What We Do   Community Health Care Centers   Specialized Services   Mobile Clinics & Outreach Programs   Lending Centers   Health Education   School Health Program   School of Community Health   Emergency Response Program   Community-Based Rehabilitation   Chronic Diseases Program   Well-Baby & Child Health Program   Women’s Health Program   Community Mobilization Programs   Advocacy & Public Awareness	Emergency Response Program  Print Version First Aid Training Mobile Clinics Emergency Centers Individual Medical Assistance Funding In the current crisis many Palestinian civilians are blocked from receiving health services. Concurrently, the Israeli army continues to escalate its deadly use of force, attacking men, women and children with tear gas, rubber-coated metal bullets, explosive high-velocity ammunition, anti-tank missiles, tank shells and attacks from helicopter gunships and F-16s. From 29 September 2000 until 8 July 2003, 2,572 Palestinians were killed, and more than 41,000 injured. In conjunction with its excessive use of force against civilians, the Israeli government has systematically imposed various collective punishment measures including arbitrary curfews preventing Palestinians from leaving their homes as well as a strict internal and external border closure which has severely restricted mobility between the West Bank and the Gaza Strip and between the cities and villages throughout the Occupied Territories. Palestine is now effectively made up of 220 discontinuous geographical entities. Palestinians in the West Bank and Gaza Strip have suffered from numerous direct and indirect health consequences of the Israeli attacks and collective punishment measures. Obviously the direct health difficulties Palestinians face include the deaths and injuries that occur on a daily basis from Israeli military attacks. However, Israel's policies of collective punishment also have severe health consequences. Closures prevent Palestinians from accessing primary health services, and approximately 70% of the population is cut off from hospital care for weeks and months on end. Closures also prevent medical staff from reaching clinics, especially those located in the isolated, rural areas which are most affected by the closures. Sometimes doctors and community health workers cannot pass through particular Israeli military checkpoints for days or weeks, even when they show identification that clearly marks them as medical personnel. Ambulances are also often denied passage, and during times of curfew in Ramallah and Nablus, our ambulances were periodically shot at. The Emergency Response Program seeks to provide emergency health services to patients in isolated villages and in towns under curfew. It also works towards training community members in the provision of first aid, ensuring patients' access to medications and surgical treatment in Palestinian hospitals and abroad and providing food assistance during incursions and curfews. First Aid Training: UPMRC has always focused on empowering communities towards self-reliance in addressing the problems they face. Thus, with the ever-present political instability and threat of violence in the region, UPMRC recognizes the importance of having a large number of people who are properly trained in First Aid and Emergency Response. In response to this need, in 1996 UPMRC developed an extensive First Aid Training program aimed at preparing communities throughout the West Bank and Gaza strip for mobilization in times of crisis. The idea was to increase people's awareness of First Aid basics and establish a national network of qualified First Aid providers who can respond to any emergency, whether during political struggle or in normal life. By the time of the start of the second Intifada in September 2000, the Emergency Response Program had trained a total of 18,000 first aid providers. These new First Aiders were able to utilize their skills in attending to the wounded during clashes. The Intifada for Independence reinforced the vital importance of the First Aid Training and Emergency Response Program. At the beginning of the conflict, UPMRC organized its First Aid teams, consisting of health professionals and qualified volunteers to ensure a presence at confrontation sites throughout the Occupied Territories, and provided the teams with First Aid Materials, supervision and support. These teams have helped approximately 12,000 individuals by providing immediate on-the-spot care to the injured, evacuating them to ambulances and UPMRC field hospitals, and administering follow-up care. They have proved their effectiveness-the teams have saved many lives, treated numerous injuries thereby preventing complications, and have worked to ensure the prompt transport of injured people to medical treatment. In addition, the program has become important because of the prolonged closures imposed on the Occupied Territories and the resulting inability of the population to reach medical facilities. Under these circumstances, empowering local community members with basic first aid and emergency response skills can save lives or prevent serious complications from developing. Palestinians, organized into 806 First Aid and Emergency Response teams throughout Gaza and the West Bank now constitute a grassroots First Aid network ready to assist communities during emergencies. The program seeks to operate in every community, school, university, or institution by training a team of First Aid providers. It focused on developing a systematic approach to providing First Aid at clash-sites and is now able to deal with a great number of injured. This systematic method reduces the chances of complications as much as it can save lives. Through its support and collaboration with the Red Crescent Society, UPMRC volunteers fill a gap by providing the link between the clash-location and ambulances (thanks especially to donated stretchers) and by offering immediate treatment for minor injuries. In 2002, the program provided 290 First Aid training courses reaching 