Date: May 23, 2018 Source: The Daily Star Hospitals in Gaza ‘on verge of collapse’ Gemma Fox| The Daily Star BEIRUT: Hospitals in Gaza are “on the verge of collapse” and in a worse state than during the 2014 war, and while under siege cannot get essential medicine and equipment needed to save lives, medical professionals and humanitarian organizations warn. Madhat Abbas, Gaza’s Al-Shifa Hospital General Director, said hundreds are still waiting for further treatment, but without essential supplies, the hospital is at breaking point trying to treat them all. “It’s inhumane just how much we need,” Abbas told The Daily Star. “Everything, from antibiotics, anesthetic medications, external bone fixators, basic painkillers.” Even during advanced surgery, doctors are having to resort to using common medicine available in pharmacies, rather than proper anesthetics or painkillers, he said. “I’ve honestly never seen a situation like this in Al-Shifa,” he added, “It’s just chaos.” Gaza’s Health Ministry warned that unless the siege lifts to allow more supplies enter the enclave, more people will continue to die from their wounds sustained from the May 14 protests. “Three patients have already died in the hospital,” ministry spokesperson Ashraf al-Qedra said. “I fear that this will rise a lot more as we still have 230 people in a critical condition.” Qedra said that in those cases, patients had been shot in the head and stomach, and while doctors were initially able to stabilize them, they didn’t have the right supplies to keep them alive. “In 2014 [the last Hamas-Israel war], Gaza had a shortage of medicine of around 20-30 percent, but already before May 14, hospitals were running on 40-50 percent depletion rates,” Fikr Shalltoot, program director for Medical Aid for Palestinians in Gaza, said. “They’re simply on the verge of collapse.” During last week’s bloodshed, doctors had to adopt a triage system to prioritize patients in order of severity. Most of those brought in suffered from lower body injuries and had to be left for hours. “You should tend [to patients with waist-down injuries] immediately but we didn’t have enough staff, enough hospital beds,” Abbas said. “We’d take off the tourniquet and the leg would already be dead.” Al-Shifa has already to amputate forty-four limbs, he said. But for all the patients in need of limb reconstruction there are only three doctors and two nurses who are qualified for this across the whole Gaza strip, and only one hospital has the necessary equipment to handle skin graft cases, according to MAP and Doctors Without Borders (MSF). There is also a grave risk of infection due to lack of proper post-operative care and medication, which could lead to further health problems, or in more severe cases, the need to amputate, MSF said in a statement. “The politics of the siege is directly impacting on whether people will live,” Qedra said. The Health Ministry had already announced in February a state of emergency and implemented strict contingency measures, including the partial closure of three hospitals. Unable to cope, the ministry is now desperately trying to medically evacuate people outside of Gaza for treatment. Abbas said they were able to send 18 people to Jordan Tuesday, most with orthopedic or vascular injuries, but that this is still a far cry from the hundreds that still need outside help. The situation is far worse than in 2014, MAP’s Shalltoot argued, when all crossings were opened on a regular basis and hundreds were allowed to leave. Egypt announced on May 18 that it would open the Rafah crossing for the month of Ramadan, but the Erez and Kerem Shalom crossings with Israel remain closed. Medical staff working around the clock have also not received salaries since October 2017 and those employed by the Palestinian Authority received only partial salaries this year, according to MAP. “Some cannot even afford the transport to work,” Shalltoot said. For Qedra, this amounts to a deliberate policy set by Israel to debilitate as many civilians as possible with life-changing injuries. Many patients will now struggle to walk again, let alone participate in any future marches or protests.