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The number of new cases in Sierra Leone remains alarming and the coming weeks will be crucial. В In addition to the difficulties generated by the economic blockade, internal problems have been added this past year. With two competing health authorities one under the Palestinian Authority and the other under Hamas, Palestinian health professionals found themselves caught in a conflict of interests conflicting instructions, access to obstructed care and difficulties for health personnel to work according to political affiliations, reduce the quality of care. Subsequently, with a forceps mosquito with very sharp tips Figure 2, a minimal hole is made in the skin, the vas deferens is removed and the segment of the vas deferens that goes to the prostate is cut and coagulated.

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