The release of two new reports point to the severity of the Israeli-imposed crisis on the Gaza Strip, with thousands of Palestinian patients — many of whom have been injured by Israeli gunfire, shells and missiles — unable to access much-needed medicines and treatment due to the ongoing Israeli siege on the Gaza Strip.
The first report, by Doctors without Borders (Médecins Sans Frontières), reports a rapid and severe increase of bone infections among injured Palestinians.
The group reports:
Médecins Sans Frontières (MSF) is dealing with immense challenges while treating many people who have developed bone infections after having been shot by the Israeli army during protests in Gaza, Palestine over the last year. These infections are adding to the already complicated path to recovery that these injured people must tread. Their serious and complex wounds require months – if not years – of dressing, surgery and physiotherapy. Infections prevent recovery, and to make matters worse, many of them are resistant to antibiotics.
Gunshot wounds prone to infection
“When you have an open fracture, you need lots of things to get better: different types of surgery, physiotherapy, and avoiding the wound becoming infected, which is a high risk with these types of injuries,” explains Aulio Castillo, MSF’s Medical Team Leader in Gaza. “Unfortunately, for many of our patients who have been shot, the severity and complexity of their wounds – combined with the severe shortage of treatments for them in Gaza – means they have now developed chronic infections.”
“What’s more, we’re finding in preliminary testing that many of these people are infected with antibiotic resistant bacteria,” says Castillo.
Gunshot wounds by their very nature are prone to infection. With a dirty foreign body breaking the skin, it is vital that the wound be cleaned to reduce the risk of infection. With injuries such as those in Gaza, where the wounds are huge, bones are splintered, and treatment is difficult, many wounds stay open long after the injury, meaning the risk of infection is drastically higher.
Antibiotic resistant wounds make treatment much harder
Complicating this is what appear to be very high rates of antibiotic resistant infections there. These infections have developed an ability to withstand many common antibiotics used to treat them. This often happens because antibiotics have been overused, whether in the community or in the environment, which is a growing problem worldwide.
Antibiotic resistance makes the already difficult task of treating people like Ayman much harder. To get better he needs antibiotics, but with the usual option useless against the resistant infection, he has to take a stronger type that carries a higher risk of side effects. These “heavy-duty” antibiotics are also much more expensive.
In the second report, focused on shortages of essential medicines, Yousef al-Jamal, writing for the Electronic Intifada, states:
Israel’s siege – imposed since 2007 – has affected Gaza’s healthcare system enormously. A new report by the World Health Organization states that of the 516 items on Gaza’s essential medicines list, nearly half had less than a month’s stock remaining in 2018. The depletion of stocks had worsened by 15 percent since the previous year, the report adds.
Data from 2019 paint a similarly disturbing picture. During August, stocks of 225 essential medicines held in the central store of Gaza’s health ministry had run out by at least 90 percent.
Rana Hussein, a nurse at al-Shifa hospital in Gaza City, says that more than 60 cancer drugs are unavailable in Gaza. Treatments for diabetes and some kidney complaints are hard to find, too.
“There are 250 patients with thalassemia [a blood disorder] who lack medication,” Hussein said.
Israel’s frequent attacks on Palestinians taking part in protests has also placed considerable burdens on Gaza’s hospitals.
More than 1,000 people who have been injured are awaiting limb reconstruction treatment in Gaza, Nickolay Mladenov, the United Nations’ Middle East envoy, stated last month. Unless such treatment is provided, many limbs could be lost because of infection.
Mladenov has claimed that “some improvements were felt” in Gaza’s economy over the past few months. Unemployment has dropped from 47 percent to 46.7 percent, he said.
The improvements have not been felt by many ordinary people. And human rights monitors have drawn attention to how a new method for calculating unemployment data has been introduced in Palestine.
Gisha, a group campaigning against movement restrictions, has estimated that the real level of unemployment in Gaza has risen since last year.
Mahmoud is a 30-year-old unemployed man. Two of his children – Wissam, 8, and Lina, 7 – have epilepsy.
Wissam can have as many as five seizures per day. He has broken teeth and injured his hands while falling down.
