Tip of the iceberg: deeper implications of COVID-19 for Palestinian communities

Photo credit: Shutterstock, Abed Rahim Khatib

As winter approaches, the COVID-19 pandemic continues to spread at an alarming rate in the occupied Palestinian territory and the Palestinian refugee camps of Lebanon. Medical Aid for Palestinians (MAP) is working tirelessly to provide vital equipment and medical supplies to support infection control efforts and help health workers treat patients.

But the rate of COVID-19 infections is the tip of the iceberg in terms of the pandemic’s humanitarian impact. Seven months since the first case in Palestine, the economic, social and health effects of the pandemic are severely affecting other aspects of life. Many people are struggling more than ever to access basic needs such as adequate food, healthcare and education.

Gaza: Rising food insecurity amid economic collapse

In Gaza, a total of 5,442 COVID-19 cases and 31 deaths have been reported. Our recent emergency response has included providing testing swabs, hygiene kits and antiseptic hand gel to Gaza’s Central Drug Store, in order to help identify and slow the spread of the disease locally.

Some local lockdown measures have begun to slowly lift. But with the academic year now restarting, and 35,00 grade 12 students returning to schools, many parents fear that COVID-19 will spread through classrooms despite attempts to implement infection control and social distancing measures. For the many Gaza families living in multi-generation homes this presents particular infection risks to older family members. Meanwhile, those students not yet able to return to schools struggle to engage with remote teaching due to limited electricity and internet access, exacerbated by a ban on 3G internet in Gaza imposed by Israel.

At the same time, the pandemic is compounding the economic distress caused by Israel’s illegal 13-year closure and blockade of Gaza. Even before the pandemic began, Gaza had one of the highest unemployment rates in the world (45%) and more than two thirds of people were moderately or severely food insecure. The UN has reported that COVID-19 has “shattered” the already-faltering Palestinian economy, and Gaza has been hit worst. Local lockdown measures to control COVID-19 have caused further loss of income for many families, with UNRWA chief Philippe Lazzarini reporting last week that some people are resorting to “going through the garbage” to try to find enough food to eat. MAP’s local partners have reported a rise in child malnutrition, making our work with the Ard El Insan Malnutrition Centre ever more vital.

MAP’s Director of Programmes, Dr Andy Ferguson, has warned:

“With rising unemployment and higher levels of poverty and food insecurity, COVID-19 has already triggered a surge in cases of childhood malnutrition; sadly, we expect this situation to worsen over the winter months, with our support more critical than ever.”

As MAP’s Senior Programme Manager in Gaza, Mahmoud Shalabi, recently wrote in indy100, the steadfastness of the Palestinian individuals, families and communities is helping people cope through these difficult times:

“We Palestinians have an abundance of what is sometimes called ‘social capital’ – the relations you have with your neighbours, relatives, and friends. These are such positive elements that help us get through not just COVID-19, but also all the bad times we have been experiencing over the years. So now, in lockdown under blockade, we use WhatsApp groups for our families, friends, and co-workers – we chat, exchange jokes, and send positive messages to each other.”

Nevertheless, there are indications that COVID-19 is beginning to challenge this remarkable resilience. The UN has expressed concern that the pandemic is exacerbating a mental health crisis in Gaza that results from a chronic political and economic crisis characterised by “recurrent violence, the ongoing blockade, deteriorating living conditions, including increasing poverty, and a sense of hopelessness.” An increase in deaths by suicide has been reported this year, and local mental health service providers have described “a spike in calls to hotlines and for phone counselling from people threatening self-harm and [in] general psychosocial distress.”

West Bank: Increasing demolitions undermine COVID-19 containment

In the West Bank, including East Jerusalem, 56,604 cases of COVID-19 have been reported in total and 488 deaths. With cases and hospitalisations continuing to rise, MAP recently delivered Continuous Positive Airway Pressure (CPAP) respirators to the Ministry of Health (MoH) in Ramallah, to help treat patients with severe breathing difficulties.

Coping with the pandemic would be challenge enough for Bedouin communities in Area C, the 60% of the West Bank where Israel maintains full civil and military control. But these communities are also facing a spike in demolitions, displacements and settler violence. The UN Office for the Coordination of Humanitarian Affairs (OCHA) reports that since the beginning of March, Israel has demolished 461 Palestinian-owned structures – including homes – and displaced 572 people. This marks a 31% increase in demolitions and displacements compared to the equivalent period in 2019. Such demolitions violate international humanitarian law and Palestinians’ right to adequate shelter and undermine the mental health and wellbeing of affected families. They also pose a particular risk to health in the context of a pandemic where social distancing is an essential measure to prevent COVID-19 transmission.

MAP’s programmes and partners continue to work to support the most vulnerable individuals and communities amid the pandemic, and to adjust regular projects to help keep people safe from the disease. Throughout the crisis, the MAP-supported mobile clinic run by the Palestinian Medical Relief Society (PMRS) has continued to provide essential primary healthcare services to seven isolated and marginalised communities in the southern Hebron Governorate. These services, which include regular check-ups for children and pregnant women and COVID-19 health education, are not only a lifeline in the middle of a pandemic, but also help such communities stay on their land in defiance of the coercive environment created by Israel authorities in Area C.

Lebanon: Young Palestinians losing hope as the pandemic affects education and employment

In Lebanon, 69,906 COVID-19 cases and 562 deaths have been reported. Of these, 1,615 cases and 43 deaths are of Palestinian refugees according to UNRWA. Lebanon’s health system is struggling to cope, particularly after the damage caused by the explosion in Beirut in August. Palestinian refugees are particularly vulnerable to ‘falling through the cracks’ in accessing healthcare for COVID and other illnesses, reliant as they are on a fragmented and chronically under-funded patchwork of private, NGO, UNRWA and other healthcare providers.

Here, too, the pandemic is compounding a chronic economic crisis, particularly for the majority of Palestinian refugees reliant on jobs in low-skilled and informal employment. As Dunia, a psychotherapist working with the National Institution of Social Care and Vocational Training (NISCVT), one of our partners in Lebanon, recently described to MAP:

“The economic impact of the pandemic is very harsh on Palestinian refugees, with many families having lost access to the scarce income-generating opportunities that were previously available to them. Families were struggling to secure the basic needs for their children before the crisis, so you can only imagine the situation now when they are not working and are spending all their days in overcrowded houses. Sadly, increasing violence and social problems are not unexpected.”

Young people have been particularly badly affected, with the pandemic disrupting education, work opportunities and social networks. As Dunia explained:

“COVID-19 has affected the youth in many ways. It has threatened their sense of safety and security and the way they see their future. This is particularly true for Palestinian youth who already had many uncertainties, for example related to whether they will be able to continue their education, whether they will be able to work after they graduate, or even if their families will be able to afford food the next day. The COVID-19 crisis intensified these fears and concerns; young Palestinians started thinking about their future prospects and the inequalities and injustices that deprived them from opportunities that other youth have in Lebanon. Some of them became more frustrated or experienced increased feelings of hopeless that their conditions may worsen.”

The pandemic has therefore made the vital mental health and psychosocial projects supported by MAP in Lebanon more important than ever, even as their programmes have to adapt to the need for social distancing and other infection control measures. You can read about how the NISCVT have met this challenge and are providing essential life skills and peer support here.

To support MAP's vital programmes responding to this emergency across the occupied Palestinian territory and Lebanon, please make a donation today:

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