November 30, 2023 • 57 mins
WHO welcomes the extension of the humanitarian pause in the conflict in Gaza, and the release of hostages and prisoners by both sides.
The pause has enabled WHO to increase deliveries of medical supplies in Gaza, and to transfer patients from Al-Shifa hospital to other hospitals south of the Wadi Gaza.
During the first three days of the pause, WHO received 121 pallets of supplies into our warehouse in Gaza, including IV fluids, medicines, lab supplies, medical disposables, and trauma and surgical supplies.
This is enough to support about 90 000 people.
Become a supporter of this podcast: https://www.spreaker.com/podcast/depictions-media--4208927/support.
The pause has enabled WHO to increase deliveries of medical supplies in Gaza, and to transfer patients from Al-Shifa hospital to other hospitals south of the Wadi Gaza.
During the first three days of the pause, WHO received 121 pallets of supplies into our warehouse in Gaza, including IV fluids, medicines, lab supplies, medical disposables, and trauma and surgical supplies.
This is enough to support about 90 000 people.
Become a supporter of this podcast: https://www.spreaker.com/podcast/depictions-media--4208927/support.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:04):
Thank you for listening to Pictures MediaRadio. Welcome to Policy and Rights,
the show about the government policy andhuman rights. Hello everybody, this is
(01:03):
Margaretta Harrison, who Headquarters Geneva.Welcoming you today November twenty nine, twenty
twenty three to our press briefing oncurrent global health issues. As usual,
we will start with opening remarks fromour Director General, doctor Tedros Adnam Gabresis,
and I will then open the floorto questions and our panel of technical
(01:26):
experts, both here in the roomand online will be available to answer your
questions. In the room, wehave a large panel on doctor Tedros.
Right, we have doctor Mike Ran, our executive director for our Emergencies program.
Next to doctor Brian, we havedoctor Ilham Nuir, our acting Incident
Manager for the Occupied Palestinian Territory Israelescalation. Next to doctor Nur is doctor
(01:51):
Maria Naira, our Director director ofour Department for Environment, Climate Change and
Health. And next to doctor Nerais mis Andy Seal, our technical officer
for HIV hepatitis it's sexually transmitted infections. And next to Missed Seal is mister
Derek Walton, our legal counsel andto doctor Tedros. Left, we have
(02:13):
doctor Maria van Kirkov, acting directorof our Department for Epidemic and Pandemic Preparedness
and Prevention. We also do haveour usual large panel of experts online and
we will call upon them whenever appropriatewhen you ask your questions. But now
without further ado, we'll go todoctor Tedros for his opening remarks. Doctor
(02:34):
Tedros, you have the floor.Thank you, Thank you. Margareta,
good morning, good afternoon, andgood evening. W JOE welcomes the extension
of the humanitarian polls in the conflictin Gaza and the release of hostages and
prisoners by both sides. The POSEhas enabled w JOE to increase deliveries of
(03:00):
medical supplies in Gaza and to transferpatients from Al Shifa Hospital to other hospitals
south of the Wordy Gaza. Duringthe first three days of the POSE,
WHO received one hundred twenty one palletsof supplies into our warehouse in Gaza,
including ivy flutes, medicines, labsupplies, medical disposables, and trauma and
(03:25):
surgical supplies. This is enough tosupport about ninety thousand people. However,
much more is needed. We continueto call for a sustained sispire so that
aid can continue to be delivered toend further civilian suffering, and we call
(03:47):
for the remaining Israeli hostage to bereleased and for those who are still being
held to receive the medical care theyneed. Who's greatest concern remains supporting Gaza's
health system and health workers to function. Only fifteen of gaza thirty six hospitals
(04:08):
are still functioning at all, butare completely overwhelmed. For example, European
Gaza Hospital is currently operating a tripleits capacity. Of the twenty five hospitals
north of the Woody Gaza before theconflict began, only three are functioning at
(04:28):
the most basic level, but theylack fuel, water and food. The
remaining health system capacity must be protected, supported and expanded. The health needs
of the population of Gaza have increaseddramatically, but they are now being serviced
by one third of the hospitals andprimary care clinics, and with severe overcrowding,
(04:56):
the risks are increasing for epidemics ofrespiratory tract infections, acute watery area
hepatitis, escabies, lies and otherdiscs. Doubly a choice. Working to
support Gaza health system and health workersin every way we can, together with
(05:16):
partners with distributing supplies, coordinating emergencymedical teams to provide extra clinical capacity for
existing hospitals, and establishing stand alonefield hospitals in strategic locations. We tank
those partners who are working with us, but we repeat that emergency medical teams
(05:41):
and field hospitals can only complement Gazahealth system, not replace it. The
priority must be to support Gaza healthworkers, hospitals and clinics to do their
jobs. This week, the worldis converging in the United Arab Emirates for
(06:02):
COP twenty eight, the United NationsClimate Change Conference. According to the inter
Governmental Panel on Climate Change, aboutthree point five billion people, nearly half
of humanity, live in areas highlyvulnerable to the climate crisis. This year
(06:24):
alone, catastrophic flooding in Libya andthe Horn of Africa has caused lives and
livelihoods, and just this week Brazilhit record temperatures. An unhealthy planet means
unhealthy people. It related death amongpeople aged over sixty five years have climbed
(06:47):
by seventy percent globally in two decades. Every year, seven million people die
from air pollution. Changing weather patternsdriven by human activity and the burning of
fossil fuels is contributing to record numbersof cholera outbreaks, and our warming planet
(07:12):
is expanding the range of mosquitoes,which carry dangerous pathogens like dengy chicken,
gunya zica, and yellow fever intoplaces that have never dealt with them before.
The climate crisis is a health crisis, so we're pleased that for the
first time, this year's scope willinclude a day dedicated to help, with
(07:38):
more than fifty health ministers attending fromaround the world. While at cop I
will make three specific calls. First, a climate friendly world who calls on
leaders from government in industry to worktogether to phase out fossil fuels urgently and
(07:59):
at accelerate the transition to clean energy. Fossil fuels, coal, oil and
gas are by far the largest contributorto global climate change, accounting for over
seventy five percent of greenhouse gas emissionswhen in the world of fossil fuels,
(08:20):
is therefore the only way for countriesto meet their commitment to limit global warning
to one point five degrees celsius.This is a public health imperative. Second,
climate friendly health systems. While thehealth sector is affected by climate change,
it also contributes to it, withabout five percent of global emissions.
(08:46):
We must focus on decarbonizing health systemsto reduce that. At the same time,
we must build continue to strengthen healthsystems to be more climate resilient.
That means strengthening the health workforce andthese surveillance systems, building on investments that
(09:07):
many countries made during the COVID nineteenpandemic, and it means scaling up vector
control and access to safe water andsanitation. Third finance, The health sector
is at the front line of theclimate crisis that it receives just half of
one percent of global climate financing.The world spends thrillions of dollars of public
(09:33):
moneys in fossil fuel subsidies every year. We call on government and investors to
redirect those funds to protecting and promotingthe health of our planet and the health
of people. And we ask alsoof the international community to honor the Plage
(09:54):
one hundred billionaires dollars for climate changeannually. This Friday marks World Age Day.
This year's theme is Let Communities Lead. It affirms the vital role that
affected communities play in leading the responseto HIV. Thanks to decades of activism,
(10:18):
advocacy and support from affected communities,millions of new infections have been averted
and thirty million people are now receivinguntil trou viral therapy. As prevention and
treatment services for HIV are increasingly deliveredin community and primary health care settings,
(10:39):
communities and community health workers are evenmore critical. We must stand together to
ensure communities have the funding and resourcesthey need to stand up for human rights,
to fight stigma, and to helpout and aids for good. I
(11:00):
thank you and Margaret, it's backto you. Thank you very much.
Doctor ted Ros will now open thefloor to questions. As I should have
mentioned, if you want to aska question, please use the raise your
hand icon if you haven't done thatalready. There are a lot of you
online and there are a lot ofyou with hands raised, so please keep
(11:20):
your questions short and clear, andif you know who it's addressed to do
mention that as well and give yourname and outlet. The first question goes
to Helen Brandswell from stat Helen couldjoin mute yourself and ask your question.
Thank you very much, Margaret.I think this is probably from Maria.
It's a follow up to the situationin China. I'm wondering if WHO is
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hearing of other places that are seeingan increase in michael plasma pneumonia in children
as well as the Chinese authorities have. Thank you, So thanks Tom for
the question. So yes, Imean we are seeing in general an increase
in respiratory infections around the world.We do tend to see increases in children
(12:07):
because they're the school age children,and in the Northern Hemisphere we're entering the
it's the autumn already and we're enteringthe winter months, so we are expecting
to see increases in acute respiratory infections. Microplasma pneumonia is not a reportable disease
to WHO, so we tend totrack this information through reporting systems and through
discussions with our member states. Wehave seen, as you and I had
(12:31):
discussed earlier or last week, weare following up with the situation in China,
and again they have seen overall anincrease in acute respiratory infections due to
a number of different pathogens, includinginfluenza, which is on the rise.
Microplasma pneumonia was on the rise forthe last couple of months and now seems
to be a little bit on thedecline. We're following up through our clinical
(12:54):
networks and working with clinicians in Chinato better understand resistance to antibiotics, which
is a problem across the world,but is a particular problem in the Western
Pacific and Southeast Asia region. Wedo. One of the things we are
following up on in terms of theacute respiratory infections is looking at burden and
healthcare systems. So it's one thingto see arise in these types of infections,
(13:18):
particularly in schoolized children, but alsoto monitor the severity and looking at
the health care capacities around the worldto be able to deal with these types
of infections, looking at what arethe treatment options that are there, and
there are many antibiotics that are availablefor microplasma pneumonia. I don't have the
specifics on the rates around the countryaround the world for this particular bacteria,
(13:39):
but we have seen outbreaks of microplasmapneumonia in a number of countries over the
course of many different years, soI can follow up with you on some
specifics on that and specifically in Chinaand elsewhere. Thank you very much,
Doctor van Kharkov. The next questiongoes to Alicia Sanchez from Europa Press News
(14:00):
Agency Spain. So, Alicia,could you unmute yourself and ask you a
question? Alicia, we're not hearingyou. Are you having problems? We'll
(14:22):
go to the next question. Thenext question goes to Alexandra Tin of CBS.
