‘A glimpse into the chaos’: How Israel’s COVID-19 policy neglects Palestinian citizens

Israel's failure to conduct Arabic outreach and include Arab professionals has made it harder to stem the virus' spread in Palestinian towns, experts warn.

A man checks the temperature of a customer to identify if he has a fever, in the northern Arab town of Deir al-Asad, April 18, 2020. (Basel Awidat/Flash90)
A man checks the temperature of a customer to identify if he has a fever, in the northern Arab town of Deir al-Asad, April 18, 2020. (Basel Awidat/Flash90)

Israel entered a weeks-long lockdown on Friday to stem a second wave of the coronavirus. As is in other parts of the world, statistics are showing that minority communities, in this case Palestinians, are being disproportionately affected by the pandemic.

It is a cliche, and an inaccurate one, to say that the coronavirus does not distinguish between Jewish and Palestinian citizens of Israel. Even the struggle shared by Jewish and Palestinian medical workers in hospitals and clinics is not proof that we are all in the same boat. If anything, the Arab community is on a boat that is floating to a particularly dark place.

In mere weeks of the second wave gripping the country, Palestinian citizens went from constituting 10 percent of patients who tested positive to the virus, to 30 percent — and the curve is rising sharply. The English Hospital in Nazareth, which has traditionally treated mostly Palestinian citizens, has had to open another coronavirus clinic.

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The map of the outbreak is increasingly falling along ethnic, national, and geographic lines — just as poverty and crime have long been. Will we, Palestinian citizens, become Israel’s backyard for the coronavirus as well, such that the hardships we endure will barely matter to the country?

‘Paternalistic mindset’

When the pandemic broke out in March, Arab communities were largely left in the dark. Many received information in Arabic based on awareness campaigns released in Turkey and even China, not from Israel’s Health Ministry. It was only about a month later that the Health Ministry finally appointed an Arabic spokesperson and ensured all materials were produced in Arabic too.

Palestinian civil society stepped in to fill the gaps in the early weeks of the pandemic, even if partially. The High Follow-Up Committee, an umbrella organization that represents the country’s Palestinian citizens, established the Arab Emergency Committee, operated by the Galilee Society, a Palestinian health research institute.

Ahmad a-Sheikh, the organization’s CEO, says that the AEC was tasked with creating their own campaigns aimed at Arab society without government support or funding. The Committee was also the only source of daily updates for Palestinian citizens about their communities.

An ultra-Orthodox Jewish man and an Arab woman wearing face masks walking in Jaffa Gate, outside the Jerusalem Old City, July 5, 2020. (Yonatan Sindel/Flash90)
An ultra-Orthodox Jewish man and an Arab woman wearing face masks walking in Jaffa Gate, outside the Jerusalem Old City, July 5, 2020. (Yonatan Sindel/Flash90)

Palestinian society in Israel was largely spared the worst of the pandemic’s first wave: five Arabs died and around 100 tested positive. Faten Ghattas, a public health expert who previously served on the High Follow-Up Committee’s health cluster, says that there are several explanations for the relatively low infection rate back then, but that official information from government bodies was not one of them. “Perhaps initial fear of high mortality helped to a certain extent, or the coronavirus was simply not present in a significant way or brought in from abroad, as was the case in Jewish society,” explains Ghattas.

Six months into the outbreak, there is still a lack of reliable and easily accessible information in Arabic. “Not only is there no spokesperson for Arab communities [during the second wave], but Palestinian experts are excluded from decision-making around stemming the spread of the virus, and there is no serious consultation with Arab medics,” Ghattas adds.

“This is a complete and utter failure on all levels,” says Dr. Nihaya Daoud, a senior lecturer on public health at Ben-Gurion University. “Nobody cared to change the paternalistic mindset toward Arab society. The Health Ministry prefers to communicate with experts who do not specialize in public health in Arab communities, or who understand the cultural nuances.”

