In Gaza, Pandemic Forces Tough Choices And Health Care System Hangs By A Thread

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People wear face masks on a shopping street in Gaza City in January.

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«I feel bad about myself. I would quarantine myself for a whole month if I could, but I have to keep the shop open. I have no other source of income, Hossam, 26, told NPR by video chat. He declined to give his full name because he could be arrested for keeping his shop open while sick.

Hossam lost his sense of taste and smell, and became fatigued, but refused to take a COVID-19 test. If it were positive, his whole family would be ordered to quarantine and he and his brother, the family’s sole breadwinners, wouldn’t be able to work. Gaza’s Hamas rulers offer no financial aid to those quarantined at home.

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«I have some savings that could last us for a day or two. But when that runs out, no one will knock on our door to help us, to say, here’s 50 shekels [$15] to help you manage, Hossam said. «No one cares about anyone here.

So Hossam went to work and tried to be careful. He wore a black mask at his shop and asked customers not to step inside.

He sells clothes Israelis don’t want anymore — army sweatshirts, elementary school T-shirts with Hebrew logos — delivered through Israel’s fortified border to the Gaza market. If his customers ever found out he had the virus, he worried they’d think he’d imported it along with the Israeli clothes and never buy from him again.

«There are many others like me who don’t want to report their illness so they can keep working, he said.

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This is common in Gaza, where most live below the poverty line and the economy is in a chokehold due to a nearly 14-year Israeli and Egyptian blockade severely restricting trade and travel to the Islamist-ruled territory.

In the first months of the pandemic, being cut off proved to be an advantage. The few infected travelers who did enter Gaza were quarantined and there was no discernible community spread.

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A Palestinian medical worker takes a swab sample from security personnel guarding the homes of quarantined patients infected with the COVID-19 coronavirus in Rafah, in the southern Gaza Strip in January.

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Palestinian Health Minister Mai al-Kaila receives a COVID-19 vaccination on Tuesday in a West Bank hospital.

Palestinian Authority Health Ministry

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Palestinian Authority Health Ministry

Palestinian Health Minister Mai al-Kaila receives a COVID-19 vaccination on Tuesday in a West Bank hospital.

Palestinian Authority Health Ministry

Gaza has yet to receive any vaccines. Dr. Majdi Duhair, a Gaza health official, said he had expected several hundred to arrive through the Israeli border crossing Thursday, but an Israeli official tells NPR that the government has not yet approved vaccine deliveries to Gaza. It is a politically sensitive issue. An Israeli lawmaker asked leaders not to allow vaccines into Gaza until Hamas releases two Israeli captives and the bodies of two Israeli soldiers killed in battle in 2014.

That kind of tradeoff is unlikely, and Israel is expected to eventually allow vaccines into Gaza. Prime Minister Benjamin Netanyahu said this week that getting vaccines to Palestinians is in Israel’s interest, calling it «the right step.

In Gaza’s COVID-19 wards, medical staff say they do not expect to receive many vaccines in early shipments, and doubt there will be enough for all staff. They plan to vaccinate only medical workers above 50 years old and medical workers with chronic illnesses.

«This should be a humanitarian issue, but politics play a role. The priority of the companies is to sell the vaccine to wealthy countries more than poor ones, says Dr. Atef al-Hout, who heads Gaza’s COVID-19 wards.

The pandemic has taken a heavy toll on Gaza’s medical specialists — the few who did not join the exodus in recent years of hundreds of doctors who found better salaries and lives abroad.

Al-Hout says four doctors and three nurses died of COVID-19 in Gaza in the past year, including 51-year-old Dr. Majdi Ayyad, one of Gaza’s last heart surgeons. Now there are only three cardiac surgeons left for a population of more than 2 million.

«Mercy be on those we lost, al-Hout says with a sigh.

Baba reported from Gaza City. Estrin reported from Jerusalem.