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Covid-19 in Palestine: Healthcare workers near breaking point

Under conditions of siege and occupation, the daily toll of the pandemic is leading to a mental health crisis among Palestinian medics
A Palestinian doctor stands by a map tracking Covid-19 cases in Hebron in July 2020 (AFP)

Hidden under the infections, deaths and unprecedented strain on Palestine’s fragile health system caused by Covid-19, there is another, underreported crisis: the pandemic’s mental health toll on Palestinian healthcare workers. The recent detection of the Delta variant in the occupied West Bank threatens to make things even worse.

Palestinian health professionals are no strangers to saving lives in extreme circumstances. Israel’s perpetual occupation of the West Bank, repeated military offensives and 14 years of illegal siege in Gaza have long placed them under immense strain.

'I used to work more than 14 hours a day. Until this day, I have not taken a day off. I am physically and mentally exhausted'

- Senior physician, Gaza

For decades, these workers have contended with de-developing infrastructure, limited access to specialist training, and shortages of essential medicines and equipment. On top of this, attacks on health workers have contributed to making the occupied Palestinian territories “one of the most dangerous places in the world for healthcare workers”, according to the UN. This was painfully illustrated during Israel’s recent attacks on Gaza.

For a new research briefing published by Medical Aid for Palestinians this month, I spoke with doctors, nurses and other health professionals across the occupied West Bank and Gaza. They told me how responding to Covid-19 in this already challenging context has left them feeling anxious, isolated, under-prepared and under-appreciated. A fresh surge of cases could further degrade Palestine’s fragmented health system, pushing some workers beyond the brink of utter exhaustion.

“I was mentally exhausted, but I also felt a duty and responsibility I had to fulfil. During my night shifts, I couldn’t even rest my eyes; I was scared that any of my patients would die during my shift,” an anaesthesia technician at a hospital in Hebron told me.

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A senior physician in Gaza said he is close to breaking point: “I used to work more than 14 hours a day. Until this day, I have not taken a day off. I am physically and mentally exhausted.”

Barriers to care

Israeli-imposed restrictions on the freedom of movement of medical teams and their patients have compounded necessary lockdown measures, deepening barriers to diagnosis, treatment and care for people infected with Covid-19, as well as those with other diseases, such as cancer. This has separated healthcare workers from their families, friends and support networks, leading to loneliness and isolation.

Unequal access to Covid-19 vaccines and personal protective equipment has exacerbated these challenges. Frontline medics told me they have struggled to access both, leaving them at high risk of infection themselves - around 5,000 Palestinian health workers have become ill with Covid-19 - while also worrying about infecting patients and loved ones.

Palestinian nurses prepare to administer the Covid-19 vaccine in Hebron on 9 March 2021 (AFP)
Palestinian nurses prepare to administer the Covid-19 vaccine in Hebron on 9 March 2021 (AFP)

While more than 60 percent of Israelis are fully vaccinated, the supply of vaccines to the occupied West Bank and Gaza has barely scratched the surface of healthcare needs, with only around nine percent of Palestinians in the territories fully vaccinated. 

With the arrival of a new, highly infectious strain of the virus, the Palestinian health system risks being totally overwhelmed. The number of confirmed cases of Covid-19 in Palestine is 344, 482, according to the most recent figures, while there have been 3,855 deaths from the disease. Only concerted international action can alleviate the burdens on those working on the frontlines.

The international community must urgently take measures to ensure a recovery from Covid-19 across Palestine, and to address the root causes of this latest crisis. This includes putting pressure on Israel to end its violations of international law, which undermine the capacity of the Palestinian healthcare system to respond to the pandemic.

Israeli violations

These violations include Israel’s repeated attacks on health facilities, its failure to meet its legal duty to ensure equitable vaccine access for Palestinians, and its illegal closure of Gaza and restrictions on Palestinians’ freedom of movement. Where Israel fails to meet its obligations, the international community must pursue accountability. 

Medics are coronavirus heroes. In Palestine, Israel attacks them with impunity
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Support also needs to be provided directly to address the mental health and wellbeing of healthcare workers. The international community must mobilise technical, economic and humanitarian assistance to the Palestinian Ministry of Health and the broader health system, in order to address the needs arising from Covid-19 and to enable the long-term sustainable development of Palestinian healthcare services.

Whether it is successive wars in Gaza or attacks on protesters across the occupied West Bank and East Jerusalem, Palestinian healthcare workers are in a seemingly constant state of emergency response.

Without urgent international action, the arrival of the highly contagious Delta variant and another wave of Covid-19 could deepen a mental health crisis that has been concealed in the shadows of Palestine’s pandemic response. 

The views expressed in this article belong to the author and do not necessarily reflect the editorial policy of Middle East Eye.

Celine Jabr is the Advocacy and Communications Officer at Medical Aid for Palestinians, based in the occupied Palestinian territory. Celine was previously the Freedom of Movement Coordinator at Physicians for Human Rights and holds a master’s degree in international relations and diplomacy.
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