‘No shortage of creative solutions’

Professor Fahed Hakim, a specialist in pediatrics and lung diseases who manages Nazareth’s English Hospital, and who is a member of the the High Follow-Up Committee’s health cluster and the Health Ministry’s Coronavirus Advisory Committee, says the problem isn’t just that Palestinian medical experts are hardly being consulted. “The committee is in constant discussion, but we feel that our recommendations aren’t sufficiently implemented on the ground,” he says.

Hakim stresses the importance of creating a reliable and accessible source of information for Palestinian citizens. “Every day, we received hundreds of questions regarding isolation or exposure to confirmed coronavirus patients,” he says. “An information center could be created across multiple platforms, and staffed with students and medical volunteers. Many would be happy to volunteer, but such a center cannot exist without funding from the Health Ministry.”

As soon as recommendations require the government to invest money and resources, “they become impossible to administer,” adds Hakim. “We are fighting an unprecedented war, yet the Finance Ministry will still sabotage plans due to bureaucratic obstacles. The entire country is suffering from this issue, but Arab communities, who are already at a disadvantage, suffer even more.”

Lab workers at Sheba Medical Center in Tel Aviv protest their working conditions at the entrance to the hospital, August 11, 2020. (Flash90)
Lab workers at Sheba Medical Center in Tel Aviv protest their working conditions at the entrance to the hospital, August 11, 2020. (Flash90)

Hakim points to another factor that could have helped stabilize the outbreak among Palestinian citizens but has been under-utilized. “Data shows that a quarter of Arab families have at least one person employed in the medical fields,” he says. “Medical teams are agents of change unlike any other, but they, too, suffered from a lack of credible information and thus of the ability to guide the public. There is no shortage of creative solutions that could have made use of the many and incredible strengths within Arab society.”

Another problem, adds Hakim, is insufficient epidemiological investigation, which is needed to break the chain of infection in Arab communities. He suggested recruiting 60 students from Nazareth Hospital’s Nursing School, but “bureaucratic hurdles” prevented its implementation. “You can’t expect a Jewish nurse, when questioning a coronavirus patient, to know what a ‘hammam’ [an Arab pre-wedding ritual] is, and subsequently determine who should be quarantined,” he explains. “The same applies when talking about areas, neighborhoods and exposure points in crowded Arab locales.”

Disconnected messaging

Information campaigns are meant to raise awareness and change behavioral and thinking patterns, says Daoud. The failure to do so in Arab communities, she argues, is rooted in the responses during the first wave. “People couldn’t find reliable information on the disease, and therefore took to social media. Many fell for conspiracy theories and misinformation. The lack of information led to neglect during the second wave.”

Low infection rates during the first wave were not only misleading, but also encouraged indifference among Palestinian citizens. They also served as an excuse for the Israeli authorities to continue ignoring the lack of information, enforcement, and access to tests.

When the government did release information in Arabic, it essentially focused on a problem that hardly existed: encouraging Palestinian citizens to get over the “embarrassment” of getting tested. The real issues were — and remain — increasing awareness and making tests easily available.

The Health Ministry’s first serious Arabic-language campaign came out in late April, coinciding with the Muslim holy month of Ramadan. By then, it was difficult to adhere to the campaign’s messaging, as the number of COVID-19 patients was going down and the country was coming out of lockdown.

Magen David Adom medical workers perform COVID-19 tests to Palestinian residents at a mobile testing station, in Jerusalem, July 5, 2020. (Yonatan Sindel/Flash90)
Magen David Adom medical workers perform COVID-19 tests to Palestinian residents at a mobile testing station, in Jerusalem, July 5, 2020. (Yonatan Sindel/Flash90)

Yet the language and messaging of the government’s campaigns were not only delayed, but revealed a significant cultural disconnect; they failed to comprehend the social behaviors and realities of the target audience. In its first public video, for example, Palestinian citizens were instructed to stay home and avoid large Ramadan gatherings by checking in on family members over video call — a solution that is not relevant to Arab families that often live alongside one another. 

