GAZA CITY/RAMALLAH, 6 January 2009 (IRIN) - The UN agency for Palestinian refugees (UNRWA) has over 10,000 staff in Gaza, but their deployment has been severely restricted due to Israeli bombing and tank shelling, UNRWA spokesman Sami Mshasha said.

They are not the only ones. The movements of all aid workers are severely restricted. The International Committee of the Red Cross (ICRC) has a staff of eight foreign nationals and 60 local staff in Gaza. The former, however, are holed up at the UNRWA compound in Gaza City, Mshasha said.

"[UNRWA] field officers are trying to move to different areas to assess the situation for food distribution, safety and the availability of water and electricity services," UNRWA's Mshasha said.

Underlining the severity of the security situation, three Gazans were killed in an Israeli attack on an UNRWA school on 5 January. They were among over 400 people who, earlier in the evening had fled their homes in Beit Lahia in northern Gaza and had been given refuge in the UNRWA school, said an UNRWA statement issued on 6 January. Another UNRWA school sheltering Gazans who had fled their homes was attacked by the Israeli army on 6 January in the northern town of Jabaliya. There were at least 40 casualties, according to John Ging, director of UNRWA in Gaza.

With the collapse of the health services in Gaza, medical professionals are volunteering in hospitals to help treat the increasing number of patients.

Health facilities

Gaza has 27 hospitals in all, with about 2,000 beds.

The health ministry manages 56 primary health care (PHC) centres in Gaza, 24 of which have been assigned as emergency centres. Two PHC centres (Al-Atatra clinic and Jabalia Martyrs clinic) were damaged in the attacks and have stopped working; two others are not functioning because of their proximity to risky areas, the World Health Organization (WHO) reported.

UNRWA manages an additional 18 PHC centres in Gaza, five of which have shut down due to their proximity to Israeli forces, according to UNRWA. UNRWA has assigned four of these centres for emergency care.

As of 6 January, the death toll had reached 578 with 2,700 injured, according to the Gaza health ministry, although officials said they were having difficulty keeping track due to the number of victims. Also, some people were rushing to bury dead bodies without notifying the health authorities, according to the WHO.

Transfer of patients

The head of Israeli NGO Physicians for Human Rights, Ron Yaron, said: "Palestinian physicians in Gaza want to transfer patients to Israel for life-saving care, but the Palestinian Authority in Ramallah [controlled by Fatah] does not want to pay for their care. Patients are suffering from the bombing and from internal political strife."

Israel has given the green light for Palestinians to enter Israel via Erez for medical care as long as the funds for their treatment are secured, said Defence Ministry spokesperson Maj Peter Lerner.

The Gaza health ministry reported that between 29 December and 31 December 46 injured were evacuated for treatment abroad.

Aid organisations are now receiving urgent requests for strong pain killers as well as for body bags and bed sheets. There is also an urgent need for more orthopaedic and open heart surgeons, the Office for the Coordination of Humanitarian Affairs (OCHA) said.

More than a million Gazans still have no electricity or water, and thousands of people have fled their homes to find safe shelter, according to OCHA.

On 29 and 30 December, the ICRC sent to Gaza 14 trucks of medical supplies, spare parts for generators, blood, surgical kits, and five ambulances, ICRC spokesperson Anne Sophie Bonefeld told IRIN.

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