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Ahmed Ibrahim University of California Irvine  Office of Environmental Health and Safety Health Under Siege: The Gaza Model
About Me ,[object Object],[object Object]
About this presentation ,[object Object],[object Object],[object Object],[object Object]
The Objective of this presentation is to ,[object Object],[object Object],[object Object],[object Object],[object Object]
The objective of this presentation is   NOT   to ,[object Object],[object Object],[object Object],[object Object],[object Object]
OK Just this once!!!
A  siege  is a military or economic blockade of a city or territory with the intent of conquering by attrition or assault.  -Constant -Relatively Low Intensity -One side maintains strong static defensive position. Year Besieged Duration 1982 Beirut, Lebanon 2.3 months 1992 Sarajeavo, Bosnia 4 years 2004 Fallujah, Iraq 1 month 2009 Northern Sri Lanka 4-7 months Year Countries Duration 1986 South Africa 8 years 1990 Iraq 12 years 1997 Burma 13 years 2001 Zimbabwe 9 years
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Threatens the top achievements in public health Introduces new disease burdens in the population. Siege Types: Blockade vs. Sanctions
What makes a Unique model? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Geographic 41 Km (25 miles) long 6-12 Km Wide 360 Km 2  (139 mi 2 ) (twice size of Irvine) Demographic 1.5 million residents (July 2009) 85% refugees from previous Arab Israeli conflicts. Pop density 4118/sq mile (2.25 times as Irvine) As of 2007, 80% of Gazans live under the poverty line. Siege of Gaza began in June 2007
Before Operation “Cast Lead” ,[object Object],[object Object],[object Object]
Israeli Policies ,[object Object],[object Object],[object Object],[object Object],[object Object],Health  in  the Gaza Strip: Siege, Fire, and Internal Division  Majdi  Ashour, MD, MPH  Public Health and Health Policy Specialist
Palestinian Division ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
"Situation Report From The Humanitarian Coordinator - January 7, 2009, 1700 hours" .  UN   Office for Coordination of Humanitarian Affairs .  2,360 air strikes -GBU-39: Small diameter missiles carrying DU warheads -2000 lb Mark 84 Bunker Busters along Sinai/Egypt border. 7,000 shells fired More than 50% were MA25A1 (White phosphorous) Ground Invasion Entered through Kissufim border to split Gaza and cutoff resources from the south.   Naval Strikes 8 Km range ER missiles Triggered UK to revoke License to sell Israel spare parts.  UAV Continues to be deployed over Gaza
Gaza Parliament Building
Petroleum Company
UN Vehicles
UNRWA Food Storage Warehouses
 
ER wing of Hospital destroyed
American International School in Gaza
American International School in Gaza
Dec. 27-Jan 18 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Damage to Health System ,[object Object],[object Object],[object Object],[object Object],[object Object]
Current Healthcare System ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Interview with MoH Dr. Bassem Naim 07/16/09
Sustained trauma to population ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Interview with Head Nurse at Shifa Hospital
Assessments largely ignored long term impact of the campaign ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Fundamental PH Perspective ,[object Object],[object Object],[object Object],[object Object]
Depleted Uranium: GBU-39’s ,[object Object],[object Object],[object Object],[object Object],[object Object],Action of Citizens for the total Dismantling of Nukes UPDATED 4th JULY 2009 REPORT On the use of radioactive weapons in the Gaza Strip during « Operation Cast Lead » (27 December 2008 – 18 January 2009)
Medical Evidence ,[object Object],[object Object],[object Object],[object Object],Interview with MoH Dr. Bassem Naim 07/16/09
Water Source and Treatment Plants Rafah Governorate Serves 184,000 residents Served by Coastal Municipalities Water Utility 65% currently connected to wastewater system Discharges untreated sewage into the sea Khan Younis Governorate Serves 250,000 residents Served by Coastal Municipalities Water Utility 25% connected to wastewater system Discharges partially untreated wastewater into the sea Deir El Balah (Middle Zone) Governorate  Serves 190,000 residents No connection to wastewater system Discharges raw sewage into Gaza Valley and runoff to sea Gaza Governorate Serves 470,000 residents Gaza Waste Water Treatment Plant damaged during the war North Gaza Governorate Serves 255,000 residents  Damaged pipe caused flow to bedouin villages
Raw sewage into the Mediterranean. ,[object Object],[object Object],[object Object]
Impact on Ground water supply ,[object Object],[object Object],[object Object],[object Object]
Effect on Human Health ,[object Object],[object Object],[object Object],[object Object]
Food Supply ,[object Object],[object Object],[object Object],[object Object],Environmental Assessment of the Gaza Strip United Nations Environment Programme following the escalation of hostilities in December 2008 – January 2009
 