Other government-led, Arabic-language campaigns featured dozens of long interviews with doctors and public figures, most of which are tedious to watch and are not fit for today’s media consumers.

A significant number of local Arab authorities also failed to spread awareness. From the start, it was clear that municipalities would have to assume some of that responsibility, and they even received special budgets to do so. But while some locales published daily updates and called on residents to help stop the virus from spreading, many others did not, and instead focused on charities delivering food packages to families in need. Some mayors called on the public to abide by the precautions while violating those rules themselves.

No Arabs, no Arabic

Two Hebrew-language information campaigns continued through May and July despite the decrease in COVID-19 cases. One of them, which talked about the correct way to wear a mask and how businesses should operate in the pandemic, was adapted into Arabic. The other, which featured patients who have fought the disease warning people of the cost of indifference, was widely broadcast in Hebrew, but had no Arabic equivalent.

At the start of the second wave, another campaign was released in Hebrew, featuring Jewish-Israeli comedian Israel Katorza encouraging people to wear masks and show responsibility for others. This campaign, too, was not reproduced in Arabic.

It seems that government information in Arabic does not correspond with developments on the ground, but has more to do with holidays and events in the Muslim calendar. As such, a small campaign was launched for Eid al-Adha in late July and early August, with two separate and inconsistent messages that lacked focus and a call to action. The content was not promoted in a way that correlated with the extent of the danger or the size of the population needed to be reached.

Police at a temporary "checkpoint" in the northern Arab town of Deir al-Asad, following the government decision on a full lockdown on the town, April 18, 2020. (Basel Awidat/Flash90)
Police at a temporary “checkpoint” in the northern Arab town of Deir al-Asad, following the government decision on a full lockdown on the town, April 18, 2020. (Basel Awidat/Flash90)

That failure is partly due to the fact that Israel’s Government Advertising Agency (Lapam) has been very poor at marketing its Arabic campaigns. It hires few Palestinian citizens, has no Arab campaign managers, and all its Arabic services are outsourced. Lapam also doesn’t have a sufficient grasp of the Arabic social media ecosystem. In addition, the inequitable distribution of funding means that Palestinian citizens receive less resources than their Jewish counterparts.

A veteran Palestinian advertiser, who asked to speak on the condition of anonymity for fear of income loss, says that low investment is not the only problem with information campaigns aimed at Palestinian society.

“The Arabic information campaigns are a glimpse into the larger chaos around which the coronavirus crisis in Palestinian communities is being handled,” the advertiser says. “You can walk in the street and be exposed to one message on billboards, and hear another separate message on the radio, then watch a totally different message on the TV or computer screen.” This confusion derives from the absence of a central campaign strategy, and of working with different service providers each time to come up with temporary solutions, he adds.

Ghattas agrees that the Arabic campaigns lacked consistency: “They have failed to dive deep into the root of the problem.” Now, the situation is changing. “We’ve reached a crucial point,” he says. “Palestinian citizens are paying attention, and we can’t lose that moment.”

Only now are campaigns finally being adjusted to Arabic-speaking audiences, explaining the chain of infection, how patients can also be asymptomatic, and why it’s important to stay in quarantine even if the tests come back negative. 

Weddings during a pandemic

The subject of weddings has been largely absent from the information campaigns. Only this week, toward the end of wedding season and after wedding parties have turned many Palestinian cities and towns into COVID-19 hotspots, has the Health Ministry remembered to launch a radio campaign addressing such events. In the message, clergy and medical professionals preach without giving a memorable catchphrase or offering a clear course of action.