“Impossible to afford”
A dose of levetiracetam – the main drug used to treat epilepsy – costs $150 each for Lina and Wissam per month – when it can be found. “This treatment is often not available in Gaza’s hospitals and pharmacies,” said Mahmoud, who does not have the money to buy the medicines, in any event.
The children’s mother Ghada is trying against the odds to remain optimistic. “After black clouds comes sunshine,” she said.
“I wish it was me [who had epilepsy], not you,” she added, looking at her children.
Imam Abdulrahman, now aged 23, was diagnosed with a heart condition in 2016. Since then he has had an aortic valve replacement operation.
It is vital that he takes regular medication to reduce the risk of a heart attack or a stroke. Like many others in Gaza, he and his family do not have the means to pay his medical bills.
Lacking a fixed job, Abdulrahman does occasional work in construction or as a cleaner.
He mainly relies on welfare payments paid to his father by the Palestinian Authority, headquartered in the occupied West Bank. The payments come to $400 and are only issued every three months.
“This is not enough money,” Abdulrahman said. “It is impossible for me to afford medicine to help me overcome my illness.”
Palestinians, in particular the elderly, sick and disabled, come together to call for international efforts to save Gaza from the humanitarian crisis
Palestinians yesterday inaugurated Atfaluna Society for Deaf Children in Gaza’s new improved building which was funded by Kuwait.
The Gulf state pumped $200 million to help reconstruct numerous projects in the besieged enclave including the Atfaluna Society project which supports 450 people with special needs.
The Kuwait Fund for the Reconstruction Program of the Southern Provinces in the State of Palestine has allocated $3 million to support the education sector through higher education institutions and NGOs. Funding has been provided to 13 institutions and associations which deal with higher education and people with special needs.
Palestinians, who were wounded by Israeli soldiers during a protest, organized to mark 70th anniversary of Nakba, also known as Day of the Catastrophe in 1948, and against United States’ plans to relocate the US Embassy from Tel Aviv to Jerusalem, receive treatments at European Hospital in Gaza City, Gaza on 17 May, 2018
A new World Health Organisation (WHO) report said 2018 saw an “unprecedented” number of attacks on healthcare by Israeli forces in the occupied Palestinian territory (oPt).
The report, “Right to Health in the occupied Palestinian territory: 2018”, launched this week in Ramallah at an event attended by senior diplomats, sets out to examine “obstacles to achieving the highest attainable standard of health for Palestinians living under occupation”.
According to Dr Gerald Rockenschaub, the head of WHO’s office in the oPt, “Palestinians in the West Bank and Gaza Strip continue to face major barriers to the realization of the right to health.”
“Sustainability of quality healthcare services is challenged by chronic occupation and fragmentation; restrictions on movement have a profound impact on access to healthcare, including for some of the most vulnerable Palestinian patients.”
The WHO noted that “Palestinians living under Israeli occupation in the West Bank and Gaza Strip are exposed to high levels of violence”, with 299 Palestinians killed by Israeli forces in 2018, and 31,723 injured (mostly in the context of Great March of Return protests in Gaza).
Moreover, the WHO reported, 2018 saw “an unprecedented 432 attacks against healthcare in the West Bank and Gaza Strip”.
“In Gaza alone, three health workers were killed and 570 injured, 41 with live ammunition, while providing care to those injured in Gaza’s Great March of Return,” the WHO stated.
Meanwhile, “over a half of conflict-affected children may be affected by post-traumatic stress disorder, while the long-term consequences of injuries, with more than 6,000 live ammunition injuries in Gaza alone over the year, put strain on an already overburdened health system.”
Speaking at the launch event, United Nations Humanitarian Coordinator for the occupied Palestinian territory, Jamie McGoldrick, described a “dire humanitarian situation” for Palestinians.
“No patient should have to worry about being prevented from accessing essential and lifesaving treatments, whether access to health facilities requiring Israeli-issued permits or access to essential medicines within Palestinian health facilities,” McGoldrick stated.
“No health worker should have to go to work with the fear of being shot at and killed. WHO’s report underlines the immediate need for our collective efforts to strengthen the protection of healthcare.”
The health condition of three Palestinian detainees has gravely deteriorated due deliberate medical negligence by the Israel Prison Service.
