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Gaza Strip: Uniquely shielded, yet ultra-vulnerable to corona

March 21, 2020

Gazans may be trying to make light of coronavirus on social media, comparing lockdowns to the Israeli blockade, but fears are growing of a disastrous outbreak in the Palestinian territory.

With movement in and out of the territory severely restricted since long before the pandemic emerged, the Gaza Strip is perhaps one of the few places on earth with a chance of staying virus-free.

But experts warn that the crippling blockade and high poverty rates, along with a densely-packed population and weak health system, create perfect conditions for a rapid outbreak, with one comparing the risk of transmission to that on a cruise ship.

In her small kitchenette in Gaza City, 80-year-old Mariam al-Khatib stacked away cleaning products and tinned goods. She said that despite living through six wars, she was terrified of COVID-19.

"Everyone is afraid. This is more important than a war. Nothing like this has happened since the day I was born," she told AFP. "If corona arrives in Gaza, many people will die. There is no treatment except to pray to God."

Israel has enforced its blockade since 2007, when the Islamist group Hamas seized control of Gaza. It argues the measures are necessary to isolate Hamas, considered a terrorist organisation by most Western countries. Israel and Hamas have fought three wars since 2008.

Critics say the blockade punishes and impoverishes all of Gaza’s residents and feeds radicalism. Gaza’s only other border, with Egypt to the south, has been closed for much of the past decade.

It has been partly re-opened in the past two years, but crossings into Egypt are limited as reaching Cairo and other cities requires an arduous journey through the restive Sinai region. Gaza has had no airport since it was bombed by Israel in the early 2000s during a Palestinian intifada, or uprising.

Khatib’s son Mustafa, 51, said he understood the "feelings of people (in isolation or quarantine) all over the world -- we have had a quarantine-like situation since 2007". In Gaza, Palestinians are closely tracking the pandemic through incessant media coverage -- and preparing for the worst.

Despite having no cases registered in the Strip so far, schools are closed and more than 2,700 people are in home isolation, mostly having returned from Egypt. Matthias Schmale, Gaza director of the United Nations agency for Palestinian refugees UNRWA, said he was already operating under outbreak conditions, putting in place social-distancing measures.

UNRWA runs schools for over 250,000 children in the coastal Strip. "The blockade may well help to contain corona, but if it breaks out I would use the comparison with the cruise ship off Japan," he said, referring to the Diamond Princess, where more than 700 of the ship’s 3,700 passengers and crew fell ill.

Much of Gaza’s population live in overcrowded refugee camps, with large families common. "It is an illusion to think you can manage it in a closed-off space like this," Schmale said.

Israeli restrictions and political tensions have caused Gaza’s health facilities to deteriorate over the past decade, said Gerald Rockenschaub, head of the World Health Organisation’s (WHO) Palestinian office.

The Strip has only 60 intensive care (ICU) beds for its two million people and not all are operational due to staff shortages, he told AFP.

"Gaza’s health system has been facing de-development over the last years because of the chronic (Israeli) closure," he said, pointing to shortages of electricity, medicine and human resources. "More than 90 percent of the drinking water is basically unfit for human consumption, and on top of that you have over-crowdedness," he added.

Israel said it has been working to ensure the supply of medical supplies to the Strip, including facilitating the delivery of 500 WHO-funded coronavirus testing kits on Wednesday. It blames Hamas for Gaza’s lack of development.

Hamas authorities are preparing to build 1,000 isolation rooms near the southern border with Egypt. With the Islamist movement’s Gaza leader Yahya Sinwar watching over, bulldozers this week cleared ground where temporary cabins are to be erected.

Palestinians suffering from cancer and other serious diseases are currently allowed to leave Gaza through Israel for treatment inside the Jewish state or in the occupied West Bank. It is as yet unclear if Israel, which has imposed tight restrictions on its own population, will allow seriously ill coronavirus patients to be transferred from the Strip.

Schmale warned any outbreak could quickly overwhelm Gaza’s health capabilities. "Everything I am hearing is if the outbreak reaches the magnitude where you need more than 60 ICU beds to treat, it will become increasingly difficult and could well turn into a disaster of gigantic proportions."