Alexandra, please unmute yourself and askyour question. Hi, thanks for
taking my question. I just wantedto follow up on the report last week
about BA two eighty six. Iwas wondering if you could clarify what you
(14:43):
think the role of JAN one isin BA two eighty six's growth, and
if you have any updates to shareon what you've heard about it's comparative severity.
Thank you, Thank you. Ithink that's another one for doctor van
Kirkov. Yeah, thanks very much. So we are continuing to track the
variants around the world and BA dottwo dot eight six was recently classified as
a variant of interest. It wasformerly a variant under monitoring within BA dot
(15:07):
two dot eight six includes this uhfurther sublineage of JN dot one. Globally,
we have about ten percent of thesequences that are reported to public platforms
are BA dot two dot eight sixand its sublineages. In terms of our
assessment, there's still very small numbers, so I don't have the exact number
of sequences in this in this grouping, but it's around four thousand, just
(15:30):
over four thousand sequences globally. Ithas a growth advantage, but this is
what we expect from variants that areyou know, classified as variants of interest.
In terms of severity, we don'tsee a change in the disease profile
of people infected with BA dot twodot eight six and its sublineages including j
in dot one. But it isone of course to watch when we look
(15:52):
at severity. We are looking atany changes in hospitalizations, we're looking at
any changes in disease presentation, andwe don't see that for this particular variant
of interest and its sublineages. Soagain, anyone who is infected with syrus
Kobe two including BA dot two doteighty six and its sublineages can cause a
full range of disease, everything fromasymptomatic infection all the way to severe disease
(16:17):
and death. Our vaccines are stillworking very well against protecting severe disease and
death and remains really critical that thoseof you who are due for an updated
vaccine of COVID nineteen, get thatvaccine, whether it's based on the new
XBB DOT one monovalent vaccines or thevaccines based on the ancestral strains. So,
(16:40):
if you're an at risk group,if you're of older age, if
you have underlying conditions, please makesure that you are up to date on
your vaccines. Thank you very much, doctor van Kekov. The next question
goes to Krystal vote from a Jens, France Press Christoph, please unmute yourself
and ask you a question. Thankyou for taking question. It's about GAZA.
(17:02):
I was just wondering if you hadteams underground doing the assessment of what
is going to be needed to bringthe health system backup to pre war quality,
so to say, so to speak, and if you have any idea
of how much money that would cost. Thank you, thank you. I
(17:22):
think we have doctor Rick pepcorn onlinewho can answer that question, and we
may have supplemented answers in the inthe room. Doctor Pepcourny, you're online,
Yes, I'm online. Thank youvery much for the question. Yeah,
maybe let me start with a bit. GAZA had thirty six hospitals before
(17:45):
this war and three five hundred hospitalbest. Currently we talk about fifteen hospitals
which are functional or we call partiallyor barely functional, and it's important to
be specific. I think the DGreferred already a bit to this. So
there's twelve in the South which arecurrently all overwhelmed and partially to fully functional.
(18:11):
There's three in the north, Aliand Al Sahaba which are working more
on minimum levels more like almost firsteight centers, and three other ones the
well known Shipha in Anesia that comeout at one. They have some patients
left, but they don't accept anypatients yet anymore. Chifa is again having
(18:33):
some dials spaces, but it isreally a minimal. So we have three
thousand and five hundred beats currently fifteenhundreds deaths. And this is maybe the
first thing what we we're focusing on. You ask what is needed? So
first of all, the bad capacityneeds to be expanded as quickly as possible
with the functional hospitals, and that'spart of the WHO operational plans. First,
(19:00):
how do we restore the health sectorand the referral pathway primary care,
secondary care and serve referral care andlinks to these hospitals. We need to
strategically position emergency medical teams, whichis currently ongoing in very few places,
to help expand the needed bad capacity. So how do we bring the bad
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capacity from fifteen hundred to two thousandto two thousand five hundreds. We estimate
there's the need of five thousand bests, so we have really a long way
to go. And doctor Taco saidcomplimentary to that, there is a need
for a few strategic located field hospitals. But again we all have to focus
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on making sure that the cripples thecripples, and very much yeah, the
vulnerable health system which we have nowis becoming fully functional. There are GASA
health workers. We have more thant one thousand guys and health workers,
very good health workers. We needto make sure that they get the right
supplies and met local equipment, thatwe have some of these emerging medical teams
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linked to that, and we getthis hospital sticking again, and secondly that
we get the primary healthcare systems workingagain. A referral, we talk always
about trauma, we have to focusas well on a material and child health.
Think about reproductive health, emergency ofstatric cares, mental health, psycho
social support non common coal diseases andthe whole referral system links to that last
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point I want to make is weare very concerned the health system at the
moment is extremely vulnerable. And whenwe talk about twelve hospitals in the South,
they are currently the backbone, thebackbone of the of the health infrastructure.
And I would like to say I'mon my way at the moment to
Gaza. I'm in and I willprobably hopefully tomorrow and to Gaza and discuss.
(21:00):
We have a team there, avery strong team which are doing all
the things I just mentioned. Butany resumption of violence, who damage the
health facilities and make more health facilitiesdysfunctional, and what to stress the point
GAZA can absolutely not afford to losemore hospital bets. We need to expand
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the number of hospital bets we make. We need to make the vulnerable system
work again. Over to you.Thank you very much, doctor Pepco.
And I'm just looking in the room. Any supplements, yes, Doctor Ryan,
Yes, just to add to uhto say that doctor ted Us expressed
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our gratitude to those other agencies whoare providing emergency medical teams support and extra
bad capacity, particularly to those structuressouth of the Wadi Gaza that requires the
deployment of up to seven hundred andfifty beds that have been requested or more.
(22:06):
It is a huge ask to getto that level. We do thank
our colleagues working in the ICRC,in MSF, the UA government, the
Jordanian government, the Turkish government,and other colleagues IMC and others who are
working with us to try and coordinatethe process of deployment. I think you'll
(22:27):
understand that deploying international teams into asetting as complex of this is both a
big logistic operation given the restrictions onthe siege and the difficulties in getting material
and equipment supplied, transported and locatedin in Gaza. There is also the
added challenge of maintaining security for theseindividuals when they do go to Gaza.
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We don't know what's going to happentomorrow. Many of these hospitals that we're
supporting are potentially in harms way againwithin the next twenty four hours, and
we need to recognize that we're notdealing right now as far as we can
see it. As much as wewould like this, we're not dealing with
the permanent polls or a long scaleceasefire. Many of these facilities lie in
very strategic locations along highways, andas would be in any major urban connobation,
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you put your hospitals in strategic locationsthat are accessible to people. Because
of that, we really do needto get reliable deconfliction of these facilities so
that we can continue to support themand that we won't end up in the
same situation again in two or threeweeks time, where what we've seen in
the North, the collapse of healthsystem from twenty five hospitals down to three
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barely functioning, that we don't repeatthat again. South of the Wadi Gaza
there are now almost two million peopleinternally displaced, so many people living within
shelters, living within family homes,thry four or five families now per apartment,
living in in other types of shelter, mosques and schools, community halls.
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Everywhere is packed. The weather hasdeteriorated, the rain is falling,
children are getting colder, Nutritional statusis dropping rapidly. Maybe calorific count is
being supported, but when we talkabout a nutritious diet for children, I
don't think anyone can claim that we'rethe children of Gaza are receiving a nutritious
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diet. At most, they're gettingbarely enough calories to survive. So all
of the conditions are there for adeterioration in the situation, as teter Us
has laid out. So as ourcolleague has asked, well, quite rightly,
what are the longer term plans forreconstruction in Gaza. I think is
very hard for people there right nowto think about reconstruction, to think about
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where we go next, because wedon't even know where we're going to be
in twenty four hours time. Wedon't know where the situation is going to
be in seventy two hours time.It is important to think about how this
can be rebuilt. But as Ricksaid, our primary focus is to support
the system that still remains, tosupport the doctors and nurses and health professionals
that are still on the ground inthe best way we can so they can
(25:11):
support their own citizens and their ownpeople. And that is the primary strategy
that who has As I said,we are being assisted in that hugely by
the emergency medical teams who are deployingsome are deploying directly into facilities to provide
extra hands, extra clinical extra clinicalcapability. As doctor Teas has said,
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some of them are deploying with extrabed capacity that they can add, and
those beds are being added to thehospital, and some are able to come
in and bring in standalone facilities whichare then being put in strategic locations.
When we combine all that together,as Ricka said, we've lost from three
thy five hundred I think beds downto less than fifteen hundred beds. We've
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lost so much capacity. Even withthat wonderful effort by many, many countries
and many organizations, there is noway that e MPT capacity can replace the
existing capacity. So therefore the singlemost precious thing right now is to preserve
the existing capacity in the health systemin Gaza and particularly for the for the
two million displaced people who are mainlydisplaced to the south. We then need
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to build from there. The costsof reconstruction giving the destruction are massive.
Reconstructing the health system, rebuilding thehealth workforce, rebuilding the surveillance systems,
rebuilding everything is going to be veryhard. The one thing I will say
is that if we use as amarker, and this is often used as
a marker of the effectiveness of healthsystems. The immunization rates in Gaza prior
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to the conflict were some of thehighest in the world, which means regardless
of of of the government situation,the reality is that primary prevention and base
secure to individuals was being carried outbeforehand, and in fact, we're in
many ways relying on that residual protectionthat exists for that population. So I
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do think that Gaza has the healthworkers, it has the previous experience to
deliver health and plan health and deliverhealth. The question is going to be,
when you see the scale of thedestruction of the system, how long
it's going to take to rebuild andnot only the shattered infrastructure, but to
rebuild the shattered confidence and the shatteredpsychology of a brave, very brave and
(27:37):
very effective health workforce. Thank you, doctor Ryan, Ryan, Doctor Pepgoen's
got a couple of things he alsowants to add. I understand, yes,
thank you very much. I justwant to add weber All's questions about
our plans, and I just wantto say, first of all, there's
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an overall flesh for these ninety daysand ninety days flash appeal for one point
two billion covering all the areas andall the sexors, and I want to
make also a plea. I wantto make a plea for ANWA for the
fantastic work they're doing in all theseshelters and the absolutely needed work they're doing.
