Human Rights Organizations Demand Emergency Evacuation of Palestinians Wounded in Gaza to Receive Lifesaving Medical Care in Israel

Physicians for Human Rights-Israel and a coalition of 10 human rights organisations based in Israel, including Adalah, request your immediate personal intervention on behalf of six of the sick and wounded, all civilians, from Gaza, for their emergency evacuation, within hours, to medical care in Israeli medical centers.

An urgent appeal was received at the offices of Physicians for Human Rights-Israel on 29.12.08, from Shifa hospital in Gaza, asking for our assistance to transfer six seriously wounded and sick persons from Gaza to lifesaving care in Israel.

Five of the six patients are civilians injured during the air strikes by Israel on 28.12.08, and are currently hospitalized, unconscious, in the Intensive Care Unit of Shifa hospital in Gaza. The medical documents and an expert opinion issued by PHR-Israel's expert neurosurgeon, Dr. Yehiel Heilbronn, point to the need for immediate evacuation to lifesaving care in an advanced medical center in Israel. As detailed below, all cases are not medically suitable for transfer to Egypt. Medical care in an advanced medical center is the only way to save their lives.

Warning! Medical confidentiality applies! Identifying details and medical information may be used only for the purpose of ensuring access and availability of medical care!

Details of the cases and PHR-Israel's doctors' opinions regarding their condition follow:

1. ******, 7 year-old, male. A known diagnosis of Down's Syndrome. He sustained a critical head injury following an explosion. Brain CT shows multiple skull fractures on the right side, intracranial bleeding. This patients is in immediate danger of his life and must be immediately evacuated, ventilated, in an ambulance, with a minimum of moving, to the nearest possible neurosurgical medical center. The patient is hospitalized alone in ICU and so far none of his family members have reached the hospitals. All attempts made by the hospital to find his family have failed so far.

2. ******, 8 year-old, male. ID 406043901. Hospitalised in ICU due to head trauma during an explosion. Suffers from bilateral brain ischemia, intracranial bleeding on the left and a hand wound. This is a life-endangering wound necessitating rain resuscitation and probably surgical draining on the left. Any moving during ambulance or helicopter evacuation must be as short as possible in order not to worsen his condition. The patient is ventilated artificially and must be evacuated to the nearest possible neurosurgical medical center.

3. ******, 5 year-old, male, ID 408088375. Diagnosed with severe liver disease, suffers from hypertension, thrombosis in the oesophagus and bleeding varicose veins. Currently suffering from a fresh bleed in the upper and lower digestive system and is in need of emergency evacuation for lifesaving care in Sheba Medical Center in Tel Hashomer, Israel.

4. ******, 30 year-old, female, ID 900209602. Wounded by an explosion. Suffers from penetration of a metal foreign body with entry wound in the forehead and exit wound in the back of the head, subarachnoid haematoma and brain edema. The patient is in immediate danger of her life and needs emergency evacuation to the closest possible neurosurgical medical center in an ambulance or a helicopter with minimum moving, artificial ventilation and other means of brain resuscitation to bring down intracranial pressure and drainage of necrotic brain tissue and of the foreign body.

5. ******, 45 year-old, female. Hospitalised due to head trauma with intracranial bleeding due to an explosion. Unconscious, ventilated and in immediate danger of her life if not treated by brain resuscitation and drainage of the bleed. Needs immediate evacuation by ambulance or helicopter to the nearest neurosurgical medical center in order to minimize moving.

6. ******, 36 year-old, male, ID 915064815. In ICU due to explosion and shock wave. Head CT showed shrapnel in the temporal brain, subarachnoid haematoma, slight distortion of the midline, shrapnel in left occipital brain. A catheter was installed due to a cyst. These are recent shrapnel wounds with bleeding, brain edema already causing movement of the midline as shown in brain CT, expressing acute enhanced intracranial pressure. This is a life endangering case with danger of severe disability if not treated in the nearest possible neurosurgical medical center. Evacuation by ambulance or helicopter must be as short as possible in order not to worsen her condition further before definitive neurosurgical treatment.

Notes:

Dr. Fawzi Nablussiya, director of the ICU at Shifaa hospital in Gaza has informed PHR-Israel that the serious medical condition of all these patients, all ventilated and unconscious, prevents their transfer to advanced medical centers in Egypt, which would necessitate long journeys of at least seven hours. For further information on this point it is possible to reach Dr. Nablussiya at **********.

Hospitals in Israel have expressed their willingness to admit the patients. Sheba Medical Center at Tel Hashomer and Wolfson Hospital in Holon can admit the three children. Confirmation of this was received at PHR-Israel's offices from Prof. Raphael Walden, the deputy director of Sheba Medical Center, Dr. Yitzhak Berlovitz, director of Wolfson hospital, and Dr. Weiss, director of Hadassah Medical Center in Ein Kerem, Jerusalem.

Erez Crossing has been completely closed since last Friday, 26.12.08, and the soldiers and civilians staffing the facilities have been evacuated from it. The Palestinian-Israeli coordinating mechanism for medical cases has stopped functioning. The army has stopped receiving requests for coordination of medical cases via Erez Crossing, and informed PHR-Israel of this fact via telephone.

The current attack found the health system in Gaza in a state of near-collapse due to the blockade imposed upon it for the past year and a half, as well as previous closures. Even before this crisis the system was working under severe restrictions: lack of professional knowledge, expertise and experience of the medical teams in dealing with complex wounds, shortages of medical equipment and staff, shortage of medicines etc. Now the health system must handle wounded people who are in need of complex care by expert professionals, which in the current situation it cannot provide.

According to various sources, several dispatches of humanitarian supplies were allowed to enter Gaza in the past days. We must stress that these supplies are not sufficient for an appropriate medical response to the complex needs of Gaza hospitals. There is no substitute for appropriate expert medical teams in such cases. For this reason the limited medical supplies sent to Gaza do not cancel the need for emergency evacuation of medical cases to advanced medical centers in Israel and in neighboring countries.

Israel has declared Gaza and its environs a closed military zone. As the occupying power currently in effective control of the area, Israel, which is carrying out a massive military operation in the Gaza Strip, must bear responsibility for the wounded of the attack, and enable their access to hospitals able to care for them, in accordance with international humanitarian law.

In these circumstances, Physicians for Human Rights-Israel and a coalition of 10 human rights organisations based in Israel have applied today to the Minister of Defense Mr. Ehud Barak to request urgent evacuation of the patients, and a consistent opening of the Crossing for the sick and wounded who cannot receive appropriate medical care in the Gaza Strip.

Intervention can be made in the following methods:
• Direct requests to the Israel Ministry of Foreign Affairs, Israeli military, Israeli Prime Minister, Israel Medical Association
• Advocacy in European and other capitals, with Foreign Ministries and parliaments
• Requests to permanent representatives to the EU in Brussels
• Requests to MEPs
• Requests to local medical associations and the World Medical Association

In the name of a coalition of 10 Israeli human rights organisations:
Physicians for Human Rights-Israel, Adalah, Gisha, Btselem, Bimkom, Yesh Din, Amnesty-Israel, Rabbis for Human Rights, ACRI, PCATI, Hamoked.

+ 972 3 5133115
+ 972 546 995199

It is possible to contact Mr. Ran Yaron of PHR-Israel for further details, at ranyaron@phr.org.il