Despite only ten confirmed cases of the coronavirus in Gaza, with the health sector critically underequipped, Al Mezan warns of an imminent catastrophe and insists that the international community focus its efforts on the removal of the closure. For decades the illegal closure has imposed severe restrictions on the movement of people and goods, keeping the health sector on the brink of collapse. With the highly-contagious coronavirus set to spread in Gaza, the illegal restrictions—considered “collective punishment” under international law—are set to compound conditions and must be lifted.

Al Mezan’s recent investigations show a medical sector severely underequipped to deal with a pandemic spreading throughout the two million population. Alarmingly, there is a total of only 110 beds in Gaza’s intensive care units (ICU) and just 96 ventilators in all medical facilities combined. More than half of the beds and ventilators are located in Gaza City, towards the north of Gaza, with zero beds and ventilators in the southern district of Rafah. Critically, with a full 72 percent of ICU beds already occupied, only 22 beds are available to accommodate serious coronavirus cases. Also, ten of the 96 ventilators are out of order and inoperable[1] and 80 percent of the functioning ventilators are in use in other emergencies. Due to a very limited number of COVID-19 test kits having entered the Gaza Strip, only around 1,500[2] tests can be conducted—focusing solely on cases showing COVID-19-like symptoms—with some of these kits already having been used.[3] The Ministry of Health has also reported a serious shortage of personal protective equipment.

International law requires that Israel, the occupying power, utilize all the necessary preventive means available to it to combat the spread of contagious diseases and epidemics, without discrimination for the areas it occupies. However, while shortages in equipment to combat COVID-19 are reported worldwide, there is still a striking disparity between Israel’s readiness to manage the crisis and Gaza’s—territory that Israel maintains effective control over. The discrepancy is best exemplified by the number of ventilators per capita: according to Israeli media reports,[4] Israel has almost 3,000 ventilators, which is roughly tenfold per capita of Gaza’s supply. In addition, while the Ministry of Health in Gaza is only equipped to carry out a few dozen COVID-19 test samples per day, Israel conducts 10,000 tests daily of its citizens and seeks to increase the number to 30,000.

Officials in Gaza are taking precautions with limited resources. The ten confirmed cases, of individuals returning home from abroad, went into immediate isolation, and hundreds of people are currently staying in 27 quarantine centers set up in schools and hotels throughout Gaza. In total, 1,769 residents returning to Gaza via Erez and Rafah crossings have been quarantined. Social distancing rules are in place, public gatherings are banned, and schools, universities, public parks, mosques and most non-essential businesses and offices are closed.

Even with the protective measures in place, the poor living and health conditions in Gaza indicate that the highly contagious virus is likely to spread. Gaza lacks proper hygiene and sanitation, the natural sources of drinking water are largely contaminated, fuel and electricity supplies are insufficient, pollution is rampant, and infrastructure is crumbling. Overcrowded living conditions in one of the most densely populated areas in the world makes social distancing impossible to maintain, particularly in the more densely populated refugee camps.

Israel’s repeated large-scale military attacks and 13 years of closure have depleted the health sector so profoundly that the Ministry of Health has suspended surgeries on several occasions even before the pandemic. The stocks of essential drugs are chronically low, medical equipment is inadequate, there is a shortage of beds, and healthcare staff are lacking in numbers and specialist training. The past two years has seen the system further weighed down by the 19 thousand injured persons needing treatment as a result of the Israeli military’s use of force—considered excessive under international law—to police the ‘Great March of Return’ demonstrations. The military also killed four of Gaza’s paramedics and injured 225 more—44 of whom were injured multiple times. Meanwhile, the thousands of patients who are forced to seek treatment that is unavailable in Gaza in Israeli and West Bank hospitals are being informed that their appointments are now canceled. 

The dire socioeconomic conditions in Gaza are exacerbated by the safety measures being implemented. Prior to the pandemic, unemployment was at 52 percent,[5] with the percentage of unemployed youth exceeding 69 percent,[6] which landed 53 percent of the population in poverty[7]. Currently, 68.5 percent[8] of families struggle to obtain food on a daily basis and are forced to reduce the quality and quantity of the food they consume due to insufficient income. The precautionary measures against the spread of the coronavirus have confined breadwinners to their homes, which means that the financial stability of more than half of Gaza’s population is undermined and the reliance on food aid in particular is likely to rise.

The 2018 UN Commission of Enquiry repeated the international community’s many calls on Israel to lift its blockade on Gaza with immediate effect, and urged all parties to uphold the right to health of Palestinians.[9] Yet, since the adoption of these most recent recommendations by the Human Rights Council in March 2019, no effective measures have been taken to implement the urgent call, and Israel seems no closer to removing the illegal closure and blockade measures. With the presence of the coronavirus in Gaza, the international community must urgently ramp up the supplies of personal protective equipment and ventilators, and crucially, must formulate tangible steps to action the removal of the closure framework.

END

[1] Interview with Hani Al-Weheidi, Director of the IT Unit in the Ministry of Health in Gaza, on Monday, 30 March 2020.

[2] As of 31 March 2020

[3] By 31 March 2020, 396 samples were tested by the MoH in Gaza, with ten of those samples testing positive for COVID-19.

[4] Haaretz, Israel Gearing Up for Spike in Coronavirus Patients Needing Ventilators Within Days, 29 March 2020, available at: https://www.haaretz.com/israel-news/.premium-israel-gearing-up-for-spike-in-coronavirus-patients-needing-ventilators-within-days-1.8721932

[5] Palestinian Central Bureau of Statistics, Labor Force Survey, July-September 2018.

[6] The figure represents youth aged 18 to 29 and is up by 16 percent from 2018. See Conditions of Youth in Palestinian Society on the Occasion of International Youth Day, 8 August 2019.

[7] Ibid, Poverty Rates for Individuals in Palestine According to Monthly Consumption Patterns by Region, 2017.

[8] Food Security Sector, Palestinian Central Bureau of Statistics, Socio-Economic Food Security Survey 2018 Preliminary Results, Ramallah, 10 December 2018.

[9] UN Human Rights Council, Resolution 40/13, 22 March 2019, UN Doc. A/HRC/RES/40/13, para. 11; UN Human Rights Council, Report of the independent international commission of inquiry on the protests in the Occupied Palestinian Territory, 25 February 2019, UN Doc. A/HRC/40/74.