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MSF's response to the 2014 Israel-Gaza conflict
The following is a day-by-day run down of MSF's work in Occupied Palestinian Territory in the summer of 2014, when conflict gripped the region.
After Israel launched the military offensive known as 'Operation Protective Edge' in July 2014, MSF sent medical teams, supplies and reinforced its existing programmes on the ground.
Last night, more that 80 rockets were launched (some reaching Tel Aviv, Jerusalem and Haifa). The Israeli Defence Forces hit Gaza with over 150 strikes.
Official figures give 25 deaths - including four children - and 180 wounded, all Palestinians. Simultaneously, in the West Bank, after massive searching operations, settler violence is on the rise.
Since 2010, MSF has run a post-surgery clinic (dressings and physiotherapy) in Gaza city, where 80 percent of the patients suffer from severe burns.
Our teams also run specialised hand-surgery in Nasser hospital, Khan Younis, and provides intensive care training to medical and paramedical staff at Nasser and Ah-Shifa hospitals.
The intensity of the bombing makes it impossible for MSF team to move at all, and impossible for our patients or Palestinian staff to reach our clinic in Gaza City. Our activity is on stand-by.Most of our patients live in the south of Gaza strip. The team is preparing dressing kits to be distributed directly to patients if the bombings' intensity lowers down and allows us to renew movements.
So far, hospitals in Gaza would be able to cope and not overwhelmed. MSF has proposed donations of medical material and medicines and is prepared to respond to any emergency needs by reinforcing its medical team with additionnal surgical capacities if the context allows for sending them.
Simultaneously in the West Bank, an MSF team is providing psychological first aid to people affected by settlers violence and searching operations in Nablus, Jenin and Qalqilya areas. They receive referrals for specialised psychiatric needs from other organisations.
Israel launched a military offensive - Operation Protective Edge - in Palestine this week.
- Bombings are still very intense, with an average of 10 strikes per hour accross Gaza strip, even more at night.
- A reduced MSF team has been able to re-opened the post-op clinic in Gaza city this morning and a dozen of patients have come for their follow up treatment.
- Gaza hospitals are still able to respond to the emergency needs as of today, but due to already existing chronic shortages of drugs and disposables, the situation could worsen quickly.
- MSF has proposed donations and HR support. An MSF surgical team is on stand-by in case a ground operation is launched.
- On Saturday night, Gaza was heavily hit. One family lost 21 members in one strike. Total toll according to the Ministry of Health (MoH) as of 4pm today is 165 deaths (among them are 36 children, 24 women and nine elderly) and 1,232 wounded.
- People living in Beit Lahiya in the north of Gaza were told by the Israeli Defense Force to evacuate. The majority of the population have now left, sheltering in schools.
- MSF visited Al Shifa hospital today where 35 surgical acts have been performed in the last 24 hours. MSF emergency stock and spare parts were donated to Nasser hospital and to MoH Central Drug Store.
- An MSF clinic opened today and received five new cases referred from Shifa hospital burn unit for post-op care out of a total of nine patients. The ability for patients to come to the MSF clinic is still very limited.
- As of yesterday at 4pm, the total toll according to the Ministry of Health in Gaza is 173 dead and 1,263 wounded.According to the Office for the Coordination of Humanitarian Affairs, 77 percent of casualties (both dead and wounded) are civilians.
- An air strike fell close to the MSF compound this morning. Dozens of rockets were launched from Gaza and bombings resumed in the afternoon (at a lesser scale than yesterday).
- Three families (22 people including 15 children) of our local staff from Beit Lahiya, north of Gaza, have sheltered in the MSF clinic after having to evacuate their homes on Sunday.
- Al Shifa hospital is referring burn patients to the MSF's clinic. Four new cases were received yesterday, all are children under five.
- MSF's clinic in Gaza city is open but only 11 patients have been able to reach the clinic so far, of a total of 87 patients registered for follow-up with MSF.
- In Nablus district, West Bank, several families severely affected by various military operations (intrusions, arrests, threats, mock raids) have been referred to MSF for mental healthcare.
As a five-hour humanitarian ceasefire ended on 17 July, explosions were heard in Gaza City near a clinic run by MSF. Earlier that day, MSF succeeded in sending an additional medical team into Gaza to reinforce its emergency response.
Within just a few hours, more than 100 missiles have been fired from Gaza and eight Palestinians have been killed in airstrikes.At 9.30 pm, news comes through that Israel has launched a ground offensive.
Fortunately most of MSF’s additional team managed to enter Gaza before the ground offensive began, while MSF is working to get its surgeon in as soon as possible. The lull in the emergency room at Al Shifa is over.
Women and children comprised most of the wounded people arriving on Sunday morning in the emergency room in Al Shifa Hospital in Gaza City, where MSF is working, following heavy shelling overnight and in the morning in the city’s Ash Shuja’iyeh neighbourhood.
