COVID-19 in the Gaza Strip: a different context, and added challenges

By: Omar Shaban

The Gaza Strip needed no new challenge to deepen its tragedy and its catastrophic reality. The Gaza Strip is small in area — 200 square miles — with a population of 2 million, living under a 14-year blockade, having endured three bloody wars — 2008–2009, 2012, and 2014 — in addition to dozens of short engagements. It faces the challenge of corona with weak capacities and very limited resources.

At a time when the COVID-19 pandemic is claiming thousands of people daily across the world — including the developed and very wealthy states such as the United States and Europe, which possess health systems considered the strongest in the world — how is the Gaza Strip to face this pandemic? How can it, amid occupation and blockade and the absence of financial safety nets and the economic capacity to fight the disease's repercussions, which have reached every side of life?

In the report the United Nations issued in 2012, the Gaza Strip would be unliveable by 2020 by the standards of health, water, education, work, and the rest. The Gaza Strip has a rate of 6 hospital beds per 10,000 citizens, compared with more than 33 beds for the same number in Italy and 46 beds in Switzerland. Beyond the shortage of beds, the pharmacy shelves inside the hospitals remain empty of many medicines and even basic medical solutions — some citizens are asked to buy what they need of these medicines from pharmacies outside the hospital, for their scarcity and unavailability. Even the medical cadre — doctors, nurses, and others — have been deprived of receiving their full salaries for many years, and the restrictions on travel bar them from receiving trainings and travelling abroad except in very limited cases.

The residents of the Gaza Strip watched the appearance of COVID-19 in the world with mixed feelings of anxiety and irony. What does the closing of borders between states mean to one who has been blockaded for 14 years? What does the closing of airports and the halt of travel in the world's airports mean, when the Gaza Strip has no airport and has been barred from travel for 14 years? As the pandemic approached the Middle East region, including Israel and the Palestinian Authority's territories, it seemed that the conditions the blockade had created in the Gaza Strip — the restrictions on entry and exit — were almost a blessing upon them. At last, a wholly unintended positive side of this blockade emerged.

The number of corona cases in Palestine reached 160, 12 of them in Gaza among arrivals through the Rafah crossing with Egypt and the Beit Hanoun (Erez) checkpoint with Israel. Arrivals to Gaza have been placed since mid-March in compulsory quarantine centres — 35 centres — for 14 days. The quarantine centres, in hospitals, schools, and clinics, work fundamentally to strengthen the first line of defence against the spread of corona in Gaza, but they need increasing supplies of test kits, of which only 1,200 have entered Gaza — insufficient for the tests needed to ensure the safety of those leaving quarantine and to follow the condition of the infected at the field hospital near the Rafah crossing.

Under the state of emergency President Mahmoud Abbas declared, and which was extended, the educational institutions, places of worship, commercial markets, and some vegetable markets remain closed — replaced by dedicating scattered areas in several quarters to compensate for the closure of the central markets for selling basic foodstuffs. Many companies and civil-society institutions likewise resorted to closing their offices partially or fully, moving to work from home over the internet — which posed a further challenge to the electricity and internet distribution companies to increase the hours of electricity supply and expand the internet networks' capacity to handle the increased demand as employees and students turned to the internet to perform their usual work. The state of emergency also affected other sectors, such as transport, which previously relied on the movement of students and employees between and within the governorates, and the private sector, many of whose establishments were compelled to let workers go or cut working hours so as to keep operating while complying with the government decisions. This worsened the economic conditions of Palestinians in Gaza, where youth unemployment exceeded 75% before the current crisis — threatening their future and warning of grave consequences: rising crime rates, many young people turning to religious extremism, and other problems of far-reaching effect.

Some consumer-goods factories in Gaza's industrial zone remain at work; some factories have doubled their production capacity of medical protective supplies. For example, a local factory provides most of the hospitals' and quarantine centres' need of masks and protective suits for medical cadres and patients. Indeed this factory in the Gaza Strip has exported large quantities of masks and protective clothing to Israel. This factory and others rely entirely on importing production inputs from and through Israel.

As we have seen in many countries, the virus's first wave was confined to cases arriving from abroad, infected through mixing with carriers of the disease in the countries they came from. The infection's escape from the quarantine centres, through mixing with others in society, would have grave, uncontrollable repercussions if we take the Gaza Strip's conditions into account. The Gaza Strip suffers from the unavailability of ventilators, which can save patients' lives by supporting the respiratory functions the disease strikes in its most dangerous stages. The number of such machines in Gaza is 62, of which only 20 are not already in use by other patients not infected with the coronavirus — and some machines are unusable for being broken and needing unavailable spare parts.

The Gaza Strip has been governed by Hamas for 14 years — an organisation in a state of enmity with the neighbour Israel, in a state of ideological rivalry with Egypt, which considers Hamas and the Muslim Brotherhood terrorist movements, and in a state of political and programmatic division with the Palestinian Authority. How are three adversaries to face a new common enemy, COVID-19? Gaza relies almost entirely on three crossings: the Erez crossing with Israel, dedicated to the movement of individuals; the Karem Abu Salem (Kerem Shalom) crossing with Israel, dedicated to the entry of imports and exit of exports; and the Rafah crossing with Sinai/Egypt, dedicated to individuals.

How is this poor, blockaded Strip to face COVID-19? Will the authorities in Gaza succeed in preventing the disease's spread beyond the quarantine centres? Will the professional bodies provide, and all parties bear, their various responsibilities toward the Gaza Strip's residents? And what is the fate of those without income, and of the Palestinian travellers stranded abroad who lost their jobs and sources of income because of the global crisis? Does social distancing seem a logical, implementable solution where 2 million citizens are packed into a geographic patch of no more than 365 square kilometres? Israel knows well that the pandemic's spread in the Gaza Strip is a terrifying nightmare for it, because of the interlacing and geographic closeness with the Gaza Strip and its responsibility for it under the Geneva conventions, which oblige the occupying power to care for the people under its control.

True, Israel withdrew its forces from inside the Gaza Strip in 2005, yet it still controls the air, the land, and the sea. COVID-19 is reshaping priorities among the three parties — Hamas, Israel, and the Palestinian Authority — who were in a state of quarrel; COVID-19 compelled the three parties to unify their efforts, openly and secretly, to face a new common enemy. Political disagreement stepped aside in favour of facing the new challenge.

Did we need COVID-19 for the politicians and decision-makers to realise that the policy of blockade, mobilisation, and enmity is unsound? In 2007, with the imposition of the blockade on the Gaza Strip that came shortly after Hamas took the reins of government in Gaza, construction materials were barred from entering the Gaza Strip, and many international institutions such as USAID withdrew from working in the Gaza Strip; the health situation deteriorated and pollution spread on land and sea because of the halt of wastewater-treatment projects. When the marine pollution reached Israel's shores, the Israeli government was compelled to allow the entry of the needed raw materials and to permit certain wastewater-treatment projects, to prevent the untreated sewage — caused by the halted projects — reaching its shores.

The blockade may bar the entry of individuals and the smuggling of weapons and drugs, but it will absolutely not bar the entry of extremism, pollution, and pandemic. These lethal diseases recognise no borders, stop at no crossings, and distinguish between no one — they strike everyone. Facing them requires adversaries to join hands before friends.

COVID-19, which created a new reality that compelled three quarrelling authorities to cooperate now, will have future repercussions too. In my assessment, the policy of mobilisation and allocating budgets for war followed hitherto will change; these parties will realise that supporting health efforts is no less important than efforts in other fields — and likewise that security cannot be achieved without lifting the blockade and the restrictions and strengthening cooperation and coordination.