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Concept: Hamas


Coeliac disease is an important clinical disorder affecting the human gastrointestinal tract leading to multiple signs and symptoms in different body organs. This disease was the subject of a cross sectional descriptive-analytic study conducted in the Gaza Strip during 2010. Objectives were oriented to identify and verify several variables and attributes affecting the prognosis of coeliac disease in the patients. Ninety five children out of 113 patients were arranged into two groups according to age from 2 to 11 years and from 12 to 18 years old. Results showed the poor interest of health professionals regarding coeliac disease in the Gaza Strip. The mean age of study population was 5.47 years for males and 8.93 years for females. The lifestyle of coeliac patients was directly proportional with better nutritional indictors. Poor recognition of the emblem illustrating gluten in foods implicates effective health awareness or promotion. The more knowledgeable patients or mothers (P = 0.036) were the more compliant. The compliance to giving gluten free foods outside home was statistically significant (P = 0.037). Similarly, cautious approach when buying foods or detergents (P = 0.011). According to BMI 74.4%, 23.4% and 3.2% of all patients were normal, underweight and overweight respectively. Albumin blood level was normal in 32.6% and low in 67.4%. Meanwhile, blood calcium level was normal in 76.8%, low in 21.1% and high in 2.1% of all patients. Conclusion: The study showed that recreation and social activities for coeliac patients are substantially missing in the Gaza Strip. Moreover, the study proved that AEI is a reliable centre for care of coeliac disease patients and conducting relevant studies. Recommendation: There is a need for thorough and continuous community and institutional mobilization regarding coeliac disease in the Gaza Strip and in Palestine.

Concepts: Hamas, Coeliac disease, Second Intifada, Gaza, Palestinian National Authority, Palestinian territories, Gaza Strip, Gluten-free diet


This article focuses on child health in the Palestinian refugee camp of Dheisheh in the West Bank region of the Occupied Palestinian Territories. Thirty in-depth interviews were carried out with parents to determine their perceptions of their children’s health. The questions related to physical, mental and social well-being, access to health facilities, factors that were likely to hinder health and measures that could be implemented to improve child health. The study was carried out prior to and during the Gaza War in December 2008 that resulted in the deaths of 1380 Palestinians including 431 children and 112 women [1]. The effects of occupation, conflict and being a refugee had a detrimental impact on perceptions of health. Interviewees revealed that their perceptions of their children’s health were determined by the camp’s conditions, the current economic climate, past and current political conflict and financial and social restrictions. The understanding of being healthy incorporated physical and mental health as well as social well-being. As a result, 70% of interviewees deemed that their children were not in good health. This finding accelerated to 100% after the Gaza War, showing the negative effect war has on health perceptions. Findings showed that perceptions of physical health are very much interlinked with mental well-being and parents' perceptions of their children’s health, and are closely related to their state of mental health. Consequently, a clear correlation can be discerned between the ongoing occupation and its detrimental effects on mental health. Therapeutic and preventive health programmes such as child therapy and stress management that have already been implemented by the Gaza Community Mental Health Programme would be highly beneficial to both children and adults in Dheisheh refugee camp.

Concepts: Hamas, Palestinian people, West Bank, Palestinian territories, Gaza, Gaza Strip, Jordan, Israel


