Assessment of ophthalmic care services in Gaza
8 March 2010
Forward Thinking - A team of health care professionals, lead by Forward Thinking's Director Mr. Oliver McTernan, and Dr Bob Roberts visited the West Bank and Gaza between the 17th and 21st January 2010.
The visit was the result of a cooperative effort between Forward Thinking and Glocalnet, an American Evangelical organisation that was founded by Dr Bob Roberts to provide humanitarian assistance in various parts of the world. They visited Gaza at the invitation of the United Nations Relief and Works Agency (UNRWA) and of the Ministry of Health Gaza with a remit to assess the ophthalmic services, equipment and training. It also included working with the Gaza ophthalmologists to develop a structure for the development of eye care in Gaza.
The team was also able to run teaching / training sessions as well as perform some surgical teaching.There are several main hospitals serving the population of Gaza. The main provider of ophthalmologic care services is the El Nasser Ophthalmic Hospital in Gaza City.
The hospital has six examination rooms, set up with slit lamps and examination stations, nursing stations and a minor operating facility. There is also an operating suite with three operating theatres, sterilization facilities and rest/changing rooms. The wards are divided into male and female blocks each having around 25 beds in each. Other areas include a waiting area for outpatients, offices and a boardroom.
There is a pleasant teaching room with a quality data projector and a working projection screen. The hospital is serviced by a reasonably stocked pharmacy department.
The vast majority of people treated in the hospital suffer from cataracts. Other ailments are glaucoma, vitreoretinal and medical retina. In some cases patients are being sent to Egypt for further or more advanced treatment.The team identified a series of training needs in the hospital including ultrasound, fluorescein angiogram, electrodiagnostics, surgical skills, vitrectomy, ophthalmic management and glaucoma management.
Also, the hospital could benefit from training on a systematic approach to quality control and infection control. The staff of the hospital may benefit from Linked Academic Training and support for Continuous Professional Development.The team also found that the embargo and the current political situation prevailing in Gaza has an impact on the formulation and delivery of ophthalmologic services. The continued internal tensions between Hamas and Fatah impacts on the provision of medical services, since most of the doctors are government employees.
The quantities and flow of medical supplies from abroad are severely restricted because of the closure of the borders by both Israel and Egypt. The continued scarcity of basic supplies such as electricity, water and fuel add to the difficulty. Also, limited international travel of both doctors and patients limits access to further medical aid.
On their visit to the West Bank, they discovered that the 1.5 million-population is served by, approximately, 70 ophthalmologists, most of which practise in the four private clinics.
There are five surgeons that serve all the facilities. Most of the cases operated were of cataract. There is also treatment available for glaucoma.The Palestinian Medical Relief Society (PMRS), plays a key role in the provision of emergency medical aid, through its offices in Ramallah and Nablus, including primary care and health education. However, PMRF is not able to provide further specialized care for ophthalmic problems.The needs identified in the West Bank are mostly in the area of cataract and retinopathy, particularly surgery but also routine scanning.
