In January, people wear face masks on a shopping street in Gaza City. Ahmad Salem / Bloomberg via Getty Images Hide caption

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Ahmad Salem / Bloomberg via Getty Images

In January, people wear face masks on a shopping street in Gaza City.

Ahmad Salem / Bloomberg via Getty Images

How is the pandemic affecting one of the most haunted and battle-scarred areas in the world? From merchants to doctors, the 2.2 million Palestinians of the Gaza Strip are forced to make difficult choices in order to survive.

On a single street recently, a vegetable seller, supermarket worker and second-hand clothes dealer showed up doing their day jobs – despite the clothes dealer saying he was convinced all three had COVID-19.

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“I feel bad about myself. I would quarantine myself for a full month if I could, but I have to keep the shop open. I have no other source of income,” 26-year-old Hossam said on video Chat to NPR. He refused to give his full name because he could be arrested for keeping his shop open while he was ill.

Hossam lost his sense of taste and smell and got tired, but refused to take a COVID-19 test. If it were positive, his entire family would be quarantined and he and his brother, the family’s only breadwinners, would not be able to work. The Hamas rulers in the Gaza Strip are not offering any financial support to the quarantined people.

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“I have some savings that could hold us for a day or two. But when that runs out, nobody knocks on our door to help us, let’s say this is 50 shekels [$15] to help you, “said Hossam.” Nobody cares about anyone here. “

So Hossam went to work and tried to be careful. He wore a black mask in his shop and asked customers not to enter.

He sells clothes Israelis no longer want – army sweatshirts, elementary school T-shirts with Hebrew logos – shipped across Israel’s fortified border to the Gaza Strip. If his customers ever found out he had the virus, he feared they would import it along with the Israeli clothing and never buy from him again.

“There are many others like me who don’t want to report their illness so they can keep working,” he said.

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This is common in Gaza, where most live below the poverty line and the economy is in bottleneck due to a nearly 14-year-old Israeli and Egyptian blockade severely restricting trade and travel to the Islamist-ruled area.

In the first few months of the pandemic, performing proved to be an advantage. The few infected travelers who came to Gaza have been quarantined and there has been no detectable spread of the community.

A Palestinian medic took a swab sample from security guards guarding the homes of quarantined patients infected with the COVID-19 coronavirus in Rafah, southern Gaza Strip, in January. Said Khatib / AFP via Getty Images hide caption

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Said Khatib / AFP via Getty Images

A Palestinian medic took a swab sample from security guards guarding the homes of quarantined patients infected with the COVID-19 coronavirus in Rafah, southern Gaza Strip, in January.

Said Khatib / AFP via Getty Images

In late August, a Palestinian woman accompanying her daughter to a hospital in Jerusalem returned to Gaza, brought back the virus and infected four relatives. It spread.

Police in the Gaza Strip imposed strict curfews and lockdowns, and even erected sandberms and concrete barriers around refugee camps and overcrowded neighborhoods with high infection rates. Those who tested positive for COVID-19 were locked in their homes and police stood guard outside. The Gazans were reluctant to be tested for this reason alone.

Although the police have closed the practice, test rates remain low. More than 52,000 Gazans have tested positive, but health officials across Gaza estimate the virus actually infected 200,000 Gazans – nearly 9% of the population. More than 500 have died.

Meanwhile, after more than a decade of blockades, wars between the Islamist fighters in Gaza and the Israeli army, and sanctions from rival Palestinian leadership in the West Bank, the health system in the Gaza Strip has been hanging by a thread. The COVID-19 stations even struggled to provide enough oxygen for the ventilators until the United Arab Emirates paid for a new supply in January.

Health officials commend night curfews and weekend closings for reducing infections. Now the curfews are being relaxed. Last month, the Hamas government reopened mosques and schools. This week, Egypt opened its border crossing and allowed Palestinian travelers to return to Gaza. Officials canceled curfews and closings on Thursday. Not everyone thinks these decisions are wise.

“Now they decide to open some of the schools and mosques. Because of this, there is a high risk of increasing the number of corona patients. We fear the cases in Gaza will get worse because [of] this step, “says pharmacist Tholfikar Swairjo.

Swairjo sees around 50 customers with COVID-19 symptoms every day. Some refuse to get tested and buy vitamins instead. Some claim the pandemic is a global imperialist conspiracy.

“It’s stupid, but they believe it,” says Swairjo.

Next door, Israel leads the world in per capita vaccination. In just a month and a half, more than a third of the country’s 9 million citizens received at least one shot.

The Palestinian territories lag far behind. The West Bank received its first COVID-19 vaccines just this week. Israel delivered 2,000 Moderna vaccines to Palestinian health workers there after human rights groups asked for help, and Russia sent 10,000 Sputnik vaccines. The Palestinians are also waiting for larger deliveries, including from Russia and the USA World Health Organization COVAX programwho sends vaccines to poor populations.

Palestinian Minister of Health Mai al-Kaila received a COVID-19 vaccination in a hospital in the West Bank on Tuesday. The Palestinian Authority’s Ministry of Health is hiding the caption

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Ministry of Health of the Palestinian Authority

Palestinian Minister of Health Mai al-Kaila received a COVID-19 vaccination in a hospital in the West Bank on Tuesday.

Ministry of Health of the Palestinian Authority

Gaza has not yet received any vaccines. Dr. Majdi Duhair, a Gaza health official, said he expected several hundred to arrive through the Israeli crossing on Thursday, but an Israeli official told NPR that the government has not yet approved the delivery of vaccines to Gaza. It’s a politically sensitive issue. An Israeli lawmaker asked Leaders are not allowed to allow vaccines into Gaza until Hamas releases two Israeli prisoners and the bodies of two Israeli soldiers who were killed in action in 2014.

This type of compromise is unlikely, and Israel is expected to eventually allow vaccines into Gaza. prime minister Benjamin Netanyahu said This week it is in Israel’s interest to get vaccines for Palestinians and calls it “the right move”.

At COVID-19 stations in Gaza, medical workers do not expect to receive many vaccines in early deliveries and doubt that there will be enough for all workers. They plan to vaccinate only medical workers over the age of 50 and medical workers with chronic diseases.

“This should be a humanitarian problem, but politics does matter. The priority for companies is to sell the vaccine to rich countries rather than poor ones,” says Dr. Atef al-Hout, who heads the COVID-19 stations in the Gaza Strip.

The pandemic has hit the Gaza Strip medical workers hard – the few who have not joined the exodus of hundreds of doctors who have found better salaries and live abroad in recent years.

According to Al-Hout, four doctors and three nurses died of COVID-19 in Gaza last year, including 51-year-old Dr. Majdi Ayyad, one of the last cardiac surgeons in Gaza. Now there are only three cardiac surgeons left for a population of more than 2 million.

“Have mercy on those we have lost,” said al-Hout with a sigh.

Baba reported from Gaza City. Estrin reported from Jerusalem.