Marwa* is a 27-year-old mother of three from Gaza. She has been struggling with breast and lymph nodes cancer for two years. As not all of her treatments are available in Gaza, Marwa goes to a hospital in Jerusalem for chemotherapy and other treatments on a regular basis. Her frequent trips through the Erez Crossing -which can take at least 2.5 hours, depending on the situation- were already taxing on her; COVID-19 and its quarantine measures have made it much more difficult for her and other patients who seek treatment outside the Strip.
Due to shortages in COVID-19 testing kits, coupled with an already paralyzed health sector, the authorities in Gaza have designated quarantine centres for those returning from abroad to avoid a major outbreak in one of the world’s most densely populated areas. The situation is particularly difficult for cancer patients, like Marwa, returning from treatment in Israel and in need of specialized medical help, as their weakened immune systems leave them at higher risk of contracting COVID-19.
“At least before COVID-19, after the difficult treatment, I used to return to my children and family which was comforting” said Marwa.
Now, every time she comes back from treatment, she is obliged to go into quarantine as part of the public health measures. Apart from the physical pain, this change has had a deep impact on her psychological well-being as she is cut off from her family and her children. Since March 2020, Marwa has had three treatments in Israel. Each time, she had to go into quarantine for 21 days upon her return in Gaza. Between her stays in Israel for treatment and quarantine afterwards, she barely sees her children.
“In four months, I have seen my children only four days. I try to stay in contact with them through social media, but the signal is weak in the centre and I use up my phone plan quickly. Because of this situation, my eldest daughter has developed withdrawal symptoms and I am very worried about her.” Said Marwa.
In the early days of the pandemic, schools and then hotels were transformed into quarantine centres. Today, there are around 13 dedicated quarantine centres across Gaza. While living conditions vary, the centres often lack proper medical equipment, adequate sanitation, air circulation, natural light and basic services for women patients. According to a rapid gender analysis conducted by UN Women in Palestine,some quarantine facilities do not adequately take into account the specific needs of women, including the provision of hygiene products and proper and dignified access to restrooms.
“They used to quarantine me in a hotel which was better. Now, I am locked in a special quarantine centre. It is very difficult here and hygiene and sanitation standards are not very good. This is very dangerous for me because I have a weak immune system.”
Families are requested to provide necessities to their quarantined relatives, including patients. But to do so, they need to go through very complicated procedures that are not always clearly communicated to them. Moreover, two thirds of Gazans rely on aid to survive and many families are unable to help.
“What the authorities have forgotten is that we in Gaza are living in a very dire humanitarian situation and that most vulnerable women receive support from women’s organizations” said Reem Frainah, a Palestinian human rights activist and the Executive Director of Aisha Association for Woman and Child Protection
Aisha is a strategic partner of UN Women in Gaza. They work hand in hand to provide women in need with psychosocial support. Aisha was one of the first civil society organizations to conduct a needs assessment for all the women in quarantine centres and has since strived to meet their needs.
“Providing specialized medical help and medication to patients in quarantine is very challenging, especially for women cancer patients” said Frainah. “By phone, we coordinate between the quarantined women and their families so we can provide them with what they need, such as medications, dignity kits, clean clothes, allergy-free foods, and even mobile phone sim-cards and laptops to facilitate communications between them and the outside world.”
“To help some quarantined women patients, like Marwa, we have asked the authorities to allow their husbands to be quarantined with them and take care of them. And we looked after the children” said Frainah.
“We are aware that a COVID-19 outbreak outside the quarantine centres would be a humanitarian disaster for Gaza. That’s why we try to cooperate as much as possible with the quarantine policy even though we take issues with many of its aspects and its negative impact on women” she added.
Thanks to advocacy efforts by various civil society organizations including Aisha, there has been progress on improving the situation of the centres. For example, the Ministry of Health has appointed a psychologist to provide to support for urgent cases, particularly for women who have self-harmed inside the facilities. Some women who were in a critical condition were also released to continue quarantine at home.
“There has been some improvements and the authorities are allowing us, NGOs, to help out and fill the gaps. But much remains to be done to make both the policy and quarantine centres more responsive to the particular needs of vulnerable people, particularly women patients” said Frainah.
“As first cases of COVID-19 have been reported in the Gaza Strip and a strict lockdown and quarantine measures have been imposed to avoid the spread of the pandemic, vulnerable women are likely to suffer most,” said Maryse Guimond, UN Women Special Representative for the Occupied Palestinian Territory. “Quarantine centers and measures need to take into account the particular needs of women, specially the ill, and work to alleviate their hardships during these difficult times.”
The name of the patient has been changed to protect her privacy.