Gaza health care suffers as Palestinian factions play blame game

GAZA (Reuters) - Ritta al-Jalees doesn't care who's to blame for the deteriorating state of healthcare in Gaza. All she wants is to ensure her three sons get the help they need to breathe.

The boys, aged nine months and six and seven years, all of whom suffer from cystic fibrosis, are getting weaker because Gaza is running out of the drugs needed to treat the inherited lung disease and because of cuts to power for oxygen pumps and ventilators.

"I blame all sides," said Jalees, a mother of six, as she held her youngest at Al-Rantissi Hospital for Children in Gaza City. "Are these children at fault?"

Gaza has been under an Israeli blockade since 2007 after Hamas forces seized control of the territory following a brief civil war with security forces loyal to Mahmoud Abbas, the Western-backed Palestinian president based in the West Bank. Egypt, at odds with Hamas, also maintains a blockade.

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Power shortages worsen healthcare crisis in Gaza
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Power shortages worsen healthcare crisis in Gaza
Palestinian boy Mohammad Shanty, who suffers from cystic fibrosis, sits next to his mother after receiving oxygen therapy during a power cut in their family house, which is equipped with a backup battery-powered system, in Gaza City July 2, 2017. Picture taken July 2, 2017. REUTERS/Mohammed Salem
The mother of Palestinian boy Ahmed Abbas, who suffers from cystic fibrosis, holds his hand as he lies on a hospital bed in Gaza City July 2, 2017. Picture taken July 2, 2017. REUTERS/Mohammed Salem
Palestinian boy Ahmed Abbas, who suffers from cystic fibrosis, sleeps as he lies on a hospital bed in Gaza City July 2, 2017. Picture taken July 2, 2017. REUTERS/Mohammed Salem
A patient undergoes dialysis at Shifa hospital in Gaza City June 12, 2017. REUTERS/Mohammed Salem
An employee checks medicines at a medicine warehouse run by health ministry, in Gaza City, April 3 2017. REUTERS/Mohammed Salem SEARCH "GAZA HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Newborns are seen at Shifa hospital in Gaza City June 12, 2017. REUTERS/Mohammed Salem
Palestinian girl Rasha al-Bayed, 5, who suffers from cerebral palsy, attends a physiotherapy session at Mabaret Falasteen charity in Gaza City, March 20, 2017. REUTERS/Mohammed Salem SEARCH "GAZA HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
A Palestinian patient sleeps as he undergoes kidney dialysis at Shifa hospital in Gaza City April 24, 2017. Picture taken April 24, 2017. REUTERS/Mohammed Salem TPX IMAGES OF THE DAY
Palestinian boys Mohammed al-Bayed (R), 13, and Amjad Bahar, 4, who suffer from cerebral palsy, lie on a a bed at Mabaret Falasteen charity in Gaza City, March 20, 2017. REUTERS/Mohammed Salem SEARCH "GAZA HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
A worker stands in a corridor at Shifa hospital, Gaza's largest public medical facility, in Gaza City, March 29, 2017. REUTERS/Mohammed Salem SEARCH "GAZA HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Palestinian patients present their documents as they wait to receive treatment at an outpatient clinic at Shifa hospital, Gaza's largest public medical facility, in Gaza City, March 29, 2017. REUTERS/Mohammed Salem SEARCH "GAZA HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Palestinian girl Jana Al-Bodi, 5, lies on a bed before nurses remove stitches over her eye at Al Awda Hospital, a private medical facility in the northern Gaza Strip, March 30, 2017. REUTERS/Mohammed Salem SEARCH "GAZA HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Palestinian boy Ahmed Abu Saman, 16, who was injured in a car accident, lies on a bed at the emergency department at Shifa hospital, Gaza's largest public medical facility, in Gaza City, March 29, 2017. REUTERS/Mohammed Salem SEARCH "GAZA HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Palestinian girl Marah Mokat, 4 months old, who fractured her leg, is carried by her father as she waits for medical checks at an outpatient clinic at Shifa hospital, Gaza's largest public medical facility, in Gaza City, March 29, 2017. REUTERS/Mohammed Salem SEARCH "GAZA HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
The grandmother of Palestinian boy Yehia al-Samna, 8, watches him as he undergoes a kidney dialysis at a public paediatric hospital in Gaza City, March 28, 2017. REUTERS/Mohammed Salem SEARCH "GAZA HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Palestinian boy Mohammed Bahtiti, 13, who fractured his leg, waits for medical checks at an outpatient clinic at Shifa hospital, Gaza's largest public medical facility, in Gaza City, March 29, 2017. REUTERS/Mohammed Salem SEARCH "GAZA HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
Palestinian man Eizz al-Deen Habash, 39, lies on a bed before his ankle surgery at Shifa hospital, Gaza's largest public medical facility, in Gaza City, March 29, 2017. REUTERS/Mohammed Salem SEARCH "GAZA HEALTH" FOR THIS STORY. SEARCH "WIDER IMAGE" FOR ALL STORIES.
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Although the Israeli blockage has eased somewhat in recent years, a new stage in the struggle between Abbas and the Islamist Hamas is turning the screws on the enclave afresh.

In what is seen as the latest step in an effort to force Hamas to relinquish its control of Gaza, Abbas in June reduced the payments the PA makes to Israel for electricity it supplies to the territory.