The Palestinian Detainees and Ex-Detainees Commission in a report released on Wednesday said that the Palestinian prisoner Mwaffaq Arrouq, 76, is suffering from stomach and liver cancer and his life is at stake.
The commission said that Arrouq is in urgent need of chemotherapy sessions but the Israel Prison Service in Negev jail is preventing that.
The second detainee is Amal Taqatqa, 25, who was injured by three live bullets during her arrest in 2014.
Taqatqa cannot stand for long hours because of her injured leg whose condition is getting worse each new day. Taqatqa needs a specialist orthopedic doctor, but the Israel Prison Service at Damon jail does not provide her the necessary treatment.
Rawan Samhan, 26, who is also held in Damon jail, suffers from anemia which causes her headaches and constant dizziness and she needs urgent medical follow-up.
The commission said that it receives daily statements trough prisoners who are suffering from medical negligence in Israeli jails.
Ramallah (QNN) – Palestinian Minister of Health, Mai Alkaila, warned late yesterday that a possible outage of power by the Israeli Electricity Company in the West Bank districts of Ramallah and Bethlehem, may put the lives of dozens of patients at risk, as such outage may cause damage to refrigerated medications.
Alkaila said in a statement quoted by WAFA, the official Palestinian news agency, that such blackout may also cause harm to a large segment of the population in these governorates, as it affects the validity of hundreds of products and food parcels that require refrigeration or freezing.
In addition, she added, the power outage “may affect medications and vaccines kept in the refrigerators of the health centers and health care clinics.”
“Any power outage on the refrigerators and vaccines of the health centers will damage them and affect their effectiveness, especially those medicines kept at low temperatures. Some of them require permanent freezing during the storing period,” Alkaila continued.
She said any power outage by IEC will certainly affect the validity of children’s vaccines, “as most vaccines are stored at temperatures between 2-8°C, and there are a number of vaccines that need freezing at temperatures as low as minus 20°C, such as the polio vaccine.”
“One of the most important factors in responding to the effectiveness of vaccines is the cold chain of storing them. This means that administering vaccines that have not been kept in proper temperature will result in them being useless,” the Health Minister emphasized.
She pointed out that JDECO has exerted great efforts to ensure the provision of electricity to the health centers in the cities, but that does not apply to all health centers, as JDECO will not be able to provide all health centers with electricity as a result of the Israeli blackout. “This threatens the lives of all patients who use the services of those centers, especially those of the serious cases.”
Alkaila stressed that the power outage will not only affect patients and medicines, but also goes beyond to refrigerators at homes, shops and shopping malls. “Such outage means that food items that need to be kept at low temperatures are at risk of deterioration.”
Video by the Palestinian Center for Human Rights (PCHR): This video sheds light on the medicine shortage crisis in the Gaza Strip, and how it impacts thousands of patients suffering from chronic and serious diseases.
Gaza’s only public eye hospital carried out 1,370 surgical operations, including 75 emergencies, in the first six months of this year, it’s biannual report revealed.
The report stated that 145 operations needed highly skilled experts. Meanwhile, the hospital carried out 6,364 minor operations, with Local anaesthesia.
According to the report, more than 27,000 patients visited the hospital, which is the only government-run eye hospital in Gaza.
Dr Abdul-Salam Sabbah, general director of hospitals in Gaza, hailed the efforts of the medical, nursing and administrative staff at the hospital, stating they have been striving to improve medical services in light of the severe shortages of medical equipment and medicines as a result of the Israeli siege and the Palestinian Authority’s sanctions.
A new report by the group ‘Forensic Architecture’ has found that widespread pesticide contamination from Israel into Gaza has occurred over decades, severely impacting the food grown in Gaza.
The full report follows below:
Staging the terrain
Over three decades, in tandem with the Madrid and Oslo negotiation processes, the occupied Gaza Strip has been slowly isolated from the rest of Palestine and the outside world, and subjected to repeated Israeli military incursions. These incursions intensified from September 2003 to the fall of 2014, during which Israel launched at least 24 separate military operations targeting Gaza, giving shape to its surrounding borders today.
