Basic health care services are hard to come by.
GAZA CITY — As negotiations continue to prevent the collapse of reconciliation talks between internal rivals Hamas and the Palestinian Authority, the lives of those living under siege in Gaza play out in very different ways. Israel's blockade coupled with the sanctions the Palestinian Authority has imposed to extract political compliance from Hamas have left many Gazans watching politics unfold from below as they are left waiting for medical treatment, stranded with no means to resume studies, looking for ways to renew expired documents and residency permits, or working toward immigration.
A visit to the central Gaza City neighborhood of Rimal begins to paint a picture of this other reality. Financial aid applicants are taking up the better part of the most lively street in the entire strip. The poverty rate in Gaza sits at 65%, and unemployment is up to 47% from 41.7% two years ago, according to figures produced by the Palestinian Central Bureau of Statistics cited in a July 2017 Palestinian Center for Human Rights report.
The economic conditions have also touched Gaza's healthcare system. The Health Ministry moved to shut down Beit Hanoun Hospital in the northern part of the strip in order to conserve fuel and prevent long power outages, according to the ministry spokesperson Ashraf al-Qidra. The spokesperson tells Mada Masr that the ministry cannot afford to buy additional supplies of fuel, and that patients would be referred to hospitals that have adopted rationing procedures. Other health centers have stopped performing surgeries due to medicine shortfalls.
The conditions are related to the sanctions that Palestinian Authority President Mahmoud Abbas imposed on Gaza in April 2017, which included slashing 30% from employee salaries and limiting the transfer of electricity from Israel. Hamas also claims that the Palestinian Authority has prevented patients from seeking healthcare outside of Gaza. The authority has stated that the lifting of sanctions is contingent on the full dissolution of the Gaza administrative committee, which Hamas set up in March 2017.
The administrative committee took on the task of managing the governance of Gaza's security, education, health, social development, financial development and economy in March 2017. It was formed as an alternative to the 2014 national unity government which was unable to take over due to disputes between Hamas and the Palestinian Authority over the details of the reconciliation.
Palestinians waiting for travel permits to cross into Egypt through the Rafah border — Photo: Wissam Nassar/DPA/ZUMA
Hamas conceded to the Palestinian Authority's demands to dissolve the administrative committee in September, following mediation efforts by Egypt. The sanctions, however, remain in effect.
The referral of patients to facilities outside Gaza is not any less difficult than providing them with treatment inside the strip. On the one hand, Israel denies most Gazans passage to the West Bank or Jordan through the Erez Crossing, claiming that they pose a security threat. On the other hand, the Rafah Border Crossing – the only crossing which is not controlled by Israel, but is co-managed by Egypt and Hamas – is usually closed for long stretches of time.
Death does not seem like the most tragic fate.
Magda Ahmed, 40, is burdened twice over by the blockade: once for being a Gazan resident and again for being a cancer patient. She tells Mada Masr that she tried to cross into Egypt via the Rafah Border Crossing several times, but each time she found it closed. And when she turned to the Erez Crossing to try to cross into Jordan, Israeli authorities refused to grant her passage to the West Bank or Jordan "for being a danger to Israeli security."
"I have appealed the travel ban, through rights organizations, to be able to seek treatment abroad. But I have not been answered," Ahmed says.
Hamas had been co-managing the Beit Hanoun and Karm Abu Salem border crossings with Israel and the Rafah Border Crossing with Egypt for over 10 years, since winning the elections for the Palestinian Legislative Council in 2006. In November 2017, Hamas handed the three crossings over to the Palestinian Authority as one of the conditions of reconciliation.
Security sources speaking on condition of anonymity report that this month, for the first time, Egyptian authorities granted passage to over 250 trucks carrying materials needed for industrial work. Israel has banned such materials from entering Gaza in an effort to hinder the progress of the Palestinian industrial sector.
In October 2017, the World Food Programme announced it would cut back its provision of food vouchers after the United States withheld US$65 million in funding for the United Nations Relief and Work Agency. But the fact remains that 80% of Gaza's population relies on external aid to secure the bare minimum of daily needs.
Palestinian media projections and daily references in the Israeli media frame Israel as preparing to wage war in Gaza.
This comes as Israeli land, air and naval combat units have been conducting military exercises. The headquarters of most Palestinian factions have been notably evacuated, and police and security checkpoints have been deployed throughout the Gaza strip, all in preparation for any security emergencies. The state of the military alert is evident on the streets.
Here in Gaza, death does not seem like the most tragic fate — sections of the population have been fading away on a daily basis due to the dire living conditions, not to mention the psychological distress as war has become the foremost topic of discussion among the public. Everyone waits in anticipation. Perhaps the coming days will usher in events that will change the situation drastically.