Posts Tagged ‘emergency department’

Al Shifa Emergency Department – largest in Gaza (part 2)

April 9, 2014

See Paramedics in Gaza for original post

In part one  I gave a brief introduction to the Emergency Department (ED) at Al-Shifa hospital, Gaza’s largest healthcare facility. I spent a few hours there last week meeting staff and seeing for myself the current situation in the ED and Intensive Care Unit. In this post I’d like to focus on the shortages affecting health care provision in the ED and ICU, which are the same shortages affecting every part of the health service here.

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Shortages here come in a few different forms. Firstly, many drugs are scarce or completely unavailable. Secondly, many disposables (single use bits of medical equipment, such as suction tubing or syringes) are expired or unavailable. Thirdly, parts and servicing for medical equipment are often unavailable. This includes ambulances themselves, as we heard from the Ministry of Health.

The reasons for these shortages is a little complicated. The largest factor is the Israeli blockade of Gaza, which includes control of goods crossing into the country at the Kerem Shalom and Erez Crossings. This means that all imports of medical equipment must be approved and coordinated by Israel, making shipments vulnerable to delays, refusal or seizure. In the past these controls were circumvented by the smuggling of medications and equipment through tunnels under the Egypt-Gaza border. In the past the Ministry of Health, for example, have received 30% of their medicines through the tunnels. In 2013, the vast majority of these tunnels were destroyed by Egypt, cutting off a vital lifeline for Gaza and the health service in particular. As a result, shortages have been exacerbated with little hope for improvement. (more…)

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Al Shifa Emergency Department – largest in Gaza (part 1)

April 2, 2014

See Paramedics in Gaza for original post

Last Thursday I visited Al-Shifa hospital, the largest medical complex in Gaza, to get a look at the Emergency Department (ED). I was hoping to get a better grasp on the structure of the ED, to meet some of the staff and to see for myself the situation they’re working in. I saw and learned so much that I’m going to split this into a couple of posts to make it manageable. In this post I’ll describe my visit, the structure of the hospital and touch on the role of the hospital in the recent history of Israeli military assaults on Gaza. Then in another post I’ll look at the day-to-day challenges of working in this environment with particular reference to equipment and drug shortages.

"What could have been a modern university-like hospital is, however, reduced to a completely worn-out, almost makeshift, field hospital after years of siege, as well as a lack of maintenance and upgrading." - Norwegian doctors Mads Gilbert and Erik Fosse, 2009

 

First off I met Dr Nser Al Tater, a cardiologist and the general director of the hospital who welcomed me and gave me a bit of an overview of the situation. We talked most about the impact of the electricity crisis on the hospital – I’d read details recently but to hear stories along with the statistics was eye-opening. The hospital is currently reliant on generators for 16 hours/day, requiring a huge amount of expensive and increasingly unavailable fuel. The generators aren’t designed to be used so much and have previously cut out completely – Dr Al Tater told me about a cardiac surgery where the electricity cut out ten times over the course of the operation. All life support had to be continued manually while each blackout lasted. In between, surgery resumed. Similarly, a recent powercut in the neonatal ICU resulted in staff manually ventilating 12 babies until the power returned to their ventilators. (more…)