As Israel Races Toward Herd Immunity, a Palestinian Town Teeters Under the Weight of COVID

Few Palestinians in the West Bank and Gaza have been vaccinated, explaining why the hospitals in Tul Karm are filling up as people die and the city remains under curfew

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Men waiting outside a hospital in the Palestinian town of Tul Karm as relatives with COVID-19 are treated inside, Tuesday.
Men waiting outside a hospital in Tul Karm as relatives with COVID-19 are treated inside, Tuesday. Credit: Moti Milrod
הגר שיזף
Hagar Shezaf

Not one empty bed is left in the coronavirus wards in Tul Karm in the West Bank. The city has two hospitals: a government-run one where a coronavirus ward was opened at the beginning of the pandemic, and one run by the Red Crescent Society that was converted into a coronavirus hospital when the government one was full.

The city has seven ventilators, 10 intensive care beds and only 33 beds in its coronavirus wards. Over the past week, 17 people in the district died of COVID-19, and the city is now under curfew at night and on weekends. The entire West Bank is at 94 percent occupancy for coronavirus beds at hospitals – in intensive care wards the number is 100 percent.

On Tuesday morning, teary-eyed families gathered at the entrance to the Red Crescent hospital and waited for the bodies of relatives who had died overnight to be taken out – four in all. Unlike in Israel, Palestinian hospitals in the West Bank haven’t quickly changed tack and let families come and say goodbye to their loved ones. One person waiting outside said his uncle, 67, arrived there Monday and died the next day.

Families of the hospitalized also stood at the entrance waiting for any news from inside. “When my mother began feeling bad, we called the hospital and they told us there was no room,” said Amar, whose mother is now in serious condition. “When the situation deteriorated, we waited in the emergency room at the government hospital for seven hours. In the end they found us a place.” 

Social activists in the city note a shortage of basic equipment in the hospitals, some of it mundane like tables to eat on and adult diapers for older people in the coronavirus wards.

“There’s crowding and there are many shortages,” said one activist who asked not to be named. “They’re not letting journalists into the wards so there won’t be any embarrassments.”

A doctor from the city added angrily: “There’s no adequate testing for the mutations or expertise on how to handle them.” Doctors are currently striking in the West Bank, in part because not all medical workers have been vaccinated yet.

Islam Abu Shama, who heads a nonprofit group that helps kidney patients receive dialysis, with an oxygen concentrator machine. Credit: Moti Milrod

Not enough oxygen

The most coveted consumer item in the city is an oxygen concentrator, a machine that removes nitrogen to provide a more pure oxygen flow. Because of the overcrowding at the hospitals, many patients who arrive are sent back home and try to obtain an oxygen concentrator. Until a few months ago a 5-liter tank cost 1,200 shekels ($360), a price that has since doubled.

“People knocked on the door and asked for an oxygen concentrator, so we started to supply them,” said Islam Abu Shama, who heads a nonprofit group that helps kidney patients who need dialysis – and now also helps COVID-19 patients. So far, Abu Shama’s organization has provided 15 such machines, and another five just came in, to be  lent out immediately.

The group suffered its own coronavirus tragedy recently when its CEO, a 29-year-old kidney patient, died after contracting the virus. “A month ago, the situation in the city began to deteriorate badly. When I go on Facebook, all I see is death announcements,” Abu Shama said.

In recent months, fundraising campaigns have been held to buy oxygen concentrators in villages near Tul Karm from people who can afford one at home, exposing the helplessness of the Palestinian health system and the influence of wealth on one’s fate. In some places donation boxes now play a role.

In the town of al-Shuweika next to Tul Karm, local people raised money for 10 oxygen concentrators this way. In Farun next to the separation barrier with Israel, another 10 were funded. In recent weeks, the group Physicians for Human Rights has donated 10 machines to the West Bank at a cost of 50,000 shekels.

While more than half of Israelis have been fully vaccinated, only about 69,000 Palestinians have received a first dose, the Palestinian Health Ministry says, and the distribution of the small number of vaccines has been harshly criticized. One magazine has reported that in addition to the controversial providing of doses to government officials and the national soccer team, vaccines have reached private institutions such as a dental clinic that senior PA officials often visit.

Also, Israel has vaccinated over 100,000 Palestinians who work in Israel, something the Palestinian Authority took credit for at a press conference. Physicians for Human Rights and other rights groups have petitioned the High Court of Justice calling for Israel to supply vaccines to all Palestinians in the West Bank and Gaza.

“The government lies and the situation is very bad; it’s not clear why they’re acting one way or another,” said a Tul Karm resident, adding that most doses pledged by the PA have not yet arrived. Critics say this lack of transparency stems from a desire to avoid criticism before the Palestinian election next month.

Women crying outside a hospital in Tul Karm; the father of the family died of COVID-19. Credit: Moti Milrod

Festive Area C

The Oslo Accords, meanwhile, are making it hard for the PA to enforce the weekend and nighttime curfew; the Palestinian police aren’t allowed to operate in villages in Area C of the West Bank. Area C has thus become popular for gatherings during the pandemic.

“People travel to make it to weddings and events in the villages of Area C,” said journalist Abd al-Karim Dalbah. “In Hawara too, which is on the main road and the army is there, all the stores are open all the time, and in Kafr Aqab, which may be in the West Bank but is considered part of Jerusalem.”

The lockdowns and lack of unemployment benefits have racked Tul Karm. “My husband is a taxi driver and has been at home for a few weeks without any work or income,” said a woman whose young daughter is a cancer patient.

The strike by the doctors and other medical staff makes it hard to obtain the prescriptions for her daughter’s medication, and the authorities told her to do it privately. “But I don’t have money; what am I supposed to do?” she asked.

Saad Ghanem, a businessman from the Tul Karm region, holding a picture of himself with his father, who died of COVID-19.Credit: Moti Milrod

Many COVID-19 patients are trying to get ahold of Tocilizumab (known by the brand name Actemra in Israel), an immunosuppressive said to ease the symptoms – it costs a few thousand shekels. Here too, the severe inequality in the West Bank divides those who can afford it and those who can’t.

Only 10 days ago, Saad Ghanem, a businessman from the Tul Karm region, discovered that his father had COVID-19. His father, who died a few days later, had never left the house during the pandemic but somehow contracted the virus. Ghanem could afford to buy a shot of Actemra for his father, to no avail.

“It cost thousands of shekels,” Ghanem said. “But even if it had cost more, I would have done everything to get it.” Ghanem’s social status also allowed him to say goodbye to his father in person at the hospital – at 3 A.M. one night after he put on two masks and gloves.

“A nurse who passed by told me to talk to him because he could hear me, and while I spoke to him I saw the tears coming down,” Ghanem said. There were tears in his own eyes as he said this.

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