inside Gaza strip Besieged since 2007, the residents of the Gaza Strip receive medical services and care from 30 basic hospitals, which – as a result of the ongoing siege – suffer from a permanent shortage of equipment, medical supplies, and necessary medicines.
Gaza’s hospitals are a front for direct and indirect targeting by the Israeli occupation army, with continuous bombing and threats of forced eviction, as part of its aggression called “Iron Swords”, which came in response to Operation “Al-Aqsa floodLaunched by the resistance on October 7, 2023, which led to the cessation of 25 hospitals and 51 primary care centers.
History of medical facilities in the sector
References to the Arab and Islamic medical heritage in Gaza indicate that the first medical facility in Gaza was called “Bimaristan Gaza” (Dar Al-Shifa), and was established by Prince Alam Al-Din Sanjar bin Abdullah Al-Jawli, who assumed the position of governor of Gaza in 1311 AD, and was the servant of King Al-Salih Ismail Al-Ayyubi. .
It was stated in the Palestinian Encyclopedia that the “Bimaristan of Gaza” was part of Prince Al-Jawli’s urban activity in Gaza during the 14th century AD. And he stood on behalf of the king Al-Nasir Muhammad bin Qalawun It has great endowments, so it was also called “Bimaristan Al-Nasiri”.
“Bimaristan Gaza” was located on an area of 3,000 square metres, in the area opposite the Al-Amer Grand Mosque from the east to Al-Bosta Street, and from the narrow street to the north to Omar Al-Mukhtar Street to the south, and was surrounded by streets on all four sides.
It included several rooms for patients, domes, iwans, a garden, a waterwheel, a mosque, a school for teaching medical sciences, a men’s ward, and a hospice for travelers and the poor.
It had a special section for women and another for people with mental disabilities. The endowments of farms, villages, and real estates that were reserved for the “Gaza Maristan” were known as the “Maristan Endowment,” including the villages of Masil, Battani al-Sharqi, Beit Jarja, Harbiyya, and Al-Mughraqa.
These antiquities remained standing until the French Emperor Napoleon Bonaparte destroyed them during his siege of Acre in 1800. Many of its stones and marble were transferred to other ancient buildings, especially the Mosque of Sayyid Hashim bin Abd Manaf. As for the Bimaristan land, part of it was annexed to some neighboring properties and shops and a gold market were built there. The other part was taken for the cemetery of the Radwan family (the rulers of Gaza during the Ottoman days).
History researchers consider that Gaza’s hospitals are an extension of the “Gaza Bimaristan” or the “Nasserite Bimaristan” as it is called.
Health care system
Primary health care in the Gaza Strip – where more than two million people live – is provided by the Palestinian Ministry of Health, in addition to the United Nations Relief and Works Agency for Palestine Refugees (UNRWA).UNRWA), non-governmental organizations and some private sectors.
Residents of the Gaza Strip governorates benefit from health services in 35 hospitals, at a rate of 1.59 hospitals per 100,000 people, 13 of which are government hospitals, 17 non-governmental hospitals, two hospitals affiliated with the Ministry of Interior and National Security, and 3 private hospitals.
The hospitals are distributed in 5 areas, 18 of which are inside Gaza, 6 in Khan Yunis, 5 located north of Gaza, 3 in Deir al-Balah, and the same in Rafah.
The number of beds available there (before Operation Al-Aqsa Flood) is about 3,412 beds, at a rate of 15.53 beds per 10,000 people, of which 527 are in the non-governmental sector, 130 beds are managed by the Ministry of Interior, and 81 beds are managed by the private sector.
The total workforce in the health sector in the sector reaches 16,259, according to data announced by the Health Information Unit of the Ministry of Health for the year 2022.
There are also 824 private licensed pharmacies in the sector, and 3,816 pharmacists who have a license to practice the profession, with a rate of 17.4 pharmacists per 10,000 people.
Public medical sector
The population of the Gaza Strip receives health services mainly through the Ministry of Health, and the government covers the expenses of treatment within these institutions through health insurance. By the end of 2022, the number of insurances exceeded 212,000.
The Ministry of Health’s annual report figures for the year 2022 indicate that the number of employees reached 11,165 employees, an average increase of 5.4% over the year 2018.
Public medical sector institutions are distributed among:
Primary care centers:
Centers operate under the supervision of the Primary Health Care Department in the Ministry of Health. Residents of the Gaza Strip receive primary health care services in 159 centers distributed as follows:
- 52 centers affiliated with the Ministry of Health, representing 32.7%, employing 1,748 employees, representing about 16% of the total employees in the Ministry.
- 22 centers affiliated with UNRWA, representing 13%, provide free care services to 2.6% of the total population of the Gaza Strip.
