More than 1000 were injured in latest violence in Gaza

BMJ 2012; 345 doi: (Published 23 November 2012) Cite this as: BMJ 2012;345:e7989
  1. Anne Gulland
  1. 1London

As the ceasefire between Gaza and Israel seems to be holding, doctors have been counting the human cost of the latest flare up in violence.

The latest information from the World Health Organization, updated on 21 November, indicated that 132 people had been killed in the Gaza Strip, 23% of whom were children, and that 1090 people had been injured, 35% children. Injuries included severe burns, wounds from collapsing buildings, and head injuries, some of which were critical. Patients have been transferred out of Gaza to Egypt. Five Israelis have also been killed in the violence, which began on 13 November.

Mathilde Berthelot, a GP working for the aid agency Médecins Sans Frontières who entered Gaza at the weekend, said that doctors and other clinical staff in Gaza were well trained to deal with emergency situations and were good at carrying out “war surgery, emergency triage, and dealing with mass casualties.”

However, she said that the main gap in care was a lack of intensive care specialists. And because of a lack of capacity patients were discharged very quickly after operations, she said. Hospitals also found it difficult to cope with postoperative care such as wound management, rehabilitation, reconstructive surgery, and the management of burns.

She added, “What is also very obvious among our colleagues in Gaza is the psychological consequences of the violence. The shells are coming regularly on a population that is already affected by violence. All our colleagues are suffering from anxiety.”

Médecins Sans Frontières has a dispensary in Gaza City, staffed by two nurses and two physiotherapists, but at the height of the violence only five patients were able to get there in six days. The charity is planning to increase the dispensary’s capacity.

WHO said that the 36 bed Beit Hanoun Hospital had a direct hit on 21 November. The missile penetrated the roof, and some injuries were reported.

A 40 bed Jordanian field hospital that has operated in Gaza City since 2009 was also hit by a missile earlier in the week but is now partially functioning again. Patients had been evacuated only 10 minutes earlier after the surrounding area came under attack.

Hospitals in Gaza have been struggling to cope with the influx in casualties over the past few days as their health services were already stretched. WHO said that even before the latest crisis there was a lack of investment in training, equipment, and infrastructure, poor maintenance of medical equipment, and frequent interruptions of power supplies.

All medical facilities have been facing critical shortages of drugs and medical supplies, with 192 drugs (40% of WHO’s essential medicines list) and 586 medical disposables (65% of the essential list) at zero stocks, said WHO, which has made an urgent appeal for $10m to assist Gaza over the next three months.

Osama Damo, a communications specialist for Save the Children in Gaza, welcomed the ceasefire.

“People are back on the streets, and you can see that life is coming back. People who were not able to get to hospital during the offensive are coming for medical checks,” he said. “Hospitals were overwhelmed with the number of casualties and in addition many organisations are facing difficulties procuring medical supplies because they were out of stock [before the offensive].”

Damo added that doctors and other hospital staff had been working flat out but that the main problem was the lack of good equipment.


Cite this as: BMJ 2012;345:e7989

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