Although infant mortality and under-5 mortality rates have fallen substantially in recent decades, they have plateaued since 2000 as a result of the worsening socio-economic environment and stresses on the health care system.36 However, the 2006 Palestinian Family Health Survey indicated that immunization coverage was high, at around 97 percent. During the war in Gaza between December 2008 and January 2009, also known as Operation Cast Lead, Israeli forces damaged 38 primary health clinics, 29 ambulances and 14 of Gaza’s 27 hospitals.37 Despite the blockade, the health facilities were repaired within a year of the conflict's end.38 Relative to other conflict-ridden zones in the region, the number of physicians is favourable in Palestine: in 2007, there were 2.2 physicians per 1,000 population (1.9 in the West Bank and 2.7 in Gaza) (box 6.4). Between 450,000 and 1.5 million Somalis have died since 1991 either as a direct result of armed clashes or because of famine caused or exacerbated by the conflict.39 This is equivalent to 10-25 percent of Somalia's population in the mid-1990s. Millions have been injured and affected by disabilities, sexual violence and disease.