Al-Jazeera / March 25, 2020
As the world calls for solidarity, Palestinians expect none from their occupiers.
As the number of infections and deaths from COVID-19 multiply by the day, there have been increasing calls across the world for people to show solidarity and care for each other. Yet for the Israeli government, there is no such thing as solidarity.
As soon as the first coronavirus infections were detected, the Israeli authorities demonstrated that they have no intention of easing apartheid to make sure Palestinians are able to face the epidemic under more humane conditions.
Repression has continued, with the Israeli occupation forces using the excuse of increased police presence to continue raids on some communities, such as the Issawiya neighbourhood in East Jerusalem, home demolitions in places like Kafr Qasim village and the destruction of crops in Bedouin communities in the Naqab desert.
Despite four Palestinian prisoners testing positive for COVID-19, the Israeli government has so far refused to heed calls to release the 5,000 Palestinians (including 180 children) that it currently holds in its jails. And there has been no sign that the debilitating siege on the Gaza Strip, which has decimated its public services, would be lifted any time soon.
Israeli Prime Minister Benjamin Netanyahu is also trying to exclude the mostly Palestinian Joint List from the formation of an emergency unity government to tackle the outbreak, calling its members “terror supporters“.
At the same time, the Israeli authorities have been quick to depict Palestinians as carriers of the virus and a threat to public health.
In early March, when the Palestinian Ministry of Health announced it had confirmed the first seven cases of the coronavirus (which causes COVID-19 disease) in the occupied Palestinian territory, Israeli Defense minister Naftali Bennett was quick to shut down the city of Bethlehem, where all the cases were located.
Of course, the concern there was not the health and safety of Palestinians in the city, but rather the threat of them infecting Israelis. The nearby settlement of Efrat – which also had confirmed infections, of course – was not put on lockdown at that time.
Shortly after, the health ministry issued a statement advising Israelis not to enter the occupied Palestinian territories.
Then last week, Netanyahu asked the “Arab-speaking public” to follow the instruction of the ministry of health saying that there is a compliance problem among the Palestinians. No such concerns were expressed about of some members of the Jewish population of Israel, who outright refused to shut down religious schools and businesses.
This attitude towards Palestinians is of course not new. The writings of early European Zionist settlers are full of racist assumptions about Arab hygiene and living conditions, and the threat of the disease coming from the Palestinian population was an early justification for apartheid.
Apart from the decades-old repression and discrimination, during the COVID-19 epidemic, Palestinians will be facing another consequence of occupation and apartheid – a broken healthcare system.
The roots of its dysfunction go back to the mandate era, when the British discouraged the formation of a Palestinian-run healthcare sector. The Palestinian population (mostly the urban parts of it) was serviced by a number of hospitals that the British colonialists set up, as well as health facilities established by various Western missionaries. Meanwhile, the Jewish settlers were allowed to set up their own healthcare system, funded generously from abroad and run independently of the mandate.
During World War II, some missionaries left and closed down their clinics, and after 1948, the British withdrew, leaving behind an ill-performing healthcare infrastructure. In 1949, Egypt annexed Gaza. The following year, Jordan did the same with the West Bank. Over the next 17 years, Cairo and Amman provided for the Palestinian population living under their rule, but they did not really establish a well-functioning healthcare system.
UNRWA – the United Nations Relief and Works Agency for Palestine Refugees in the Near East – had to step up its services, providing primary healthcare, while the Palestinians started building a network of charitable healthcare facilities.
After the war of 1967 and the Israeli occupation of the Gaza Strip and the West Bank, Israel as an occupying power was legally responsible for healthcare of the Palestinians, but unsurprisingly, it did nothing to encourage the development of a robust healthcare sector. To illustrate the point: in 1975, the budget allocated for healthcare in the West Bank was smaller than that of one Israeli hospital for the whole year.
