The announcement that nine cases of COVID-19 have been confirmed in Gaza filled me with a new level of anxiety and despair. Gaza is at the beginning of the pandemic curve. With two million people crowded together in area six by twenty-five miles, 70 percent are refugees, 97 percent of the water contaminated and unfit for consumption, basic measures to prevent the spread of the virus will prove challenging. With above a 50 percent unemployment rate and a lack of supplies due to restrictions on the import of goods, it is impossible for families to stock up on essential items and shelter in place, let alone practice social distancing.
While I hunker down in my first world quarantine (with adequate food, electricity, clean water, a home, and phone calls from anxious friends), more vulnerable populations have a much more dangerous prognosis. Groups without clean water and hygiene products, the ability to socially distance from other contacts, and a functional first-world health care system, are facing much higher rates of disease and death. With competent, honest public health assessments, widespread testing and education, and strategic financial support, these outcomes can be mitigated and possibly improved.
Of course, our inadequately organized and funded U.S. health care institutions and governmental agencies are rapidly experiencing what can only be called third world challenges, (a lack of test kits, swabs, masks, personal protective gear, respirators, uninfected staff). This is only made worse by our deceitful and incompetent national leadership, with the notable exceptions of the head of the National Institute of Allergy and Infectious Diseases, Dr. Anthony Fauci, other reputable scientists, and health care and emergency workers. (And all the folks working to be sure we are fed.)
While the most vulnerable populations can easily be defined by poverty and lack of resources, this group encompasses a wide range of individuals from prisoners, asylum seekers on the border and in detention centers, to refugees living in congested camps, to people in occupied territories under siege like Gaza and countries under international sanctions like Iran.
There are louder and louder calls to free people from prisons and detention centers, many of whom are awaiting trial or are detained for lesser offenses, or trapped in the immigration nightmare, for their own safety as well as the safety of their guards. There are fewer voices on the international scale. We know what happens to the health of populations under crushing sanctions. The near-total financial and trade embargo on Iraq starting in 1990 resulted in high rates of malnutrition and death, a lack of medical supplies, and the breakdown of many modern facilities. Some scholars and international aid workers likened this to a crime against humanity or genocide– and that was without a pandemic. The rates of bribery and corruption exploded as Iraqis fought to survive and the society deteriorated into sectarian factions, a weakened government, and failed infrastructure and social supports.
When we look at the situation in Iran today, numbers as of March 25 indicate more than 27,000 people have been infected and more than 2,000 have died, although many experts calculate that the numbers are grossly underreported. After Trump withdrew from the international nuclear agreement in 2018, U.S. sanctions pushed an Iranian economy into deep recession, with rising inflation, skyrocketing food prices, and decreased access and outright shortages of medications, critical medical equipment, and massive financial stresses on the nearly universal health care coverage system.
Gaza suffers from a thirteen-year siege, a barely-functional health care system subjected to repeated military attacks and an inability to obtain adequate rebuilding supplies, a decimated civil infrastructure, and shortages of waste disposal, electricity, and fuel. The Gazans are also uniquely vulnerable due to their declining levels of health in the face of poverty and substandard health care. The World Health Organization has warned that large numbers of COVID-19 patients will cause a “collapse” of Gaza’s health system.
Clearly, this is a time of grave urgency and the need for forward, global thinking. To survive as a planet, we need to take care of each other, it’s as basic as that.
While conspiracy theories, incompetency, and complacency are rampant (this is not a “Wuhan virus” or a “bioweapon”), now is not the time to listen to racist, xenophobic, or free market advice. This virus knows no boundaries and the people in charge need to listen to and share scientific data, take advice from other countries, mobilize industries to produce the products we need, and plan on an international scale how to limit the viral spread and distribute needed resources.
Basic to that is lifting the sanctions on Iran and the siege of Gaza in the name humanity and decency. This is not a war; it is a medical and public health emergency on a global scale.