MSF personnel witnessed hundreds of people fleeing the area. MSF calls on Israel to stop bombing civilians trapped in the sealed-off Gaza strip, and to respect the safety of medical workers and health facilities.
“Shelling and air strikes are not only intense but are also unpredictable, which makes it very difficult for MSF and other medical workers to move and provide much needed emergency care,” said Nicolas Palarus, MSF field coordinator in Gaza.Separately this morning, a clearly identified MSF vehicle escaped an air strike 300 meters away.
Israeli authorities had earlier guaranteed secure movements for MSF from the Erez border crossing to Gaza City, so that an incoming surgical team could be picked up.
Read the full story: Gaza Strip: Israel must stop bombing trapped civilians
As the Israeli offensive continues in Gaza, clashes in the West Bank, on top of several weeks of raids and arrests by Israeli forces, are taking a heavy toll on the already fragile psychological wellbeing of Palestinians.
Anxiety, post-traumatic stress disorder, psychosomatic problems and feelings of harassment are the most common problems experienced by patients.
Many of MSF’s patients in Hebron are children, in a state of shock after witnessing scenes of violence, or suffering sleeping problems caused by fear of their homes being raided at night.
Read the full story: West Bank: Clashes, raids and arrests damage Palestinians' psychological health
Michele Beck, a medical team leader with MSF, is in Gaza City. In the following update, she explains what MSF teams have and have not been able to do in the last few days:
“A 72-hour truce began yesterday morning, but it did not last long. During the truce we had planned to go to Nasser hospital in Khan Younis, in the south of the Gaza Strip, to see if they needed any additional supplies or staff.
"But we couldn’t— we had to turn around as the fighting resumed. The truce would have given people here a bit of time to breathe and to bury their dead. It would have also allowed us to move. But it didn’t happen that way..."
Read the full update: Gaza: "The truce did not last"
MSF currently has nine international and 30 national staff working in the Gaza strip.
Read today's update on our Occupied Palestinian Territory blog, written by medical team leader Michèle Beck
Al-Shifa hospital, Gaza City
Al-Shifa, with its 600 beds, is the main referral hospital for the entire Gaza Strip. MSF began work in Al-Shifa hospital on 17 July in the emergency room, intensive care unit, operating theatre and burn unit departments.
Depending on the intensity of the shelling, between 80 and 180 patients can arrive in Al-Shifa hospital. The gravity of cases is variable but two thirds of patients are women and children.
Since Israel launched operation ’Protective Edge’ around 2,000 internally displaced people have taken refuge inside the hospital. MSF also donated medical supplies to Al-Shifa hospital on 17 July.
On 28 July, the hospital was hit by shelling as MSF staff worked inside. This attack has been strongly condemned by MSF.
MSF post operative care clinics in Gaza City
Opened in 2007, this project treated hundreds of patients each day prior to the conflict. Today the team is treating only 20 or 30 patients per day.
The majority of the patients are unable to reach the clinic due to shelling.
Nasser Hospital in Khan Younis
In 2010, a specialist surgical programme was opened at Nasser Hospital in Khan Younis, southern Gaza, but had to be suspended because of the conflict.
Nasser hospital, with a regular capacity of 100 beds, is overcrowded. MSF set up a small emergency team on 4 August with one logistician, one anaesthetist and one surgeon for three days to help the staff of the hospital with the huge workload.
MSF donated medical supplies on 12 and 30 of July to support the hospital.Others donations of medical supplies have been made to Kamal Edwan hospital in Beit Lahya (in the north of the Gaza strip) on 30 July and to the central drugs store of the Ministry of Health (MoH) for northern and southern Gaza on 15 July. Other ad-hoc donations have been made to the MoH since the beginning of the crisis.
MSF also runs regular medical-psycho-social programmes in Nablus, Hebron and East Jerusalem to those suffering psychological trauma related to conflict. Last year, 2,749 psychological consultations were carried out.
"A new 72-hour truce was declared yesterday morning. Until then, I had been sceptical about truces, as previous ones had barely been observed. But, this time, the Israeli army announced its withdrawal from the Gaza Strip. And, very quickly, we felt a change."
Read today's update on our Occupied Palestinian Territory blog, written by medical team leader Michèle Beck.
"My daughter is still scared; she doesn’t understand why everything has been destroyed. Yesterday she said to us, ‘Don’t go out, they may break the truce.’ My sons, aged 11 and 12, have lost their childhood. One can only hope that their teenage years won’t be lost too." MSF doctor Abu Abed has time to think during the ceasefire.
Read today's update on our Occupied Palestinian Territories blog.
"When I woke at seven o'clock, my wife said, ’We still have one hour’. At eight o'clock, I received a text message from a friend saying, ’We’re stuffed’. I turned on the radio to hear them announce that rockets had been fired into Israel." MSF doctor Abu Abed writes about the breaking of the ceasefire in today's update on our Occupied Palestinian Territories blog.