In 1994, the Palestinian Authority was created and took over service provision. Needless to say, the continuing occupation and the fact that the Authority’s budget was dependent on foreign donors and the whims of the Israeli government, as well as the corruption of PA officials, did not allow the Palestinian health sector to improve.
As a result, if you were to enter a Palestinian hospital in the West Bank today, you would be struck by the overcrowding of patients, the shortages of supplies, the inadequate equipment and the substandard infrastructure and sanitation. Medical professionals have repeatedly protested the poor working conditions in their hospitals, most recently in February this year, but to no avail.
With just 1.23 beds per 1,000 people, 2,550 working doctors, less than 20 intensive care specialists and less than 120 ventilators in all public hospitals, the occupied West Bank is facing a public health disaster if the authorities do not contain the spread of COVID-19.
The situation in the West Bank may seem bleak, but the one in the Gaza Strip is simply catastrophic. The United Nations announced that the strip will be unlivable by 2020. It is now 2020 and the residents of the Gaza Strip – apart from inhuman living conditions – are now also facing a COVID-19 outbreak, as the first cases were confirmed on March 21.
The Israeli, Egyptian and PA-imposed blockade of Gaza has brought its healthcare system to the brink of collapse. This has been compounded by cycles of destruction of health facilities and a slow rebuilding efforts following repeated large-scale military offensives by the Israeli military.
The people of Gaza already face dire conditions: unemployment is at 44 percent (61 percent for the youth); 80 percent of the population is dependent on some form of foreign assistance; 97 percent of water is undrinkable; and 10 percent of children have stunted growth due to malnutrition.
Healthcare provision is on a constant decline. According to the NGO Medical Aid for Palestinians, since the year 2000 “there has been a drop in the number of hospital beds (1.8 to 1.58), doctors (1.68 to 1.42) and nurses (2.09 to 1.98) per 1,000 people, leading to overcrowding and reduced quality of services”. Israel’s ban on the import of technology with possible “dual use” has restricted the purchasing of equipment, such as X-ray scanners and medical radioscopes.
Regular power cuts threaten the lives of thousands of patients relying on medical apparatuses, including babies in incubators. Hospitals lack about 40 percent of essential medicines, and there are inadequate amounts of basic medical supplies, such as syringes and gauze. The 2018 decision of the Trump administration to stop US funding for UNRWA also affected the agency’s ability to provide healthcare and bring doctors to perform complex surgeries in Gaza.
The limits of the Gaza healthcare system were tested in 2018 during the March of the Great Return, when Israeli soldiers opened mass fire on unarmed Palestinians protesting near the fence separating the strip from Israeli territory. In those days, hospitals were overwhelmed with wounded and dead, and for months they were struggling to provide proper care for the thousands injured by live ammunition, many of whom were permanently disabled.
The Gaza Strip is one of the most densely populated areas in the world, which also experiences severe problems with water and sanitation infrastructure. It is clear that stopping COVID-19 from spreading will be next to impossible. It is also clear that the population, which is already worn down by malnutrition, a higher rate of disability (due to all the Israeli assaults), and psychological distress due to war and hardship will be that much more vulnerable to the virus. Many will die and the healthcare system will likely collapse.
So as the West Bank and Gaza face potential health catastrophes amid an impeding COVID-19 epidemic, the question is, what will Israel do? Will it give access to its healthcare system to Palestinians? Will it at least stop blocking foreign medical aid?
A recent video that went viral on Palestinian social media can give us the answer. In it, a Palestinian labourer is seen struggling to breathe by the side of a road at an Israel checkpoint near Beit Sira village. His Israeli employer had called the Israeli police on him after seeing him severely sick and suspecting that he had the virus. He had been picked up and dumped at the checkpoint.
Decades of settler colonial rule, military occupation, and repeated deadly assaults have taught Palestinians not to expect any “solidarity” from the Israeli apartheid government. In this, like in previous crises, they will pull through with their proverbial sumud (perseverance).
Osama Tanous is a Haifa-based pediatrician and a Masters student in Public Health