But of course we talk about foodsecurity, we talk about WASH,
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we talk about shelter, et cetera. On health, who leads and codinates
and with partners. The ninety dayappeal was two and twenty million based on
that WHO and on the request fromour partners and dollars focused on what can
WHO then do specifically besides coordinating andleading the parties. So we came with
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the ninety eight days plan for oneon at eight million, and that is
actually outlined very well by the DGAMike. Focus on the existing system,
the cripple system, but still theresilience system, to expand and to make
it work again. Make sure thatwe linked this EMTs to it and a
few field hospitals, but also verymuch restored the public health intelligence and the
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early warning, disease prevention and control, and sure as a cert biller assured
that we have a sustained supply ofhealth and logistics and that we focus on
the emergency coordination for that, ofcourse, there's a need for flexible funding.
Over to you. Thank you verymuch, doctor Pepcoin. The next
question we'll go to Ari Daniel fromn PR USA. Ari, please unmute
(29:32):
yourself and ask you a question.Yes, Hi there everyone, Thanks so
much for taking my question. Forthe last you know, several weeks,
we've you know, we've known thatthere's been concern around the possible spread of
infectious disease, diarrheal diseases, otherother types of disease within Gaza, and
(29:53):
I'm just wondering if there's been anylike, if you've actually seen that starting
to material lies, or if it'sjust that the threat remains ever present and
more concerning than ever. Doctor Ryan, did you want to start, and
then we could go to doctor Pepcorn. I think we could start with Rick.
(30:17):
I mean, all I can Ican say is that, as you
said, the risks are clear.We've been tracking the various diseases over a
number of weeks now, both throughthe medical system but also within the unaware
the spacement. Campson and Rick cangive a sense of of that. I
(30:37):
do know that we've picked up somevery serious signals around accuse Johndae syndrome in
particular part of the south of theWadi Gaza. A cute Johnde syndrome is
a very very serious disease, particularlyin the context of if if someone is
pregnant, and it can spread extremelyrapidly once it's Once you've you've seen those
(31:00):
first cases, there are many,many more. So there have been a
number of signals around the cute jaundicesyndrome and that would be a harbinger for
other epidemic diaryial disease. The maincause of acute jaundice in this context is
hepatitis E, and we've seen largescale outbreaks of hepatitis E in the past
in refugee situations and situations of populationdisplacement. It's a very worrying indicator of
(31:26):
the underlying risk and it is particularlyimpactful in the health of pregnant women.
But Rick can give more details ofother signals or other information. So if
teed up to people, Quinn,thank you very much, can you hear
me? So let's be just givesome figures. And I think it's not
(31:48):
easy to get his figures because ofcourse a surveillance system and the existing system
is not working as it should work. But I think with the technical staff
from the Ministry of Health and Lawand who since mid October, So let
me give you first one figures.We've seen one of the eleven thousand cases
of acute reserratory infections, twelve thousandcases of scavias lies, eleven thousand,
(32:13):
diarrhea under five thirty six thousands,diarrhea over five forty thousand, skin wresh
twenty four thousand. What might justman said, John Dish eleven hundreds check
in box two thousand, five hundredsand also meningitis on one hundred and eleven
cases of which seventy four in thelast two weeks, and outboard trends.
(32:35):
Now, what does it say?And it's difficult. So diarrhea increase you
compare it to last year forty fivetimes, I mean thirty thirty one times
when you look at you under fiveand over one hundred times when you look
over the above five years when youcompare it to twenty twenty two. So
yes, it's deeply alarming. Andcollege we just had a team meeting with
(33:00):
our team in Gaza and one ofour colleagues had visited them just as an
example, an UNUSH school with nineteenthousands people, with eight toilets, with
an enormous lack of water, etcetera. So I mean describes a little
bit of the situation. I meanlike the enormous need for wash et cetera.
(33:22):
We also the lap capacity. Normallythose samples would go to Shifa and
to the Turkish hospital where you atthe central lap. Those are not functional
anymore as we know. So weare looking into can we bring in mobile
labs, can we get samples outto Egypt, et cetera. We have
(33:42):
to really quickly start going on it. It's a very concerning situation. One
other point, I want to raiseroutine vaccination. Routine vaccination in Gaza,
Gaza and the West Bank and oneof the best routine immunizations actually globally close
to hundred percent from most vaccine basedNow, I mean we struggle, we
(34:06):
together with with an UN team UNIseven who we got some of the vaccines
from the warehouse from the North overthe last couple of days back to the
South, et cetera. But weneed to get going to to make sure
that children are getting vaccinates. Andas Mike said, the system and this
is somebody despite all the challenges,the Gaza and West Ben East Erusalem Opitit
(34:31):
health system produced health indicators at paror, I would say even better than
its neighbors. So it is possibleand we should get back to that level.
Over to you can, I justsupplement because I think it's important again
to recognize too that there was avery good system of surveillance before the conflict
(34:54):
and it was linked to a lobar, the confirmation system that was based in
the Central Public out Laboratory that washoused in Al Chifa and the Turkish Friendship
Hospital in northern Gaza. So notonly has Gaza lost its hospital capability,
it's lost its ability to confirm eventhe most basic of diseases in that context.
(35:14):
In terms of infectious diseases, thiscreates a blind spot where we have
huge risk of epidemic diseases in acontext where we have limited capacity to diagnose
those diseases right now. Historically,many of those samples that might have been
processed that to see the Central PublicLaboratory would also have gone to the West
(35:35):
Bank or in sent to reference labsin Israel. That is no longer possible,
So we're trying to work out howcan we get samples to move from
Gaza back into Egypt and get referencefacilities in order to be able to do
that. But right now, notonly is the potential for epidemics a risk
for the people of Gaza, butnot knowing what's happening, not being able
(35:57):
to confirm having diseased potential potentially spreadis a risk that we don't want to
currently leave in place. We're blind. We're blind at the moment to what
is actually going on, and that'swhy we have very good syndromic surbillance on
the ground. That means help workersgoing around and filling in telly sheets for
(36:17):
what they're seeing in the camps.But what we don't have right now is
the capability to do on the grounddiagnostics and be able to tell exactly what
we're looking at. So, forexample, in the case of a cute
John the syndrome or meningitis, it'svery important to work out what the cause
of the agent are because the rootsof transmission are different, the agents are
different. Meningitis can be a mildviral meningitis that doesn't need to be treated
(36:40):
except with antiporetics and ivy fouls,but it could be bacterial meningitis that requires
immediate treatment of a child to preventdeath. So knowing what the diagnoses are
becomes extremely important. So this issomething we do need to focus on in
the coming weeks. But again it'snot that we have to provide this capacity
to Gaza. This capacity existed before. It has been put beyond use of
(37:05):
the system in Gaza and we needto restore us. Thank you very much,
doctor Ryan and doctor Peppercorn. Thenext question goes to Mohammed Aslan of
Andelou. Muhammed, please unmut yourselfand ask you a question. Okay,
thank you so much Margaret for takingmy question. There is any information and
(37:27):
it says no foil reached the hospitalin the north of Gaza since the humanitarian
powers start, does w a choiceeight reach all part of Gaza? If
not, what is the obstacle tothis? Thank you so much, Thank
you. I think that's one fordoctor Pepercorn. Sorry, thank you very
(37:58):
much. I think over the lastcouple of days, who as and I
really want to stress is really oneyou went together with with ANDRAI and Osha
who that we had a mission,for example today to the north to deliver
fuel and medical supplies to Al Ahliand our Sahaba hospitals, and that was
(38:20):
seven thousand leaders of fuel to AlAhli covering their minimum requirements for the next
seven days and three thousand and fivehundred leaders for Al Sahaba covering the minimum
requirements for the next seven days aswell. We also had some medications surgical
supplies delivered to those two hospitals.There's also plans to bring fuel to come
(38:43):
out at one and Al Atama Hospital. We are planning that for tomorrow.
We hope that that will continue.It is of course absolutely needed that those
four remaining hospitals which are i wouldsay barely partly functionals, that they keep
that they keep keep on going.We would hope, of course, because
(39:06):
we know there's there's still a numberof patients in Ol Shifa and and and
they opened again for the dialysis aswell as in Indonesian noted there are still
some patients and they will need fuelas well. And we hope and that
we can also bring some fuel andsome additional medication in the future there as
(39:27):
well. But yes, over thelast couple of days so there have been
uh there that that we have wehave managed to bring a certain level of
fuel and medical medical medicine, essentialmedicine and equipment over to you. Thank
you very much, doctor Pepcon.The next question goes to Omar Abdelbaki of
(39:49):
the Wall Street Journal. Omar,can you please u mute yourself and ask
you a question? Hi there,thanks for thanks for taking the time.
What countries have taken injured and saidcozzens for treatment, how many gusens have
left for district for treatment? Andis the World Help organization helping facilitate this
(40:10):
effort? Thank you. I'll startwith doctor Pepcoin, but maybe doctor Newark
can help as well, but we'llstart with doctor Pepcinn. Thank you very
much. Well, first of all, I think it's the HO as you
(40:31):
know, have been assisting over thelast week actually, and I think the
DG was referring to this as wellover the last ten days now, almost
to what we call to transfer,to transfer the most vulnerable complex patients,
(40:51):
trauma patients, but also very seecritically injured and sick from the North,
some of the hospitals in the Northto the South and Gaza, and specifically
to these larger hospitals in the SouthEuropean Gaza Hospital Nation Medical Complex et cetera.
