As a result of Israel’s 21-day assault on Gaza ending Jan. 17^th, 2009, the Palestinian Ministry of Health (MoH) reported a Palestinian death toll of 1,440, of which 431 were children. The MoH also reported that the number of injuries stood at 5,380, of whom 1,872 were children.[1] The UN human rights coordinator reported that 3 Israelis had been killed and 183 injured since 27 December by rocket and mortar attacks of Palestinian militants in the Gaza Strip. Furthermore, 11 Israeli soldiers were killed and 340 wounded. [2]

What is the state of Gaza’s health services?

• Damaged health facilities: Of 122 health facilities assessed as of 4 February, around 48% were found to be damaged or destroyed, including 15 hospitals and 43 primary health care centres.[3]
• Shortage of supplies: The World Health Organization (WHO) reported an urgent need to address shortages of medical supplies – in particular psychotropic medication – as well as shortages of spare parts needed for the functioning of medical machinery. [4]
• Reduced access to health care: The WHO further noted that patients are unable to access health facilities, while some agencies like the International Committee of the Red Cross are reporting problems obtaining access to patients.[5] [6]

What are the major health challenges faced right now in Gaza?

• Increased risk of water-borne diseases: WHO has warned of an increased risk of diarrhoeal disease outbreaks such as cholera resulting from a lack of clean water and proper sanitation facilities. [7]
• Increased need for medical specialists: Preliminary figures from the Palestinian MoH suggest that 30 percent of individuals injured during the hostilities are at risk of becoming permanently disabled. This places an increasing demand on rehabilitation and other specialized services in order to prevent or mitigate disabilities.[8]
• Psychological trauma: WHO estimates that 25,000 to 50,000 new Palestinians are likely to be in need of psychological treatment for long-term effects of the hostilities.[9]
• Interruption of treatments: According to WHO, an estimated 40 percent of chronic patients interrupted their treatment during the hostilities, with negative consequences on their projected treatment outcomes.[10]
• Malnutrition: The Office of the UN Humanitarian Coordinator for the Occupied Palestinian territory (UNSCO) reports that 88 per cent of Gaza's 1.4 million inhabitants are dependent on food aid from UNRWA and the UN World Food Programme (WFP).[11]

What has been the effect of the war on Gaza’s economy?

• Increased poverty and unemployment: Two thirds of Gazans are currently living below the poverty line and the latest round of violence has exacerbated the situation further.[12] A Feb. 2008 UNDP survey indicates a 7 point increase in unemployment, from 36% to 43% at that time.  Full-time employment was also down from 50% to 45%.[13]  The Israeli siege of the past year, capped by the Israeli military assault at the end of 2008 only deepens the crisis.
• Destruction of commercial enterprises: Nearly two thousand business establishments (56 percent) in heavily hit neighbourhoods were completely destroyed. Commercial fishing has also seen losses of over $2.2 million as a result of Israel’s assault.[14]
• Agricultural sector decimated: The agriculture sector has also suffered tremendous damage, with much of the agricultural infrastructure shattered, compounding the problem of food security for Gazans. Israel’s Assault has resulted in widespread razing of cultivated lands (18 percent), as well as the destruction of greenhouses, livestock (8 percent) and poultry farms, registered groundwater wells (13 percent), irrigation networks and other productive agricultural assets.[15]

What about damage to other necessary infrastructure?

• Private and public infrastructure damage: An initial survey by the UN development Programme (UNDP) estimated that over 14,000 homes, 58 government buildings and 31 NGO headquarters were either totally or partially damaged as a result of Israel’s assault.[16]
• Education facilities: A UNDP rapid damage assessment of 170 out of the 407 government and private schools in the Gaza Strip found that ten schools (eight government and two private) were severely damaged, and that 160 government and ten private schools were partially damaged, during Israel’s assault.[17]
• Shortage of educational tools: UNRWA continues to face challenges distributing textbooks, due to refusal by Israel to import the necessary paper to print textbooks. An estimated 60% of children are now without textbooks. [18]
• Water and Sanitation infrastructure: Water and sanitation infrastructure was badly damaged during the war, reducing crucial access to clean water. Gaza’s water utility reports that “50,000 people do not have access to water while an additional 150,000-200,000 receive water only every 5 to 6 days.”[19] The repair of needed infrastructure, which depends on the entry of spare parts into Gaza, remains a problem.[20]
• Power infrastructure: Power Gaza’s power utility, GEDCO, has estimated damages to the electricity network since the outbreak of the recent conflict to be over $10 million. Spare parts needed for repair continue to be lacking, as its reserves of spare parts were close to depletion before the conflict due to continued 18-month blockade imposed on Gaza. [21]

Other problems (lawlessness, hopelessness, etc.?)

• Fragile ceasefires: Violent incidents continue to undermine the cease-fires unilaterally announced by Israel, Hamas and other Palestinian factions.[22]
• Barriers to aid provision: The provision of aid continues to be hindered by parties to the conflict. UNRWA temporarily suspended all aid imports in response to repeated commandeering of supplies by Hamas.[23] Israeli authorities continue to obstruct the delivery of aid.  The UN’s Office for the Coordination of Humanitarian Aid (OCHA) notes that the Israeli government continues to impede on delivery of humanitarian aid, stating that the number of truckloads of aid Israeli authorities permit into the Gaza Strip is insufficient. Furthermore, a restricted list of items continues to deny Gazans of items which fall under the categories of basic shelter, teaching aids and recreational kits.[24]
• Limited access: NGOs continue to face difficulties entering the Gaza Strip in order to carry out humanitarian work. Humanitarian personnel need to receive permission from the Israeli authorities in order to enter the Gaza Strip and if allowed, may only enter through the Erez crossing. [25]