Since Israel intensified its attacks on Palestine in October 2023, not even sparing hospitals, more than 66,000 Palestinians have been killed, according to the latest bulletin from the Gaza Health Ministry. But almost three times as many people, around 1.6 lakh, have been left seriously injured.
In this crisis comes a worrying report on the health crisis in Gaza in the latest edition of The Lancet Infectious DiseasesAccording to the paper, disease outbreaks have spread in the area, and now infections are also becoming multidrug-resistant, imposing a new challenge on an already beleaguered population.
Multi-drug resistance is defined “as nonsusceptibility to at least one drug in three or more classes.” In the study, the researchers calculated the multiple antibiotic resistance index (MAR) for each isolate. The index is equal to the number of antibiotics an organism is resistant to divided by the number of antibiotics it has been exposed to.
Ballistic, crush trauma
Tests on 1,317 samples collected at al-Ahli Hospital in Gaza revealed that MAR was reported in more than two-thirds of samples (in the form of pus, wound swabs and urine) collected last year, “reflecting the overwhelming burden of ballistic and crush trauma,” said the paper, written by scientists including Islamic University faculty of Gaza.
Pseudomonas aeruginosaa bacterium already known to be associated with serious diseases, including hospital-acquired infections such as ventilator-associated pneumonia, dominates, followed byStaphylococcus aureuscommon cause of skin abscesses and respiratory infections; Klebsiellaknown to cause pneumonia, urinary tract infections and meningitis; And Escherichia coli, which can cause serious food poisoning.
The study also found that two-thirds of all isolates were multidrug resistant.
“We noticed great resistance among the people Enterobacteria spp. isolates, with more than 90% of wound isolates resistant to amoxicillin-clavulanate, cefuroxime and cefotaxime. Resistance to ceftriaxone and ceftazidime was also alarmingly high in wound isolates,” the paper said.
Children oriented
Gaza’s healthcare system has been gradually destroyed by Israel’s attack. As of October 2023, one of Gaza’s only functioning microbiology service centers is a small laboratory at Al-Ahli Arab Hospital in Gaza City, which maintained power largely through diesel generators and battery inverters.
“The hospital, which is one of the few hospitals in Gaza that has remained partially operational, has treated large numbers of traumatic injuries despite frequent airstrikes (which began as early as October 2023 and continued at the time of writing) in the northern two governorates of the Gaza Strip,” the newspaper said.
According to the World Health Organization (WHO), Israel carried out 498 attacks on healthcare facilities in the Gaza Strip between October 7, 2023 and July 30, 2024. “A total of 747 people were directly killed and 969 were injured in these attacks, and 110 facilities were affected,” the UN Independent International Commission of Inquiry reported. As many as 500 medical personnel were killed, while Israeli security forces also blocked access to humanitarian organizations.
“Direct attacks on health care facilities, including those providing sexual and reproductive health care and services, have affected approximately 540,000 women and girls of reproductive age in Gaza,” it added.
The UN report also states that the high number of child deaths is likely due to the fact that “children constitute a majority of patients treated in hospitals for blunt and penetrating trauma.”
Medical professionals told the Commission that they had treated children with direct gunshot wounds, meaning the children were targeted.
“Children were operated on without pre- and post-operative care, increasing the risk of wounds becoming infected, including by insects and parasites, leading to complications and, in some cases, death,” the report said.
Vulnerable to diseases
“A key finding is that approximately 76% of that sample came from explosion or trauma-related injuries, which speaks to the number of explosion-related injuries coming in as a result of the Israeli military assault on Gaza,” Bilal Irfan, co-author of the study and a global health scientist with interests in bioethics, conflict medicine and trauma systems, at the Center for Bioethics of Harvard Medical School, said in an interview with an American newspaper.
We don’t even know the true extent “because of the destruction of almost all the laboratories and the murder of a large part of the medical staff, so to gain even a small insight into what is happening in Gaza is extremely important,” Dr. Irfan, who also conducts research at Harvard’s Brigham and Women’s Hospital and the University of Michigan. The Guardian. “We don’t even know the true extent due to the destruction of almost all the laboratories and the murder of a large part of the medical staff, so it is extremely important to gain even a small understanding of what is happening in Gaza.”
According to the newspaper, Al-Ahli Arab Hospital is also reporting an increasing number of daily admissions with little sterile irrigation fluid, wounds left undressed for days and only ad hoc donations of broad-spectrum antibiotics. “Prolonged shelter of displaced families outside the hospital could also have contributed to the transmission of infectious diseases,” it added.
Outside the borders of Gaza
The international medical community “has an obligation” to act and respond to this crisis, the paper’s authors wrote.
“First and foremost, healthcare professionals and governments around the world must advocate for a halt to the Israeli military invasion that has resulted in a wave of trauma injuries and widespread deliberate targeting of hospitals, laboratories and water desalination plants; without this ceasefire, infection pressure will further escalate.”
It added that the supply of medicines should be coordinated between humanitarian organizations and donors, perhaps through WHO, so that the antimicrobial response can be tailored to the documented needs of hospitals.
“If protection of Palestinian health facilities, antibiotic supply pipelines and functional laboratories are not quickly secured, the resistant organisms documented here are likely to spread far beyond Gaza’s borders,” the paper warned.
#Drugresistant #bacteria #multiplying #Gaza