That one, there has been anumber of patients transferred. I mean
(41:12):
you've seen all the we've reported allthe stories of course of the neonase and
when I count roughly, I thinkthere's at least forty fifty more patients transferred.
But what we and this is notwe do, this of course is
split by the technical that's the Ministryof Health and the respective hospitals to treat
(41:36):
their patients, to make sure likewhich patients need to be referred outside Gaza
and which are the most critical patientsover the next weeks a month, And
what we really want to help facilitatesis a more orderly transfer transfer of these
patients into Egypt. First of all, is absolutely needed and patients deserve that
(41:58):
that they get the treatment which whichthey need. Uh. But it's also
it will also of course relieve thecompletely overwhelmed health system in Gaza, and
I want to make one point onthat. First, in one of the
hospitals we work closely with the EuropeanGaza Hospital, which is is having a
(42:21):
three and a seventy bets capacity,which includes already a field hospital which was
established during the COVID period. Theyhave more than nine of the patients current
more than triple. Now, whatis needed is this orderly, orderly transfer.
And then yes, there's a numberof countries. And then and maybe
might want to refer to that aswell. A number of countries have actually
(42:45):
offered their services to there. Therethey welcome the idea to actually get some
of those referral patients for treatment intheir country. But the first, the
first and foremost, they need tobe orderly transfer transferred into Egypt, get
the treatment there. And what happensfrom there, well, wherever they can
(43:06):
get the best treatments, they should, they should should be able to go
there, including of course their familiesand companions. Over to you, thank
you doctor people going doctor Ryan.We'll add something. Yes, first of
all, we thank all of ourmember states further in their intention to support
(43:30):
people affected by this crisis. There'sno question that all help is welcome,
and primarily, as as Rick said, we need to help people of Gaza
in Gaza where they are, andwe need to shore up that medical system.
There has been a process of medicalevacuation to Egypt, and I'd just
like to recognize the government of Egyptand the Ministry of Health in particularly they
(43:52):
have put eleven thousand beds at thedisposal of medical evacuation, one seven hundred
ICU beds, one hundred and fiftyambulances, thirty eight thousand physicians, twenty
five thousand nurses. They really havestepped up not just an Alurisian around in
terms of triage and stabilization, butin terms of onwoud referral within the Egyptian
(44:14):
system. So there's an incredibly powerfulcapability within Egypt to do that. We
have encouraged third parties other countries towork with Egypt to ensure that we have
the transfer of patients to Egypt theirproper triage and assessment and clinical assessment,
and then as needed, a discussionwith third party countries to transfer maybe more
complicated patients, patients that need moreintensive interventions for burns, repatriating nationals.
(44:40):
There are various other reasons why,and in that sense we think this is
a useful enterprise. But again thecosts of doing this versus the actual costs
of investing in the system and investing, as Rick said, in the ability
to support people where they are.We have to balance those two things.
We'd also like to recognize the governmentof fran for deploying a medical ship with
(45:01):
special surgical capacities, and they're workingvery closely with our Egyptian colleagues to base
that at l Arish, and theywill be working in close collaboration with the
Egyptian authorities on exactly the basis Iexplained earlier in situations like this, and
I think this is something that wereally all need to redouble down on.
(45:23):
In a crisis, everybody wants tohelp, and that's fantastic. The real
trick is to be coordinated and organizedand deploy in a meaningful and targeted way.
So we look at EMTs. We'renow beginning to see more coordination,
more direction more strategic placement of theseand I think that's really beginning to help.
(45:45):
The problem is when everyone rushes intohelp, then we lose the directionality
of the response. It's the samewhen you bring people out. It's got
to be done in an orderly fashion, like we facilitated in Ukraine and we
facilitated in other situations. And Ithink we would point our third countries really
to work with Egypt to ensure thatthe patients that are being selected for onword
(46:07):
referral can truly benefit from the processof international referral, and in particular too
that they be accompanied by companions ina way that the person doesn't lose entire
contact with their social networks. Soit's very important that we don't just take
patients out of the system. Theyneed to come with companions and the necessary
(46:29):
social and psychological support. Their medicalcondition is only one part of what those
people are suffering. Thank you,Thank you very much, doctor Ryan.
Doctor Nuru is going to add somethingas well, just to add one thing
that this system is not new ofMEDEVAC. Before this crisis, MEDIEVAC existed
between Gaza and West Bank and Israelactually which is now is not possible,
(46:53):
but also existed before with Egypt forcases like cancer and other chronic diseases.
Only that the needs have increased manyfolds. Just that as a background things.
Thank you very much. Doctor.Now we've running out of time,
but we've got time for one morequestion, and that goes to Imagen.
(47:16):
Folks of the BBC. Imagen,please unmute yourself and ask you a question.
Yeah, hi, thanks very much. It's also about Gaza. I'm
really interested. It's almost this notableoptimism or planning for the future in what
you're saying. You talk about acrippled but resilient health service. What you're
(47:38):
talking about seems to be based onthe premise that fighting won't start again.
I'm just wondering if you fear that'sover optimistic. I think I'll start with
doctor Ryan on this one. Mthanks imagin. I'm I don't know if
(48:00):
we've communicated too much optimism, butI don't think myself or Rick or Ilam
or Ted Ross before we're speaking inoptimistic terms. You're absolutely right, what
happens in any resumption of the violenceis going to greatly affect what's happening now.
(48:21):
If and we all hope if therecan be an extension of a pause,
if we can get to a placeeven with that happening tomorrow, even
if peace was declared, we havea massive challenge ahead of us, and
absolutely gargantuan public health and health deliverychallenge ahead of us. If fighting resumes,
and particularly if that fighting pushes intothe Arabella, pushes into Canunis,
(48:44):
pushes into Rafa, we are goingto see further displacement of people to the
west, concentrating people on the westernside of Canyunis, where there are very
little in the way of services.Many people have been directed again and again
to the area of Almawazi, whichhas no infrastructure whatsoever in place, to
continue to concentrate people and push themthrough there with the promise that when they
(49:07):
get there there will be services fromthem. Because again that has been repeated
again and again. Go there becausethat's where you'll get the necessary assistance.
I think there's some there's a verytroubling narrative associated with that push of people.
If the violence starts again, thenimagine that is a real scenario.
And I really don't know what tosay to you about that scenario because it
(49:31):
is truly horrific in terms of theimpact of so many people out in the
open. We're not talking about peopleintended cities yet, we're talking about open
ground onto which we could have upto two million people approaching into the depths
of winter, with their underlying nutritionstatus, with the overcrowding, with the
stress, and with the wounded,and the old, and the disabled,
(49:54):
and the mentally and psychologically damaged,and and and and suffering. I really
don't know. I maybe Rick willspeak to this, But if we go
to that scenario and we see thathappen that I shoulder to think. Quite
frankly, I should have to thinkwhat will happen in terms of the numbers
(50:16):
we've we've seen up to now ofdebts and casualties maybe a distant memory in
weeks, in weeks to come.It really depends what happens on the side
of the on the side of theforces that are combating each other, and
the particularly the occupying force as towhat its intentions are. And so the
(50:37):
military and security intentions right now willdetermine life and health in Gaza over the
coming weeks. Maybe Rick wants tosupplement and that US may want to come
in on that too, How vidyou, doctor Pepcin, Yeah, yeah,
thank you very much, because Iwant to be very clear and if
(50:58):
I have not been clear now thenlet me state again. So we are
extremely concerned about the vulnerability of theof the what I called a cripple's health
system, and we are extremely concernedabout this. These twelve hospitals in the
(51:19):
south with some of them are moreimportant than the other ones which are currently
the backbone of the health services ofmore than two million people. Now we
what I think I had made itmade it clear. So when we would
see a resumption of violence and whichpotentially would also damage health facilities or make
(51:45):
them even dysfunctional. Uh, wehave a further humanitarian disaster, an increasing
humanitarian disaster. And again I said, the health system can absolutely not afford
to lose more sit all that weneed to expand. But also the resumption
of violence would mean a resumption ofviolence in an even more densely populated area.
(52:10):
Data is already the one of them. It is the most popular densely
populated area in the world or oralmost now. We see one point seven
million people displaced. It's extremely denselypopulated. We have seen many, many,
many many deaths and injuries, sowe would expect much more, many
(52:34):
more from from from a resumption ofviolence. Besides that, you will get
more I d P s and Id P s, IDP flows, et
cetera. Everything related to that overcrowdedshelters with what we just described and where
we're very concerned in the increase ofcommunical diseases and the chance for outbreak.
(52:54):
So we have that combination. Soyeah, I mean, I think we
are all extremely concerned and it shouldnot happen. The health system should remain
as intact as possible. We shouldbe able to expand the capacity and it
simply should not happen. So yeah, if we didn't express that enough,
(53:15):
extremely concerned over here, Thank youvery much and on net note in the
Q and A session and hand itback to doctor Tedros for any final remarks.
Yeah, thank you. Maybe i'lltouch the last question. Are you
(53:42):
optimistic? Maybe I wouldn't use theoptimism and pessimism category, but if you
read the reality on the situation,the chances of resumption of the conflict is
very very high. And if thatmeans the health system is already broken,
(54:07):
I mean it's just less than athird of the health facilities are you know,
providing service, and even of providingvery difficult to say providing service.
Actually they are overcrowded and beyond theirtheir capacity and the way they take care
(54:29):
of their patients or the service isreally really bad, so you cannot say
there is service anyway, But forwhat it is, at least there is
a small proportion compared to what theGaza had, you know, providing service.
(54:51):
But as you rightly said, okay, based on the situation, the
resumption of the conflict is you know, there is a high chance. But
at the same time, I reallybelieve that the humanitarian pause or even ceasefire
(55:13):
is possible if those with influence cantake it. Seriously, I believe it's
possible. So the question is,will those who have the influence will do
everything to stop it, I mean, to stop, to sustain the pouse
(55:37):
or then ultimately have a ceasefire andyou know, having a political solution to
this, to this problem. Soit's possible except the forore the you know,
those with influence are not doing it. I mean that's the situation,
(55:57):
So it can it can happen.It's a my of will to be honest.
