“I was helpless”: Health workers speak of unpreparedness and uncertainty during Gaza’s COVID-19 response

“We had the ingredients for an imminent catastrophe: our health system is fragmented and fragile,” said a senior nurse at Al-Rantisi hospital in Gaza. “Fourteen years of isolation from medical development was reflected during the pandemic. We had to learn how to contain an infectious disease in a besieged city with our limited resources.”

Half a century of military occupation and 14 years of illegal closure and blockade had pushed Gaza’s health system close to collapse long before the arrival of COVID-19. Israel’s 11-day military offensive in May has compounded these challenges. Healthcare workers have been on the frontline responding to the pandemic, while also working to maintain other essential health services. “It was stressful to watch and wait for the catastrophe,” said the nurse.

Hospitals and medical centres in Gaza had shortages of essential equipment and medicines, staff with specialist training, and adequate clean water and hygiene facilities. This unpreparedness was a major source of stress for Gaza’s health workers.

A social worker in the pediatric oncology department at the same hospital, said that an increase in deaths of children was not caused by COVID-19, but by the interruptions to and local unavailability of their treatment. “The death of a 14-year-old girl had a heavy toll on me,” she said. “She needed a bone marrow transplant. We cannot perform that type of surgery in Gaza. It is available in Israel or in Europe, but due to the outbreak of COVID-19 and the permit regime her treatment got interrupted. I wanted to help as much as possible, but I was helpless.”  

Obtaining a permit from the Israeli authorities to exit Gaza is a lengthy and unpredictable process, fraught with delays and arbitrary denials. The waiting time for a permit can be weeks or even months. These delays, compounded for the last year by limitations on movement because of COVID-19, risk the health of patients with potentially lethal consequences.

Even before the outbreak of COVID-19 in Gaza, this social worker’s work was stressful and mentally exhausting. Due to the pandemic, her workload and responsibilities increased dramatically. She also felt immense stress about infecting the children she worked with. “I became extra cautious and responsible, knowing that these kids’ immune systems are weak,” she said. “I was stressed about infecting my family as well. I did not visit my mother for half a year, we used to only talk on the phone.”

A senior physician at Gaza’s Al-Nuseirat Medical Centre, also witnessed an increased workload. “I used to work more than 14 hours [a day]. Until this day I have not taken a day off,” he said. “I was and still am mentally and physically tired.” The time he spent at work and his fear of infecting his family when he returned led him to spend less time with them and feel isolated.

Alongside the isolation, the physician also faced social stigma. “They used to call us ‘corona’, people used to move away from me, while others used to gaze at me differently,” he said. “It is frustrating to be stigmatised after risking your life and working on the front line to save other’s lives.”

The physician felt that responding to the outbreak of COVID-19 was more challenging than any of the military offensives Gaza has experienced. “We are not certain of the duration of this situation,” he said. “The war in 2008 to 2009 lasted 25 days, the war in 2014 lasted 51 days. Today, we are not certain when all of this will be over; we cannot see any rays of hope.”

The nurse also expressed feelings of uncertainty, particularly for his patients. “I wish we could say that these days are over,” he said. “Until 50 to 60 percent of Gaza’s population receives the vaccine, we will be endangering the most vulnerable groups.” But this target is far from being met. According to the Ministry of Health in Gaza, as of 5 July, less than four percent of the two million population have been fully vaccinated and Gaza faces a major vaccine shortage.

In addition to a shortage in vaccinations and insufficient medical resources, healthcare workers lacked access to mental health or psychosocial support. They were left feeling helpless with nowhere to turn during a crisis. “I wanted to share my feelings with someone or just to have the ability to run away from this situation,” said the social worker.

Lockdown restrictions deepened existing barriers to movement outside of Gaza, leaving healthcare workers feeling trapped and cut off from the world. “In Gaza, there is no place to go. It is a complete lockdown and a closure,” said the physician. “Any plan for a holiday or an escape is only a dream.”

Read our briefing on the impact of COVID-19 on the mental health of Palestinian healthcare workers here.

Read the briefing

Read the story in Arabic here.

Photo: Palestinian healthcare workers walk as they arrive to collect swab samples from people to be tested for COVID-19 in southern Gaza, 14 January 2021. Credit: REUTERS/Ibraheem Abu Mustafa.

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