Violence increased across the Occupied Palestinian Territory in 2014, and the year was marked by a 50-day war with Israel. Médecins Sans Frontières (MSF) doubled its capacity to help meet medical and psychological needs.
Tensions mounted between Israel and Palestine in June, and Operation Protective Edge was launched in the Gaza Strip on 8 July, leaving 2,286 Palestinians dead (25 per cent of which were children), over 11,000 injured and 3,000 with permanent disabilities. A ceasefire was declared on 26 August, but of the 500,000 people displaced, 54,000 have still not been able to return home.
Access to healthcare across the occupied territories remains severely limited by the West Bank wall, the Gaza blockade and other measures. There is a shortage of technical equipment and training for specialist care, including surgery and mental healthcare, in Gaza. Living conditions continue to deteriorate and people’s coping mechanisms are stretched. In the West Bank, including East Jerusalem, daily violence, collective punishment, and humiliation at checkpoints are common and have taken a psychological toll.
A mental health programme was started by MSF in Hebron, Nablus and Qalqilya governorates in the West Bank in 2000, extending to east Jerusalem in 2011. The programme focuses on adults and children who have experienced or witnessed violence (Israeli–Palestinian or inter-Palestinian), and whose psychological suffering impedes their normal life. It aims mostly to help those served evacuation orders, whose homes are demolished, and those under regular attack from settlers and Israel Defense Forces search and arrest operations. More than 5,500 patients received psychological support during the year.
The demand for reconstructive surgery in Gaza dramatically increased because of the acute conflict. Normally teams work on a fly-in/fly-out basis to perform hand surgery, post-burn surgery and correct defects, but a rise in the number of casualties led MSF to establish an emergency surgical team in Gaza between July and September to perform lifesaving operations. A permanent reconstructive surgery team was present until December. Over 320 surgical procedures were carried out in 2014.
Two MSF clinics, in Gaza City and in an inflatable tent at Nasser hospital, provided post-operative care, including wound dressings (12,700), physiotherapy (11,800 sessions) and occupational therapy. More than 1,000 patients received rehabilitative care and 350 patients were being treated at the close of the year.
After one and a half years, MSF’s support to the intensive care unit at Nasser hospital was suspended after results were not as good as expected. Training sessions with doctors and nurses are now planned.
A Gaza mental health programme suspended in 2011 by local authorities resumed in October, responding to a rise in needs following Operation Protective Edge. Mental health consultations were integrated into post-operative care. MSF plans to launch a dedicated paediatric mental health programme within Ministry of Health structures in the coming months.
No. staff in 2014: 121 | Expenditure: €4.3 million | Year MSF first worked in the country: 1989 | msf.org/palestine
Hazem Abu Malouh – doctor
It's very hard because we have no news from patients who used to come regularly for care. Or we see patients that tell us terrible stories like this little girl of seven who has burns to her face, caused by an explosion. She came for treatment. But when I asked her where her father and mother were, she said they died. There is also this 32-year-old woman who was slightly injured by shrapnel and was pretty good physically. But she was very shaken by the loss of her four brothers. Two of them just got married and all died in recent weeks. We listen to patients, they need to talk but they do not understand what happened to them.
We really go through a lot of emotions. Sometimes incredible things happen also. A patient we follow up for a while is in a wheelchair … When I learned that the city of Shujahia where he lives was under heavy shelling and that everybody was fleeing, I wondered how he would do. How to escape in a wheelchair? And then one night I was watching television that showed refugee families in a school and I saw him on TV! He was alive. It was great.
To read more, visit blogs.msf.org/hazem