Coronavirus testing re-started in the Gaza Strip after 480 testing kits purchased by the World Health Organization (WHO) reportedly arrived in the enclave on Sunday night. The Palestinian health ministry had warned of a critical health situation in Gaza after the central laboratory ran out of supplies to process COVID19 tests last week.

Ashraf al-Qudra, spokesman for the health ministry, pointed out last Thursday that the absence of such supplies would cause a large backlog of pending tests, and delay the procedures for ending the isolation of hundreds of quarantined people as a result. In a news briefing on Saturday, Qudra appealed to the international community and relief organisations to help Gaza face the pandemic by procuring vital medical and lab necessities.

As of 14 April, there were 13 confirmed cases of COVID19 in the coastal strip, nine of them having recovered and four, in a stable condition, remaining in isolation at Rafah crossing field hospital, on the border with Egypt.

“Even before the disease epidemic, Gaza capacity was under heavy strain because of more than a decade of severe restrictions on movement of goods and people”, Suhair Zakkout, the International Committee of the Red Cross (ICRC) spokeswoman in Gaza, stressed, “the already shaken health system will be incapable of handling a coronavirus outbreak”.

Fears of rapid contagion

Officials and aid workers have voiced serious concern that a shortage of essential equipment and medical supplies could trigger rapid contagion in the besieged territory, 365 square kilometres in area and home to a population of two million people.

Currently, the Strip has some 2,500 available beds; its 13 hospitals have only 110 intensive care unit (ICU) places, of which the majority are occupied. There is a 50% shortage of medication and medical facilities, and just 93 ventilators are available.

Public primary healthcare facilities are operating at limited capacity, providing key services only, in an attempt to further curb the spread of the virus. There is an acute scarcity of essential drugs, medical disposables, equipment necessary for medical examination, and specialised health professionals. Based on ICRC estimates, Gaza would currently only be able to deal with 100-150 coronavirus cases.

Social distancing is hardly feasible in the small enclave, one of the most densely populated places on earth, where the majority of the inhabitants live in tightly-packed refugee camps, making essential hygiene and infection control a huge challenge.Gaza on the edge

“Gaza is on the edge”, Aseel Baidoun. Advocacy and Communications Officer at Medical Aid for Palestinians (MAP), highlighted with alarm, “its health sector has endured three devastating wars waged by Israel, then more Israeli military aggression during the Great Return March protests, and the illegal blockade has made the situation dire all along.”

Hamas authorities in Gaza have imposed a series of measures to stem the spread of the novel virus, such as closing all mosques, schools, universities, markets, restaurants and event halls until further notice. Citizens returning to Gaza through the crossings with Israel and Egypt have been quarantined since 15 March in one of 27 designated quarantine centres including health facilities, schools or hotels. The quarantine period was recently extended from two weeks to 21 days.

“When I heard of the first coronavirus cases, I was in panic. I knew all we needed was just one case, then it would spread out like a fire. Thankfully things are under control, but people are still apprehensive about it”, commented Rana Shubair, a writer and activist from Gaza.

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Gaza has been under an Israeli land, sea and air siege since Hamas seized control in 2007. Israel restricts the movement of people in and out, imports are limited and exports banned, while also controlling such vital sectors such as electricity and water. Routine fuel shortages, power cuts and contaminated water make daily life a nightmare in the enclosed and embattled strip. Three all-out Israeli military assaults have left much of Gaza’s health infrastructure damaged.

Isolation nothing new

Moreover, the Israeli government also restricts the import of huge quantities of materials it considers are "dual-use" (civil and military). These include basic building materials and health equipment, both of which might presumably be misused by Hamas and armed groups in Gaza. As such, every import of a good or material on the dual-use list must be approved by the relevant Israeli authorities.

“Isolation is not something new to Gaza, but being further isolated makes it very stressful”, Gaza ICRC spokeswoman said, noting that under the present conditions – when there’s no electricity and no chance to stay in touch via the Internet – it becomes a double lockdown for Gazans.

The Israeli closure has produced untenable conditions throughout the Gaza Strip. A UN report in 2012 warned that Gaza would become uninhabitable by 2020. The prediction of unliveability has arrived as conditions in the Palestinian enclave have turned increasingly hostile to sustainable life.

Construction of a field quarantine hospital, intended to isolate those suspected to be infected with COVID-19 on their return to Gaza, 23.03.2020 (photo: ICRC/Abed Zagout) — Gaza's Hamas-run government temporarily re-opened the Rafah border crossing with Egypt on Monday, shut due to the novel coronavirus pandemic, to allow hundreds of Palestinians to return. One-way traffic would be allowed for the coming four days, Gaza's interior ministry said. All those returning would be put into compulsory 21-day quarantine which could be extended, interior ministry spokesman Iyad al-Bozm said. How many will end up in this field hospital - here under construction in March - remains to be seen

The World Bank estimated that above 50% of Gaza’s population is unemployed, with youth unemployment exceeding 70% and roughly half of the residents living below the poverty line. More than two-thirds of households are food insecure and a scant 3% of the water is safe to drink, according to official statistics and aid agencies.

No sign of Israel relenting

In its efforts to confront the pandemic, Gaza mostly needs medical supplies, respirators, laboratory test kits for COVID19 detection. Hospitals which depend on 24-hour access to electricity are unable to perform life-saving surgeries. With greater use of heavy generators, the maintenance required has increased, which is difficult to provide as spare parts are restricted from entry to Gaza. Most of the medical equipment is either out of date or broken beyond repair.

“The health ministry has been operating under a state of emergency for years. If there’s an outbreak, it won’t be able to handle any new cases that might burst in large numbers”, said a concerned Shubair.

There have been multiple calls to pressure Israel to agree to allow the entry of medicines and health assistance to Gaza, yet there is no sign that the Israeli government might ease the siege.

In a joint statement last week, MAP and 18 Israeli, Palestinian and international organisation called on Israel to lift the closure on Gaza so as to permit safe and swift access for medical personnel, supplies and equipment alongside aid agencies.

Alessandra Bajec

© Qantara.de 2020

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