After reading so many reports (for years) on Gaza’s failing health system and economy, I became a bit numb to the reality of what zero-stock drugs and supplies, and over 45% unemployment of the working age actually means. I know it means people with serious diseases like cancer, diabetes, hypertension, psychological disease, kidney failure… suffer for want of treatment, and that the thousands of new university and college graduates sit jobless, parents sit jobless and line for food aid, families suffer.
But the words “shortage” or “suffer” or “crisis” don’t suffice. Nor even the numbers or facts which should shock, especially considering that these are long-term shortages, increasing by the year:
-180 of the 480 essential medications at zero
-190 of the 700 essential medical disposables at zero
-rubber gloves are being re-used, disposable tubes re-sterlized
-200 kidney patients waiting to receive dialysis from machines without filters because filters unavailable
-diabetes patients lacking medications, insulin shortages
-medication for hypertension patients out of stock for 3 months
-17% of antibiotics for serious infections out of stock
-9% of chemotherapy drugs zero stock
-syringes at zero stock
-gauze out of stock
When I think of real, personal examples, these already staggering statistics then become horrific. Family and friends outside of Gaza who’ve endured cancer treatments, died from the disease. What if they had not even had the luxury of the medications? Of pain-killers? Loved ones with high blood pressure. How hellish their daily life if they didn’t have medications or means to stabilize their blood pressure or treat their diabetes.
Last year I met a woman here with kidney failure, needing dialysis 3 times a week. The procedure was a day-long one that left her exhausted. She tried to find a kidney donor among her children, but the testing facilities in Gaza were destroyed when Israel bombed the Islamic University. She tried to exit with some of her children but didn’t have the money to bribe the Egyptian officers at the border and was turned back.
Re-using rubber gloves? It’s disgusting, unhygienic, and obviously doctors in Gaza are aware of that, but what other option is there?
I was forwarded an email with twenty or so photos of Gaza, lovely photos. Some new, most old…the bombed Islamic University which now (2.5 years later) has had much repairs; the small number of tallish buildings (I, like most others, thought Gaza had only the squalid, one-level refugee camp cement houses, never thought there’d be apartment buildings or “high-rise” –twenty floors at best) which were mainly begun after the Oslo accords were signed, when Palestinians who’d been exiled outside Gaza returned and invested…like people anywhere do. The photos did not include those very basic, cramped, hot cement houses which are all over the Strip (Palestinians don’t want to live in shoddy, asbestos rooved houses, but the small cement blocks are still better than the tents which the original refugees from 1948 Palestine lived in for years. And whatever the quality of the house, all I have seen are kept impeccably clean inside, no matter how bare-bones the home).
The photos included shots of the Jundi, a park in central Gaza city, in the days when the fountains flowed with clean water and grass flourished. The fountain runs sometimes, with grey, recycled water, but most of the time is dry. The fountain in Gaza’s municipal park is dry, as are the flowers and trees. The children’s play areas are falling apart, swings with stumps of ropes.
The photos did not include lines of food-aid dependent Palestinians waiting for their hand-outs of sugar, oil, flour… nor the putrid sewage water flowing in the sea and stinking the shore along Wadi Gaza as well as the dangerously full pools in the north which overflowed a few years ago, drowning locals in the filth.
The aim of the photo essay was to portray Gaza’s economy as flourishing, Gaza as not under the maiming siege it is under.
And while there are a small few with some wealth in Gaza, the staggering majority are impoverished. Gaza’s “middle class” would be those who earn roughly 1000 shekels (~$300) a month, but have families to provide for and high food prices to contend with. After the 2008-2009 Israeli war on Gaza, housing and rental prices increased to unaffordable levels, with thousands of houses demolished and homes damaged. Even for a families with 2 incomes, paying rent of $300 ($200 might be the cheapest for a very modest apartment in Gaza City; most are $400 or more) leaves little money for food, transportation, and living expenses.
