Outbreak might overwhelm fragile health sector in Gaza

DR AHMED el-Rabii spent years treating Palestinians wounded by Israeli fire during wars and clashes in the Gaza Strip. Now that the coronavirus has reached the blockaded territory, the 37-year-old physician finds himself in the unfamiliar role of patient.

He is the first Gaza doctor to be diagnosed with Covid-19, and is among dozens of health-care workers infected during the local outbreak, which was detected late last month. The spread among front-line workers has further strained an already overburdened health-care system.

Speaking from one of the two hospitals designated to treat coronavirus cases, el-Rabii said the threat was, in many ways, more terrifying than war.

During fighting, “you only fear being hit by shrapnel by mistake,” he said. “But with the virus, you constantly worry because you do not know how or from where it will hit you: from a patient, from your colleague, or by touching the elevator or any other surface.”

Since 2007, Gaza has been under an Israeli-Egyptian blockade meant to isolate Hamas, the Islamic militant group that seized control of the territory that year from the internationally recognised Palestinian Authority.

The blockade is believed to have played a key role in slowing the arrival of the coronavirus. Few people can move in and out of the territory, and Hamas placed anyone returning to Gaza into mandatory quarantine centres for three weeks.

Before last month, the handful of Gaza’s coronavirus cases were confined to the isolation facilities. But on August 24, the first cases were detected among the general population, and the numbers have multiplied since.

Despite limited testing capacity, over 1 000 active cases have already been detected. Nine people have died.

The outbreak has been especially hard for Gaza’s medical workers. For more than a decade, they have been on the front lines, treating injuries during conflicts with Israel. They have worked in an ailing health system gutted by the blockade and intra-Palestinian political feuding that left doctors, nurses and other medical workers with only partial salaries.

Now, the virus is straining medical workers physically, mentally and financially. Ahmed Shatat, a Health Ministry official, said at least 68 medical workers had been infected.

Experts have warned that a wider outbreak in Gaza, home to some two million Palestinians, could be catastrophic because of the fragile health sector. “Gaza’s health system is woefully under-equipped to cope with a large outbreak, with only enough intensive care beds and ventilators to cope with a few dozen serious cases,” the International Committee of the Red Cross warned last week.

Shatat said there had been a shortage of medical workers before the outbreak. To help alleviate a staffing crunch, the Health Ministry has shortened the mandatory quarantine times for doctors and nurses who may have been exposed to the virus, from three weeks to two weeks. But it is still struggling to sufficiently staff the quarantine centres and isolation hospitals.m

“Advanced health systems in the world could not sustain the outbreak, so how could our fragile, besieged, aid-dependent health system stand up to the crisis?” Shatat asked.