Statement of Concern for the Public Health Situation in Gaza

31 July 2006

Palestinian relatives carry the body of Anas Zoumlot, 12, during his funeral in Jabaliya refugee camp, northern Gaza Strip July 26, 2006. (MaanImages/Thaeer al-Hassany)


As Canadian health professionals, we are deeply concerned by the silence of the Canadian government and the Canadian media about the humanitarian disaster in Gaza. We are calling on the Canadian government and the media to truthfully recognize the humanitarian situation and to respond with compassion and effective help.

Even before the capture of Cpl. Gilad Shalit on June 25, 2006, and even before the election of the Hamas government, the humanitarian situation in Gaza was dire.

  • When the settlers left Gaza in August, 2005, the Israeli army left all of the land they occupied covered in millions of tons of rubble, rendering it unusable for cultivation. Israel continued to control all access to Gaza and continued to control water resources.
  • After the Hamas government was elected, the Palestinian health system collapsed due to the freeze of tax revenues by Israel and the stoppage of international aid (led by Canada). Physicians for Human Rights-Israel reported at the time that Israel is responsible for the outcome of the collapse of the Palestinian civil society in general and the health system in particular. Specific to Gaza, PHR-I stated that Shifa Hospital, the central hospital in Gaza, has not received (for at least a month) the essential medicines it needs for basic care , such as furosemide (a diuretic medicine that reduces fluid pressure on the lungs and other organs) and erythromycin (broad-spectrum antibiotic). In Shifa Hospital four patients already have died as a result of the reduction in the number of their dialysis treatments from three per week to only two. James Wolfensohn, Special Envoy for Disengagement to the U.S. Foreign Relations Committee, stated on March 15, 2006, that the collapse of health services and the education system, which addresses the needs of one million children, would be a total failure for the new government, and would have tragic consequences for the Palestinian people. This should not be permitted under any circumstances.
  • Six months before the capture of Cpl. Shalit, PHR-I filed a petition and a request to the Israeli Supreme Court for a temporary injunction to stop the sonic booms, deeming it a collective punishment of the civilian population that particularly traumatized children. The petition was rejected and the sonic booms persist. According to The Guardian Weekly (June 16-22), daily life was violent: 3000 Qassam rockets were fired into Israel over the past five years from Gaza, killing five people; on the other side, Israel dropped 6,000 shells on Gaza since the beginning of April, claiming the lives of elderly farmers, children, and women as well as the family of Huda Ghalia on the Gaza beach; no figures were given about Israeli ground assaults in the same five year period. The June 8th report of MSF-USA, however, reports that Israeli bombing in north Gaza was particularly intense, in one incident killing 45 cows which affected the food supply; MSF continues that bombing since the beginning of the year was so intense in the north that people could not access health-care facilities. Extra- judicial executions and kidnappings by the IDF persisted, and the day before Cpl. Shalit was captured, the IDF kidnapped a Gazan doctor and his brother.
  • Before the current offensive, UN aid relief workers were giving daily food rations to 735,000 Gazans, more than half the overcrowded territory’s population of 1.4 million people. 79 percent of households were living under the poverty line and unemployment was 40 percent.(U.N. Office for the Coordination of Humanitarian Affairs, report July 12, 2006)

    Since the capture of Cpl. Shalit, the situation is far worse in Gaza because of the destruction of the water, sanitation, food, health, and electricity infrastructure. As of July 8, 2006

  • World Health Organisation (WHO) reports that the public health system is facing an unprecedented crisis. WHO estimates that though hospitals and 50 percent of Primary Health Centres have generators, the current stock of fuel will last for a maximum of two weeks. WHO, based on UNRWA’s data related to communicable diseases, stated that the total number of cases of watery and bloody diarrhoea amongst refugees for the last week in June and the first week in July has increased by 163 percent and 140 percent compared to the same period last year (also reported in Defense for Children International-Palestine section). WHO estimates that 23 percent of the essential drug list will be out of stock within one month. WHO is also alarmed by the tightening of restrictions on patients needing to leave Gaza for treatment.
  • The World Food Programme (WFP) estimates that in June 70 percent of the Gaza population were already unable to cover their daily food needs without assistance. As of 8 July, WFP has 20 days of emergency food stocks to cover its expanded caseload of 220,000. Given the escalating crisis, there are growing numbers of people who now need assistance. WFP believes it is essential that a humanitarian corridor for relief items and personnel remains open to avert a further deterioration in the food security situation at this critical time.
  • UNICEF reports that children are living in an environment of extraordinary violence, insecurity and fear. Care givers say children are showing signs of distress and exhaustion, including a 15 percent-20 percent increase in bedwetting, due to shelling and sonic booms.
  • The Office of the Co-Ordination of Humanitarian Affairs (OCHA) states that since destruction of the electric plant, the lives of 1.4 million people, almost half of them children, worsened overnight. In the hottest time of the year, most Gaza residents have power for only 6-8 hours/day. In urban areas, water is available between 2-3 hours/day. The water authority has enough chlorine for two months. UNRWA reports that the Water Utility’s daily operation has been cut two thirds, resulting in water shortages and a critical situation at the sewage plants.
  • On 19 July the Palestinian Human Rights Centre reports that since 28 June 2006, 115 people, mostly civilians, have been killed in Gaza, 550 have been wounded, passage of food, fuel and medicine is denied, six bridges have been destroyed, and transportation and access to medical clinics is disrupted.

