people displaced in the West Bank between 2015 and 2018
employment rate in Gaza in 2019 (one of the highest in the world)
people have very limited access to healthcare, including 1.3 million refugees
Forced to abandon their lands over 70 years ago, the Palestinians have been living under Israeli occupation for over 50 years. For the last 13 years a large proportion of the population has also been subjected to the blockade of the Gaza Strip. This is the context in which Médecins du Monde has been working in Palestine for 25 years, providing direct support to Palestinian communities and healthcare facilities, while also bearing witness to the many difficulties Palestinians face in their everyday lives.
Living under the blockade in Gaza
The Gaza Strip is one of the most densely populated areas in the world. There are 1.9 million people living there, including 1.3 million refugees, 70% of whom live in the eight refugee camps. Since 2007, the humanitarian situation has worsened with the intensification of the land, air and sea blockades imposed by Israel and the Israeli military operations of 2008, 2009, 2012 and 2014. The poverty rate among the people of the Gaza Strip was 86% in 2019 (with 33% in extreme poverty). The shortage of medicines, supplies and equipment is an ongoing problem and reached record levels in July 2019 when over 50% of essential medicines were unavailable. Gaza also lacks ambulances and properly equipped health and emergency centres.
The shortage of medicines reached levels with over 50% of essential medicines unavailable.
The number of exit permits granted to patients requiring urgent treatment outside Gaza has kept decreasing, falling from 76.6% in 2015 to 44% in 2017. This situation has put hundreds of people at risk and no less than 52 people died in 2018 while they were waiting for an exit permit. Some cancer patients and people with chronic conditions require treatment which is not available in Gaza and need to be transferred. But even aside from these cases, access to basic healthcare is often impossible due to frequent power cuts.
Linving alongside the israeli settlements
In the West Bank, particularly in the region of Nablus, people live in a constant state of tension due to the proximity of Israeli settlements. Children and young people are particularly at risk. Surrounded by a significant military presence, the Palestinians frequently have to endure searches and checkpoints. Some Israeli settlers regularly attack the Palestinian communities: harassment, beatings, stonings, shootings, damage to homes and destruction of crops are a common experience. The attacks by settlers have increased substantially in recent years and are carried out with complete impunity. These traumas come on top of the multiple forced displacements and demolitions of Palestinian homes by the Israeli occupation authorities (931 demolitions between 2017 and 2019).
The stress and other mental health problems resulting from this situation only rarely receive treatment. Medical staff are poorly trained in identifying such conditions and the facilities to which sufferers can be referred are too few in number to meet the level of need. Furthermore, there is stigma around psychological and mental health problems and families do not automatically turn to health centres for help with this type of illness.
Médecins du Monde works in the Gaza Strip helping healthcare facilities prepare for emergencies and improve how they coordinate their activities. Healthcare staff also receive specific training in emergency care. In emergency situations, directing victims to suitable facilities helps to alleviate the burden on overstretched hospitals and to improve the quality of primary care.
Médecins du Monde also works with the Palestinian NGO, the Culture and Free Thought Association, to provide psychosocial support and mental healthcare for those affected. Over the last five years, this work has provided a response in many cases of psychosocial problems and gender-based violence.
During the events around the Great March of Return, Médecins du Monde provided support for the emergency services at several healthcare centres through a disaster preparedness programme. Staff from 11 healthcare centres were trained and supervised, in order to support them in managing the enormous influx of injured people.
Did you know ?
The number of Palestinians injured during the Great March of Return was more than during Operation Protective Edge, the military operation mounted by Israel in 2014. Although the 2014 operation was the most destructive to date in the Gaza Strip, with over 11,000 civilians injured, in 2018 more than 18,000 people were hurt during the demonstrations that took place on the border between Israel and Gaza. In both cases, health workers, ambulances and healthcare facilities were targeted, resulting in a number of injuries and deaths. Médecins du Monde continues its activities to address the consequences of the conflict and the 13 years of the Gaza blockade.
Médecins du Monde works in the Nablus region to provide psychosocial support for victims of settler violence. Medical staff are trained to identify psychosocial disorders so patients can be referred to appropriate healthcare facilities. A referral system for mental health problems developed with the Ministry of Health was officially adopted as a tool for national use.
Médecins du Monde also offers direct psychosocial support, in particular through discussion groups. People who have suffered attacks or who feel under threat can come and share their experiences.
This enables them to build their resilience to the violence and to manage their stress better. Sessions involving psychosocial support activities are also organised in the villages affected.
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