- 80 specialized centers and clinics for non-governmental organizations, representing 51%, of which 19 centers provide services according to the Ministry’s standards, and the rest provide specialized medical services, in addition to 5 centers affiliated with the military medical services, representing 3%.
Government hospitals:
The Ministry of Health is the main provider of secondary care in the Gaza Strip, and is responsible for managing 13 hospitals in the five governorates of the Strip, employing 7,000 employees, constituting 65.7% of the total workers in the Ministry.
The capacity of these hospitals is estimated at about 2,674 beds, or 12.17 beds for every 10,000 people, with a rate of 0.7 doctors per bed, as well as 1.1 nurses per bed.
Surgery constitutes the largest percentage in the Ministry’s hospitals, reaching 29% of the total number of beds, followed by internal medicine and pediatrics at 23%, obstetrics and gynecology at 12%, and central treatment at 14%.
While 274 intensive care departments in government hospitals until 2009 were distributed across the governorates of the Gaza Strip.
Hospital classification
Central hospitals:
Al-Shifa Medical Complex: It is the oldest and largest in the sector. It was established in 1946. It includes 3 specialized hospitals: surgery, internal medicine, gynecology and obstetrics, with 642 beds, and employs about 1,500 employees.
Nasser Medical Complex: It was established in 1956. It includes 4 specialized hospitals, including Al-Nasser Children’s, Al-Rantisi Specialized, Eye and Psychiatric Hospitals, and has 424 beds.
European Hospital: It was established with a grant from the European Union in 1989, and includes 308 families. It is managed by the Palestinian Ministry of Endowments and Religious Affairs in the Gaza Strip.
General hospitals:
Jerusalem (Red Crescent): It is the second largest hospital in Gaza. Work began in 2001, and it was reconstructed, built and equipped with full funding from King of Morocco Mohammed VIafter it was bombed by Israeli occupation aircraft in 2008. It includes several specialized departments, the most important of which is the intensive care department, the obstetrics and gynecology department operating rooms, and it also includes 10 nurseries for premature babies.
Algerian Military Hospital: It was opened in 2014, at an estimated cost of about $150,000, a large portion of which was contributed by the Association of Scholars in Algeria.
Indonesian Hospital: It was established in 2011, with funding from the Indonesian Mercy Foundation.
Kamal Adwan Hospital: Established in 2002, it was originally a small medical center called the “Beit Lahia Project Clinic” before it was developed into a hospital.
Abu Youssef Al-Najjar Hospital: He started a primary health care clinic and was converted into an emergency hospital in 2000. Its capacity increased after its expansion in 2007.
Al-Aqsa Martyrs Hospital: It is the main hospital in the central governorate of the Gaza Strip.
Al Awda National Hospital (North Gaza): It was opened in 1997. About 75% of its construction cost came from private donations, and improvements were made to it that increased its capacity.
Al Hayat Specialized Hospital: It is only approximately 500 meters away from Al-Shifa Hospital, and provides multiple medical services.
In addition to Al-Hilu International Private Hospitals, Al-Amal (Red Crescent), Beit Hanoun, Nasser, and Al-Awda (Central) Hospitals.
Single specialty hospitals:
- Eye Hospital: Founded in 1965.
- Al Durrah Children’s Hospital, established in 2000.
- Al-Rantisi Hospital – Al-Nasr Children’s Hospital, was established in 2003 and began operating in 2007.
- Psychiatric Hospital, established in 1980, is the only one in the sector in its specialty.
- Dar es Salaam Hospital, a non-profit charitable hospital founded in 1995.
- Kuwait Specialized Hospital, established in 2007, serves about 100,000 Palestinian citizens.
- The Turkish Friendship Hospital, which is the only cancer treatment hospital in the Gaza Strip, was established by the Turkish Cooperation and Coordination Agency (TIKA) and donated to Palestine in 2015.
- St. John’s Charitable Eye Hospital, established by the Qatar Fund for Development for $2 million, was opened in 2016.
- Patient’s Friends Hospital, a charitable hospital established by the Patient’s Friends Charitable Society.
- Al-Sahaba Medical Charitable Complex.
- Eye Specialized Hospital.
- Haifa Charitable Medical Hospital.
- Al Karama Specialized Hospital.
- General Service Hospital, which is the medical center for maternity and general surgery.
- Jaffa Specialized Medical Hospital.
- Al-Khair Hospital, which specializes in women, childbirth and children, was established by Al-Khair Foundation in partnership with a local institution.
