Al Najjar Sanaa, Al Shaer Tamer, Hamad Khalil, Al Kahlout Mahmoud, Mughari Hala, Al Jadba Ghada
UNRWA Health Program, Gaza Field Office, Gaza Strip, occupied Palestinian territoryxs.
UNRWA Health Program, Gaza Field Office, Gaza Strip, occupied Palestinian territoryxs.
Lancet. 2021 Jul;398 Suppl 1:S4. doi: 10.1016/S0140-6736(21)01490-2.
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.
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.
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.
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.
None.
联合国近东巴勒斯坦难民救济和工程处（近东救济工程处）是加沙地带主要的医疗服务提供者之一。它为约130万巴勒斯坦难民提供初级卫生服务，约占加沙地带人口的76%。近东救济工程处根据以往的冲突经验制定了完善的应急卫生计划。然而，自2018年3月31日以来近东救济工程处面临的回归大游行（GMR）受伤情况被视为一种新的紧急情况。回归大游行是加沙地带巴勒斯坦人发起的一项抗议活动，以表达他们返回1948年被驱逐家园的权利。本研究旨在描述与回归大游行相关的患者损伤模式以及作为近东救济工程处在加沙应急响应一部分所提供的卫生服务。
这是一项对2018年3月31日至9月30日期间在加沙22个近东救济工程处卫生中心因与回归大游行相关损伤而寻求治疗的患者的医疗和数据报告的描述性分析。在患者首次与医疗服务提供者接触时收集每位患者的数据。我们使用SPSS 21版分析数据。该研究方案得到了加沙外地办事处的批准，每位参与者口头同意披露其医疗数据用于分析。
在研究期间，2020名患者因与回归大游行相关的损伤前往22个近东救济工程处卫生中心就诊。18.9%（381名）患者年龄在18岁以下，94.9%（1916名）为男性。10.0%（2020名中的202名）损伤被归类为重伤，54.2%（1095名）为中度伤，35.8%（723名）为轻伤。大多数损伤（86%；2020名中的1737名）是由枪伤造成的，14%（283名）是由其他原因（如吸入毒气、橡皮子弹、烧伤和摔倒）导致的。54%（2020名中的1090名）接受了伤口护理和包扎，20%（404名）仅接受了药物治疗，26%（526名）既接受了药物治疗又接受了伤口护理。9%（2020名中的169名）出现运动功能障碍或残疾并发症，并在近东救济工程处卫生中心接受了康复理疗。除了损伤治疗外，所有患者均根据近东救济工程处心理健康和社会心理支持服务指南接受了心理急救。根据需要为受伤人员及其家人提供了个体和团体社会心理支持会议以及家访。近东救济工程处卫生项目与合作伙伴（如红十字国际委员会和无国界医生组织）合作，将需要进一步治疗的重伤患者转诊至医院。
鉴于这一前所未有的情况，近东救济工程处卫生中心对与回归大游行相关的损伤做出了积极全面的响应，提供了护理以及基本的医疗和社会心理支持。然而，许多患者因其损伤将需要长期护理。应进一步考虑制定针对此类紧急情况的更系统化应对措施，以及加沙地带支持卫生、理疗和康复所需的人力资源。
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