Emergency response of the UNRWA health programme to Great March of Return injuries: a descriptive analytic study in Gaza.

BACKGROUND

The United Nations Relief and Work Agency for Palestine Refugees (UNRWA) is one of the main health-care providers in the Gaza Strip. It provides primary health services to approximately 1·3 million Palestine refugees, comprising approximately 76% of the population of the Gaza Strip. UNRWA has well-prepared emergency health plans that are based on previous conflict experiences. However, the Great March of Return (GMR) injuries that UNRWA has faced since Mar 31, 2018, are considered a new experience of emergency. GMR is a protest activity launched by Palestinians in the Gaza Strip to express their right to return to their homes, from which they were expelled in 1948. This study aimed to describe the GMR-related injury patterns in patients and the health services provided as a part of the UNRWA emergency response in Gaza.

METHODS

This was a descriptive analysis of medical and data reports of patients who sought care at 22 UNRWA health centres in Gaza for GMR-related injuries between Mar 31 and Sept 30, 2018. Data were collected from each individual on first contact with their health-care provider. We analysed the data using SPSS version 21. The study protocol was approved by the Gaza Field Office, and each participant provided oral informed consent to disclose their medical data for analysis.

FINDINGS

2020 patients attended the 22 UNRWA health centres for GMR-related injuries during the study period. 18·9% (381) were below 18 years of age, and 94·9% (1916) were male. 10·0% (202 of 2020) of injuries were classified as severe, 54·2% (1095) as moderate, and 35·8% (723) as mild. The majority of injuries (86%; 1737 of 2020) were due to gunshots, and 14% (283) were due to other causes (such as gas inhalation, rubber bullets, burns, and falling down). 54% (1090 of 2020) received wound care and dressing, 20% (404), received medical treatment only, and 26% (526) received both medical treatment and wound care. 9% (169 of 2020) developed motor dysfunction or disability as a complication, and received rehabilitation physiotherapy at UNRWA health centres. In addition to injury treatment, all patients received psychological first aid according to UNRWA Mental Health and Psychosocial Support Services guidelines. Individual and group psychosocial support sessions and home visits were provided for injured individuals and their families as needed. The UNRWA Health Programme collaborated with partners (eg, the International Committee of the Red Cross and Médecins Sans Frontières) for hospital referral for patients with severe injuries who needed advanced treatment.

INTERPRETATION

Given the unprecedented situation, UNRWA health centres responded positively and comprehensively to the GMR-related injuries, providing care and essential medical and psychosocial support. However, many patients will require long-term care owing to their injuries. Further consideration should be given to developing a more systemised response to such emergencies, and to the human resources that are needed to support health, physiotherapy, and rehabilitation in Gaza.

FUNDING

None.