As the world races to vaccinate against COVID-19, Israel has been touted for having one of the fastest response rates. The country has, as of January 1, 2021, already vaccinated 10 percent of its 9 million citizens and predicts another 2 million will be vaccinated by the end of the month. While these are laudable statistics, Palestinians living in the West Bank (including East Jerusalem) and in the Gaza Strip have been explicitly excluded, including health care workers on the front lines of the COVID-19 response.
My organization, UNRWA USA, is a national committee of the United Nations Relief and Works Agency for Palestine Refugees (UNRWA). The agency, mandated by the UN General Assembly to support the lives, dignity and well-being of Palestine refugees, including those living in Gaza and the West Bank, runs a primary health care system. UNRWA’s doctors and nurses have been on the front lines of providing critical public health information to refugees about COVID-19, triaging patients, quarantining those infected with COVID and engaging in home delivery of critical medicines to reduce the numbers of patients inside clinics. Through creative and effective health practices, UNRWA still manages to keep the infection rates among Palestine refugees equal to or lower than the broader populations in each area of operation. Despite this heroic work, these frontline staff, let alone those who they serve, will not have priority access to the vaccine like their neighbors.
Instead, UNRWA and other humanitarian organizations operating in the West Bank and Gaza must rely on COVAX, a project co-led by the World Health Organization and Gavi, the Vaccine Alliance, which aims to accelerate the development and manufacturing of the vaccine to guarantee equitable access for every country, including low- to middle-income countries. COVAX is an essential component of the global vaccine response and the only one that will reach the most vulnerable. Still, it is only able to target 20 percent of the global population for vaccination by the end of 2021.
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“While [COVAX] reduces the impact of the overall health burden, it still may not mitigate the effects of the pandemic,” UNRWA Director of Health Akihiro Seita told Truthout, explaining that COVAX is a start, but no panacea. “It is still important to request the international community and host countries to make sure no Palestinian will be left behind. COVID-19 vaccines are the global public health goods, and there should be universal and equitable access to all.”
UNRWA reports that it will coordinate closely with COVAX and work to ensure that Palestine refugees receive an equitable share of vaccinations and advocate for no Palestine refugee to be left behind. The challenge is exacerbated, however, by the fact the agency, which relies on voluntary contributions, is facing the most significant funding shortfall in its history, due in large part to the funding cuts of the Trump administration. In December 2020, the agency was not able to pay its staff on time, including its health care workers, due to a lack of available funds. These crises are only further compounded by the ongoing Israeli occupation of the West Bank and the Israeli blockade over the Gaza Strip.
In Gaza, where a 14-year comprehensive land, sea and air blockade prevents even jam and some brands of chocolate from crossing its borders, no vaccinations have been allowed in, and the wait for the vaccine may be even longer than that in the West Bank.
Frontline worker Ghada al-Jadba has been chief of the UNRWA Health Program in Gaza since 2015. She manages a staff of over 900 and all of the health operations and services provided by 22 UNRWA health centers for approximately 1.2 million Palestine refugees — and yet, she and her staff have yet to receive information on when they may receive a COVID-19 vaccine. When asked about the access to health care and the challenges of working as a provider in Gaza with limited resources, she responded, “We [UNRWA] are the most cost-efficient health provider [of] quality health services that respect the dignity of refugees. We are saving lives with minimal resources. Health is a humanitarian issue and right. It is unacceptable to deny people of this basic human right in the Gaza Strip.”
The COVID-19 pandemic has only aggravated existing health concerns in Gaza, including mental health. “Gaza was destroyed in 2014. And it wasn’t just physical injuries,” says al-Jadba. “There were psychological injuries. [Palestine refugees] lost friends, family members, their homes. They lost the feeling of feeling safe and secure. Everyone is traumatized in some form.”
Despite the agency’s rapid response to the crisis, there is no way to sidestep the dire context of serving a refugee population. This is especially true in Gaza, which represents one of the most densely populated places on the planet, where prevention of the virus’s spread and social distancing are nearly impossible, even with the most thoughtful and proactive response in place. These conditions are in fact an argument for prioritizing refugees, not leaving them behind.
As countries across the globe have been rolling out the vaccine to the public, the process has only highlighted global inequities, where, predictably, wealthier countries and individuals have been the first to benefit. No clearer is this reality than in Israel and the occupied Palestinian territory. As al-Jadba said, access to health is a fundamental human right. We have seen this year that COVID-19 does not discriminate based on nationality, and neither should the global response to it.