So with that, thank you somuch for joining to the press who
joined us today, and see younext time. MM. The show has
(57:05):
been produced by Depictions Media. Pleasecontact us at Depictions dot media for more information.
Thank you for listening to Pictures MediaRadio. Welcome to Policy and Rights,
the show about the government policy andhuman rights. Hello everybody, this is
(01:03):
Margaretta Harrison, who Headquarters Geneva.Welcoming you today November twenty nine, twenty
twenty three to our press briefing oncurrent global health issues. As usual,
we will start with opening remarks fromour Director General, doctor Tedros Adnam Gabresis,
and I will then open the floorto questions and our panel of technical
(01:26):
experts, both here in the roomand online will be available to answer your
questions. In the room, wehave a large panel on doctor Tedros.
Right, we have doctor Mike Ran, our executive director for our Emergencies program.
Next to doctor Brian, we havedoctor Ilham Nuir, our acting Incident
Manager for the Occupied Palestinian Territory Israelescalation. Next to doctor Nur is doctor
(01:51):
Maria Naira, our Director director ofour Department for Environment, Climate Change and
Health. And next to doctor Nerais mis Andy Seal, our technical officer
for HIV hepatitis it's sexually transmitted infections. And next to Missed Seal is mister
Derek Walton, our legal counsel andto doctor Tedros. Left, we have
(02:13):
doctor Maria van Kirkov, acting directorof our Department for Epidemic and Pandemic Preparedness
and Prevention. We also do haveour usual large panel of experts online and
we will call upon them whenever appropriatewhen you ask your questions. But now
without further ado, we'll go todoctor Tedros for his opening remarks. Doctor
(02:34):
Tedros, you have the floor.Thank you, Thank you. Margareta,
good morning, good afternoon, andgood evening. W JOE welcomes the extension
of the humanitarian polls in the conflictin Gaza and the release of hostages and
prisoners by both sides. The POSEhas enabled w JOE to increase deliveries of
(03:00):
medical supplies in Gaza and to transferpatients from Al Shifa Hospital to other hospitals
south of the Wordy Gaza. Duringthe first three days of the POSE,
WHO received one hundred twenty one palletsof supplies into our warehouse in Gaza,
including ivy flutes, medicines, labsupplies, medical disposables, and trauma and
(03:25):
surgical supplies. This is enough tosupport about ninety thousand people. However,
much more is needed. We continueto call for a sustained sispire so that
aid can continue to be delivered toend further civilian suffering, and we call
(03:47):
for the remaining Israeli hostage to bereleased and for those who are still being
held to receive the medical care theyneed. Who's greatest concern remains supporting Gaza's
health system and health workers to function. Only fifteen of gaza thirty six hospitals
(04:08):
are still functioning at all, butare completely overwhelmed. For example, European
Gaza Hospital is currently operating a tripleits capacity. Of the twenty five hospitals
north of the Woody Gaza before theconflict began, only three are functioning at
(04:28):
the most basic level, but theylack fuel, water and food. The
remaining health system capacity must be protected, supported and expanded. The health needs
of the population of Gaza have increaseddramatically, but they are now being serviced
by one third of the hospitals andprimary care clinics, and with severe overcrowding,
(04:56):
the risks are increasing for epidemics ofrespiratory tract infections, acute watery area
hepatitis, escabies, lies and otherdiscs. Doubly a choice. Working to
support Gaza health system and health workersin every way we can, together with
(05:16):
partners with distributing supplies, coordinating emergencymedical teams to provide extra clinical capacity for
existing hospitals, and establishing stand alonefield hospitals in strategic locations. We tank
those partners who are working with us, but we repeat that emergency medical teams
(05:41):
and field hospitals can only complement Gazahealth system, not replace it. The
priority must be to support Gaza healthworkers, hospitals and clinics to do their
jobs. This week, the worldis converging in the United Arab Emirates for
(06:02):
COP twenty eight, the United NationsClimate Change Conference. According to the inter
Governmental Panel on Climate Change, aboutthree point five billion people, nearly half
of humanity, live in areas highlyvulnerable to the climate crisis. This year
(06:24):
alone, catastrophic flooding in Libya andthe Horn of Africa has caused lives and
livelihoods, and just this week Brazilhit record temperatures. An unhealthy planet means
unhealthy people. It related death amongpeople aged over sixty five years have climbed
(06:47):
by seventy percent globally in two decades. Every year, seven million people die
from air pollution. Changing weather patternsdriven by human activity and the burning of
fossil fuels is contributing to record numbersof cholera outbreaks, and our warming planet
(07:12):
is expanding the range of mosquitoes,which carry dangerous pathogens like dengy chicken,
gunya zica, and yellow fever intoplaces that have never dealt with them before.
The climate crisis is a health crisis, so we're pleased that for the
first time, this year's scope willinclude a day dedicated to help, with
(07:38):
more than fifty health ministers attending fromaround the world. While at cop I
will make three specific calls. First, a climate friendly world who calls on
leaders from government in industry to worktogether to phase out fossil fuels urgently and
(07:59):
at accelerate the transition to clean energy. Fossil fuels, coal, oil and
gas are by far the largest contributorto global climate change, accounting for over
seventy five percent of greenhouse gas emissionswhen in the world of fossil fuels,
(08:20):
is therefore the only way for countriesto meet their commitment to limit global warning
to one point five degrees celsius.This is a public health imperative. Second,
climate friendly health systems. While thehealth sector is affected by climate change,
it also contributes to it, withabout five percent of global emissions.
(08:46):
We must focus on decarbonizing health systemsto reduce that. At the same time,
we must build continue to strengthen healthsystems to be more climate resilient.
That means strengthening the health workforce andthese surveillance systems, building on investments that
(09:07):
many countries made during the COVID nineteenpandemic, and it means scaling up vector
control and access to safe water andsanitation. Third finance, The health sector
is at the front line of theclimate crisis that it receives just half of
one percent of global climate financing.The world spends thrillions of dollars of public
(09:33):
moneys in fossil fuel subsidies every year. We call on government and investors to
redirect those funds to protecting and promotingthe health of our planet and the health
of people. And we ask alsoof the international community to honor the Plage
(09:54):
one hundred billionaires dollars for climate changeannually. This Friday marks World Age Day.
This year's theme is Let Communities Lead. It affirms the vital role that
affected communities play in leading the responseto HIV. Thanks to decades of activism,
(10:18):
advocacy and support from affected communities,millions of new infections have been averted
and thirty million people are now receivinguntil trou viral therapy. As prevention and
treatment services for HIV are increasingly deliveredin community and primary health care settings,
(10:39):
communities and community health workers are evenmore critical. We must stand together to
ensure communities have the funding and resourcesthey need to stand up for human rights,
to fight stigma, and to helpout and aids for good. I
(11:00):
thank you and Margaret, it's backto you. Thank you very much.
Doctor ted Ros will now open thefloor to questions. As I should have
mentioned, if you want to aska question, please use the raise your
hand icon if you haven't done thatalready. There are a lot of you
online and there are a lot ofyou with hands raised, so please keep
(11:20):
your questions short and clear, andif you know who it's addressed to do
mention that as well and give yourname and outlet. The first question goes
to Helen Brandswell from stat Helen couldjoin mute yourself and ask your question.
Thank you very much, Margaret.I think this is probably from Maria.
It's a follow up to the situationin China. I'm wondering if WHO is
(11:46):
hearing of other places that are seeingan increase in michael plasma pneumonia in children
as well as the Chinese authorities have. Thank you, So thanks Tom for
the question. So yes, Imean we are seeing in general an increase
in respiratory infections around the world.We do tend to see increases in children
(12:07):
because they're the school age children,and in the Northern Hemisphere we're entering the
it's the autumn already and we're enteringthe winter months, so we are expecting
to see increases in acute respiratory infections. Microplasma pneumonia is not a reportable disease
to WHO, so we tend totrack this information through reporting systems and through
discussions with our member states. Wehave seen, as you and I had
(12:31):
discussed earlier or last week, weare following up with the situation in China,
and again they have seen overall anincrease in acute respiratory infections due to
a number of different pathogens, includinginfluenza, which is on the rise.
Microplasma pneumonia was on the rise forthe last couple of months and now seems
to be a little bit on thedecline. We're following up through our clinical
(12:54):
networks and working with clinicians in Chinato better understand resistance to antibiotics, which
is a problem across the world,but is a particular problem in the Western
Pacific and Southeast Asia region. Wedo. One of the things we are
following up on in terms of theacute respiratory infections is looking at burden and
healthcare systems. So it's one thingto see arise in these types of infections,
(13:18):
particularly in schoolized children, but alsoto monitor the severity and looking at
the health care capacities around the worldto be able to deal with these types
of infections, looking at what arethe treatment options that are there, and
there are many antibiotics that are availablefor microplasma pneumonia. I don't have the
specifics on the rates around the countryaround the world for this particular bacteria,
(13:39):
but we have seen outbreaks of microplasmapneumonia in a number of countries over the
course of many different years, soI can follow up with you on some
specifics on that and specifically in Chinaand elsewhere. Thank you very much,
Doctor van Kharkov. The next questiongoes to Alicia Sanchez from Europa Press News
(14:00):
Agency Spain. So, Alicia,could you unmute yourself and ask you a
question? Alicia, we're not hearingyou. Are you having problems? We'll
(14:22):
go to the next question. Thenext question goes to Alexandra Tin of CBS.
Alexandra, please unmute yourself and askyour question. Hi, thanks for
taking my question. I just wantedto follow up on the report last week
about BA two eighty six. Iwas wondering if you could clarify what you
(14:43):
think the role of JAN one isin BA two eighty six's growth, and
if you have any updates to shareon what you've heard about it's comparative severity.
