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12 C BX .BBM TZN G A street ro o ts tlB Education * Dialogue * Independence INTERNATIONAL Life returns - in pieces Doctors in Gaza work around barriers to repair the damage compounded by years o f conflict BY EVA BARTLETT STREET NEWS SERVICE on a Saturday; now there are at least 30. ICRC figures show that in 2008, 63 patients GAZA CITY, Palestine received 71 prosthetic limbs (some had n a Saturday morning in Gaza city, multiple amputations), and the center the Artificial Limb and Polio Center served, 1,500 patients. In the first half of (ALPC) is filled with people waiting 2009,1,018 patients have come to the to see the director, Dr. Hazem Al-Shawwa. centre, 53 for prosthetic limbs. Following consultation with him and with the specialist in prosthetics and orthotics rehabilitation from the International Committee of the Red Cross (ICRC), many will begin thelong road to treatment. “It was the second day of the war,” says Omar Al-Ghrub (24), referring to the three weeks of Israel attacks in the winter of 2008-2009. “I was working that day,” he > said. By day he worked in the Al-Waleed marble and granite factory northwest of Gaza cijty, and by night served as its watchman. A missile struck, and Ghrub lost both his legs. Six months later, he waits for the stumps to heal enough to begin the process of fitting artificial legs, and learning to walk anew. Loay Al-Najjar, 22, also lost both his legs. At 11 pm Jan. 13, Najjar was tiyingto help his sister evacuate a house that had been hit by shelling in the Khoza’a region, east ofT Khan Younis. “I was hit by a drone missile,” says Najjar. His legs were lacerated with A t the artificial limbs center in Gaza, shrapnel. But he is one of theluckier ones; he was able to travel to Saudi Arabia where he received treatment for three months, and H • ar tificial "leg»;1-...... ....... ..... . — ------ Ghrub and Najjar are among the many waiting for a consultation this particular Saturday. The artificial limb center is unique in that it makes and fits the limbs on the premises. With the help of staff from the ICRC and Doctors Without Borders , it also provides physiotherapy and other support The eerttre is overcrowded -v it is the only one of its kind. The waiting listhas lengthened dramatically since the Israeli attacks on Gaza. Gaza’s Ministry of Health says between 120-150 new patients have had to have amputations following the Israeli attacks on Gaza. Gerd Van de Velde, head of the ICRC’s physical rehabilitation team in Gaza, says the number could rise with patients whose wounds worsen. “Even now we are getting new patients,” says Van de Velde. “Some patients are having problems with their stumps as they were not carecLfor properly during their initial treatment due to the hectic situation. At the time, treatment was focused on life saving.” In January 2008, five to 10 patients came “We have 146 patients on the waiting list, including 101 with war wounds,” says Van de Velde. “Of these, over 50 percent are above the knee amputations.” Blast injuries become even more complicated, because shrapnel must be extracted from the stump of the limb before it can heal énough for prosthetics treatment. A few years ago, the center used its funding to pay all the costs of the materials. Nearly allcamefrom a specialist company in Germany, some were bought at twice their usual price from an Israeli importer. Now, the ICRC, which began working with the center in November 2007, supplies most of the materials, buying directly from the manufacturer, and also facilitating transfer through-Israel. The Céntre also gets help from the United Nations Relief and Works, Agency (UNRWA), Handicap International and Islamic Relief. Van de Velde sees early hospital care, or the lack of it, as the origin of the problem for many of the patients. In a crisis, he , said, Send two Palestinians to India for an internationally recognized 18-month training program. Vande Velde says the ICRC plans to send three more to be trained next year, with the aim of building .a pool of qualified technicians. All sorts of people were injured in the last assault “During thé first and second Intifadas (Palestinian uprisings, 1987-1991 knd then from September 2000), most of the injuries were among the shebab (young men>,” says Mohammed Ziada. “But in this last war, most of the injuries were people other than shebab: elderly, children, women...” Farah pointé to severfo siege-related difficulties the center faces. The artificial limb center uses hundreds of différent parts, plastics and materials to make the prosthetic arms and legs. “Without even just one Of the materials, the limb cannot be made. We don’t have the materials or the chemieals in Gaza to make the limbs.” Israel often prevents or greatly delays materials from entering, says Farah, Walking through a storage room, Farah points out various empty shelves. Among clusters of different weaves of stocking net cloth used iii the making of limbs, size 10 shelf sits empty. “We haven’t had size 10 for E M A D B A D W A N /IP S the last month,” Farah says. Also absent are artificial foot parts L23, unavailable for the last 10 days, and R24 and R25, depleted for the last two mopths. “We "ReïpTîPstuîosewiroiîeecrnei^xn^nosïr^™ other hospitals, focusing on quality of post- says Farah. _ g _ . . . surgical physiotherapy care and ensuring Gerde Van de Velde says, however, that that patients receive the treatment that they “not oné patient had to wait because of a need.” Likewise, Doctors Without Borders is lack of material.” Items like the cloth can be working throughout the Gaza Strip to substituted by a closely related size, he says. provide post-operation wounds care and He admits there are restrictions on certain physiotherapy. chemicals, but adds that thèse are more At the artificial limbs center, faking a related to international law, and delayed by pause from casting and sculpting limbs, other bureaucratic procedures regarding the Nabil Farah and Mohammed Ziada, two of transport of chemicals. four specialists in prosthetics,-take turns to Farah cites some sample costs: a below- demonstrate work at the center. The the-knee prosthetic is about $800. An ahove- specialists have both studied abroad, in the-knee limb is twice as much. An arm Germany and in India, and want the trainees costs $1,200. Yet these seemingly expensive here to be sent for specialized studies. But? limbs cost a fraction of what they might in with the siege on Gaza and the sealed other countries. borders, it has become difficult to leave “Our salaries are very low,” says Farah. Gaza. “We aren’t working for the money, obviously. Likewise, says Farah, many specialists We’re working for the many Palestinians want to come to Gaza to train technicians in who need limps and therapy.” malting and working with prosthetic limbs, but they cannot enter because of the. siégé. Courtesy o f Inter Press Service, in agreement But on July 1, after much coordination with with the International Network o f Street the Israeli authorities, the ICRC1 was able to Papers © Street News Service: www.street- “patients are evacuated quickly to make room for new patients. They did not receive the treatment and follow-up physiotherapy that they needed.” . The ICRC has now taken on a second, hospital-based project. “We’ve started with Shifa hospital, and hope to expand to Gaza’s papers:org PDC is proud to help preserve the historic Hung Far Low sign a symbol of the rich cultural heritage > in Old Town/Chinatown. PDC assisted the project w ith a Signage and Lighting Improvement Program (SLIP) grant, I The program provides property owners and tenants w ith funds to upgrade signage and awnings, and improve w indow and facade lighting. This in turn helps create a positive retail and pedestrian environment in our city. 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