The Guardian (USA)

Despite the ceasefire, Gaza’s health service is on the brink of collapse

- Raja Musleh and Alaa Alkhatib

Today the streets of Gaza City are full of cheering in response to the news of a ceasefire. But during the 11 days of the aerial bombardmen­t by Israel, the streets told a different story: they were empty, except for ambulances rushing to hospitals and people displaced from their homes by bombings looking for a place to sleep. It was a ghost town with the soundtrack of a nightmare: explosions, sirens and the cries of our children as we sheltered in our kitchens at night would punctuate the eerie silence.

Now we are left to pick up the pieces. And though we hope the ceasefire will hold and the bombing has ended, the health sector in Gaza is still on the brink of collapse. This is something you may have heard many times over the past 16 months, as the world has dealt with the Covid-19 pandemic with differing degrees of success. But in Gaza it is to another magnitude: trauma is always most harrowing to deal with. Children came into hospitals torn apart. At least 12 families were completely wiped out, all of their family members killed. Hospitals battled against massive power cuts as they tried to save critically wounded patients.

The devastatin­g escalation in hostilitie­s resulted in a sustained bombardmen­t on Gaza, which left 230 dead and at least 1,900 people injured from airstrikes. Before this escalation, we only had about eight hours of electricit­y a day. Many electricit­y lines were left damaged by the airstrikes and one of the hospital’s three electricit­y generators stopped working. We would constantly worry that this would cut off patients’ oxygen supplies and lead to even more lives lost. Health facilities issued urgent appeals for donations of blood. Health workers tried to save as many lives as they could, though we did not have enough medicine, resources, or manpower to keep up with the rising number of injuries each day.

Gaza’s health system has suffered from chronic issues for years. The region’s 14-year blockade has destroyed our ability to get much-needed medical equipment and supplies. Over 42% of essential medication­s in Gaza are consistent­ly depleted. There is also a critical shortage of doctors, nurses, and midwives. Those with severe illnesses that need continuing treatment, such as women with breast cancer, must pray for their exit permits to be approved so they can receive treatment in East Jerusalem. About a third never are. Now we do not know what people with cancer, kidney diseases, and other severe chronic illnesses will do. They are at the most dire risk.

Covid-19 added an additional burden. Before last week’s bombardmen­t, doctors were busy dealing with the rising number of Covid cases in Gaza. The total number of cases stands at 102,323, with 2,980 active cases. ICUs and inpatient wards in hospitals have been simply unable to absorb the influx of Covid-19 patients. Humanitari­an organisati­ons such as ours, MedGlobal, have had to fill in the gaps, supporting the health system by providing critically needed personal protective equipment, medical supplies, and PCR machines to allow for rapid Covid testing.

We worry that one more deadly effect of the airstrikes will be an increase in Covid-19 cases, as patients who were recovering were released to free up hospital beds for people injured by airstrikes. Many residentia­l buildings were bombed out, sending hundreds of families to relatives’ homes to find refuge. In many instances, social distancing measures have become impossible. The number of Covid-19 tests offered daily decreased dramatical­ly during the bombardmen­t, from nearly 3,000 a day to only 256. Earlier this week, the al-Remal healthcare centre, the largest primary health clinic in Gaza, which houses the lab responsibl­e for Covid-19 tests, was severely damaged during the airstrikes. All testing and Covid-19 services had to be halted. We worry this will result in a further public health disaster.

Including that on the al-Remal healthcare centre, the Israeli airstrikes damaged six hospitals and 11 primary healthcare centres, in addition to wounding dozens of health workers and killing two of our best doctors: Dr Ayman Abu al-Ouf, head of internal medicine at Al-Shifa Hospital, and Dr Mooein Ahmad al-Aloul, one of the only neurologis­ts in Gaza. Now, as we mourn, the remaining hospitals must pick up the pieces from having responded to the needs of casualties gravely injured from the bombardmen­t. We are in dire need of medication, nutrition supplement­s, personal protective equipment and supplies such as blood bags, anaesthesi­a and oxygen tanks. We also still need medical assistance such as ventilator­s to properly confront our Covid-19 crisis.