Omar Shaban, Palestinian economist and head of PalThink for Strategic Studies, a Gaza based think-tank, said of the economy and siege:
The humanitarian crisis in Gaza is not about food. People don’t live on food alone. The humanitarian crisis is about education, it’s about development, about imprisonment; it’s about a cultural and physical siege and isolation. There is no starvation in Gaza, but 90 percent of Gazans cannot feed themselves.
Sustainable development needs a complete lifting of the siege. There is a danger that Gazans are becoming completely aid dependent. If the siege is kept in any form and only United Nations and other international agencies work, private industry will not be able to function, individuals will not be able to build their own houses, and industry will not operate, leaving all of Gaza dependent on either cash aid or in-kind assistance.
We need to export, people need to be able to travel, to make business, and people need to be able to come to Gaza. Banks need to be able to operate normally and cash needs to be injected.
The World Food Program reported on Israel’s “easing” of the siege from June 2011 (Gaza eased or un-eased):
On 8 December 2010, the GoI announced that it would allow the export of agricultural products, furniture, and textile products through the crossings to assist the Gaza economy….The planned expansion of commercial crossings did not take effect; rather Karni was closed in March 2011 and only one crossing is open for import and export of goods. [kerem abu salem]
The average monthly trucks entering the Gaza Strip between n July 2010 and March 2011 represented only 41 percent of the average truckloads entering before the blockade for the same duration (July 2005 to March 2006). The new access regime has brought mainly additional consumption goods, with potential increase in availability of better quality and a wider range of products for consumers. However, most of this stock increase came in the form of new types of soft drinks, hygiene products, chocolate and chips.
A lack of substantial quantities of raw materials and construction items for the private sector, and the heavy restrictions still imposed on exports, failed to translate into a significant creation of long term jobs with adequate wages, which would help reduce poverty levels.
Although economic growth in Gaza was estimated at 15 percent in 2010, the high number fails to expose the fact that it came from a very low base and was mainly donor-driven.
Some improvement in the agriculture sector was noted following the June 2010 decision; however, it is mainly linked with seasonal employment patterns.
Meanwhile, restricted areas along the Israeli border take up 35 percent of agricultural land and fishermen cannot access areas beyond 3 nautical miles from the shore . Such restrictions deteriorate livelihoods dependent on fishing and agriculture and prevent sustainable growth in the agriculture sector as well. Although economic growth in Gaza was estimated at 15 percent in 2010, the high number fails to expose the fact that it came from a very low base and was mainly donor-driven. With the private sector still moribund, growth at this rate is unsustainable, according to the World Bank .
Despite growth and increase in consumption goods, more than half of Gaza households remain food insecure compared to pre-June 2010. Due to a lack of well-paid jobs, business and investment opportunities, food insecure families still have difficulties accessing quality goods with their low levels of income.
Soaring prices of basic commodities such as wheat flour, vegetable oil, and fuel exacerbate poor economic access to food for Gaza households.
Therefore, the effect of the new access regime has not materialized into a more productive economy and the slight improvements in some sectors in 2010 have not trickled down to the household level: three-quarters of households continue to rely on humanitarian assistance in Gaza.
Sixty-six percent of households in the Gaza Strip are food insecure or vulnerable to food insecurity compared to 65 percent before June 2010. Furthermore, the types of food consumed by households worsened post-June 2010 for part of the population. Impoverished households reported an increase in consumption of products made mostly of oils/fats (45 percent increase) and sugar (195 percent increase), leading to poorer diet and nutrition.
Due to a hike in the international market price of wheat flour and increased transport costs for traders, prices of staple food witnessed a particular increase: wheat flour price increased by 50 percent between June 2010 and March 2011 , and vegetable oil increased by 40 percent over the same period. However, over the same period, average nominal daily wages increased slightly . In terms of real average wages, there has been a decrease by nearly 9 percent comparing 2009 to 2010, while compared to 2007 it decreased by more than a fourth.
In June 2011, Christopher Gunness, UNRWA’s spokesman, said “the number of people coming to us, the abject poor living on just over 1 dollar a day, has tripled to 300,000 since the blockade was imposed…”
Add to these facts on the medical crisis and hobbling economy the power cuts, the stupendous heat, and the continuous awareness of being locked in with no chance of a breather outside.