Thank you, Thank you. Ithink that's another one for doctor van
Kirkov. Yeah, thanks very much. So we are continuing to track the
variants around the world and BA dottwo dot eight six was recently classified as
a variant of interest. It wasformerly a variant under monitoring within BA dot
(15:07):
two dot eight six includes this uhfurther sublineage of JN dot one. Globally,
we have about ten percent of thesequences that are reported to public platforms
are BA dot two dot eight sixand its sublineages. In terms of our
assessment, there's still very small numbers, so I don't have the exact number
of sequences in this in this grouping, but it's around four thousand, just
(15:30):
over four thousand sequences globally. Ithas a growth advantage, but this is
what we expect from variants that areyou know, classified as variants of interest.
In terms of severity, we don'tsee a change in the disease profile
of people infected with BA dot twodot eight six and its sublineages including j
in dot one. But it isone of course to watch when we look
(15:52):
at severity. We are looking atany changes in hospitalizations, we're looking at
any changes in disease presentation, andwe don't see that for this particular variant
of interest and its sublineages. Soagain, anyone who is infected with syrus
Kobe two including BA dot two doteighty six and its sublineages can cause a
full range of disease, everything fromasymptomatic infection all the way to severe disease
(16:17):
and death. Our vaccines are stillworking very well against protecting severe disease and
death and remains really critical that thoseof you who are due for an updated
vaccine of COVID nineteen, get thatvaccine, whether it's based on the new
XBB DOT one monovalent vaccines or thevaccines based on the ancestral strains. So,
(16:40):
if you're an at risk group,if you're of older age, if
you have underlying conditions, please makesure that you are up to date on
your vaccines. Thank you very much, doctor van Kekov. The next question
goes to Krystal vote from a Jens, France Press Christoph, please unmute yourself
and ask you a question. Thankyou for taking question. It's about GAZA.
(17:02):
I was just wondering if you hadteams underground doing the assessment of what
is going to be needed to bringthe health system backup to pre war quality,
so to say, so to speak, and if you have any idea
of how much money that would cost. Thank you, thank you. I
(17:22):
think we have doctor Rick pepcorn onlinewho can answer that question, and we
may have supplemented answers in the inthe room. Doctor Pepcourny, you're online,
Yes, I'm online. Thank youvery much for the question. Yeah,
maybe let me start with a bit. GAZA had thirty six hospitals before
(17:45):
this war and three five hundred hospitalbest. Currently we talk about fifteen hospitals
which are functional or we call partiallyor barely functional, and it's important to
be specific. I think the DGreferred already a bit to this. So
there's twelve in the South which arecurrently all overwhelmed and partially to fully functional.
(18:11):
There's three in the north, Aliand Al Sahaba which are working more
on minimum levels more like almost firsteight centers, and three other ones the
well known Shipha in Anesia that comeout at one. They have some patients
left, but they don't accept anypatients yet anymore. Chifa is again having
(18:33):
some dials spaces, but it isreally a minimal. So we have three
thousand and five hundred beats currently fifteenhundreds deaths. And this is maybe the
first thing what we we're focusing on. You ask what is needed? So
first of all, the bad capacityneeds to be expanded as quickly as possible
with the functional hospitals, and that'spart of the WHO operational plans. First,
(19:00):
how do we restore the health sectorand the referral pathway primary care,
secondary care and serve referral care andlinks to these hospitals. We need to
strategically position emergency medical teams, whichis currently ongoing in very few places,
to help expand the needed bad capacity. So how do we bring the bad
(19:25):
capacity from fifteen hundred to two thousandto two thousand five hundreds. We estimate
there's the need of five thousand bests, so we have really a long way
to go. And doctor Taco saidcomplimentary to that, there is a need
for a few strategic located field hospitals. But again we all have to focus
(19:45):
on making sure that the cripples thecripples, and very much yeah, the
vulnerable health system which we have nowis becoming fully functional. There are GASA
health workers. We have more thant one thousand guys and health workers,
very good health workers. We needto make sure that they get the right
supplies and met local equipment, thatwe have some of these emerging medical teams
(20:10):
linked to that, and we getthis hospital sticking again, and secondly that
we get the primary healthcare systems workingagain. A referral, we talk always
about trauma, we have to focusas well on a material and child health.
Think about reproductive health, emergency ofstatric cares, mental health, psycho
social support non common coal diseases andthe whole referral system links to that last
(20:36):
point I want to make is weare very concerned the health system at the
moment is extremely vulnerable. And whenwe talk about twelve hospitals in the South,
they are currently the backbone, thebackbone of the of the health infrastructure.
And I would like to say I'mon my way at the moment to
Gaza. I'm in and I willprobably hopefully tomorrow and to Gaza and discuss.
(21:00):
We have a team there, avery strong team which are doing all
the things I just mentioned. Butany resumption of violence, who damage the
health facilities and make more health facilitiesdysfunctional, and what to stress the point
GAZA can absolutely not afford to losemore hospital bets. We need to expand
(21:23):
the number of hospital bets we make. We need to make the vulnerable system
work again. Over to you.Thank you very much, doctor Pepco.
And I'm just looking in the room. Any supplements, yes, Doctor Ryan,
Yes, just to add to uhto say that doctor ted Us expressed
(21:45):
our gratitude to those other agencies whoare providing emergency medical teams support and extra
bad capacity, particularly to those structuressouth of the Wadi Gaza that requires the
deployment of up to seven hundred andfifty beds that have been requested or more.
(22:06):
It is a huge ask to getto that level. We do thank
our colleagues working in the ICRC,in MSF, the UA government, the
Jordanian government, the Turkish government,and other colleagues IMC and others who are
working with us to try and coordinatethe process of deployment. I think you'll
(22:27):
understand that deploying international teams into asetting as complex of this is both a
big logistic operation given the restrictions onthe siege and the difficulties in getting material
and equipment supplied, transported and locatedin in Gaza. There is also the
added challenge of maintaining security for theseindividuals when they do go to Gaza.
(22:51):
We don't know what's going to happentomorrow. Many of these hospitals that we're
supporting are potentially in harms way againwithin the next twenty four hours, and
we need to recognize that we're notdealing right now as far as we can
see it. As much as wewould like this, we're not dealing with
the permanent polls or a long scaleceasefire. Many of these facilities lie in
very strategic locations along highways, andas would be in any major urban connobation,
(23:18):
you put your hospitals in strategic locationsthat are accessible to people. Because
of that, we really do needto get reliable deconfliction of these facilities so
that we can continue to support themand that we won't end up in the
same situation again in two or threeweeks time, where what we've seen in
the North, the collapse of healthsystem from twenty five hospitals down to three
(23:41):
barely functioning, that we don't repeatthat again. South of the Wadi Gaza
there are now almost two million peopleinternally displaced, so many people living within
shelters, living within family homes,thry four or five families now per apartment,
living in in other types of shelter, mosques and schools, community halls.
(24:04):
Everywhere is packed. The weather hasdeteriorated, the rain is falling,
children are getting colder, Nutritional statusis dropping rapidly. Maybe calorific count is
being supported, but when we talkabout a nutritious diet for children, I
don't think anyone can claim that we'rethe children of Gaza are receiving a nutritious
(24:25):
diet. At most, they're gettingbarely enough calories to survive. So all
of the conditions are there for adeterioration in the situation, as teter Us
has laid out. So as ourcolleague has asked, well, quite rightly,
what are the longer term plans forreconstruction in Gaza. I think is
very hard for people there right nowto think about reconstruction, to think about
(24:48):
where we go next, because wedon't even know where we're going to be
in twenty four hours time. Wedon't know where the situation is going to
be in seventy two hours time.It is important to think about how this
can be rebuilt. But as Ricksaid, our primary focus is to support
the system that still remains, tosupport the doctors and nurses and health professionals
that are still on the ground inthe best way we can so they can
(25:11):
support their own citizens and their ownpeople. And that is the primary strategy
that who has As I said,we are being assisted in that hugely by
the emergency medical teams who are deployingsome are deploying directly into facilities to provide
extra hands, extra clinical extra clinicalcapability. As doctor Teas has said,
(25:32):
some of them are deploying with extrabed capacity that they can add, and
those beds are being added to thehospital, and some are able to come
in and bring in standalone facilities whichare then being put in strategic locations.
When we combine all that together,as Ricka said, we've lost from three
thy five hundred I think beds downto less than fifteen hundred beds. We've
(25:52):
lost so much capacity. Even withthat wonderful effort by many, many countries
and many organizations, there is noway that e MPT capacity can replace the
existing capacity. So therefore the singlemost precious thing right now is to preserve
the existing capacity in the health systemin Gaza and particularly for the for the
two million displaced people who are mainlydisplaced to the south. We then need
(26:18):
to build from there. The costsof reconstruction giving the destruction are massive.
Reconstructing the health system, rebuilding thehealth workforce, rebuilding the surveillance systems,
rebuilding everything is going to be veryhard. The one thing I will say
is that if we use as amarker, and this is often used as
a marker of the effectiveness of healthsystems. The immunization rates in Gaza prior
(26:47):
to the conflict were some of thehighest in the world, which means regardless
of of of the government situation,the reality is that primary prevention and base
secure to individuals was being carried outbeforehand, and in fact, we're in
many ways relying on that residual protectionthat exists for that population. So I
(27:11):
do think that Gaza has the healthworkers, it has the previous experience to
deliver health and plan health and deliverhealth. The question is going to be,
when you see the scale of thedestruction of the system, how long
it's going to take to rebuild andnot only the shattered infrastructure, but to
rebuild the shattered confidence and the shatteredpsychology of a brave, very brave and
(27:37):
very effective health workforce. Thank you, doctor Ryan, Ryan, Doctor Pepgoen's
got a couple of things he alsowants to add. I understand, yes,
thank you very much. I justwant to add weber All's questions about
our plans, and I just wantto say, first of all, there's
(27:57):
an overall flesh for these ninety daysand ninety days flash appeal for one point
two billion covering all the areas andall the sexors, and I want to
make also a plea. I wantto make a plea for ANWA for the
fantastic work they're doing in all theseshelters and the absolutely needed work they're doing.