 
Built Environment ,[object Object],[object Object],[object Object],[object Object]
Effect of housing conditions on public health ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Fourth Ministerial Conference on Environment and Health Budapest, Hungary, 23–25 June 2004 Review
 
 
 
 
Greater Context: Siege is Unique in the Public Health Perspective in that ,[object Object],[object Object],[object Object],[object Object],[object Object]
Siege: Redefined ,[object Object],[object Object],[object Object],[object Object]
Is Iraq a Predictive Model? ,[object Object],[object Object],[object Object],[object Object],International Commission of Inquiry on Economic Sanctions BM 2966, London WC1N 3XX, Britain Release Date: November 20, 1996
Two subliminal messages here ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],ALL OF GAZA BELONGS TO ME!!
Last Thoughts ,[object Object],[object Object],[object Object],[object Object]
Thanks ,[object Object],[object Object],[object Object],[object Object],[object Object]

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Public Health Situation in Gaza 2009

  • 1. Ahmed Ibrahim University of California Irvine Office of Environmental Health and Safety Health Under Siege: The Gaza Model
  • 2.
  • 3.
  • 4.
  • 5.
  • 6. OK Just this once!!!
  • 7. A siege is a military or economic blockade of a city or territory with the intent of conquering by attrition or assault. -Constant -Relatively Low Intensity -One side maintains strong static defensive position. Year Besieged Duration 1982 Beirut, Lebanon 2.3 months 1992 Sarajeavo, Bosnia 4 years 2004 Fallujah, Iraq 1 month 2009 Northern Sri Lanka 4-7 months Year Countries Duration 1986 South Africa 8 years 1990 Iraq 12 years 1997 Burma 13 years 2001 Zimbabwe 9 years
  • 8.
  • 9.
  • 10. Geographic 41 Km (25 miles) long 6-12 Km Wide 360 Km 2 (139 mi 2 ) (twice size of Irvine) Demographic 1.5 million residents (July 2009) 85% refugees from previous Arab Israeli conflicts. Pop density 4118/sq mile (2.25 times as Irvine) As of 2007, 80% of Gazans live under the poverty line. Siege of Gaza began in June 2007
  • 11.
  • 12.
  • 13.
  • 14. "Situation Report From The Humanitarian Coordinator - January 7, 2009, 1700 hours" . UN Office for Coordination of Humanitarian Affairs . 2,360 air strikes -GBU-39: Small diameter missiles carrying DU warheads -2000 lb Mark 84 Bunker Busters along Sinai/Egypt border. 7,000 shells fired More than 50% were MA25A1 (White phosphorous) Ground Invasion Entered through Kissufim border to split Gaza and cutoff resources from the south. Naval Strikes 8 Km range ER missiles Triggered UK to revoke License to sell Israel spare parts. UAV Continues to be deployed over Gaza
  • 18. UNRWA Food Storage Warehouses
  • 19.  
  • 20. ER wing of Hospital destroyed
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31. Water Source and Treatment Plants Rafah Governorate Serves 184,000 residents Served by Coastal Municipalities Water Utility 65% currently connected to wastewater system Discharges untreated sewage into the sea Khan Younis Governorate Serves 250,000 residents Served by Coastal Municipalities Water Utility 25% connected to wastewater system Discharges partially untreated wastewater into the sea Deir El Balah (Middle Zone) Governorate Serves 190,000 residents No connection to wastewater system Discharges raw sewage into Gaza Valley and runoff to sea Gaza Governorate Serves 470,000 residents Gaza Waste Water Treatment Plant damaged during the war North Gaza Governorate Serves 255,000 residents Damaged pipe caused flow to bedouin villages
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