Densely-populated Gaza prepares to face COVID-19

Hamas-run Health Ministry says it urgently needs more than $20 million to stave off the collapse of Gaza's health system if there is a major outbreak of coronavirus.

GAZA - Although the Gaza Strip has been cut off from the world for years by an Israeli-Egyptian blockade, it has not been spared the presence of the novel coronavirus, with 10 confirmed cases of COVID-19 raising the terrifying possibility of a large outbreak in one of the world's most crowded territories.

The blockaded Palestinian enclave's Islamist rulers Hamas have begun building two massive quarantine facilities, hoping to prevent the disease from spreading and overwhelming a health system shattered by years of economic stagnation due to the blockade. 

Several wars between Hamas and the Israeli army since 2000 have also caused long-lasting damage to Gaza's infrastructure, while political infighting between Hamas and the rival Palestinian Authority in the West Bank means Gaza is chronically under-funded.

The virus can cause severe illness and death, particularly in older patients or those with underlying health problems. High rates of obesity, smoking and stress-related disorders appear to make Gaza’s population especially vulnerable. Many people in Gaza also live in crowded refugee camps and densely populated cities. Gaza is one of the most densely populated territories in the world.

Quarantine measures

The construction of the new quarantine facilities was ordered by Hamas leader Yahya Sinwar after photos spread on social media from makeshift quarantine centers showing people ignoring the social distancing advice that much of the world's population has been advised to heed during the global pandemic.

Gazans who were supposed to be isolated to prevent the disease spreading were instead seen socialising with visitors and sharing group meals and shisha together.  Meanwhile seven members of Hamas' security forces, who were guarding the facility housing the first two people with confirmed virus cases, became infected themselves.

UNRWA, the UN Palestinian refugee agency, had converted its schools into medical clinics in order to protect vulnerable patients at other medical facilities from COVID-19. The Hamas-run Health Ministry took similar measures, converting two schools into quarantine centers, but those measures were criticised by Gazans who said the schools were unsuitable for quarantine purposes, after reports that multiple people were asked to sleep together in a single room with few measures to enforce isolation and distancing.

Hamas has since sought to beef up its quarantine efforts, opening 18 additional facilities in clinics and hotels and declaring them off-limits. It also has banned weekly street markets and shut down wedding halls, cafes and mosques and extended quarantine periods by a week.

Qatar, which provides extensive humanitarian aid to Gaza, has also stepped in, pledging $150 million in aid and providing furniture, clothes and electrical appliances for the quarantine centers. Qatar's financial assistance to Gaza has been occasionally criticised by the PA which says Doha is undercutting the internationally recognised Palestinian government by providing funding to Hamas.

In the meantime, residents of Gaza may perhaps be too willing to accept Hamas' assurances that the coronavirus has been contained, and that all affected patients are being held in quarantine centers. Despite the shutdown orders, people still walk the streets and congregate around small coffee kiosks and food stalls.

Dr. Yahia Abed, an epidemiologist, said the public's apparent lack of commitment to safety precautions is worrisome and that anyone who might have been exposed to the virus must go into full and enforceable isolation.

“If, God forbid, people hid the fact that they had contact with the infected, this will be very dangerous for an area like Gaza. The epidemic will spread,” Abed, a public health professor at Al-Quds university near Jerusalem, told the Associated Press news agency.

Israeli policies

The Gaza Health Ministry says it urgently needs more than $20 million to stave off the collapse of the health system if there is a major outbreak. One key hurdle for Gazan authorities to overcome is the lack of testing people for the virus. COGAT, the Israeli military body responsible for overseeing Israel's occupation of Palestinian territory, said it has coordinated the delivery of hundreds of coronavirus testing kits by the World Health Organization, as well as protective equipment, medicine and disinfectant.

Israel, along with most Western nations, considers Hamas a terrorist group and says the blockade is a necessary step towards preventing attacks on Israeli citizens. But it likely fears the fallout from a catastrophic outbreak would spill over the frontier.

Palestinians in Gaza had staged protests throughout the last year along the fence that separates the blockaded enclave from southern Israel. Those protests, called the "March of Return", demanded that Israel allow Palestinians to return to the ancestral lands they were expelled from in the 1948 war that founded the Israeli state. A mass protest scheduled for March 30, to mark the second anniversary of the protest movement, was cancelled due to coronavirus fears.

Gazan doctors and medics also said they would be switching their focus to battling the coronavirus. The presence of medics at the border protests had been hugely important as Palestinian protesters faced up against Israeli soldiers who fired live ammunition.

Protests had been scheduled along the Gaza fence on Monday for the annual "Land Day", held by Palestinians to commemorate the killing of six Arab-Israelis (Palestinian citizens of Israel) by Israeli security forces, during a 1976 march against Israeli plans to seize large sections of Palestinian land in the north of the country.

The annual event usually sees thousands of Arab-Israelis and Palestinians take to the streets in demonstrations against Israeli policies. But this year with Israel and the Palestinian territories locked down to limit the spread of COVID-19, organisers gave speeches online instead, and people in both the occupied West Bank and the blockaded Gaza Strip were encouraged to mark the day at home.

Dr. Gerald Rockenschaub, the World Health Organization’s director in the Palestinian territories, says there is still time to improve quarantine procedures in Gaza. “The issue is to move quickly and mobilize support to get them on the way to meet the right international standards,” he told the AP news agency.

“But this is obviously easier said than done in Gaza, where there is substantial shortage in almost everything.”