But of course we talk about foodsecurity, we talk about WASH,
(28:21):
we talk about shelter, et cetera. On health, who leads and codinates
and with partners. The ninety dayappeal was two and twenty million based on
that WHO and on the request fromour partners and dollars focused on what can
WHO then do specifically besides coordinating andleading the parties. So we came with
(28:42):
the ninety eight days plan for oneon at eight million, and that is
actually outlined very well by the DGAMike. Focus on the existing system,
the cripple system, but still theresilience system, to expand and to make
it work again. Make sure thatwe linked this EMTs to it and a
few field hospitals, but also verymuch restored the public health intelligence and the
(29:06):
early warning, disease prevention and control, and sure as a cert biller assured
that we have a sustained supply ofhealth and logistics and that we focus on
the emergency coordination for that, ofcourse, there's a need for flexible funding.
Over to you. Thank you verymuch, doctor Pepcoin. The next
question we'll go to Ari Daniel fromn PR USA. Ari, please unmute
(29:32):
yourself and ask you a question.Yes, Hi there everyone, Thanks so
much for taking my question. Forthe last you know, several weeks,
we've you know, we've known thatthere's been concern around the possible spread of
infectious disease, diarrheal diseases, otherother types of disease within Gaza, and
(29:53):
I'm just wondering if there's been anylike, if you've actually seen that starting
to material lies, or if it'sjust that the threat remains ever present and
more concerning than ever. Doctor Ryan, did you want to start, and
then we could go to doctor Pepcorn. I think we could start with Rick.
(30:17):
I mean, all I can Ican say is that, as you
said, the risks are clear.We've been tracking the various diseases over a
number of weeks now, both throughthe medical system but also within the unaware
the spacement. Campson and Rick cangive a sense of of that. I
(30:37):
do know that we've picked up somevery serious signals around accuse Johndae syndrome in
particular part of the south of theWadi Gaza. A cute Johnde syndrome is
a very very serious disease, particularlyin the context of if if someone is
pregnant, and it can spread extremelyrapidly once it's Once you've you've seen those
(31:00):
first cases, there are many,many more. So there have been a
number of signals around the cute jaundicesyndrome and that would be a harbinger for
other epidemic diaryial disease. The maincause of acute jaundice in this context is
hepatitis E, and we've seen largescale outbreaks of hepatitis E in the past
in refugee situations and situations of populationdisplacement. It's a very worrying indicator of
(31:26):
the underlying risk and it is particularlyimpactful in the health of pregnant women.
But Rick can give more details ofother signals or other information. So if
teed up to people, Quinn,thank you very much, can you hear
me? So let's be just givesome figures. And I think it's not
(31:48):
easy to get his figures because ofcourse a surveillance system and the existing system
is not working as it should work. But I think with the technical staff
from the Ministry of Health and Lawand who since mid October, So let
me give you first one figures.We've seen one of the eleven thousand cases
of acute reserratory infections, twelve thousandcases of scavias lies, eleven thousand,
(32:13):
diarrhea under five thirty six thousands,diarrhea over five forty thousand, skin wresh
twenty four thousand. What might justman said, John Dish eleven hundreds check
in box two thousand, five hundredsand also meningitis on one hundred and eleven
cases of which seventy four in thelast two weeks, and outboard trends.
(32:35):
Now, what does it say?And it's difficult. So diarrhea increase you
compare it to last year forty fivetimes, I mean thirty thirty one times
when you look at you under fiveand over one hundred times when you look
over the above five years when youcompare it to twenty twenty two. So
yes, it's deeply alarming. Andcollege we just had a team meeting with
(33:00):
our team in Gaza and one ofour colleagues had visited them just as an
example, an UNUSH school with nineteenthousands people, with eight toilets, with
an enormous lack of water, etcetera. So I mean describes a little
bit of the situation. I meanlike the enormous need for wash et cetera.
(33:22):
We also the lap capacity. Normallythose samples would go to Shifa and
to the Turkish hospital where you atthe central lap. Those are not functional
anymore as we know. So weare looking into can we bring in mobile
labs, can we get samples outto Egypt, et cetera. We have
(33:42):
to really quickly start going on it. It's a very concerning situation. One
other point, I want to raiseroutine vaccination. Routine vaccination in Gaza,
Gaza and the West Bank and oneof the best routine immunizations actually globally close
to hundred percent from most vaccine basedNow, I mean we struggle, we
(34:06):
together with with an UN team UNIseven who we got some of the vaccines
from the warehouse from the North overthe last couple of days back to the
South, et cetera. But weneed to get going to to make sure
that children are getting vaccinates. Andas Mike said, the system and this
is somebody despite all the challenges,the Gaza and West Ben East Erusalem Opitit
(34:31):
health system produced health indicators at paror, I would say even better than
its neighbors. So it is possibleand we should get back to that level.
Over to you can, I justsupplement because I think it's important again
to recognize too that there was avery good system of surveillance before the conflict
(34:54):
and it was linked to a lobar, the confirmation system that was based in
the Central Public out Laboratory that washoused in Al Chifa and the Turkish Friendship
Hospital in northern Gaza. So notonly has Gaza lost its hospital capability,
it's lost its ability to confirm eventhe most basic of diseases in that context.
(35:14):
In terms of infectious diseases, thiscreates a blind spot where we have
huge risk of epidemic diseases in acontext where we have limited capacity to diagnose
those diseases right now. Historically,many of those samples that might have been
processed that to see the Central PublicLaboratory would also have gone to the West
(35:35):
Bank or in sent to reference labsin Israel. That is no longer possible,
So we're trying to work out howcan we get samples to move from
Gaza back into Egypt and get referencefacilities in order to be able to do
that. But right now, notonly is the potential for epidemics a risk
for the people of Gaza, butnot knowing what's happening, not being able
(35:57):
to confirm having diseased potential potentially spreadis a risk that we don't want to
currently leave in place. We're blind. We're blind at the moment to what
is actually going on, and that'swhy we have very good syndromic surbillance on
the ground. That means help workersgoing around and filling in telly sheets for
(36:17):
what they're seeing in the camps.But what we don't have right now is
the capability to do on the grounddiagnostics and be able to tell exactly what
we're looking at. So, forexample, in the case of a cute
John the syndrome or meningitis, it'svery important to work out what the cause
of the agent are because the rootsof transmission are different, the agents are
different. Meningitis can be a mildviral meningitis that doesn't need to be treated
(36:40):
except with antiporetics and ivy fouls,but it could be bacterial meningitis that requires
immediate treatment of a child to preventdeath. So knowing what the diagnoses are
becomes extremely important. So this issomething we do need to focus on in
the coming weeks. But again it'snot that we have to provide this capacity
to Gaza. This capacity existed before. It has been put beyond use of
(37:05):
the system in Gaza and we needto restore us. Thank you very much,
doctor Ryan and doctor Peppercorn. Thenext question goes to Mohammed Aslan of
Andelou. Muhammed, please unmut yourselfand ask you a question. Okay,
thank you so much Margaret for takingmy question. There is any information and
(37:27):
it says no foil reached the hospitalin the north of Gaza since the humanitarian
powers start, does w a choiceeight reach all part of Gaza? If
not, what is the obstacle tothis? Thank you so much, Thank
you. I think that's one fordoctor Pepercorn. Sorry, thank you very
(37:58):
much. I think over the lastcouple of days, who as and I
really want to stress is really oneyou went together with with ANDRAI and Osha
who that we had a mission,for example today to the north to deliver
fuel and medical supplies to Al Ahliand our Sahaba hospitals, and that was
(38:20):
seven thousand leaders of fuel to AlAhli covering their minimum requirements for the next
seven days and three thousand and fivehundred leaders for Al Sahaba covering the minimum
requirements for the next seven days aswell. We also had some medications surgical
supplies delivered to those two hospitals.There's also plans to bring fuel to come
(38:43):
out at one and Al Atama Hospital. We are planning that for tomorrow.
We hope that that will continue.It is of course absolutely needed that those
four remaining hospitals which are i wouldsay barely partly functionals, that they keep
that they keep keep on going.We would hope, of course, because
(39:06):
we know there's there's still a numberof patients in Ol Shifa and and and
they opened again for the dialysis aswell as in Indonesian noted there are still
some patients and they will need fuelas well. And we hope and that
we can also bring some fuel andsome additional medication in the future there as
(39:27):
well. But yes, over thelast couple of days so there have been
uh there that that we have wehave managed to bring a certain level of
fuel and medical medical medicine, essentialmedicine and equipment over to you. Thank
you very much, doctor Pepcon.The next question goes to Omar Abdelbaki of
(39:49):
the Wall Street Journal. Omar,can you please u mute yourself and ask
you a question? Hi there,thanks for thanks for taking the time.
What countries have taken injured and saidcozzens for treatment, how many gusens have
left for district for treatment? Andis the World Help organization helping facilitate this
(40:10):
effort? Thank you. I'll startwith doctor Pepcoin, but maybe doctor Newark
can help as well, but we'llstart with doctor Pepcinn. Thank you very
much. Well, first of all, I think it's the HO as you
(40:31):
know, have been assisting over thelast week actually, and I think the
DG was referring to this as wellover the last ten days now, almost
to what we call to transfer,to transfer the most vulnerable complex patients,
(40:51):
trauma patients, but also very seecritically injured and sick from the North,
some of the hospitals in the Northto the South and Gaza, and specifically
to these larger hospitals in the SouthEuropean Gaza Hospital Nation Medical Complex et cetera.
That one, there has been anumber of patients transferred. I mean
(41:12):
you've seen all the we've reported allthe stories of course of the neonase and
when I count roughly, I thinkthere's at least forty fifty more patients transferred.