Rehabilitation hospitals:
Sheikh Hamad Hospital for Rehabilitation and Prosthetics: It was established in 2016 by the Qatari Committee under the guidance of the Father Emir Sheikh Hamad bin Khalifa Al Thani, and was operated by the “Qatar Fund for Development” and officially opened in 2019. It is considered one of the largest rehabilitation hospitals operating in the sector, providing rehabilitation services and free detection of nerve, bone and muscle diseases, amputees and curvature of the spine. Hearing problems and cochlear implants.
Al-Wafa Hospital: It was established in 1996 for medical rehabilitation with functional physical therapy services, and was licensed in 1999 as the first and only hospital in the field of comprehensive medical rehabilitation. It developed in 2007 from a single building to an integrated complex, and during the aggression on Gaza in 2014, it was completely destroyed. The hospital is now operating in a temporary headquarters in Madinat Al-Zahraa.
Maternity hospitals:
Al Hilal Emirates Hospital: It was established in 2005 to provide natural childbirth, childbirth, nursery and emergency services, and includes 72 beds.
Financial obstacles
The Ministry of Health faces several obstacles that constitute a burden on health care services in the sector, the most important of which, according to the Ministry’s report, is the lack of financial resources and its inability to cover expenses, as cash revenues exceeded 7 million dollars, including approximately 200 thousand dollars in workforce expenses.
While claims and debts amounted to approximately $7 million, the amount of repayments did not exceed $3 million.
The sector’s needs for medicines, medical supplies, and vaccinations amount to $44.3 million annually, according to a local report in 2022, and there is a need to increase the number of beds by no less than 5% annually.
Occupation practices against hospitals
In 1967, one government agency was working in the field of medical services in the Gaza Strip under the management of the Israeli occupation authorities, and the second was managed by UNRWA.
The military administration took control of the existing health care systems in the Gaza Strip, and worked to make them affiliated with the Israeli health care system, where it managed 4 hospitals, 25 clinics and health centers.
The occupation permanently closed the “Fever Hospital” and Tal Al-Zuhour Hospital, which was the only central hospital in Gaza during the 19th century, and was then known as Tal Al-Sakan, and turned them into military administrations in 1980.
It reduced the number of beds in the Chest Diseases Hospital – the only one in Gaza – to 70 beds in 1980. Between 1974 and 1982, it reduced the number of beds available to provide health care to the residents of the region from 1,004 beds to 755 beds, and the surgery department at Nasser Hospital in Khan Yunis was closed, before It closed permanently in 1984.
In early July 1988, the Gaza Strip included instructions from the military command to hospital directors, including that everyone treated due to a security incident should pay “280 shekels” ($170) for each night in the hospital.
If the patient is admitted to the hospital, he pays a fee for 3 days in advance, and after the end of the period, he pays a fee for another 3 days, and anyone who does not pay has his property quarantined without a court order. The patient signs a pledge to pay in full before entering the hospital.
Trust Palestine’s libiration organisation These Israeli measures were mentioned in a memorandum addressed to the emergency Arab summit conference in 1990.
Days after these instructions were issued, the military leadership announced its decision to terminate about 10% of the contracts of workers in the health system and hospitals.
Effects of the siege
The health sector in the Gaza Strip suffers from the low efficiency of health facilities, due to a set of restrictions and procedures imposed by the Israeli blockade since 2007, the manifestations of which include:
- Power outages and constant running out of fuel lead to the disruption of many medical devices.
- A severe shortage of medical equipment, including imaging and medical diagnostic equipment, which the occupation authorities prevent entry into, except with special permits extending for nearly a year.
- These restrictions also hinder the import of basic medical supplies, such as medicines, medical equipment, and necessary medical materials such as nitrous gas, which is used for anesthesia.
- Restrictions imposed on the freedom of movement of patients who are in urgent need of treatment outside the Gaza Strip, and the policy of reducing the number of medical referrals for patients.
Israeli incursions and attacks
On many occasions, Gaza Strip hospitals were the target of Israeli attacks. The Arab National Hospital, known asBaptist Hospital In 1989, the occupation also committed a massacre on October 17, 2023.
Israeli forces also stormed Nasser Hospital in Khan Yunis, arrested dozens of wounded, and destroyed hospital equipment in February 1990.
On November 14, 2023, the Israeli army stormed Al-Shifa Hospital In Gaza, it took control of some of its buildings, and bombed its surroundings and parts of it.
In the same month, the occupation also targeted Al-Quds Hospital, Al-Nasr Hospital for Children, and the Eye Hospital in Gaza, and bombed Al-Rantisi Specialized Hospital for Children and the Indonesian Hospital.
Due to the Israeli aggression on the Gaza Strip in 2023, 21 hospitals and 47 health centers were out of service.
Source : Palestinian press + Websites
