MARY LOUISE KELLY, HOST:
Now, how has the pandemic affected one of the most crowded places on Earth, the Gaza Strip? The health system is already stretched. The economy leaves most Palestinians so poor that self-isolation is not something they can afford. So they are forced to make tough choices to survive. NPR's Daniel Estrin reports from Jerusalem.
HOSSAM: (Speaking Arabic).
DANIEL ESTRIN, BYLINE: I reached Hossam on video chat at his shop in Gaza. He sells secondhand clothes from Israeli - army sweatshirts, school uniforms in Hebrew, clothes Israelis don't want anymore. Hossam is 26. He's lost his taste, his smell. He's fatigued. He's sure it's COVID.
HOSSAM: (Through interpreter) I feel bad about myself. I would quarantine myself for a whole month if I could, but I have to keep the shop open. I have no other source of income.
ESTRIN: Hossam won't say his last name. He could get arrested for keeping the shop open while sick. He won't get a COVID test because if it comes out positive, his whole family would be ordered to quarantine, and he and his brother wouldn't be able to work to support the family.
HOSSAM: (Through interpreter) I have some savings that could last us for a day or two. But when that runs out, no one will knock on our door to help us, to say, here's $15 to help you manage. No one cares about anyone here.
ESTRIN: So Hossam tries to be careful. He wears a black mask at his shop and asks customers not to step inside.
HOSSAM: (Through interpreter) There are many others like me who don't want to report their illness so they can keep working. There are two near my shop - a vegetable seller and a supermarket worker on this same street.
ESTRIN: Gaza initially had few infections because the Islamist-ruled territory is blockaded by Israel and Egypt, and there's little travel. But the virus eventually spread in the crowded strip of land. With many hiding their symptoms, like Hossam, confirmed cases are lower, but Gaza health officials estimate nearly 9% of about 2 million Gazans have had the virus. Partial lockdowns have helped reduce infections, but now Gaza's Hamas government has reopened mosques and schools. That worries pharmacist Tholfikar Swairjo.
THOLFIKAR SWAIRJO: You know, but now they decide to open some of the schools and the mosques. Because of that, there is high risk to increase the patients of corona. We are afraid that the cases will be more bad in Gaza because this step.
ESTRIN: Next door, Israel leads the world on vaccinations per capita, but the Palestinian territories still wait for vaccine shipments. Human rights groups say Israel is obligated to help provide them. Israel disagrees, but it has given a few thousand doses to Palestinian health workers in the West Bank. Palestinian officials say some 50,000 doses will be coming from abroad soon, but they'll still be far behind.
Dr. Atef al-Hout runs Gaza's COVID wards.
ATEF AL-HOUT: (Through interpreter) This should be a humanitarian issue, but politics play a role. The priority of the companies is reserve the vaccine to wealthy countries more than poor ones.
ESTRIN: Gaza's health system is hanging by a thread after more than a decade of blockades, wars between Gaza's Islamist fighters and Israel's army and sanctions by the rival Palestinian leadership. Gaza's COVID wards even struggled to supply enough oxygen for ventilators until the United Arab Emirates paid for a fresh oxygen supply in January. I asked Dr. al-Hout if his medical team had suffered any losses from the virus.
AL-HOUT: (Through interpreter) That the most difficult question of all. Mercy be on those we lost.
ESTRIN: He said four doctors died of COVID in Gaza this past year, including 51-year-old Majdi Ayyad. He was one of Gaza's last heart surgeons. Now Gaza has only three cardiac surgeons left for a population of more than 2 million.
Daniel Estrin, NPR News, Jerusalem.
(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.