But what we and this is notwe do, this of course is
split by the technical that's the Ministryof Health and the respective hospitals to treat
(41:36):
their patients, to make sure likewhich patients need to be referred outside Gaza
and which are the most critical patientsover the next weeks a month, And
what we really want to help facilitatesis a more orderly transfer transfer of these
patients into Egypt. First of all, is absolutely needed and patients deserve that
(41:58):
that they get the treatment which whichthey need. Uh. But it's also
it will also of course relieve thecompletely overwhelmed health system in Gaza, and
I want to make one point onthat. First, in one of the
hospitals we work closely with the EuropeanGaza Hospital, which is is having a
(42:21):
three and a seventy bets capacity,which includes already a field hospital which was
established during the COVID period. Theyhave more than nine of the patients current
more than triple. Now, whatis needed is this orderly, orderly transfer.
And then yes, there's a numberof countries. And then and maybe
might want to refer to that aswell. A number of countries have actually
(42:45):
offered their services to there. Therethey welcome the idea to actually get some
of those referral patients for treatment intheir country. But the first, the
first and foremost, they need tobe orderly transfer transferred into Egypt, get
the treatment there. And what happensfrom there, well, wherever they can
(43:06):
get the best treatments, they should, they should should be able to go
there, including of course their familiesand companions. Over to you, thank
you doctor people going doctor Ryan.We'll add something. Yes, first of
all, we thank all of ourmember states further in their intention to support
(43:30):
people affected by this crisis. There'sno question that all help is welcome,
and primarily, as as Rick said, we need to help people of Gaza
in Gaza where they are, andwe need to shore up that medical system.
There has been a process of medicalevacuation to Egypt, and I'd just
like to recognize the government of Egyptand the Ministry of Health in particularly they
(43:52):
have put eleven thousand beds at thedisposal of medical evacuation, one seven hundred
ICU beds, one hundred and fiftyambulances, thirty eight thousand physicians, twenty
five thousand nurses. They really havestepped up not just an Alurisian around in
terms of triage and stabilization, butin terms of onwoud referral within the Egyptian
(44:14):
system. So there's an incredibly powerfulcapability within Egypt to do that. We
have encouraged third parties other countries towork with Egypt to ensure that we have
the transfer of patients to Egypt theirproper triage and assessment and clinical assessment,
and then as needed, a discussionwith third party countries to transfer maybe more
complicated patients, patients that need moreintensive interventions for burns, repatriating nationals.
(44:40):
There are various other reasons why,and in that sense we think this is
a useful enterprise. But again thecosts of doing this versus the actual costs
of investing in the system and investing, as Rick said, in the ability
to support people where they are.We have to balance those two things.
We'd also like to recognize the governmentof fran for deploying a medical ship with
(45:01):
special surgical capacities, and they're workingvery closely with our Egyptian colleagues to base
that at l Arish, and theywill be working in close collaboration with the
Egyptian authorities on exactly the basis Iexplained earlier in situations like this, and
I think this is something that wereally all need to redouble down on.
(45:23):
In a crisis, everybody wants tohelp, and that's fantastic. The real
trick is to be coordinated and organizedand deploy in a meaningful and targeted way.
So we look at EMTs. We'renow beginning to see more coordination,
more direction more strategic placement of theseand I think that's really beginning to help.
(45:45):
The problem is when everyone rushes intohelp, then we lose the directionality
of the response. It's the samewhen you bring people out. It's got
to be done in an orderly fashion, like we facilitated in Ukraine and we
facilitated in other situations. And Ithink we would point our third countries really
to work with Egypt to ensure thatthe patients that are being selected for onword
(46:07):
referral can truly benefit from the processof international referral, and in particular too
that they be accompanied by companions ina way that the person doesn't lose entire
contact with their social networks. Soit's very important that we don't just take
patients out of the system. Theyneed to come with companions and the necessary
(46:29):
social and psychological support. Their medicalcondition is only one part of what those
people are suffering. Thank you,Thank you very much, doctor Ryan.
Doctor Nuru is going to add somethingas well, just to add one thing
that this system is not new ofMEDEVAC. Before this crisis, MEDIEVAC existed
between Gaza and West Bank and Israelactually which is now is not possible,
(46:53):
but also existed before with Egypt forcases like cancer and other chronic diseases.
Only that the needs have increased manyfolds. Just that as a background things.
Thank you very much. Doctor.Now we've running out of time,
but we've got time for one morequestion, and that goes to Imagen.
(47:16):
Folks of the BBC. Imagen,please unmute yourself and ask you a question.
Yeah, hi, thanks very much. It's also about Gaza. I'm
really interested. It's almost this notableoptimism or planning for the future in what
you're saying. You talk about acrippled but resilient health service. What you're
(47:38):
talking about seems to be based onthe premise that fighting won't start again.
I'm just wondering if you fear that'sover optimistic. I think I'll start with
doctor Ryan on this one. Mthanks imagin. I'm I don't know if
(48:00):
we've communicated too much optimism, butI don't think myself or Rick or Ilam
or Ted Ross before we're speaking inoptimistic terms. You're absolutely right, what
happens in any resumption of the violenceis going to greatly affect what's happening now.
(48:21):
If and we all hope if therecan be an extension of a pause,
if we can get to a placeeven with that happening tomorrow, even
if peace was declared, we havea massive challenge ahead of us, and
absolutely gargantuan public health and health deliverychallenge ahead of us. If fighting resumes,
and particularly if that fighting pushes intothe Arabella, pushes into Canunis,
(48:44):
pushes into Rafa, we are goingto see further displacement of people to the
west, concentrating people on the westernside of Canyunis, where there are very
little in the way of services.Many people have been directed again and again
to the area of Almawazi, whichhas no infrastructure whatsoever in place, to
continue to concentrate people and push themthrough there with the promise that when they
(49:07):
get there there will be services fromthem. Because again that has been repeated
again and again. Go there becausethat's where you'll get the necessary assistance.
I think there's some there's a verytroubling narrative associated with that push of people.
If the violence starts again, thenimagine that is a real scenario.
And I really don't know what tosay to you about that scenario because it
(49:31):
is truly horrific in terms of theimpact of so many people out in the
open. We're not talking about peopleintended cities yet, we're talking about open
ground onto which we could have upto two million people approaching into the depths
of winter, with their underlying nutritionstatus, with the overcrowding, with the
stress, and with the wounded,and the old, and the disabled,
(49:54):
and the mentally and psychologically damaged,and and and and suffering. I really
don't know. I maybe Rick willspeak to this, But if we go
to that scenario and we see thathappen that I shoulder to think. Quite
frankly, I should have to thinkwhat will happen in terms of the numbers
(50:16):
we've we've seen up to now ofdebts and casualties maybe a distant memory in
weeks, in weeks to come.It really depends what happens on the side
of the on the side of theforces that are combating each other, and
the particularly the occupying force as towhat its intentions are. And so the
(50:37):
military and security intentions right now willdetermine life and health in Gaza over the
coming weeks. Maybe Rick wants tosupplement and that US may want to come
in on that too, How vidyou, doctor Pepcin, Yeah, yeah,
thank you very much, because Iwant to be very clear and if
(50:58):
I have not been clear now thenlet me state again. So we are
extremely concerned about the vulnerability of theof the what I called a cripple's health
system, and we are extremely concernedabout this. These twelve hospitals in the
(51:19):
south with some of them are moreimportant than the other ones which are currently
the backbone of the health services ofmore than two million people. Now we
what I think I had made itmade it clear. So when we would
see a resumption of violence and whichpotentially would also damage health facilities or make
(51:45):
them even dysfunctional. Uh, wehave a further humanitarian disaster, an increasing
humanitarian disaster. And again I said, the health system can absolutely not afford
to lose more sit all that weneed to expand. But also the resumption
of violence would mean a resumption ofviolence in an even more densely populated area.
(52:10):
Data is already the one of them. It is the most popular densely
populated area in the world or oralmost now. We see one point seven
million people displaced. It's extremely denselypopulated. We have seen many, many,
many many deaths and injuries, sowe would expect much more, many
(52:34):
more from from from a resumption ofviolence. Besides that, you will get
more I d P s and Id P s, IDP flows, et
cetera. Everything related to that overcrowdedshelters with what we just described and where
we're very concerned in the increase ofcommunical diseases and the chance for outbreak.
(52:54):
So we have that combination. Soyeah, I mean, I think we
are all extremely concerned and it shouldnot happen. The health system should remain
as intact as possible. We shouldbe able to expand the capacity and it
simply should not happen. So yeah, if we didn't express that enough,
(53:15):
extremely concerned over here, Thank youvery much and on net note in the
Q and A session and hand itback to doctor Tedros for any final remarks.
Yeah, thank you. Maybe i'lltouch the last question. Are you
(53:42):
optimistic? Maybe I wouldn't use theoptimism and pessimism category, but if you
read the reality on the situation,the chances of resumption of the conflict is
very very high. And if thatmeans the health system is already broken,
(54:07):
I mean it's just less than athird of the health facilities are you know,
providing service, and even of providingvery difficult to say providing service.
Actually they are overcrowded and beyond theirtheir capacity and the way they take care
(54:29):
of their patients or the service isreally really bad, so you cannot say
there is service anyway, But forwhat it is, at least there is
a small proportion compared to what theGaza had, you know, providing service.
(54:51):
But as you rightly said, okay, based on the situation, the
resumption of the conflict is you know, there is a high chance. But
at the same time, I reallybelieve that the humanitarian pause or even ceasefire
(55:13):
is possible if those with influence cantake it. Seriously, I believe it's
possible. So the question is,will those who have the influence will do
everything to stop it, I mean, to stop, to sustain the pouse
(55:37):
or then ultimately have a ceasefire andyou know, having a political solution to
this, to this problem. Soit's possible except the forore the you know,
those with influence are not doing it. I mean that's the situation,
(55:57):
So it can it can happen.It's a my of will to be honest.
So with that, thank you somuch for joining to the press who
joined us today, and see younext time. MM. The show has
(57:05):
been produced by Depictions Media. Pleasecontact us at Depictions dot media for more information.
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Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.
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If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.