“As you pay your water bill, think of others (those who are nursed by clouds).
As you return home, to your home, think of others (do not forget the people of the camps)…
… As you think of others far away, think of yourself (say: ‘If only I were a candle in the dark.’)”
– “Think of Others,” Mahmoud Darwish
The rapid spread of COVID-19, and the fear that healthcare facilities could become sources of contagion, have encouraged new models of care that avoid physical contact. Like many doctors, I have turned to ‘telemedicine’ to adapt to these difficult times. This approach allows physicians and patients to communicate 24/7 by using smartphones or computer webcams, while protecting the patients, clinicians, and the community from possible exposure to the novel coronavirus.
Working from my clinic in Haifa, fully equipped and wired, I greatly appreciate the effectiveness of these methods in consoling my patients and providing them with an easy, accessible, and safe service.
Yet I cannot stop thinking of my fellow medical colleagues in the blockaded Gaza Strip, whom I was able to visit several times as part of medical delegations organized by Physicians for Human Rights-Israel.
I recall a foolish question that popped into my mind during one of my recent visits to Gaza’s hospitals and clinics: “You still use paper medical files? Why don’t you use electronic medical records?” This naive question quickly vanished, as I remembered the electricity crisis and regular power outages caused by the Israeli- and Egyptian-imposed siege, along with the repeated Israeli bombardments that destroyed hospitals and medical infrastructures.
I felt strangely embarrassed by the entire experience. I — a Palestinian pediatrician, educated and trained in Israeli universities and hospitals, with unlimited access to online resources, trainings, and conferences abroad — had come to Gaza to “help,” “consult,” and be the “foreign expert” to brilliant, hard-working, and inspiring Palestinian doctors and nurses who face unimaginable working conditions.
These medical workers are forced to develop their skills with scarce resources at Gaza’s universities and training centers. They have very limited internet or electricity to access online resources. The Israeli siege bars them from interacting with the outside world, importing new devices and equipment, or participating in international conferences and fellowships.
Yet despite all these obstacles, Gaza’s doctors and nurses continue to work professionally in overcrowded wards and clinics, with very little material rewards, while having to tolerate their patients putting more trust in the opinion of a “foreign expert” like myself who happened to be born on the “right” side of the Green Line.
Structural violence is man-made
In 1848, after witnessing the horrible typhus epidemic in the marginalized and impoverished region of upper Silesia, the founding father of public health, Rudolf Virchow, wrote: “These enormous compilations of misery cannot be disavowed without the demolition of the old edifice of our state and achieving full and unlimited democracy… Let it be well understood, it is no longer a question of treating one typhus patient or another by drugs or by the regulation of food, housing and clothing… Typhus would not have caused such damage if the population had been free, educated and well-to-do.”
Over a century and a half later, faced with the current coronavirus epidemic, Virchow’s diagnosis is just as fitting for the Gaza Strip.
In the literature on public health, structural violence is described as “social arrangements that put individuals and populations in harm’s way.” They are “embedded in the political and economic organization of our social world,” and generate unnecessary and avoidable suffering upon ordinary people, including on their health and well-being.
Architects of structural violence rely on the erasure of historical memory as a form of de-socialization. It allows cruel conditions that are regarded as “sinful” and ostensibly “nobody’s fault” to be accepted as normal, while new, hegemonic, and misleading accounts of history take over. This process is subtle and incremental, and requires erasing connections across time and space.
Put simply, it is about forcing people to forget the source of their misery and oppression.
Arguably, nowhere is this as evident as in Gaza. The history that Israel seeks to erase is that the Gaza “Strip” is in fact an artificially-created geographical unit; a frontier designed by a settler colonial project as a place to squeeze Palestinian refugees away from their occupied land. Most of Gaza’s population today are descendants of those refugees of 1948, residing in overcrowded and impoverished camps, waiting for their right to return to their land.
The erasure of memory occurs in other ways, too. Watching the efficient response by the government of Singapore to contain the COVID-19 outbreak, I am reminded of the old mantra of Gaza’s capacity to become a “Singapore” in the Mediterranean – a line frequently uttered by Israel and its advocates.
“A free, neutralized democratic Gaza has the potential to turn into a Singapore of the Middle East,” reads one letter to the New York Times in 1988. “Being small and compact allows easy development of infrastructure. A free trade area removed from the conflict could assume the role once held by Beirut.”
This fantasy of Gaza’s development under Israeli occupation has now vanished. Today’s rhetoric openly calls for Gaza to be “flattened,” “sent back to the Middle Ages,” or sent even further back to “the Stone Age.” Instead of creating pockets of economic growth to pacify Palestinians — as is being done in the occupied West Bank — Israeli authorities are making calculations of the precise number of calories needed to ensure Gaza’s two million residents do not starve while being suffocated under siege and military assaults.
End the siege
For Palestinians in Gaza living under these conditions, basic medical instructions like hand-washing, wearing protective masks, staying at home, and reaching doctors via telemedicine to fight COVID-19, are a dark, cynical joke. Even if individuals could do all these things, blockades and sanctions will always feed an epidemic by hampering the society’s capacity to respond, including by crippling the population, economy, and health sector.
It is for this reason, among many others, that progressive voices around the globe are intensifying their call to lift sanctions on Iran, Venezuela, and Cuba. The same must be done for Gaza. Now more than ever, it is urgent to end Israel’s blockade in order to rebuild Gaza’s healthcare services, and to ensure that its two confirmed cases of COVID-19 do not turn Gaza into a pandemic dystopia.
At the same time, it must not be forgotten that true historical justice for Gaza — which includes the right to live with good health and healthcare — cannot be solved by humanitarian aid alone. It is achieved by abandoning the “Gaza Strip” as a place of defined and closed borders, and replacing it with a future that revives Gaza as a port city of Palestine — and one that allows its refugees to return to their homes.