In the past days, we have hidden in the bottom of apartment complexes with our families as bombings targeted our neighbourh­oods. It became normal to remove windows and open the doors of our apartments when we heard that a building near us would be targeted, to avoid shattering the glass and ripping doors to splinters. This helped save our apartments from being smashed, but it didn’t prevent our homes from filling with smoke, sand, and bits of debris after the airstrikes. We regularly hid under tables and in bathrooms, knowing they were the safest places in our apartments. We went long nights without sleeping, just listening to the explosions and praying that our loved ones would be safe.

We are overwhelme­d with relief for the ceasefire, but we were praying each day that this situation would not last this long and that lives would be spared. Isn’t it time for the whole world to open their eyes to what has gone on in the Gaza Strip over this past fortnight, and for all government­s to work to prevent violations of internatio­nal law? At least 65 children in Gaza were killed by airstrikes, with hundreds more left injured. We are haunted by thinking about each one of these children who lost their lives, and the others who have lost their families. Please think of them too. This chaos has left behind so many people who are now injured and traumatize­d. We pray that the bloodshed has ended, but we must work together to bring Gaza’s shattered medical sector back to some semblance of its former health.

Raja Musleh is the MedGlobal Gaza programme director and Alaa Alkhatib is MedGlobal Gaza programme manager

things that make a country prosperous … we should always aspire to lower tax rates, particular­ly on corporatio­n tax.” What’s more he wanted to undercut other countries: “We will try to set it still at a competitiv­e rate, so the US, Canada, Korea, Japan and Germany will all have higher rates than the one to which we are moving.”

Analysis by the campaignin­g group Tax Justice UK says that the tax rise would have brought £13.5bn into the Treasury last year. This would rise to £22bn if the government did set it at 25%. A report from Church Action for

Tax Justice, signed by a group of bishops and former archbishop­s, calls on the government to promote the Biden plan, saying it could raise $640bn globally, more than 27 times what it would cost to vaccinate the whole world.

The government has made various excuses, including that Biden is not doing enough to see that the big tech companies are taxed in each country where they earn their profits. The UK introduced its own digital services tax (DST) ahead of any internatio­nal agreement, but Robert Palmer, the head of Tax Justice UK, points out that our DST raises a puny £500m a year. Tory tax phobia is a more likely explanatio­n, and a refusal to be prevented from undercutti­ng others in future.

But another reason is Britain’s responsibi­lity for so many tax havens. This would end that archipelag­o of British-sponsored tax avoidance in places such as the Cayman Islands and Bermuda. Britain itself is a money-laundering centre, with far laxer implementa­tion of rules and lower fines than the US imposes on its banks.

Britain is blocking what the Tax Justice Network calls “the best opportunit­y for a generation to curb corporatio­n tax abuse across the board”, standing against the world in defence of tax havens. Inflicting this shame on ourselves is odd: this is highly popular and would yield fat sums for whatever else Johnson wants to spend money on – a few more bridges, perhaps.

No one knows with this government who is influencin­g ministers, who has their ear, what deals are struck or what winks and nods point to post-ministeria­l lucrative careers. With emails, texts and WhatsApps zinging about unseen by their officials, we may never know why. But Labour’s shadow chancellor, Rachel Reeves, rightly sees this as prime territory – a popular tax to raise urgently needed funds, which Labour would spend better. Labour’s 2010 corporatio­n tax rate was 28%, now it’s 19%. Returning to that old rate will feel right if Biden succeeds in raising the US tax to 28%, as he plans, yielding $2.5tn over 15 years for his great spending programme.

For those who think Labour is done for, just count the ways this government is accumulati­ng own goals.

• This article was amended on 21 May 2021 to correct the name of the group Church Action for Tax Justice.

Polly Toynbee is a Guardian columnist

 ??  ?? ‘Isn’t it time for the whole world to open their eyes to what is going on in the Gaza Strip’ A Palestinia­n ambulance evacuates a family after airstrikes on Gaza City. Photograph: Mohammed Saber/EPA
‘Isn’t it time for the whole world to open their eyes to what is going on in the Gaza Strip’ A Palestinia­n ambulance evacuates a family after airstrikes on Gaza City. Photograph: Mohammed Saber/EPA

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