BACKGROUND: β-Thalassemia is a disorder caused by mutations at the hemoglobin β-gene (HBB) locus. Its most important manifestation, the major form, is characterized by severe hypochromic and hemolytic anemia and is inherited in an autosomal recessive mode. In Gaza Strip, Palestine 0.02% of the population has been identified as β-thalassemia major. DESIGN AND METHODS: An assessment of mutations was performed in 49 transfusion dependent patients with β-thalassemia major and in 176 β-thalassemia carriers diagnosed with a mean erythrocyte cell volume (MCV) <80fl and a proportion of HbA(2)>3.5%. In addition 39 individuals suspicious for β-thalassemia carrier status due to a reduced MCV (<80fl) but a normal HBA(2) were screened. RESULTS: By screening with three hybridization assays a proportion of 80% of the thalassemic chromosomes from patients and carriers was identified to carry five different mutations of the hemoglobin (Hb) β-gene. Subsequent DNA sequencing confirmed these and revealed further 9% of the chromosomes to be affected by other mutations. In addition six chromosomes from suspicious carriers were detected to carry β-thalassemia mutations. Of the 15 different HBB mutations identified the variant IVS-I-110 G>A was the most frequent mutation identified in 34% of the thalassemic chromosomes, followed by IVS-I-1 G>A, IVS-I-6 T>C, Codon 39 C>T, and Codon 37 G>A. Three novel HBB variants were discovered by direct sequencing of the gene: 5' UTR-50 (-/G), 5' UTR-43 C>T, and IVS-II-26 T>G. CONCLUSIONS: The spectrum of HBB mutations described is of the Mediterranean type whereby the allele frequencies of the most common mutations differ from those, which were previously described for the population of the Gaza Strip and other Palestinian populations. The data presented may promote the introduction of molecular testing to the Palestinian premarital screening program for β-thalassemia in Gaza Strip, which will improve the screening protocol and genetic counseling in the future.

Concepts: Second Intifada, Hamas, Gaza, Palestinian National Authority, Palestinian territories, Israel, DNA, Gaza Strip


The United Nations Relief and Works Agency for Palestine refugees in the Near East (UNRWA) has periodically estimated infant mortality rates among Palestine refugees in Gaza. These surveys have recorded a decline from 127 per 1000 live births in 1960 to 20.2 in 2008.

Concepts: Demography, Yasser Arafat, United Nations Relief and Works Agency for Palestine Refugees in the Near East, Second Intifada, Gaza, Infant mortality, Hamas, Gaza Strip


The late president of the Palestinian Authority, Yasser Arafat, died in November 2004 in Percy Hospital, one month after having experienced a sudden onset of symptoms that included severe nausea, vomiting, diarrhoea and abdominal pain and which were followed by multiple organ failure. In spite of numerous investigations performed in France, the pathophysiological mechanisms at the origin of the symptoms could not be identified. In 2011, we found abnormal levels of polonium-210 ((210)Po) in some of Arafat’s belongings that were worn during his final hospital stay and which were stained with biological fluids. This finding led to the exhumation of Arafat’s remains in 2012. Significantly higher (up to 20 times) activities of (210)Po and lead-210 ((210)Pb) were found in the ribs, iliac crest and sternum specimens compared to reference samples from the literature (p-value <1%). In all specimens from the tomb, (210)Po activity was supported by a similar activity of (210)Pb. Biokinetic calculations demonstrated that a (210)Pb impurity, as identified in a commercial source of 3MBq of (210)Po, may be responsible for the activities measured in Arafat's belongings and remains 8 years after his death. The absence of myelosuppression and hair loss in Mr Arafat's case compared to Mr Litvinenko's, the only known case of malicious poisoning with (210)Po, could be explained by differences in the time delivery-scheme of intake. In conclusion, statistical Bayesian analysis combining all the evidence gathered in our forensic expert report moderately supports the proposition that Mr Arafat was poisoned by (210)Po.

Concepts: Fatah, Hamas, Mahmoud Abbas, Gaza Strip, Palestinian people, Second Intifada, Palestinian National Authority, Yasser Arafat


Historically, dehumanization has enabled members of advantaged groups to ‘morally disengage’ from disadvantaged group suffering, thereby facilitating acts of intergroup aggression such as colonization, slavery and genocide. But is blatant dehumanization exclusive to those at the top ‘looking down’, or might disadvantaged groups similarly dehumanize those who dominate them? We examined this question in the context of intergroup warfare in which the disadvantaged group shoulders a disproportionate share of casualties and may be especially likely to question the humanity of the advantaged group. Specifically, we assessed blatant dehumanization in the context of stark asymmetric conflict between Israelis (Study 1; N = 521) and Palestinians (Study 2; N = 354) during the 2014 Gaza war. We observed that (a) community samples of Israelis and Palestinians expressed extreme (and comparable) levels of blatant dehumanization, (b) blatant dehumanization was uniquely associated with outcomes related to outgroup hostility for both groups, even after accounting for political ideologies known to strongly predict outgroup aggression, and © the strength of association between blatant dehumanization and outcomes was similar across both groups. This study illuminates the striking potency and symmetry of blatant dehumanization among those on both sides of an active asymmetric conflict.

