Doctors in Gaza and the West Bank warn they are battling an epidemic of antibiotic-resistant superbugs, a growing problem in the world’s conflict zones and one that risks spilling over borders and diminishing the global medical arsenal against serious illness.
The rise and spread of these virulent infections adds to the devastation of war, increasing medical costs, blocking hospital beds because patients need longer care and leaving people whose injuries might once have been healed with life-changing disabilities.
Gaza is a particularly fertile breeding ground for superbugs because its health system has been crippled by years of blockade and antibiotics are in short supply. Even though doctors know the protocols to prevent the rise of drug resistant bacteria, they do not have supplies to follow them.
Shortages of water, power and fuel for generators mean doctors often cannot meet even basic hygiene standards. Staff sometimes can’t even wash their hands, sterilising machines are unreliable, and there are shortages of gloves, gowns and chlorine tablets for sanitising the hospitals, medical professionals say.
“This is a global health security issue because multi-drug resistant organisms don’t know any boundaries,” said Dina Nasser, lead infection control nurse at Augusta Victoria hospital in East Jerusalem who has also worked in Gaza. “That’s why the global community, even if it’s not interested in the politics of Gaza, should be interested in this.”
Decade-long Israeli restrictions on travel and trade mean Gaza is relatively isolated compared to conflict areas that have also proved fertile ground for super-bugs like Syria or Iraq.
The spread of one drug-resistant bacteria from Iraq was noted by the US military over a decade ago; they logged such a huge rise in injured personnel returning with resistant Acinetobacter that the bacteria was eventually dubbed ‘Iraqibacter’.
Gaza is not totally isolated. Small numbers of patients do cross its borders to transfer to other hospitals in Palestine, to Israel and to nearby countries like Jordan, Egypt and Lebanon.
Healthy people can also carry the bacteria without showing any symptoms, so workers, doctors and aid workers traveling in and out of Gaza could carry superbugs to other countries, where they could cause hard-to-treat infections. The super-bugs can also travel without human hosts.
“It will always get out,” said Dr Ghassan Abu Sittah, who also studies conflict medicine at the American University of Beirut Medical Center. “The untreated sewage from Gaza containing multi-drug resistant bacteria goes into the aquifer” which also supplies Egypt and Israel.
“There are papers from Scotland that show actually multi-drug resistant bacteria can be found in the pellets of migrating birds. The idea anyone could be immune to this phenomena is absurd.”