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“During the first years of the siege, we could still manage, but nowadays we have no alternatives,” says Dr Hassan Khalaf, deputy health minister in Gaza.

“It is a major crisis: many health services have stopped, and I’m afraid this will spiral out of control, because Gaza doesn’t have the essential medicines and supplies  needed.”

Cancer, kidney, heart and organ transplant patients, as well as patients needing routine surgeries, including eye and dental surgery, have been suffering for the past five years under the Israeli-led, internationally-backed siege of the Gaza Strip.

The latest warning from Gaza’s health ministry states the strip is at emergency levels of medical supplies.

After the democratic elections in 2006 that brought Hamas to power, the population in Gaza has been constrained under a siege, which bans food items, construction materials and school supplies among thousands of items.

Medical supplies and equipment do not escape the blacklist, which for years now has deprived Palestinians in Gaza of basics like baby formulas, antibiotics, and MRI and X-ray machines, which Israel reasons could be used for “terror”  purposes.

Alarming zero-stock levels of drugs were already being reported in 2007 — when 80 to 90 of the 480 drugs deemed essential were at zero — but Palestinian physicians could still find ways around the  shortages.

The International Committee of the Red Cross reported in November 2008 that “medical staff try to cope by using the next best solution which is not always a good one — for example, if they need tubes for a medical procedure, they will use a tube size smaller or bigger than the appropriate one”.

But with each year of the total siege on Gaza, particularly after the 23 days of Israeli war on Gaza in 2008-2009, the already dilapidated medical system has been rendered more sickly.

During the Israeli war on Gaza, Israeli warplanes bombed more than half of the hospitals, as well as 44 clinics and the medical storage facility of the Palestine Red Crescent Society.

In February 2011, Israeli bombing destroyed a medical warehouse in Jabaliya.

“We lost a large amount of stocks we had finally received from Ramallah just a few days prior to the bombing,” says Khalaf.

In June 2010, the World Health Organization (WHO) issued a call for “unimpeded access into the Gaza Strip of life-saving medical supplies, including equipment and medicines, as well as more effective movement of people in and out of the territory for medical training and the repair of devices needed to deliver appropriate health care and respond to the population’s humanitarian health needs”.

Khalaf said: “During 2008, Gaza received less than half of the needed medicines and supplies. The WHO reported that in 2010 Gaza received even less, only 40 percent of the Strip’s needs transferred to Gaza.

“As of now, in 2011 we’ve received only a third of what is needed.”

Gaza’s zero-stock items list is now at 180 items.

“We’re missing painkillers and anesthetics, cancer and epilepsy drugs, antibiotics, infant formulas, medicines for dialysis, even rubber gloves,” says Khalaf.

The Palestinian Centre for Human Rights (PCHR) noted on June 13 that Gaza has not received medical supplies since February 2011.

The PCHR said the medical shortages affect “ICUs, nurseries of premature infants; operation rooms; anesthesia and recovery; emergency; cardiac catheterization; hematology and oncology; nephritic diseases; and pediatrics”.

Khalaf said hundreds of patients await “eye surgeries, endoscopic, vascular and pediatric surgeries, and neurosurgery” among  others.

A group of Norwegian doctors surveyed Gaza’s hospitals and clinics in February. Their study, reported in The Lancet medical journal, highlighted the difficulties for cancer patients in Gaza who receive only part of their chemotherapy treatments.

Many have died as a  result.

“Oncologists said 100 of 260 cancer patients at Gaza’s largest hospital were unable to receive effective treatment because the required combination of several drugs was not obtainable,” The Lancet said.

[Abridged from www.electronicintifada.net .]