Coronavirus and the Occupied Palestinian Territories

Anna Dickson

This is a fast-moving issue and should be read as correct at the date of publication (28.04.20).

The Occupied Palestinian Territories (OPTs) were initially shielded from coronavirus because of limited travel in and out of the territories. In recent weeks the number of cases has increased. The economic impact on the OPTs of the pandemic is predicted to be severe.

This Insight looks at the main challenges facing the territories in responding to the crisis as well as Israeli and international donor responses.

Incidence and issues

As of 21 April, according to the UN Office for the Coordination of Humanitarian Affairs (OCHA) 329 Palestinians are confirmed to have contracted Covid-19 in the OPTs: 15 in the Gaza strip and 314 in the West Bank.

In addition, there are 120 cases in East Jerusalem. The majority of those Palestinians who have contracted the virus are labourers who work in Israel. As a result, all travel to and from Israel has been stopped.

The Department for International Development (DFID) notes that:

Overcrowded living conditions, physical and mental stress and years of protracted conflict make the population of over 5.6 million Palestine refugees across the Middle East particularly vulnerable.

Gaza is a concern because poverty is widespread, population density makes social distancing difficult, healthcare infrastructure has been damaged by the conflict and medical supplies are restricted.

On 20 April Palestinian Prime Minister, Dr Mohammad Shtayyehr, announced that the lockdown, which began on 5 March, will gradually be lifted across the territories. Conditions of opening will vary between governorates depending on the incidence of the disease.

Signs of cooperation

The UK Government has welcomed cooperation between the Israeli Government and Palestinian authorities in tackling the coronavirus pandemic.

According to WHO, the situation in East Jerusalem is being managed by the Israeli authorities. Patients there are being treated by the East Jerusalem Hospital Network (EJHN) and by Israeli hospitals. In addition, Israeli authorities have opened six testing centres in East Jerusalem.

OCHA reports that since the beginning of the crisis, the Israeli authorities have largely frozen the demolition of inhabited homes but have continued targeting livelihood and service-related structures. The UK Government has expressed concern about the demolition of temporary health centres which weakens the capacity of the Palestinian authorities to respond to the crisis.

Importantly, the intention to annex parts of the West Bank remains. The new coalition agreement between Benny Gantz’s Kahol Lavan Party and Prime Minister Benjamin Netanyahu’s Likud, states that Mr Netanyahu can advance legislation to annex parts of the West Bank starting 1 July on the condition that the move is supported by the US Administration.

Focus on Gaza

Israel has maintained an economic blockade on Gaza since Hamas’s seizure of the territory in June 2007. Hamas is a Palestinian militant Islamist movement whose political wing is the governing authority in the Gaza Strip. Hamas’ military wing is proscribed as a terrorist organisation by the UK Government.

Egypt also sealed its border with Gaza in 2007, reopening the border only occasionally on humanitarian grounds. Both countries continue to control the flow of commercial goods and people in and out of the territory.

With entry in and out of Gaza only possible via a handful of tightly monitored crossings into Israel and Egypt the Hamas Government has focused on preventing the virus’s entry. From 15 March, anyone entering from either Rafah or the Beit Hanoun/Erez crossing with Israel was placed under compulsory two-week quarantine, subsequently raised to three weeks.

OCHA reports that over 2,000 people are currently staying in 21 active designated quarantine centres, up from around 600 last week. This surge is due to the arrival of over 1,630 people, who returned to Gaza from Egypt through the Rafah Crossing.

Gaza’s damaged infrastructure

Although Gaza has fewer cases, there are fears that Gaza’s damaged health infrastructure will be unable to cope with the worst-case scenario. According to the NGO International Crisis Group, there are 2,500 beds available for a population of two million and 96 ventilators.

Al-Monitor reports that hospitals need an additional 100 ventilators and 140 beds in intensive care units. Another challenge is the lack of access to equipment necessary for examining the samples collected from those suspected of contracting the virus.

However the biggest risk factor in Gaza is poverty: more than 80 per cent of the population relies on humanitarian aid. According to Crisis Group:

Pharmacists report that people have been coming to buy Paracetamol, antibiotics and other anti-inflammatory medications by the pill rather than the packet. Most Palestinians in Gaza cannot afford even locally manufactured sterilisers, let alone the imported sanitisers, gloves and masks, which are in any case no longer available. Some families bought single masks and gloves for repeated use, thereby rendering them ineffective.

The blockade

Israel’s blockade on goods entering and leaving Gaza includes medical equipment which could have dual purposes, although not pharmaceuticals and disposables.

In early April Gaza ran out of testing kits. On 14 April Israeli newspaper Maariv reported that an Israeli army laboratory had begun examining Gazan test samples. In addition, Reuters reports that Israel allowed the WHO to supply five new test kits (which can test 500 samples) and a PCR machine into the territory and has offered to expedite approvals for items needed in relation to the Covid-19 response.

However, commentators say that the blockade restricts opportunities for building the resilience necessary to tackle the disease. Echoing this sentiment, Crisis Group have called on Israel to lift the blockade and to allow the transfer of medical supplies and personnel to mitigate the shortage of doctors.

Donor responses

The Inter-Agency donor response plan was established to coordinate donor responses to the crisis in the OPTs. It initially called for US$34 million. At 20 April the OPTs had been allocated over US$29 million in aid of which US$12 million has come through the Response Plan. DFID’s contribution through the plan has been US$1,120,000 making it the fourth largest donor country.

On 27 April the plan was revised to provide a bridge between the public health response and the broader socio-economic recovery plan.

The revised plan has increased the funding requirement to US$41.9 million.

The UK Government also funds UNRWA, the UN agency that supports Palestinian refugees (£65.5 million for 2019-20), which is supporting the delivery of pandemic response plans and has put in place a range of measures to help prevent the spread of Covid-19 and to treat patients with symptoms.

UNICEF is leading on the coordination of the procurement of medical supplies and equipment. Additionally, the World Food Programme (WFP) has set up a logistics working group to support humanitarian partners in providing key supply chains, reducing duplication and increasing cost efficiency.

The UK Government has warned that the impact on economic development in the OPTs will be significant:

The Palestinian Authority’s revenues, which come mostly from levies on trade, are expected to decline by between 60 and 70 percent as a result of the crisis. The Occupied Palestinian Territories are excluded from most international mechanisms, including the World Bank’s $14 billion Covid-19 fund.