    According to the provisions of the Geneva Conventions (1977), the onus is on the warring state to protect the civilian population from the impact of military operations. As the occupying power, the State of Israel is bound by the Fourth Geneva Convention Articles 19 and 50 to treat humanely Gaza’s wounded and sick, to protect hospitals, to protect and care for children. Article 55 states that the Occupying Power has the duty to ensure the food and medical supplies of the population. Article 56 states that the Occupying Power has the duty, in cooperation with the national local authorities, to ensure and maintain medical and hospital services, public health and hygiene. The Association for Civil Rights in Israel, and Physicians for Human Rights-Israel, demand Israel’s immediate compliance with the Geneva Conventions and restoration of Gaza’s infrastructure.

    The undersigned Canadian health professionals fear for the lives of Palestinian people. We ask the Canadian Government to demand that Israel fulfil its responsibilities as a signatory of the Fourth Geneva Convention and take immediate and effective measures to provide protection of the civilian population in Gaza, to reduce severe risks to public health, and to secure appropriate medical care. We ask our own government for the immediate restoration of Canadian aid to the elected Palestinian government to ensure that water, food, medicine and the necessities of life are immediately available and accessible in Gaza.

    Signed
    (as of July 31, 2006)

    Elia Abi-Jaoude, M.D.
    Saadia Ahmad MSW RSW M.Ed
    Michael Allen, M.D.
    Federico Allodi, M.D.
    Zalman Amit, Ph.D.
    Maria Applewhite, R.N., M.P.H.
    Neil Arya, M.D., Past President Physicians for Global Survival,
    Rand Askalan, Ph.D., M.D.
    George A. Awad, M.D.
    Ahmed Bayoymi, M.D.
    Warren Bell, BA MD CM CCFP, Past President, Physicians for Global Survival
    Saleha Bismilla, Acting Family Home Visitor supervisor
    Gary Bloch, M.D.
    Irene Bond, R.N.
    Stephen Connell, M.D.
    Andrea A. Cortinois, MPH, PH.D. Centre for International Health University of Toronto
    Minella De Souza, MBBS, FRCPC
    James Deutsch, M.D., Ph.D.
    Judith Deutsch, M.S.W., R.S.W.
    Dale Dewar, M.D., CCFP, FCFP
    Irfan Dhalla, M.D.
    Farzana Doctor, M.S.W.
    Paul Duchastel, M.D., Past President of Association des Medecins de Langue Francaise du Canada
    A.F. Elzawi, M.D. cardiologist
    Vivien Fellegi, M.D.
    Jane Finlay-Young, Registered Health Practitioner
    Sarah Freke, M.D.
    Maha Gabarin, O.D.
    Sharon Gazeley, M.D.
    Miriam Garfinkle, M.D.
    Qais Ghanem, M.D.
    R.F. Gindi, M.D.
    Louis Girard, M.D.
    Dr. Frank Guttman
    Dr. Herta Guttman
    Ted Haines, M.D.
    Paul Hamel, Ph.D. Faculty of Medicine University of Toronto & President Science for Peace
    Kathy Hardill, RNEC Nurse Practitioner
    Fred Harris, M.D.
    Sameh Hassan, M.D.
    Raed Hawa, M.Sc., M.D.
    D.J. Hill, M.D.
    Hanna Hinnawi, M.D.
    Debbie Honickman, M.D.
    Paul Hwang, M.D.
    Seema Khan, M.D.
    Haresh Kirpalani, M.D., Professor Neonatal Medicine, McMaster University
    Tara Kiran, M.D.
    Peggy Lathwell, M.D.
    Mark Leith, M.D.
    Abby Lippman, Ph.D.
    Christie Maccalum, M.D.
    Harriet MacMillan, M.D.
    Roy Male, M.D.
    Debra Mandel, M.Ed., psychotherapist
    Vashti Mascoll, Primary care nurse
    Gabor Mate, M.D.
    Alison Miculan, M.D.
    Lois Milne, Optometrist
    Basem Naser, M.D.
    Nancy Olivieri, M.D.
    Mario Ostrowski, M.D.
    Reem Abdul Qadir, M.S.W. R.S.W.
    Clare Pain, M.D.
    Michael Potter, M.A. Medical Ethics
    Elizabeth Pringle, M.D.
    Jane Pritchard, M.D.
    F. Rabie, M.D.
    Meb Rashid, M.D., CCFP
    Guillaume Rouselet, Ph.D. Neuroscientist
    Manuel Rozental, M.D.
    Nasri J. Sami, MB, FRCSC consultant neurosurgeon
    Mounir Samy, M.D. Assoc. Professor of Psychiatry, McGill
    Joanna Santa Barbara, M.D. Past President Physicians for Global Survival
    Eshrat Sayani, M.D.
    Fred Schloessinger, M.A. psychotherapist
    Gihad Shabib, M.D., Ass. Professor Ob/Gyn Ottawa U.
    Nayana Somaiah, MBBS, CCFP
    Christina Stonehouse, R.N.E.C. Nurse practitioner
    Jim Sugiyama, M.D.
    Tanya Suvendrini Lena, M.D., MPH
    Teresa Tran, M.D.
    Wahida Valiante, M.S.W.
    Cheryl Wagner, M.D.
    Scott Weinstein, R.N.
    Judith Weisman, psychotherapist
    Gordon Yanchyshyn, M.D.
    Tanya Zakrison, M.D. Chief Senior Resident University Health Network

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