{"id":150223,"date":"2019-12-23T12:00:13","date_gmt":"2019-12-23T12:00:13","guid":{"rendered":"https:\/\/www.transcend.org\/tms\/?p=150223"},"modified":"2019-12-20T09:38:24","modified_gmt":"2019-12-20T09:38:24","slug":"i-feel-constant-pain-drug-resistance-adds-to-misery-of-gaza-gun-victims","status":"publish","type":"post","link":"https:\/\/www.transcend.org\/tms\/2019\/12\/i-feel-constant-pain-drug-resistance-adds-to-misery-of-gaza-gun-victims\/","title":{"rendered":"\u2018I Feel Constant Pain\u2019: Drug Resistance Adds to Misery of Gaza Gun Victims"},"content":{"rendered":"

The suffering of people wounded in conflict zones is being compounded by what doctors say are \u2018horrifying levels\u2019 of antibiotic resistance.<\/em><\/p><\/blockquote>\n

\"\"<\/a>

MSF say 83% of patients seen in Gaza have infections, which complicates the treatment of fractures. Photograph: Loay Ayyoub\/The Guardian<\/p><\/div>\n

5 Dec 2019 – <\/em>When Jihad Nasser arrived at al-Awda trauma clinic in Gaza<\/a>, he was hoping doctors could finally stop his pain. A gunshot wound in his right leg had not been not healing properly. The news, however, was bad.<\/p>\n

The complex bone fracture he had suffered was badly infected with MRSA. Doctors told him it would not respond to treatment and they would need to amputate.<\/p>\n

\u201cI thought about suicide several times,\u201d says Nasser, 28, a former blacksmith. \u201cI was wishing the Israeli soldier [who shot me] had killed me with the bullet.\u201d<\/p>\n

Nasser refused to consent to amputation and is now on his second round of a six-week course of Vancomycin, a last-resort antibiotic for fighting MRSA.<\/p>\n

Infection rates are high in conflict zones, where bullets or other debris often pierce the skin and treatment is delayed or inadequate. Now, doctors from M\u00e9decins San Fronti\u00e8res face a further complication to recovery rates: \u201chorrifying levels\u201d of antibiotic resistance in its trauma clinics across the Middle East.<\/p>\n

\u201cThere are patients from Iraq, Yemen, Palestine and Syria where they have had acute injury as a result of conflict and they have had inadequate follow-up,\u201d says Clair Mills, one of MSF\u2019s medical directors. \u201cThese are patients with fractures that have never healed, or with chronic nerve injuries from burns. Where people have injuries to bone, the majority are coming in with antibiotic-resistant organisms.\u201d<\/p>\n

In Gaza, the number of Palestinians shot by Israeli forces in clashes at the border since protests<\/a> began on 30 March 2018 has declined significantly since May, when 6,000 people were killed or injured.<\/p>\n

Last year, MSF tripled its capacity in Gaza because it was believed that most patients might be suffering from multi-resistant organisms like MRSA.Until April, however, doctors lacked the specialised labs to test their theory.<\/p>\n

\"\"<\/a>

A patient receives physical therapy in a dedicated exercise room.
Photograph: Loay Ayyoub\/The Guardian<\/p><\/div>\n

Since then, bone and tissue biopsies have shown that 83% of patients seen by MSF in Gaza have infections. Of those with infections, 62% have multi-resistant organisms like MRSA.<\/p>\n

Such infections further complicate the treatment of complex fractures. Patients must be isolated, which takes a huge psychological toll.<\/p>\n

Dr Mohammed Abu Mughaiseeb, of MSF in Gaza, says: \u201cInfections of the bone are very difficult. The micro-organism is embedded within the bone. These patients will have to have three to five surgeries over three years to fix the injury. Many of them need to be isolated in a special room with special precautions for patients and for workers.<\/p>\n

\u201cIf patients are not treated properly, they could end up with amputation. It is a very sensitive topic.\u201d<\/p>\n

No one can enter the isolation unit of al-Awda hospital without wearing scrubs. Nasser\u2019s room has two beds and a TV. One of the beds is for visitors but he hasn\u2019t had any, he says. The injury has taken a toll on his relationships as well as his earnings. He now receives a small amount from a Qatari charity, which has been helping those injured during the protests.<\/p>\n

\u201cI feel pain all the time, the pain doesn\u2019t stop,\u201d says Nasser. \u201cI went through a difficult time psychologically as a result of the injury. My relationship with my family is bad. I thought about suicide many times. I was depressed. I went to the border many times and got close to the fence, but I wasn\u2019t shot.\u201d<\/p>\n

Before coming to the trauma clinic, Nasser spent nine weeks in intensive care at a health ministry hospital. MSF doctors stopped him killing himself, he says. \u201cNow I wish to be healed and return to normal life.\u201d<\/p>\n

