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Gaza City. Gaza Strip. January 27 , 2009.
 A medical unit of Medecins Sans Frontieres (Doctors Without Borders). A doctor plays with Hala, 1 year old, burnt on her body, next to her mother.
  *** Local Caption *** <br/>Le 18 janvier 2009, soit 22 jours apres le debut de l¿offensive Israelienne, l¿arret des bombardements a permis a MSF de reprendre et renforcer ses activites medicales dans la bande de Gaza. Les trois cliniques (soins post-op à Gaza city, pediatrie à Beit Lahia, dans le nord, et soins post-op a Khan Younis, dans le sud) ont pu rouvrir ; 80% des 70 membres du staff ont repris le travail.
 
 Deux blocs operatoires et une unite de soins intensifs de dix lits ont ete installes sous deux tentes gonflables, a proximite de la clinique de soins post-operatoires de MSF dans la ville de Gaza. Des medicaments, des kits comprenant le materiel necessaire pour 300 operations chirurgicales et 100 hospitalisations ont ete receptionnes le 19 janvier, dans un fret de 21 tonnes de materiel au total. 
 
 Dix premiers patients ont ete  identifies pour etre operes par nos équipes. Il s¿agit de chirurgie de reprise, essentiellement orthopedique, activite identifiee par MSF comme ayant une reelle valeur ajoutee a cet instant. Le 26 janvier, notre equipe chirurgicale a opere les trois premiers patients.
An MSF doctor plays with one-year-old Hala, who suffers burns on her body, next to her mother.
© Frederic Sautereau

Intensive care training for doctors

An MSF doctor plays with one-year-old Hala, who suffers burns on her body, next to her mother.
© Frederic Sautereau
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Médecins Sans Frontières (MSF), working with the Ministry of Health, is organising intensive care training for local doctors in Gaza from 25 to 27 June 2013. The course will be run at the Al Shifa hospital. Owing to the Israeli blockade in place since 2007, Palestinian doctors find it very difficult to leave Gaza to receive specialist training.

The blockade, set up when Hamas came to power in Gaza in June 2007, imposes tight restrictions on people’s movements and access to goods. In addition to its economic impact, with the rise in unemployment and poverty, the blockade also affects the health sector. Patients who cannot be treated in Gaza have to ask for authorisation to leave the territory and travel to foreign hospitals, or Palestinian hospitals in the West Bank, for treatment. Delays in exit permits granted by the Israeli authorities often cause patients’ health to deteriorate. Doctors living in Gaza are also affected by the blockade. Since it is very hard for them to leave Gaza, they are unable to receive training to update their medical knowledge and thus improve the way that they treat the pathologies that affect the people of Gaza.

In response to this situation, MSF is making efforts to meet the needs of the Palestinian people, particularly by providing access to certain treatments. “Although the medical system in Gaza is functional, the support and training that medical staff need to treat patients in intensive care situations has now become an issue that MSF wishes to tackle,” explains Tommaso Fabbri, head of mission in Gaza.

Patients in intensive care units are the most at-risk patients in the hospital environment. In January 2011, following a series of assessments implemented in partnership with the Ministry of Health, MSF decided to set up an intensive care programme with several facets. In addition to the training courses for Gazan doctors offered at the Al Shifa hospital, MSF will be sending specialist medical equipment technicians to the Nasser de Khan Younis hospital in southern Gaza. They will provide the hospital with technical support so that it can optimise its use of intensive care equipment. An MSF nurse has been giving staff at the Nasser hospital intensive care training since March 2013, using a bedside teaching approach. MSF also plans to develop its intensive care support programme by offering physiotherapy training in the near future.

MSF will use the 25 to 27 June training programme to offer a group of around thirty doctors clinical teaching with a focus on technical support. The goal is to develop the medical staff’s knowledge, skills and attitude so that they are better equipped to treat seriously ill patients.

The training offered by MSF draws on a programme developed by the Chinese University of Hong KongProgram BASIC « Basic Assessment and Support in Intensive Care », a recognised training programme supervised by a group of international specialistsHong Kong, Australia, India, Malaysia, New Zealand, United Arab Emirates and United Kingdom. Training modules address comprehensive treatment of patients suffering from reversible serious illnesses. The programme has been approved by the International Pan Arab Critical Care Medicine Society (IPACCMS) and the World Federation of Societies of Intensive and Critical Care Medicine. Trainees will take part in sixteen modules spread over three days. At the end of the programme, participants will validate their training with a test and receive a certificate from the Chinese University of Hong Kong.

MSF has been active at the Nasser de Khan Younis hospital in Gaza since 2010. It runs a specialist hand surgery programme and secondary reconstructive surgery for domestic burn victims. Patients at the MSF clinic in Gaza receive post-operative care in the form of physiotherapy and wound dressings. In Nablus, on the West Bank, MSF runs a psycho-social and health care programme. MSF has been working in the Palestinian Territories since 1989.