humanitarian disaster.
exist just over a centuryGaza’s health system is managed by six authorities: Ottoman Empire until the end of World War Ithis British people during the Mandate From 1917 to 1947, Egypt 1949-1967under Israel Occupation began in 1967then the Ministry of Health, led first by the Palestinian Authority from 1995 to 2006 and then by Hamas.
What they all have in common, from my perspective as a global health expert, is that they have very little investment in Palestinian health.At various points in the 20th century, the health priorities of successive governing bodies appeared to be more focused on reducing the spread of disease infectious disease Protect foreigners who interact with the native Palestinian population.
Little attention seems to be paid to building health infrastructure, adequately training health personnel, promoting preventive care and other long-term measures that constitute a sustainable health system.
Under Israeli occupation since 1967, several Palestinian hospitals were converted into a detention center or military office, while others are closed and new openings prohibited. Palestinian doctors working in the occupied territories earn one-third the salary of their Israeli counterparts.
As a result of this neglect, health indicators in what is now known as the occupied territories (the West Bank and Gaza Strip) have been poor.
Maternal and infant mortality rates—typical indicators of health system functioning—tend to be high. For example, mid-1980sThe infant mortality rate among Palestinians is more than 30 per 1,000 live births, while among the Israeli Jewish population it is less than 10 per 1,000.Infant mortality rate has been Gaza’s exchange rate remains high.
At the same time, a lack of reliable drinking water infrastructure and overall unsanitary conditions have led to the spread of parasites and other infectious diseases, such as rotavirus, cholera, and salmonella, which Still the leading cause of death Children of Gaza.
die before they leave
Most residents of Gaza Escaped there in 1948 After being displaced from their homeland in the State of Israel.They are classified as refugees and many receive limited services from UNHCR United Nations Relief and Works Agency for Palestine Refugees in the Near East The agency was established in 1949.
Since then, chronic underfunding of public hospitals means Palestinians in Gaza have remained dependent on external funding and NGOs for basic health services.This started a trend humanitarian dependence This situation continues to this day, with many health facilities in Gaza being managed by the United Nations, humanitarian agencies such as Doctors Without Borders and religious organizations.
during the passage Oslo Accords In the mid-1990s, the Palestinian Authority was established to manage affairs in the occupied territories. The agreements call for the handing over of health responsibilities to the newly created Palestinian Ministry of Health in preparation for the establishment of a sovereign Palestinian state within five years that the agreements call for.
The Palestinian Authority received Huge influx of humanitarian aid Because it assumes civil liability including health.Therefore, health indicators for Palestinians, including life expectancy and Immunization ratebegan to improve in the late 1990s.
But it became increasingly clear as the Oslo Accords’ overarching goal for the Palestinians – statehood – became clearer. won’t happenDisillusionment with the Palestinian Authority led to Hamas’ victory in the 2006 elections in Gaza. Since then, Hamas has been considered the de facto governing body in Gaza, while the Palestinian Authority operates in the West Bank.
The rise of Hamas, United States, Israel, etc. Gaza is classified as a terrorist organization and isolated by the international community. At the same time, Israel imposed a comprehensive land, sea and air blockade on Gaza.
There is no doubt that the lockdown has accelerated rapidly health system deterioration in Gaza and directly affects mortality speed.
Gazans in need of advanced care, whether for cancer or other chronic illnesses, trauma and other life-threatening illnesses, often have to Get the services you need at an Israeli hospital and required a permit to cross the border from Gaza.some people die Licensing process completed.
Health services in Gaza after the siege
This fragile health system now faces unprecedented challenges and its health professionals Committed to being with patients Even under hospital evacuation orders and at risk of death.
What the future of Gaza’s health system will look like is uncertain.
In the past years, International aid will help repair Rebuilding some, but not all, infrastructure damaged in the air strikes, especially schools and hospitals.
But Israeli Prime Minister Benjamin Netanyahu promised “a long and arduous war”. Given the extent of damage seen in just a few days, it’s unclear what will be left in the aftermath.
already At least 28 doctors and other health workers People have been killed in Gaza, and ambulances and some hospitals have been rendered useless by bombs.
Replacing human capital and critical infrastructure can take years, even generations – and this is not limited by punitive blockades and constant bombing.
Yara Say is an assistant professor of global health management and informatics. University of Central Florida.
This article is reproduced from dialogue Licensed under Creative Commons.read Source article.
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