On 13 Jan Israeli missiles destroyed the PHC clinic (for maternal and child health) of the Near East Council of Churches in Al-Shuja’ia area. 
MSF Spain in Jerusalem and MSF Belgium in Rafah still waiting to enter Gaza.

According to the Palestinian Ministry of Health (MoH) on 14 January, at least 1011 people have been killed since 27 December, including at least 85 women and 311 children. 4650 Palestinians have been injured, including 1552 children and 652 women.

Since 27 December 2008, 13 health personnel have been killed and 22 health personnel have been injured while on duty according to reports from the health information centre of the MoH in Gaza.

HEALTH SITUATION IN THE GAZA STRIP
14 January 2009
OVERVIEW
This is the 14 January update on the health sector situation since Israel launched its military offensive in Gaza on 27

December.
 On 13 Jan Israeli missiles destroyed the PHC clinic (for maternal and child health) of the Near East Council of Churches in

Al-Shuja’ia area.
20 additional patients expected to be evacuated via Rafah.
 Monitoring and surveillance of water quality has not been carried out since the central public health laboratory closed on 4

January due its proximity to open conflict area.
At least 35 520 people displaced in Gaza by crisis.
 All hospitals have 8-12 hours partial power supply.
MSF Spain in Jerusalem and MSF Belgium in Rafah still waiting to enter Gaza.
International Humanitarian Law requires all medical personnel and facilities be protected at all times, even during armed

conflict. Attacks on them are grave violations of International Humanitarian and Human Rights laws. Access to heath is a

fundamental human right.
CASUALTIES
According to the Palestinian Ministry of Health (MoH) on 14 January, at least 1011 people have been killed since 27

December, including at least 85 women and 311 children. 4650 Palestinians have been injured, including 1552 children and

652 women1. WHO has not been able to independently verify these details.
OCHA reports that the number of people who have fled their homes in Gaza remains unknown, but is estimated in the tens of

thousands, with the majority staying with host families. OCHA reported on the 13 January that growing pockets of the

population in Gaza are trapped in their homes. As of 12 January, UNRWA was operating 38 emergency shelters, with 35,520

displaced people. UNRWA has provided bread and drinking water to all shelters, tinned meat to the three southern districts of

Gaza.
CASUALTIES TO HEALTH PERSONNEL
Since 27 December 2008, 13 health personnel have been killed and 22 health personnel have been injured while on duty

according to reports from the health information centre of the MoH in Gaza.
DAMAGES TO HEALTH FACILITIES
On 13 January, missiles destroyed the PHC clinic (for maternal and child health) of the Near East Council of Churches in

Al-Shuja’ia area.
1 The reason for the high increase in the death count is the identification of many bodies that were previously not identified or

found under the rubble or in areas previously not accessible.
Health situation in Gaza - 14 January 2009
Shelling on 4 January damaged and forced the closure of the administrative building of the Palestinian Red Crescent Society

(PRCS) in Tal El Hawa, near Al Quds Hospital, WHO learned on 14 January.
The MoH health information centre in Gaza reports that since 27 December, 2008:
- 15 ambulances have been damaged;
- 13 health facilities have been damaged through direct or indirect shelling.
Ambulances were stuck 13 January in Jurdiek, in east Gaza City, and Khozaa, east of Khan Younis, while attempting to

evacuate patients and could not leave because of intense conflict.
Damage to hospitals:
Dorah Paediatrics Hospital was again directly hit 13 January while eight patients and medical staff were inside. No information

is available on the impact to emergency services. Dorah hospital has been closed since 8 January except for emergency

services due to its proximity to an open conflict area and damages sustained.
ELECTRICITY AND FUEL SUPPLY TO HEALTH CARE FACILITIES
All health care facilities are receiving 12-16 hours of electricity supply. Hospitals have received some fuel. On average all

MoH hospitals and the Central Drug Store have 40-50% of their fuel storage capacity. UNRWA and WHO are working to

ensure hospitals are receiving enough fuel.
HOSPITAL BED CAPACITY AND OCCUPANCY RATE
Shifa Hospital ICU remains overwhelmed. Some patients were evacuated but the ICU is functioning at almost full capacity,

with more than 20 out of its total 30 beds occupied due to the low evacuation rate of patients through the Rafah Crossing.

Shifa Hospital continues to try to keep the bed occupancy rate below 75% to allow space for urgent and emergency cases.
REFERRALS AND EVACUATIONS OUTSIDE GAZA
All 18 patients were evacuated 13 January through the Rafah Crossing. The number of patients evacuated through Rafah

since 27 December is 266, most for injuries and some for chronic conditions.
Another 20 were en route to Rafah for evacuation 14 January. The Egyptian Red Crescent Society is expected to send 25

ambulances to collect the patients.
As of 12 January, the Palestinian Health Liaison Officer had submitted 20 requests for evacuation of chronically ill patients

through Erez Crossing. Israeli authorities have granted seven permits, but patients are still waiting to cross Erez. None exited