In Gaza, antibiotics are available over the counter at pharmacies without a prescription. This leads to misuse, with the drugs frequently used when they are not needed, treatment courses not completed, or inadequate doses taken \u2013 all of which increase the risk of bacteria developing resistance.<\/p>\n

In addition, Gaza\u2019s health system has been weakened by a decade of blockades and lacks good quality antibiotics and adequate surveillance.<\/p>\n

\"\"<\/a><\/p>\n

Read more: Gaza border protests: 190 killed and 28,000 injured in a year of bloodshed<\/strong><\/a> <\/em><\/p><\/blockquote>\n

Dr Mohammed Barayka, an antibiotic specialist at the al-Awda hospital, says patients are tested if they are suspected of having antimicrobial resistance.<\/p>\n

\u201cWhen doctors feel the patient suffers from constant pain, the wound does not heal and there\u2019s fever at night, we do a bone biopsy,\u201d he says. \u201cWe used to send the samples to a lab in Tel Aviv, Israel but now we send them to a health ministry hospital in Gaza. We get the results after five to seven days.\u201d<\/p>\n

In the majority of cases the tests are positive, he says. \u201cMRSA is widespread in the Gaza strip.<\/p>\n

\u201cWe had one case of a 17-year-old boy who had received the protocol three times, but his body didn\u2019t heal the wounds and he lost his leg.\u201d<\/p>\n

At least 170 Palestinians became permanently disabled as a result of gunshot wounds in the first year of the border protests, mainly due to amputation, according to World Health Organi<\/a>zation data<\/a>.<\/p>\n

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Some suffer such physical and psychological pain that they go to the border in the hope of being shot, says psychologist Mohamoud Awad.
Photograph: Loay Ayyoub\/The Guardian<\/p><\/div>\n

Mohamoud Awad, a psychologist, says some suffer such physical and psychological pain that they go to the border of Gaza and Israel, in hope of being shot dead by an Israeli sniper.<\/p>\n

\u201cEvery injury causes trauma to the patients and it depends on each one and the support they receive,\u201d says Awad. \u201cThey become nervous. They talk to us constantly about family problems. Their financial problems get worse after injury. Many complain that friends have been cured of their injuries but they are still infected. They become frustrated \u2026 whether it\u2019s isolation or mental illness, many have lost hope and say the future is very dark.<\/p>\n

\u201cI do not have any accurate statistics on cases of attempted suicide, because there have been cases outside the clinic and some of them in a non-traditional way (returning to the border and approaching the fence), but there are certainly attempts.\u201d<\/p>\n

___________________________________________________<\/p>\n

\"\"<\/a><\/em><\/p>\n

Karen McVeigh has been a senior news reporter for the<\/em> Guardian since December 2006. Before that, she freelanced for the<\/em> Times following a five-year stint as<\/em> The Scotsman’s London correspondent.<\/em><\/p>\n

 <\/p>\n

Go to Original \u2013 theguardian.com<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

5 Dec 2019 – The suffering of people wounded in conflict zones is being compounded by what doctors say are \u2018horrifying levels\u2019 of antibiotic resistance. \u201cI thought about suicide several times,\u201d says Nasser, 28, a former blacksmith. \u201cI was wishing the Israeli soldier [who shot me] had killed me with the bullet.\u201d<\/p>\n","protected":false},"author":4,"featured_media":150228,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[54],"tags":[1571,120,1030,87,267,1029,487,88,771,1027,427,85,109,287,1572,985,880,292,70,126,1025,886],"class_list":["post-150223","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-palestine-israel-gaza-genocide","tag-apartheid-wall","tag-conflict","tag-fatah","tag-gaza","tag-geopolitics","tag-hamas","tag-human-rights","tag-israel","tag-nakba","tag-oslo-accords","tag-palestine","tag-palestine-israel","tag-politics","tag-power","tag-settlers","tag-social-justice","tag-state-terrorism","tag-un","tag-usa","tag-violence","tag-west-bank","tag-zionism"],"_links":{"self":[{"href":"https:\/\/www.transcend.org\/tms\/wp-json\/wp\/v2\/posts\/150223","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.transcend.org\/tms\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.transcend.org\/tms\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.transcend.org\/tms\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.transcend.org\/tms\/wp-json\/wp\/v2\/comments?post=150223"}],"version-history":[{"count":0,"href":"https:\/\/www.transcend.org\/tms\/wp-json\/wp\/v2\/posts\/150223\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.transcend.org\/tms\/wp-json\/wp\/v2\/media\/150228"}],"wp:attachment":[{"href":"https:\/\/www.transcend.org\/tms\/wp-json\/wp\/v2\/media?parent=150223"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.transcend.org\/tms\/wp-json\/wp\/v2\/categories?post=150223"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.transcend.org\/tms\/wp-json\/wp\/v2\/tags?post=150223"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}