Coronavirus threat now is real in Gaza, with Israel’s policies triggering twin crises

Laura El Hayek
Researcher, ImpACT International for Human Rights Policies

Ever since the first person with the novel coronavirus was detected in Wuhan, China, in December, virtually the entire world – except for the Gaza Strip – reported mounting infections, with a smaller but still alarming death rate. Some believed Gaza would escape the reach of the pandemic due to the rigid restrictions on who is allowed to enter Gaza, long imposed by the governments of Israel and Egypt.

However, the specter of the virus entering the blockaded coastal enclave now is an inescapable reality. On 24 August, Gaza’s Ministry of Health recorded the first four cases of COVID-19 outside its quarantine facilities, causing panic and tension in light of the extremely fragile state of the health sector in the Strip.

How the 14-year-long blockaded coastal enclave will cope with a crisis that has crippled even the largest developed countries is an open question. 

While the previously robust health sectors of developed Western countries strain and sometimes collapse under the coronavirus onslaught, health care facilities in the Gaza Strip have been operating on a shoestring for over a decade, due to the Israeli blockade. How they will cope with a crisis that has crippled even the largest developed countries is an open question.

Classified as one of the most densely populated areas in the world (​​365 square meters and a population of about 2 million), the Gaza Strip suffers from a chronic shortage of medicines, equipment, infrastructure and staff. A COVID-19 outbreak will overwhelm what meager preparedness the Gaza Strip can muster.


Barriers to entry of essential medical supplies

In 2005, Gaza officials reported a 16% shortage of essential medicines. Then the Israeli government imposed the blockade, dramatically increasing the gap between needs and available supplies to 52% by January 2020. That same month, the number of hospital beds available per 1,000 persons dropped to 1.4. Patients who need elective surgery must wait up to 16 months.  Gaza’s representative to the World Health Organisation, Dr. Abdul Naser Soboh, has issued a plea for relief of the acute shortage in medicines and equipment.  

Meanwhile, only a limited supply of coronavirus test kits is available, according to Ministry of Health spokesperson Ashraf al-Qedra, M.D., on 26 August.


Targeting of medical staff

The Israeli blockade also has halted most travel out of Gaza by medical staff, preventing them from further developing their skills via educational courses, workshops and medical conferences. Either the Rafah crossing into Egypt is closed or accepting only a small percentage of those who want to travel, of the Israeli authorities ’refuse to issue a permit for the travelers to cross.

Likewise, during the recent protests along Gaza’s border with Israel, medical staff who treated the injured appeared to be deliberately targeted. Four paramedics were killed and 685 health providers injured; about 120 ambulances were damaged. All of these incidents were a result of direct targeting.

Israel’s periodic wars on Gaza also targeted medical staff.

“At least two ambulance workers were killed and at least 35 were injured by the Israeli army (during the 2014 war),” notes Dr. Bashar Murad, director of Palestinian Red Crescent Society’s (PRCS) emergency and ambulance unit in Gaza.

Israeli authorities appear to have as a goal destruction of the health sector in the Gaza Strip by eroding its medical capacity. And now that the coronavirus has invaded, the Strip is highly vulnerable.

If Israel does not lift its restrictions on the Gaza Strip, thus allowing the entry of fuel and medical supplies and the exit of patients needing urgent, advanced care, it will be responsible for twin crises that amount to a real humanitarian disaster


Systematic destruction of infrastructure

Destruction of health facilities themselves also is common. During their 2014 "Operation Protective Edge," Israeli forces damaged 75 hospitals, medical clinics and primary health centers. One hospital (al-Wafaa Hospital) and five primary health centers were completely destroyed, two hospitals and five clinics were severely damaged, and 63 facilities suffered minor damage. On 19 July, 2014, Shuhadaa al-Aqsa Hospital in central Gaza was hit by a barrage of tank shells, destroying the operating rooms and life-saving units in the hospital.

During the 2012 military campaign on the Gaza Strip, which lasted for eight days, Israeli forces damaged or destroyed 16 hospitals and medical clinics, in addition to six ambulances, and injured three medical workers. Before that, during the 2008-2009 "Operation Cast Lead,” Israeli forces damaged or destroyed 58 hospitals and medical clinics, and 29 ambulances. A number of medical workers were targeted as well—killing 16 and wounding 26.


Fuel for electricity in short supply

Also crippling the ability of Gaza’s health sector is a continuous shortage of fuel for electricity. The start of the crisis was an Israeli airstrike in June 2006, which targeted the Gaza Power Plant. The plant hasn’t been fully operational since then.

Six years ago, on 29 July, 2014, the plant was again hit by Israeli bombing during Israel’s "Operation Protective Edge." The plant shut down, paralyzing the health sector.

Furthermore, Israeli authorities frequently impose a ban on fuel imports as punishment when Palestinians fail to follow their wishes. This practice is a serious threat to the lives of thousands of patients, with many patients dying. 

If Israel does not lift its restrictions on the Gaza Strip, thus allowing the entry of fuel and medical supplies and the exit of patients needing urgent, advanced care, it will be responsible for twin crises that amount to a real humanitarian disaster.


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