14 January. The Palestinian Referral Abroad Department remains closed.
MEDICAL SUPPLIES
No information available on the WHO medical supplies that entered 14 January.
PRIMARY HEALTH CARE CENTRES
WHO remains concerned about public health including sanitation and water quality in Gaza while waste management has not

been assured and garbage is not collected. Monitoring and surveillance of water quality has not been carried out since the

central public health laboratory closed due its proximity to open conflict area on 4 January. The vaccination program has been

seriously interrupted. There have been some attempts to operate in several centres. Reduced vaccination coverage could

result in outbreaks, a risk increased by Gaza's high population density and dire living conditions.
MoH PHC centres:
Health situation in Gaza - 14 January 2009
Of 58 PHC centres managed by the MoH, 37 were functioning (with major interruptions) as of 14 January. The 1O PHC

centres that have been converted into emergency evacuation centres continue to function. For the geographical distribution of

functionality of the MoH PHC centres see Annex 1.
Bani Suhalia clinic (in Khan Younis District) and Shuhada’a Nusierat clinic (in Middle Zone District) are functioning as triage

centres to back up hospitals in their respective areas.
The use of PHC activities has dramatically declined since 27 December, according to the director of PHC. About 40% of

chronically ill patients regularly attending PHC centres have interrupted their treatments and are no longer attending PHC

centres. However, antenatal care (ANC) has resumed in all currently functioning PCH clinics.
There have been improvements in staff attendance although it remains low in Gaza city at 30% in functioning PHC centres:
 
 
‐ Rafah: 95-100%
‐ Khanyounis: 95-100%
‐ Middle zone: 95-100%
‐ Gaza: 30%
‐ North: 60%
UNRWA PHC centres:
UNRWA reopened two PHC centres on 12 January. Three out of 18 remain closed.
COORDINATION
WHO is coordinating the emergency health response through its offices in Jerusalem, Gaza, Cairo and Geneva, working

closely with the Palestinian MoH in Ramallah and with health cluster partners.
CONTACTS
WHO West Bank and Gaza
Ms. Chiara Stefanini
Health and Human Rights Officer
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Tel.: + (972) (0)2 540 0595 – Mobile: + (972) (0) 54 717 9024
WHO Regional Office for the Eastern Mediterranean
Mr Altaf Musani
Regional Adviser
Emergency Preparedness and Humanitarian Action
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Tel.: + (202) 26 76 50 25 – Mobile: + (201) 02 58 58 22
WHO Headquarters, Geneva
Paul Garwood
Communications Officer
Health Action in Crises
Tel.: +41227913462 - Mobile: +41794755546
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Annex 1: PHC functionality status:
District
Functioning PHC clinic
Emergency PHC clinics
Non-functioning PHC clinic
North Gaza
• Shuhada’a Jabalia center.
• Biet El Maqdis center-Biet Lahia
• Old Biet Lahia clinic
• Biet Hanoun clinic
• Shuhada’a Jabalia center
• Al Atatra clinic
• Abu Shbak clinic
• Al Shayma’a clinic
• Izbet Biet Hanoun clinic
• Jabalia Camp clinic
• Biet Hanoun –Al Atatra
Gaza District
• Shuhada’a El Remal center
• Shuhada’a El Daraj center
• Al Huria clinic- Tufah area
• Zayton clinic
• Shiekh Radwan clinic
• Al Falah clinic
• Al Salam clinic
• Zayton clinic
• Shiekh Radwan clinic
• Surani clinic
• Ata Habeeb clinic
• Al Rahma clinic
• Al Qubba clinic
• Sabha Al Harazeen clinic
• Hala Al Shawa clinic
• Shuhada’a El Shate’ center
Health situation in Gaza - 14 January 2009
Old Nablus Road – Sheikh Jarrah
POBox 54812 – Jerusalem 91547
Tel: +972 2 540 0595
Fax: + 972 2 581 0193
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ةمظنم
شارع نابلس القديم – الشيخ جراح
ص ب 54812 – القدس
الصحة العالمية
91547
نوفلت :0595 540 2 972+
سآاف :0193 581 2 972+
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Health situation in Gaza - 14 January 2009
Middle zone
• Nusierat old clinic
• Shuhada’a Nusierat center
• Old buriej clinic
• Dier El Balah clinic
• New Buriej clinic
• West Nusierat center
• Mughazi clinic
• Hekr El Jame’ clinic
• Zawada clinic
• Nusierat old clinic
• Shuhada’a Nusierat center
• Al Zahra clinic
• AL Mussadar clinic
• Nusierat old clinic
• Shuhada’a Nusierat center
• Old buriej clinic
• Dier El Balah clinic
• Wadi Al Salqa clinic
• The medical institution clinic
• Sawarha clinic
• Al Mughraqa clinic
• Johor El Diek clinic
District
Functioning PHC clinic
Emergency PHC clinics
Non-functioning PHC clinic
North Gaza
• Shuhada’a Jabalia center.
• Biet El Maqdis center-Biet Lahia
• Old Biet Lahia clinic
• Biet Hanoun clinic
• Shuhada’a Jabalia center
• Al Atatra clinic
• Abu Shbak clinic
• Al Shayma’a clinic
• Izbet Biet Hanoun clinic
• Jabalia Camp clinic
• Biet Hanoun –Al Atatra