Concepts: Conventional warfare, Terrorism, Israel, Unconventional warfare, Guerrilla warfare, Asymmetric warfare, Hamas, War


The links between two commonly used measures of health-self-rated health (SRH) and self-reported illness (SRI)-and socio-economic and contextual factors are poorly understood in Low and Middle Income Countries (LMICs) and more specifically among women in conflict areas. This study assesses the socioeconomic determinants of three self-reported measures of health among women in the occupied Palestinian territories; self-reported self-rated health (SRH) and two self-reported illness indicators (acute and chronic diseases). Data were obtained from the 2010 Palestinian Family Health Survey (PFHS), providing a sample of 14,819 women aged 15-54. Data were used to construct three binary dependent variable-SRH (poor or otherwise), and reporting two SRI indicators-general illness and chronic illness (yes or otherwise). Multilevel logistic regression models for each dependent variable were estimated, with individual level socioeconomic and sociodemographic predictors and random intercepts at the governorate and community level included, to explore the determinants of inequalities in health. Consistent socioeconomic inequalities in women’s reports of both SRH and SRI are found. Better educated, wealthier women are significantly less likely to report an SRI and poor SRH. However, intra-oPt regional disparities are not consistent across SRH and SRI. Women from the Gaza Strip are less likely to report poor SRH compared to women from all other regions in the West Bank. Geographic and residential factors, together with socioeconomic status, are key to understanding differences between women’s reports of SRI and SRH in the oPt. More evidence is needed on the health of women in the oPt beyond the ages currently included in surveys. The results for SRH show discrepancies which can often occur in conflict affected settings where a combination of ill-health and poor access to health services impact on women’s health. These results indicate that future policies should be developed in a holistic manner by targeting physical and mental health and well-being in programmes addressing the health needs of women, especially those in conflict affected zones.

Concepts: Hamas, Gaza, Medicine, Palestinian National Authority, Palestinian territories, Israel, West Bank, Gaza Strip


The majority of Gazans who were killed or injured in the 2014 Israel-Gaza war were civilians, and one-fourth of the population were internally displaced. As the Gaza Strip is a small territory, the whole population was exposed to the war and its effects on the health care system, supplies and infrastructure. Our aim was to assess the overall, sex and age-group mortality in Gaza for the period July-September 2014 that was not caused by war injuries, and the proportion of non-trauma deaths among adults that occurred outside hospital wards. A comparison was made with the mortality for the same period in 2013.

Concepts: Israel's unilateral disengagement plan, Israel, Palestinian territories, Hamas, Gaza, Second Intifada, Palestinian National Authority, Gaza Strip


The purpose of the study was to estimate health expectancy for the Palestinian population and to evaluate changes that have taken place over the past 5 years.

Concepts: Hamas, Second Intifada, Palestine Liberation Organization, West Bank, Israel, Palestinian National Authority, Palestinian territories, Gaza Strip


Within a preventive framework, we outline a school-based intervention aimed at strengthening skills of survival and psychological functioning in children who have experienced war and political violence in the Gaza Strip. In accordance with a socio-ecological perspective on wellbeing and resilience, the pilot study aimed at evaluating the outcomes of a psychosocial narrative school-based intervention with a group of school-aged children in the aftermath of war. The intervention was oriented at empowering positive emotions, life satisfaction, and optimism in children as protective factors in preventing posttraumatic reactions after war. Findings showed the efficacy of the intervention in favoring life satisfaction in different ecological domains. Children in the intervention group showed greater appreciation for friends, school, family, themselves, and their living environment. At the end of the activity, children were increased the level of positive emotions, but negative feelings were stronger than before the narrative intervention. Clinical implications and future direction or community work are, then, discussed.

Concepts: Israel's unilateral disengagement plan, Israel, Palestinian territories, Hamas, Gaza, Second Intifada, Palestinian National Authority, Gaza Strip