Monday, 9 March 2009

Os médicos lutam para tratar os feridos da guerra de Gaza


Doctors struggling to treat Gaza war wounded
Report, The Electronic Intifada, 8 March 2009

Salman Salama, 14, lies in al-Wafa Rehabilitation Hospital in northern Gaza. (Erica Silverman/IRIN)
GAZA CITY (IRIN) - Mohammed Abu Shabah, aged 22, lies in al-Wafa rehabilitation center in northern Gaza, paralyzed from the waist down after a missile fired by an Israeli drone on 11 January left pieces of shrapnel near his spine. Doctors at the center, Gaza's only rehabilitation hospital, fear removing them could lead to complete paralysis.

"I was just walking down the street," said Abu Shabah, recounting the incident near his home in Rafah. He was eventually sent to al-Madee military hospital in Cairo for emergency care.

He needs, his doctors say, a vasotrain machine to improve blood circulation to his limbs and a urodynamic machine to measure bladder capacity, but both machines are currently unavailable in Gaza.

"They were destroyed by Israeli tank fire on 15 January," Tareq Dirdes, head of the men's unit at the al-Wafa centre, told IRIN, adding "the machine's keyboard was hit by shrapnel, and there are no spare parts available."

Some 2,315 (43 percent) of the injured were wounded by shrapnel, and spinal cord injuries are common, according to the health ministry.

Hospital staff told IRIN they were struggling to provide medical care with intermittent electricity supplies and shortages of items like wheelchairs and medication as well as the more sophisticated equipment needed for patients with paralysis.

Thousands of war wounded in Gaza, including 785 women and 1,815 children, will require long-term care, according to health ministry official Samir Radi.

Patients trickling back

Patients have begun trickling back into Gaza, according to the World Health Organization (WHO), the health ministry and people interviewed by IRIN. WHO official Mahmoud Daher in Gaza estimates that 470 patients are still receiving care abroad, but it is not clear how many of them are war wounded.

Salman Salama, aged 14, sustained a traumatic brain injury after his home in Beit Lahiya was hit by Israeli tank-fire on 14 January. Shrapnel in his skull caused bleeding in his brain. After lying in a coma in al-Shifa hospital he was taken to Egypt for neurosurgery.

Salman returned to Gaza last week, partially paralyzed on his right side.

"We tried to run from the house when the tanks entered," said Salman from his hospital bed at al-Wafa.

Hospitals damaged

Fifteen hospitals out of a total of 27, and 41 primary health care clinics out of 118, in Gaza were damaged during the war, according to WHO, and about half the ambulance fleet was damaged or destroyed.

During the 22-day Israeli offensive, in response to rocket fire from Gaza, access to health care was severely restricted. An estimated 40 percent of the chronically ill were forced to interrupt their treatment, according to WHO.

A recent UN Population Fund (UNFPA) assessment indicates that during the offensive there were an increased number of miscarriages in surveyed hospitals (al-Shifa, al-Aqsa, Naser, Rafah) and increased neonatal mortality in al-Shifa.

"The majority of serious cases still in Gaza are recovering at home or are waiting to travel to receive treatment abroad," said health ministry spokesperson Hamam Nasman.

150 amputees

Nasman estimated there were about 150 amputees, and 815 sustained head and neck injuries due to falling debris.

Medecins Sans Frontieres (MSF) operates three clinics in Gaza -- in Khan Younis, Gaza City and Beit Lahiya -- and four mobile teams. MSF is currently treating 370 patients (330 war wounded), Gaza field coordinator Jessica Pourraz told IRIN.

Since mid-January, about 100 new amputees have been registered at the Artificial Limb and Polio Center in Gaza City, and 10 have started their treatment. The International Committee of the Red Cross is supporting the center.

$49 million of the recent UN flash appeal for Gaza for $613 million was for the health sector.

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