The borders around Gaza—one of the most densely-populated areas on Earth—continue to be hardened and heightened into a sophisticated system of under- and overground fences, forts, and surveillance technologies. Part of this system has been the production of an enforced and expanding military no-go area—or ‘buffer zone’—on the Palestinian side of the border.
Since 2014, the clearing and bulldozing of agricultural and residential lands by the Israel military along the eastern border of Gaza has been complemented by the unannounced aerial spraying of crop-killing herbicides.
This ongoing practice has not only destroyed entire swaths of formerly arable land along the border fence, but also crops and farmlands hundreds of metres deep into Palestinian territory, resulting in the loss of livelihoods for Gazan farmers.
Farmers near the border in Gaza
Tractors flattening land for the ‘buffer zone’ in eastern Gaza, in 2018
(Read the press release from Gisha Legal Center for Freedom of Movement here.)
To this end, our investigation sought to answer the following questions: how do airborne herbicides travel into Gaza? How far into Gaza does it enter? What is the concentration of the herbicide that drifts into Gaza? And what is the damage to the farmland on the Gazan side of the border?
Weaponising the wind
Our analysis of several first-hand videos, collected in the field, reveals that aerial spraying by commercial crop-dusters flying on the Israeli side of the border mobilises the wind to carry the chemicals into the Gaza Strip, at damaging concentrations.
The videos support the testimonies of farmers that, prior to spraying, the Israeli military uses the smoke from a burning tire to confirm the westerly direction of the wind, thereby carrying the herbicides from Israel into Gaza.
Our investigation shows that each spray leaves behind a unique destructive signature. No two aerial sprays will have the same effect, nor can their damage be reasonably predicted by the army, since the location where the toxic chemicals land, and their respective concentrations, depend heavily on the direction and speed of the wind relative to the flight path of the aircraft.
In November 2016, in response to a Freedom of Information (FOI) request filed by the NGO Gisha, the Israeli Ministry of Defense confirmed that aerial herbicides are sprayed along the width of the perimeter of Gaza. Aerial spraying is conducted between the Erez crossing in the north and Kerem Shalom in the south, over an estimated area of 12,000 dunums (12 square kilometres).
The Israeli government’s response to an FOI request filed by the NGO Gisha. (Gisha)
Following the advice of a contracted civilian agronomist, Israeli military spraying is conducted during key harvest periods, targeting spring and summer crops. Working with the private Israeli civilian aviation firm Chim-Nir (כימ-ניר), the army’s destruction of vegetation along the eastern perimeter is carried out in a continuous manner, using two aircrafts simultaneously, each equipped with a GPS system to enable precision.
The Ministry of Defense also confirmed that the Israeli military sprays a combination of three herbicides: Glyphosate, Oxyfluorfen (Oxygal) and Diuron (Diurex).
Glyphosate, formulated as ‘Roundup’, is the most widely-used herbicide in the world, leaving traces in soil, foodstuffs, air, and water, as well as human urine. Roundup is the flagship product of the Monsanto Company, a leading agricultural chemicals business that previously produced herbicides and defoliants used by the US military in Vietnam.
In March 2015, the World Health Organization’s Cancer Research Agency classified glyphosate as ‘probably carcinogenic to humans’. Since then, the US Environmental Protection Agency, the European Food Safety Authority and the European Chemicals Agency have ruled it safe for use, although a number of European environmental groups have opposed this ruling.
Oxyfluorfen, formulated as ‘Oxygal’, is manufactured by the Israeli company Tapazol Chemical Works Ltd, and suppresses the growth of certain broad-leaf and grassy weeds. According to the Material Safety Data Sheet provided by Tapazol, Oxygal can cause ‘severe irritation’ upon contact with skin or eyes, and must be ‘kept out of water supplies and sewers’.
The Ministry claimed that it is ‘not carrying out any aerial spraying over the area of the Gaza Strip… [but] only over the territory of the State of Israel along the security barrier’. Citing Israel’s Plant Protection Law, 5716-1956, the Ministry claimed that its spraying practices along the Gaza border are identical to aerial spraying carried out in other Israeli-controlled areas.
A bottle of Oxygal herbicide
However, wind direction is a key factor that determines the movement of aerial herbicides from the purportedly-targeted area, and when effective drift control techniques are not applied, the Israeli army cannot mitigate the reach of those chemicals into Gazan farmland.