The resulting cuts mean that Gaza's two million people now have only 3 to 4 hours of power a day, forcing hospitals and other medical facilities to rely chiefly on generators and expensive fuel, while many private homes just go without.

Hamas says that Abbas restricted transfers of medicine to Gaza in March, accusing Hamas of failing to reimburse the PA for its purchases, and cut the salaries of its officials in May.

The spokesman for Gaza's Hamas-run health ministry, Ashraf Al-Qidra, said PA shipments of medicine, especially drugs to treat cancer and cystic fibrosis, have dropped 35 percent since late March.

"We believe the actions of the Palestinian Authority and the Israeli occupation together are undermining the entire health service system in Gaza," Qidra told Reuters.

Hamas also accuses the PA of delaying the transfer of hundreds of seriously ill patients to Israel or the Israeli-occupied West Bank, actions which it says has resulted in 13 deaths since April.

The PA denies the allegations and accuses Israel of holding back permits. Israel denies the allegations.

Whoever is at fault, a U.N. report released last week said power shortages are deepening a humanitarian crisis, with hospitals in a precarious condition, water shortages increasing and raw sewage being dumped into the Mediterranean because treatment plants aren't functioning.

"The two million residents of Gaza are suffering through a humanitarian crisis that is entirely human-made," the report said. "It represents a complete failure of all parties to uphold their fundamental human rights obligations, including the inalienable right to life."

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Health clubs in Gaza
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Health clubs in Gaza
Palestinians relax at As-Samra bath house in Gaza City July 11, 2016. REUTERS/Suhaib Salem 
A Palestinian man is seen at As-Samra bath house in Gaza City July 11, 2016. REUTERS/Suhaib Salem 
Palestinian Saleem Al-Wazeer, owner of As-Samra bath house, reads a newspaper in Gaza City July 11, 2016. REUTERS/Suhaib Salem 
A Palestinian man has his body exfoliated with soap at As-Samra bath house in Gaza City July 11, 2016. REUTERS/Suhaib Salem 
A Palestinian man relaxes after having his body lathered with soap at As-Samra bath house in Gaza City July 11, 2016. REUTERS/Suhaib Salem 
A Palestinian man exercises in a gym in Gaza City July 17, 2016. REUTERS/Suhaib Salem 
Palestinians smoke shisha or hookah (waterpipe) at a coffee shop in Gaza City July 17, 2016. REUTERS/Suhaib Salem 
A Palestinian man rides a camel on a beach in Gaza City July 19, 2016. REUTERS/Suhaib Salem 
A Palestinian man exercises in a gym in Gaza City July 17, 2016. REUTERS/Suhaib Salem S
Palestinian children take part in a karate training session at a club in Gaza City July 17, 2016. REUTERS/Suhaib Salem 
Palestinians dip in the Mediterranean Sea to cool off on a hot day in Gaza City July 19, 2016. REUTERS/Suhaib Salem 
Palestinian family rests on a beach on a hot day in Gaza City July 19, 2016. REUTERS/Suhaib Salem 
A Palestinian man lifts weights in a gym in Gaza City July 17, 2016. REUTERS/Suhaib Salem 
Palestinians dip in the Mediterranean Sea to cool off on a hot day in Gaza City July 19, 2016. REUTERS/Suhaib Salem 
A Palestinian man plays billiards at a club in Gaza City July 17, 2016. REUTERS/Suhaib Salem 
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POLITICALLY MOTIVATED

Omar Al-Naser, director of media and public relations at the West Bank-based ministry of health, said Hamas' complaints were politically motivated. Hospitals in the West Bank were also suffering from drug shortages, he said.

"Shortages in Gaza may happen, just like there are shortages in the north counties (West Bank), because there are debts the health ministry is trying to pay," he added.

The Israeli government body that supervises civil activities in the Palestinian territories, the Coordination and Liaison Administration (CLA), said any holdup in patient transfers from Gaza was an internal Palestinian affair.

"We would like to emphasize that in cases in which the Palestinian Authority sends requests, especially those defined as urgent, the Gaza CLA coordinates the crossing of patients immediately during every hour of the day in order to save lives," it said in a written response to Reuters.

It said nearly 16,000 patients and escorts have been allowed to leave for hospitals in Israel and the West Bank so far in 2017, including 6,400 in the past three months.

It also said it reduced power supplies to Gaza on a request from the Palestinian Authority.

Cystic fibrosis causes the lungs and digestive system to become clogged with thick, sticky mucus. Over many years, the lungs and pancreas may eventually stop functioning.

Gaza health officials say 320 people in the enclave have the disorder. Although it can be managed for years with regular visits to hospital, some sufferers in Gaza are now being admitted to hospital because of their worsening condition and because drugs there are cheaper and in some cases, free.

Police officer Ashraf Shanty and his wife Jihan, who have two children with cystic fibrosis, started a charity in 2008 to help patients get medication and medical checks.

Dozens of bags of medicines sit on a table next to breathing equipment in a room that Jihan Shanty, a medical laboratory technician, has turned into a mini-clinic in their home.

One of the medicines in short supply is Creon. Made by the U.S. drugmaker AbbVie, it is used to treat a common condition in cystic fibrosis in which the sticky mucus prevents enzymes getting from the pancreas to the small intestine, where they would normally help break down food.

"I have two sons suffering from the disease but I see myself as the father of 320 cystic fibrosis patients, whom I must help," Ashraf Shanty said.

"Without Creon, the enzyme of life, they may die," he said.

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