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While the outbreak and spread of the hantavirus on a cruise ship is causing quite a stir and some are already worried about a coronavirus pandemic 2.0, outbreaks of infectious diseases elsewhere are going largely unnoticed.

In Gaza, these diseases are omnipresent and that is hardly surprising. The conditions under which people have to live there greatly favor the spread of communicable diseases: polluted drinking water, poor hygienic conditions, many people in a confined space, weakened immune systems and a healthcare system that is constantly on the verge of collapse.

Infectious diseases are spreading

According to the WHO, 19% of all medical consultations in Gaza are related to communicable diseases, with more than half due to respiratory infections, 27% to skin diseases and parasites and 16% to diarrheal diseases – the latter increasingly.

At the PRCS field hospital, our team repeatedly treats patients whose suffering can be traced back to life-threatening circumstances. Photo: CADUS

Our medical team at the Palestinian Red Crescent Field Hospital (PRCS) also repeatedly treats cases of scabies and viral infections in particular. The likelihood that many of these infections are caused by rodent transmission is high.

While experts are still puzzling over how and where exactly the passengers on the ship became infected, the possibilities in Gaza are quite obvious. The collapse of all public infrastructure, with destroyed sewage systems and piles of garbage on the streets, offers the best conditions for the proliferation of rats and thus potential disease carriers.

Precise diagnoses are lacking

However, there is a lack of opportunities to make more accurate diagnoses in Gaza: the WHO reports that 87% of all materials required for laboratory tests are no longer available. Without laboratory tests, however, it is almost impossible to determine whether it is the hantavirus, for example, as it can hardly be distinguished from other infections, especially in the early stages.

Mountains of garbage are omnipresent in the streets of Gaza; there is no longer a functioning waste recycling system here. The piles of garbage are often searched for something usable, the risk of infection is high here. Photo: Mattia Bidoli

So what attracts international attention and decisive reactions from the authorities on a cruise ship is presumably part of everyday life in Gaza, but remains undetected and, from an international perspective, largely without consequences.

Less space, more transmission

Instead of making it possible to address the situation with increased access for humanitarian aid and supplies, the Israeli military is making conditions even worse. Just a few days after the end of the ceasefire, it is expanding its security zones, once again forcing people in Gaza to flee.

Many Palestinians have already been displaced and are forced to live in tents that offer little protection and inadequate sanitation. With more people in less and less space, conditions will only get worse. Photo: CADUS

The more than two million inhabitants now have to live on just under 35% of the former Gaza Strip, further increasing the risk of infectious diseases spreading. The bombardments are also continuing, claiming more lives and destroying more housing and infrastructure, further worsening living conditions.

Bombings are an omnipresent threat in Gaza. Photo: CADUS

Shortage, shortage, shortage

The shortage in medical care remains omnipresent: 47% of essential medicines are no longer available, as are 59% of medical consumables such as syringes and bandages. Even the simplest treatments and diagnoses are barely feasible, not to mention dialysis, heart, kidney and cancer treatments, eye operations and many more.

Nevertheless, our teams on the ground continue to provide support with medical training, medical evacuations (MedEvacs) and in the PRCS field hospital. Since the beginning of May, we have already treated 250 patients, evacuated 10 patients and provided medical training for 30 people in two training sessions.

Even minor interventions consume medical material, the supply of which is not guaranteed, while stocks are constantly falling. Photo: CADUS

Unfortunately, this does little to change the structural shortage. What is needed here is public and political pressure on the Israeli government to facilitate access for humanitarian aid on a large scale.

No danger – no interest?

Unlike the passengers on the ship, the patients in Gaza will not be able to leave the Strip for the foreseeable future, even if they wanted to. They therefore pose no health risk to the rest of the world and are largely left to their own devices.

It is important and right to investigate outbreaks of infectious diseases and treat patients as best as possible. However, it should not matter whether it affects people on a cruise ship or in Gaza.

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