To keep the coronavirus at bay and prevent its outbreak into the wider population in the Gaza Strip, mandatory quarantining is being ordered by the local authorities for recent arrivals into Gaza. Al Mezan’s monitoring and documentation of conditions within the centers show a number of areas for improvement. As the ministries of Health, Interior and Social Affairs implement recommended medical and health advisories—using a severely under-resourced health sector, in one of the most densely populated areas on earth—Al Mezan issues recommendations to support the dignity and rights of residents, and to increase the effectiveness of the safety measures.

Gaza’s frontline medical staff have been testing and treating individuals returning home from abroad since 15 February 2020. The official precautions commenced with individuals returning from China being placed in a quarantine center set up at Rafah crossing, in the south of the Gaza Strip. Four days later, the quarantine order was expanded to include countries with high numbers of confirmed COVID-19 cases, and on 3 March 2020, a mandatory 14-day home quarantine was instituted, signed by all arrivals.         

On 15 March 2020, the Governmental Follow-Up Committee, a group tasked with managing the pandemic in Gaza, announced that residents returning via Erez and Rafah crossings would be quarantined, and set up centers in schools and hotels throughout Gaza. Twenty-nine centers were established, with 27 remaining open throughout Gaza’s five districts. The quarantine centers hosted an initial 1,864 residents coming home through Erez and Rafah crossings; 1,108 of them were kept under medical observation at Muscat Khan Younis and Muscat Jabalia medical centers, as well as in the following hotels: Al Amal, Commodore, Blue Beach, Al Quds International, Al Mathaf, and Beach Hotel, and 53 were admitted to the hospital as a strict precaution. By 31 March 2020, 396 test kits had been used by the Ministry of Health, with ten individuals testing positive for COVID-19; since then, three people have reportedly recovered.     

Al Mezan has been carefully monitoring and documenting the implementation of the precautionary and preventative measures implemented by the authorities in Gaza, and has formulated a number of recommendations. These concerns were issued in a letter to the Deputy Minister of Health in Gaza, Dr. Yousef Abu El-Reesh. In particular, the right to health of quarantined patients, who require specialist care, must be upheld, and ensuring the dignity of individuals and families must be at the center of the authorities’ approach. The lack of resources available to the ministries to manage this crisis does not warrant discrimination or negligence.

Al Mezan issued the following recommendations to competent authorities:

• Stop the transfer of quarantined persons from one center to another. Instead, the conditions that would prompt a transfer should be improved, notably with regard to healthcare.
• Healthcare and essential drugs must be made available.
• Should a confirmed COVID-19 case be identified, the authorities must swiftly transfer the patient to a specialized hospital. Quarantined persons must also be admitted to hospital if more medical observation is required, with all preventive measures taken.
• All group activities or gatherings inside the quarantine centers must be banned.
• Cleaning supplies and disinfectant must be provided in sufficient quantities.
• The number of medics at quarantine centers should be increased to ensure the implementation of daily medical check-ups for all quarantined individuals.
• The interaction with medical staff and the entry of food and other supplies must be done in close observation of safety measures.
• If a coronavirus case is confirmed at a school that is being used as a quarantine center, social distancing guidelines must be maintained and rooms must not be overcrowded.
• Movement must not be permitted in and out of the centers, except where urgently required. Maintenance workers that must enter should be equipped with personal protective equipment and must work in isolation. Disinfection practices upon arrival and during departure must also be implemented.
• Further protection, including regular testing and quarantine, must be employed in regard to personnel working at Erez and Rafah crossings, especially police officers. Workers should be organized around shifts and the number of staff handling travel documents and luggage must be minimized.
• Visits by officials, journalists, and field organizations to quarantine centers must be suspended, and instead, mechanisms for remote monitoring and documentation must be set up and maintained.
• The disposal of medical waste—the Central Lab’s waste in particular—must be done in accordance with sterilization and safety guidelines.
• Municipalities must publish and implement the medical waste disposal guidelines in regards to trash collection and disposal. Municipalities must provide personal protective equipment to all sanitation workers and must ban unofficial garbage collection.

The authorities must deliver transparent and straightforward messages to the public regarding the severity of the threat of the coronavirus, and the safety and preventative measures required to curb its spread. Al Mezan encourages residents to adhere to relevant orders.

Al Mezan is encouraged by the swift and determined response of the local authorities, who are working with minimal resources and a healthcare system that is on the brink of collapse after years of illegal closure restrictions and repeated military attacks. Al Mezan calls on the international community to urgently ramp up the supplies of personal protective equipment, ventilators, ICU beds, and testing kits, and to formulate tangible steps to action the removal of the closure framework.

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