6,692 trainees. It provides continuous follow-up and refresher courses for teams, forms emergency committees in villages and neighborhoods, and is expanding the activities conducted by first aid teams to include social and humanitarian tasks. Often, First Aid providers have had to risk their lives to save the lives of others and to rescue injured people. Israeli forces systematically violate international conventions and standards by targeting First Aid providers, despite their special uniforms easily identifying them as medics. Eighty-eight UPMRC First Aid providers, including two physicians have been injured while performing their duties. One of our volunteers lost an eye. Mobile Clinics: UPMRC mobile clinics regained their active role with the advent of the second Intifada and the increasing level of Israeli collective punishment measures. The need for this type of service became evident in view of the deteriorating economic situation of the population and obstruction of patients' access to health services. The operation of mobile clinics started in February 2001, about four months after the outbreak of the Intifada. They provided free medical examinations, basic diagnostic services and medications in most villages throughout the West Bank and Gaza Strip. The mobile clinics work towards facilitating patient access to health services in view of restricted mobility, alleviating the economic burdens by providing free-of-charge diagnosis and treatment, and preventing or minimizing the development of medical complications. They alleviate the suffering of patients, prevent complications in patients with chronic diseases, and bridge the gap of services in towns and villages by addressing both patients' inability to move due to closure and curfew and the effects of economic devastation. In 2002, 16 mobile clinic teams conducted 1,934 mobile clinic visits, providing treatment to 232,080 patients in the West Bank and Gaza Strip, 60% of whom were children, and 68% of whom were female. Emergency Centers: In response to the Israeli reoccupation of Palestinian towns and the imposed protracted curfews on civilian areas, UPMRC began operating emergency centers in all occupied towns under curfew to provide urgent assistance to wounded, ill and needy individuals and families. A hotline was established to receive people's requests for medical assistance. Medical consultations were provided over the phone to mild cases and chronic patients. Physicians were dispatched to patients' houses to examine and treat intermediate cases, while severe cases were transported to the hospital by ambulance. Since citizens were not prepared for such prolonged curfews, the majority suffered acute shortage of food supplies. In response to this need, UPMRC took the initiative in distributing food supplies to needy families through the efforts of emergency teams and volunteers, who reached families by ambulances and even on foot. In 2002, the Program established 226 emergency units focusing on providing treatment to patients through direct or over-the-phone medical consultation for the wounded and for urgent medical cases. The program also provided treatment to chronic disease patients. The program reached 66,018 beneficiaries. It further provided food supplies to 17,821 families and baby food to 13,775 children. We would like to extend our special thanks to the international volunteers who helped facilitate our teams' access to villages and neighborhoods. Individual Medical Assistance: The Israeli policies of closures and collective punishment have caused severe damage to the Palestinian economy leading to very high rates of unemployment and poverty. Medical treatment has become unaffordable to many patients, especially in view of Ministry of Health's inability to adequately respond to patients' needs for medications and surgical procedures due to the severe financial crisis it is facing. UPMRC responded to this need with its Individual Medical Assistance project, which seeks to provide diagnostic and therapeutic services including medication and surgery, as well as providing technical aids to people with special needs. It provides patients with certain medications, contributes to the costs of diagnostic tests unavailable at Ministry of Health facilities, cooperating with some hospitals in covering partial cost of surgical procedures performed by local specialists, or approaching international specialists to assess and treat special cases, either locally or abroad. Ambulance Services: The idea of providing ambulance services originated in response to the considerable restrictions on movement people faced between towns and villages and the need to assist patients in accessing hospitals. Another factor was the need to support the increasingly expanding emergency services, first aid, mobile clinics and individual assistance in times of curfews. The Program covers all towns, villages and refugee camps in the West Bank and Gaza Strip. There has been a need to increase the number of ambulances in response to the increased need for emergency services and the expansion of UPMRC's reach by emergency teams and mobile clinics. Ambulance services include: Transporting patients from villages to medical facilities in towns. Transporting the wounded from clash sites to medical facilities. Providing different emergency services in times of curfews. In 2002, a total of 7,749 patients, 900 medical teams (during curfews), and 476 mobile clinic teams were transported by only two ambulances in Ramallah and Nablus. Several times Israeli soldiers shot at our ambulances with rubber bullets and live ammunition. Funding: UPMRC's First Aid Training and Emergency Response Program is funded through a special emergency fund. Donations are welcome, and will allow the expansion of the program to new communities. Contributions can be made by check to: UPMRC PO Box 51483 Jerusalem Via Israel Tel: 972-2-583-4021 Fax: 972-2-583-0679 Thank you to our partners and supporters who have already donated funds necessary to this program.