A/HRC/8/17 page 11 Internal Security Service reported that there had been an increase in the exploitation of Israel’s humanitarian policy by way of Gazan doctors issuing fraudulent medical permits in return for bribes, claiming that requests of “terrorist activists” to enter Israel for medical treatment had increased the danger to State security.33 23. Moreover, according to the Palestinian Ministry of Health in Ramallah, on 21 April most ambulances in Gaza stopped working due to the lack of fuel. According to the Ministry, fuel shortages and the constant electricity outages also resulted in a diminished ability to sterilize medical equipment, and in non-operational medical equipment. The Ministry also stressed that back-up generators used to maintain the function of life-sustaining medical equipment only had capacity to operate for a very limited period of time.34 24. In relation to the right of everyone to the enjoyment of the highest attainable standard of mental health, the closure and the frequent military incursions had a negative effect on the psychosocial well-being of Gazans. During the first two weeks of March, UNRWA’s Community Mental Health Programme screened 39,000 students from UNRWA schools in the north of Gaza to determine the extent of exposure and reaction to the military incursions in February and March 2008. UNRWA found that 790 students were exposed to traumatic events, including 281 who had a relative killed, 199 who saw mutilated bodies and 101 whose homes were damaged.35 During the same period, UNRWA counsellors provided group and individual counselling to these 790 children, 94 per cent of whom showed significant post-traumatic reactions and potential for developing Post-Traumatic Stress Disorder. A study conducted by the Islamic University Psychology Department on 244 families of the Gaza Strip in February 2008, showed behavioural changes and increased psychosocial problems among children: fears (61 per cent), anxiety (63 per cent), anger (45 per cent), sleeping difficulties (43 per cent), school absenteeism (40 per cent), lack of concentration at school (50 per cent), difficulties completing homework (47 per cent) and no desire to engage in recreational or educational activities (51 per cent).36 25. Regarding access to education, the fuel shortages resulting from the restrictions on the quantities of fuel available to Gaza residents, the strike declared by the Gaza Petrol and Gas Station Owners Association, and the continued closure of the Nahal Oz crossing to supplies of petrol and diesel, almost entirely paralysed Gaza’s transportation system.37 According to 33 Jerusalem Post, 21 April 2008, http://www.jpost.com/servlet/ Satellite?cid=1208422652388&pagename=JPost%2FJPArticle%2FshowFull. 34 Ministry of Health press release, 21 April 2008. 35 OCHA, Gaza Strip Inter-Agency Humanitarian Fact Sheet, March 2008. 36 Ibid. 37 Gaza Fuel Restrictions: Walking Toward Crisis, Gisha-Legal Centre for Freedom of Movement, 17 April 2008. See also PCHR, Press Release, 14 April 2008.