Plant scientists have noted that under similar environmental conditions, and with all sprayers adjusted properly, herbicide drift is ‘generally greater from aerial application than from ground application’; the use of ground-based field crop sprayers through tractors reduces the likelihood of extensive drift.
The Israeli military has confirmed that it sprayed aerial herbicides at least thirty times in along the border with Gaza in the period from November 2014 to December 2018. The spring of 2019 season was the first spring season during which the military has not conducted aerial spraying in the past four years.
To date, no Palestinian farmers have ever been compensated for damages to their crops.
Tracking a single spraying
On 5 April 2017, standing on the Gazan side of the border area near Khan Younes, a fieldworker with the NGO Gisha recorded a video of an Israeli crop-dusters spraying herbicides.
Palestinian farmers in the area reported concerns that their crops would be damaged as a result of this spraying, once it was carried by the wind, considering that crops had already been harmed in a previous round of spraying that took place only months prior. Further, most of the crops in the area had been recently sown, making them particularly susceptible to damage from herbicide spraying.
Leaves damaged by herbicide
To determine the unique destructive signature of this spraying event, we threaded together evidence derived from vegetation on the ground, the testimony of civilians living and working in the area, and the nature of the environmental elements mobilised in the event.
We identified the plane spraying herbicides along the eastern border of Gaza as a Model S2R-T34 Turbo Thrush.
Using the GPS location of the videographer as recorded on their smartphone, we were able to establish the camera’s cone of vision by comparing the dimensions of visible landmarks, such as a watchtower. Through a process of camera calibration we found the location of the plane and used motion-tracking to model its path, in time and space, as it sprayed.
The flight paths seen in videos collected by Forensic Architecture were mapped onto a 3D model
Our analysis revealed that before each spray, the plane dives to roughly 20m altitude to get closer to the ground. Each spray goes on for a duration of 2–5 seconds, covering the area to be fumigated by travelling back and forth in linear paths.
For the spraying that took place on 5 April 2017, we were able to identify six such spraying paths during the course of the two videos. All six of the sprayings were conducted on the Israeli side, close to the eastern border of Gaza.
With the assistance of a fluid dynamics expert, Dr Salvador Navarro-Martinez, we sought to determine the extent and concentration of herbicide drift.
To this end, each spray event was simulated using our flight path reconstruction, the local topology, the injector systems fixed to the plane, and meteorological conditions at the time of spraying. We then collected key variables such as wind direction and speed, droplet distribution, and ground chemical deposition to determine the extent of the drift.
The results of Forensic Architecture’s analysis show the distribution of concentration of herbicide as it travels westward into Gaza
The results showed that as the wind moves across the path of the herbicide spray, it carries chemicals westward that are then deposited onto Gazan farmland. The simulation indicates that for the spraying on 5 April, harmful concentrations of herbicide drift reached in excess of 300m into Gaza. This confirms that Palestinian crops could have been harmed as a result of herbicide drift.
Satellite imagery analysis
Analysis of satellite imagery corroborates the findings of our drift simulation. We compared satellite imagery 5 days after the spraying, and 15 days after the spraying, to reveal visual indicators for the presence and health of vegetation. When the two analyses are overlaid with one another, vegetation degradation becomes visible across much of the same area potentially affected by herbicide drift.
An NDVI analysis showing losses of vegetation between 5 days and 15 days after the herbicidal spraying. Red indicates areas in which vegetation has been lost
These findings suggest that herbicides carried by winds during and after the Israeli military spraying on 5 April contributed to the degradation of vegetation on the Gazan side of the border, in Khan Younes. We believe that these findings are largely generalisable, since similar vegetation degradation is also visible in other areas in Gaza which are close to the border and in the vicinity of known Israeli target areas for aerial herbicide spraying.
Following another confirmed spraying flight by the Israeli military on 9 and 10 January 2018, also in the Khan Younes area, the Palestinian Ministry of Agriculture actively surveyed dozens of farms that had reported crop damage. Gazan farmers living hundreds of metres away from the border reported damage to crops totaling 250 acres following the January spraying.
