Occupied Palestinian Territory

• People in need: 2.1 million¹
• People targeted: 1.6 million
• People in need of health assistance: 1.5 million
• Requirements (US$): 24.6 million

Context

The occupied Palestinian territory (oPt) remains a protracted protection crisis, characterized by nearly 55 years of Israeli military occupation, internal Palestinian political divisions and recurrent escalations of hostilities. In 2022, humanitarian vulnerabilities were exacerbated by the escalation of hostilities and mobility restrictions, aggravating socioeconomic conditions. According to the Humanitarian Country Team (HCT), 2.1 million Palestinians across the oPt require some form of humanitarian assistance, of whom 64% (1.3 million people) live in Gaza. Outbreaks of violence in Gaza during May 2021 and August 2022 have also increased the population’s aid dependency and their reliance on negative coping strategies to address basic needs.

The health sector is also suffering from restrictions and both health workers and patients face delays, reducing contact time with patients or resulting in missed appointments. Patients are sometimes unable to reach health facilities, preventing access to services. Ambulances are experiencing delays crossing checkpoints, threatening the life of patients in transit and, in certain instances, attacks on paramedics and health workers have been recorded. WHO will continue to advocate for access to health services for vulnerable communities and strengthen protection against attacks on health care staff and facilities.

Emergency response

WHO’s response strategy is aligned with the Strategic Health Cluster Objectives. The response will focus on supporting the capacity of the national health system to prepare for and respond to different emergencies and promote and advocate for Palestinians’ right to health.

Activities will aim to minimize the equity gap in service availability and accessibility and achieve equitable access to essential services for vulnerable populations, including women, girls, the elderly and people with disabilities across different age groups. Capacity-building activities will also provide equal, and non-discriminatory opportunities for participants. Through its different interventions, WHO will promote protection and accountability to the affected population. To enhance preparedness and response to (re)emerging communicable diseases, WHO will strengthen the oPt’s International Health Regulation (IHR) core capacities, and support life-saving emergency interventions. As part of its work on addressing the humanitarian-development-peace-nexus, WHO will contribute by enhancing access to essential health services, focusing on non-communicable diseases (NCDs), including mental health, with specific emphasis on gender-based violence.

In 2023, WHO plans to strengthen the emergency preparedness response in Gaza, expand into the West Bank and support health partners including the Ministry of Health (MOH), NGOs and the United Nations Relief and Works Agency for Palestine Refugees (UNRWA) to improve access to essential services during times of crisis or any sudden onset disaster. Israel has closed off communities and cities in the West Bank during incursions, confrontations, or in retaliation following attacks carried out by Palestinians, demonstrating the need to increase response capacities at different levels of care. This is particularly pertinent at the primary health care level, as this will help sustain essential services, provide life-saving emergency responses and serve communities isolated from the wider health system.

WHO will work closely with the MOH in Gaza and in the West Bank to respond to the needs identified in the Humanitarian Response Plan (HRP). WHO will also continue working with the Palestinian Red Crescent hospital entities in Gaza, West Bank and east Jerusalem to strengthen their ambulance services and support their role as the first respondents. Work will be undertaken at a community level to increase emergency preparedness and response for vulnerable communities, like those in East Jerusalem, Hebron and several communities in Area C of the West Bank. WHO will continue to convene the trauma working group to streamline and strengthen coordination between key stakeholders, including local and international NGOs as well as donors and the MOH. Furthermore, WHO is partnering with UNICEF through the COVID-19 vaccine delivery support (CDS) program to further enhance the MOH’s capacity to manage COVID-19 outbreaks and improve the capability of the health system to better respond and sustain essential services in the event of additional waves.

Strategic objectives

Key activities

• Enhance trauma and emergency response by improving emergency response capacity for mass casualty incidents in six primary health care centers and supporting blood bank services in Gaza
• Enhance emergency medical service (EMS) coordination at the national level, health information systems and data management at prehospital and hospital levels of care and emergency preparedness at the community level
• Provide essential medical supplies for 30 000 patients and train 500 health workers on their management, expanding the integration of the HEARTS approach at primary health care centers
• Enhance health information systems at primary health care level
• Train 400 health workers on mhGAP intervention guidelines, with a specific emphasis on child and adolescent mental health and gender-based violence. Procure five essential psychotropics, and carry out awareness-raising campaigns related to mental health
• Provide essential drugs, supplies and equipment for diagnostics, case management, infection, prevention and control (IPC), surveillance of and vaccines for emerging and re-emerging communicable diseases. Train 300 health care workers on the use of these resources, enhance the surveillance system and operationalize the PHEOCs
• Improve detection and surveillance capacities of the two points of entry in occupied Palestinian territory
• Introduce and implement the ‘One Health’ approach
• Monitor, document and report barriers to health care access and attacks against health care, undertaking capacity-building activities to strengthen health care workers’ understanding of barriers to health access

Funding requirements 

Overall country funding requirements, including COVID-19, by pillar (US $ '000)

Success stories

Mass Casualty Management (MCM) training in action

Dr. Naseem was off-duty when the August 2022 escalation in Gaza began. Within an hour of the news breaking, he was back at the hospital supervising his staff to prepare for receiving and treating casualties.

“I knew from previous experience that the situation could deteriorate quickly, so we needed to act fast and get ourselves organized. Delay in getting the injured immediate care could cost their lives”, says Dr. Naseem, Head of Emergency at the Al-Aqsa Hospital in Gaza.

Equipped with new skills from the Mass Casualty Management (MCM) training delivered by WHO, he declared a state of heightened readiness and worked with key teams to reorganize the hospital’s entrances and exits to avoid crowding and to ensure optimal patient flow. An emergency triage area was set up, family and press waiting areas were defined, non-emergency patients were discharged or moved to make space for critical cases and 50 emergency medical kits were prepared to be deployed.

“We had developed the hospital emergency plan during our MCM training and now we are putting it into action. We had all done our best during previous emergencies but lacked a cohesive approach and plan. This time was different. We were like a well-oiled machine, all units working together as one”, says Dr. Naseem.

He is one of 90 clinical and non-clinical health workers trained on MCM protocols since June 2021, using a standardized curriculum developed by the WHO Academy. In the future, this approach will allow the emergency deployment of Dr. Naseem, and many like him, to any of the seven main hospitals in Gaza, to ensure adequate availability of health workers during crises.

“I’m used to difficult situations, but the calm I felt this time was something else. I think it comes from the feeling of being prepared and organized. It also allows introspection. We evaluated what we did right and what needed improving after the escalation. This was a first for us”, says Dr Naseem.

For more information

Dr. David Lai | Health Emergencies Team Lead | WHO oPt | laidavid@who.int

Eng. Hazim Khwais | Project Management Officer | WHO oPt | khwaish@who.int