Safe Surgical Management for Gaza's Vulnerable People Based on International Humanitarian Law (IHL) and the International Human Rights Law (IHRL), Right to Health and Right to Live are the most fundamental of all human rights. 

Gaza under its 12 years’ blockade and protracted crises, its health care system facing many serious challenges, such as: lack of medicines (especially essential medications) an energy crisis salary cut crises Palestinian internal divisions as well as other conflict related problems that have overburdened the system to which we add the recent global COVID 19 pandemic emergency.

All these realities have led to a long waiting list that reached 9,000 persons in elective surgeries especially Ear, Nose and Throat (ENT) that has reached 4,000 patients who can't afford them in the private sector nor wait without their health conditions worsening.

To respond to this need, Al Ahli Hospital (AAH) in Gaza has proven capacities as a surgical hospital with a high reputation in safe surgical management. It has operated as a surgical hospital for 140 years and has been an implementing partner for two previous Country Based Pooled Fund (CBPF) projects either in elective surgeries, trauma management and limb reconstruction.

Therefore, AAH with the support of Augusta Victoria Hospital (AVH) operated by the Lutheran World Federation (LWF), found it crucial to support vulnerable women, men, boys and girls who are now on the waiting list of the Ministry of Health (MoH). Coordination was done with MoH to conduct 2,350 surgeries. 1,750 will be ENT. The rest are advanced Minimally Invasive Surgeries (MIS), general surgery, orthopedic and gynecology.

AVH will also develop AAH’s capacity in Infection Prevention Control (IPC) and rational uses of antibiotics, especially with Palestine's current COVID 19 emergency situation.

AVH will train 30 staff from AAH either through coaching, mentoring and onsite demonstrations. AVH is aiming to visit AAH 3 times, the 1st for follow up visit/training and another 2 visits for follow up.  

LWF has strong financial, monitoring and accountability systems in place and adheres to policies ensuring sustainable quality programming, such as the Code of Conduct, Child Protection, Core Humanitarian Standards, Gender Justice and Complaints Response Mechanism (CRM) all to be shared with AAH. 

Furthermore, AAH will work with Handicap International to develop a checklist to determine the People With Disabilities (PWD), to track and report on them. GBV cases will be referred to specialized centers to address this issue. 

Scenario risk analysis was done based on previous experiences and similar projects and based on the new proposed COVID 19 possible scenarios as mitigations were planned such as remote management with AVH. 

Coordination with MoH, the Health Cluster (HC), Women’s Centers, the Union of Health Work Committees (UHWC) for complementarity and referrals are well  defined in the project.

Regarding finance and procurement, AAH has implemented successfully USAID projects, CBPF projects and followed either USAID or OCHA guidelines and has a strong PMER (planning, monitoring, evaluating, reporting) system in place. 

This project links to Obj. 2: The basic needs of vulnerable Palestinians living under occupation are met through the provision of quality basic services and improved access to resources, in accordance with the rights of protected persons under IHL.

The project is aligned with the Gaza segment under "Health" targeting "Deployment of medical teams to conduct surgeries, to reduce the need for referrals outside of Gaza and reduce the waiting period for patients in need for treatment" (1st Std. Alloc. Strat. 2020, p. 3)

The project is aligned with HC Obj. 2: "Ensure the availability, accessibility, acceptability, and quality of essential lifesaving health services to vulnerable communities in Gaza amp West Bank/EJ, incl. through health system strengthening, preparedness and community resilience bu