Emergency preparedness and response of the Palestinian health system to an Israeli assault on the Gaza Strip, occupied Palestinian territory, in 2012: a qualitative assessment

Background Although the Gaza Strip, occupied Palestinian territory, has been subjected to repeated Israeli assaults, its health system preparedness and response to emergency situations have rarely been assessed. The response of the health system to the Israeli assault on the Gaza Strip during Nov 14–21, 2012, was assessed. Methods Data were gathered through review of documents, participants' observations, in-depth interviews with nine health providers, and a focus group of key informants to discuss the performance of the health system in response to the Israeli military attack during Nov 14–21, 2012. Written transcripts were analysed with an emerging-themes method. A series of discussion meetings were held to triangulate the findings. We obtained verbal informed consent from participants and health providers. Findings The violent events of past decades have affected the capacities and vulnerabilities of the health system in the Gaza Strip for dealing with emergency situations. Different health stakeholders have improved their preparedness because of their experiences. The health facilities—namely, hospitals—are barely adequate for dealing with the regular situations. Although hospitals increased their capacity during emergency situations by discharging patients and suspending regular operations, the burden of casualties was not equitably distributed between them. Not all primary health-care services were operational during the attacks, implying that the delivery of health services, in the event of wider assaults, could be a challenge. The capacity and the performance of human resources in response to most of the emergencies were adequate, making it possible to overcome various logistical deficiencies, inadequate training, and suboptimal organisation of work. Interpretation The latest assault on the Gaza Strip showed that the emergency preparedness of the Palestinian health system had improved compared with that during previous assaults. This improved preparedness, however, still has shortcomings that could be addressed with further interventions. However, the focus on the Palestinian health system increasing its capacity and reducing its vulnerability is of little use and a short-term solution. The best form of preparedness for an avoidable emergency is to stop the Israeli violence and end the isolation of the Gaza Strip through international efforts. Funding None.