Leaders of the Arab sector and heads of Arab authorities in Israel participate in a rally calling for financial support from the Israeli government outside the Finance Ministry in Jerusalem, May 4, 2020. (Yonatan Sindel/Flash90)
Leaders of the Arab sector and heads of Arab authorities in Israel participate in a rally calling for financial support from the Israeli government outside the Finance Ministry in Jerusalem, May 4, 2020. (Yonatan Sindel/Flash90)

It is clear that Israeli health officials did not understand the weight that weddings carry in Palestinian society. For many Palestinian families, declining to attend a wedding is a difficult and sometimes inconceivable notion, especially when many families sacrifice their standard of living to be able to afford an event that makes them feel they belong to a local collective.

Weddings are also an important source of local business. As unemployment rates continue to surge in the country, Palestinian citizens are paying a particularly high cost: though they make up 14 percent of the the workforce, they constitute 19 percent of those unemployed in Israel.

The Health Ministry has produced only one video referring to weddings. It rightly warned that asymptomatic patients could spread the virus at such gatherings. But the video was only promoted once, and it is unclear how many Palestinian citizens have seen it. The ministry has yet to create an information campaign that manages to encourage people to reduce or postpone their weddings.

According to Daoud, even when information campaigns were published in Arabic, they were patronizing and accusatory, especially on the topic of weddings. The state finds it convenient to absolve itself of responsibility for what goes on in Palestinian society, she says, and it finds it challenging to think outside the security-focused lens through which it sees Palestinian citizens. It was also unhelpful when coronavirus czar Ronni Gamzu referred to the behavior of Palestinian citizens amid the pandemic as “terrorism.”

In the meantime, growing internal criticisms within Palestinian society have helped to decrease the throwing of wedding parties during the pandemic. But with the new academic year, the source of infection has moved to schools. As a result, entire classes are going into isolation and schools are having to close on a daily basis.

Police at a temporary "checkpoint" in the northern Arab town of Deir al-Asad, following the government decision on a full lockdown on the town, April 18, 2020. (Basel Awidat/Flash90)
Police at a temporary “checkpoint” in the northern Arab town of Deir al-Asad, following the government decision on a full lockdown on the town, April 18, 2020. (Basel Awidat/Flash90)

Hakim says that if  there was an illusion at the start of the outbreak that only the elderly and people with chronic conditions were vulnerable to the disease, now the infection rate is increasing among children. This is the time to let fear among parents kick in, he adds.

Here, too, the government failed to release timely Arabic information campaigns. While the Education Ministry has launched a Hebrew campaign featuring celebrity Guy Zoaretz explaining how to go back to school safely, Palestinian families and children only received flyers and printed materials.

Need for enforcement

A month ago, Gamzu appointed Aiman Saif, former head of the Authority for the Economic Development of Minorities, as an advisor in the government’s efforts to combat the coronavirus in Palestinian society.

Saif admitted to Local Call that even “without looking at the numbers, one can’t deny that the government’s investment in Arabic information materials is trivial compared to the sums it has allocated for information in Hebrew.” But now, he adds, “considerable efforts are being made, and there is already an improvement. As long as this pandemic is around, we must adopt a relevant, convincing, and designated strategy for Arab society.”

But if, as members of the Advisory Committee for Arab Society claim, recommendations are not being implemented, then what’s the point of the committee? “We are dealing with a complicated pandemic within a complicated system,” explains Saif. His team of four is working “day and night” to coordinate an appropriate response both with government entities, such as the Home Front Command, police, Interior Ministry, and Welfare Ministry, as well as with local authorities and experts in relevant fields such as medicine, education, and business.

“So far I have received the full support of Prof. Gamzu and the Health Ministry’s leadership,” continues Saif. “For example, the government approved my recommendation to impose a lockdown on all the ‘red’ localities. The wedding plan I presented was also approved by the government. But a plan is not enough. It has to be accompanied by significant enforcement. Unfortunately, there was a lack of enforcement in Arab communities. We will continue to assist Arab communities in confronting this difficult pandemic, but nothing will help if we as a society and as individuals don’t accept responsibility over ourselves and our environment.”

A version of this article was first published in Hebrew on Local Call. Read it here.