Three days after another spraying in December 2018, we gathered similar samples of leaves that exhibited characteristic damage from a contact herbicide.
Spraying by the Israeli military was conducted along the border on 3 December 2018. On 6 December 2018, samples were collected from Palestinian farms whose leafy crops showed visible damage
Leafy crops sampled from two locations along the border with Israel in East Gaza and Juhor ad Dik, hundreds of metres into Gaza, revealed visible damage from fungal pathogens, insect feeding, and possible herbicide drift carried by the wind into Gaza. Corroborating human testimony on the ground, leaves of plants along the Israel-Gaza border function like sensors, recording memories of environmental violence.
Aerial spraying: Less control, unpredictable damage
When analysing the elements of a single spraying event on 5 April 2017, the testimonies of farmers, satellite imagery, and drift analysis we have gathered all confirm that agricultural lands more than 300m from Gaza’s eastern border experienced damage, and with concentrations of herbicides above the recommended amounts for drift, according to the European Union.
Evidence derived from vegetation on the ground, civilian testimony, and the environmental elements mobilized in the spraying event all correspond to show that the Israeli practice of aerial fumigation at times when the wind is blowing into Gaza causes damage to farmland hundreds of metres inside the besieged strip.
This confirms that as a practice for the clearing of vegetation, aerial spraying causes indiscriminate damage: the effects are less readily controllable, and the extent of damage to Palestinian farmland per spray is largely unpredictable. As such, the Israeli military cannot guarantee the reach of the chemicals it sprays by air, nor ensure that those chemicals remain proportionate to the declared objective of improving visibility for security operations.
Israeli military authorities continue to reject calls to end the practice of aerial herbicide spraying along the border with the Gaza Strip. Israel does not coordinate or share the proposed timing of planned operations with the Palestinian Ministry of Agriculture, the International Committee of the Red Cross, or with Gazan farmers, a practice which could mitigate some of the harm to those farmers’ property, and possibly to the surrounding environment as well.
Damage to land, health and livelihoods
The inability to control both the effects and reach of this ongoing military practice along the eastern border enacts a heavy price on Gaza’s farming community and the broader civilian population.
The Palestinian Ministry of Agriculture estimates that between 2014 and 2018, herbicide spraying damaged upwards of 13,000 dunams of farmland in Gaza. The NGO Al-Mezan has further warned that, in addition to crop damage, the long-term consumption by livestock of plants affected by the sprayed chemicals has negative effects that may harm the health of humans who then consume meat from those livestock.
In the context of an ongoing Israeli blockade—with restrictions on the movement of people and goods into Gaza, and diminishing possibilities for farmers to cultivate land, maintain livelihoods, raise livestock, and to fish—the agricultural lands along Gaza’s eastern border are an important part of the food security of its population.
This map displays long-term changes to visual indicators of vegetation health across the Gaza region over the past three decades of Israeli occupation. Red indicates areas in which vegetation was completely eradicated. Vegetated areas that have degraded over time are shown across a gradient from yellow to red, according to the severity of vegetation degradation over time. Areas that have become greener over time are shown across a gradient of light to dark green, and occur mainly on the Israeli side of the border
Along with the regular bulldozing and flattening of residential and farm land, aerial herbicide spraying is one part of a slow process of ‘desertification’, that has transformed a once lush and agriculturally active border zone into parched ground, cleared of vegetation.
These practices have provided the Israeli military with visibility along the eastern border of Gaza—a visibility that has also left Palestinian civilians, including farmers, youth and families, further exposed to Israeli fire from hundreds of metres away.
The slow violence of spatial degradation through the mobilisation of environmental elements thus accelerates into an eruptive violence.
The Palestinian Commission of Detainees’ and Ex-Detainees’ Affairs has accused the Israeli administration of Ashkelon jail of procrastinating over providing Palestinian prisoner Basem al-Na’san with medical treatment.
According to the Commission, prisoner Na’san suffers from a bullet injury and serious colon and bowel problems, and thus he uses special bags attached to his body for excretion and secretion.
The prisoner, a 24-year-old from the West Bank village of al-Mughayyir, has been waiting long for medical tests and an urgent surgical operation, but the administration of Ashkelon only pays him lip service.