SATURDAy, MARCH 21 , 2020. THE WASHINGTON POST eZ re A
the coronavirus outbreak
musA Al sHAer/Agence frAnce-Presse/getty ImAgesA Palestinian sanitation department worker sprays disinfectant around the refugee camp of Aida, with
Israel’s separation barrier in the background, in Bethlehem on Monday.
moHAmmed Al-rIfAI/Agence frAnce-Presse/getty ImAgesA syrian woman wearing a protective face mask snaps a selfie in a
camp for displaced people in Kafr Lusin, Idlib, on Wednesday.
work with as the virus advances.
Yemen, at war for more than
five years, has seen its health
infrastructure collapse. Scores of
hospitals and clinics have been
destroyed by airstrikes. An air and
sea embargo imposed by the Sau-
di-led coalition of regional na-
tions, which is battling northern
Yemeni rebels known as Houthis,
has helped cause shortages in
medicines, medical equipment
and other vital health supplies f or
millions of Yemenis.
Between march 2015 and De-
cember 2018, Yemen’s warring
parties have staged at least 120
attacks on medical facilities and
health workers, according to a
report released Wednesday by the
New York-based Physicians for
Human rights and mwatana for
Human rights, an independent
Yemeni group.
flight bans and closed cross-
ings have raised concerns that
coronavirus measures could
themselves disrupt ongoing hu-
manitarian relief efforts in a
country described by the United
Nations as the world’s worst hu-
manitarian catastrophe, where at
least 10 million are one step away
from famine.
Humanitarian agencies have
scaled back their teams to essen-
tial staff and medical evacuations
have been halted, a ccording to the
New Humanitarian, a news ser-
vice focused on relief efforts.
The United N ations on Tuesday
appealed f or humanitarian agen-
cies not to allow the coronavirus
to interrupt the vital work that
sustains the needs of 100 million
vulnerable people worldwide who
are dependent on the delivery of
U.N. aid.
In Lebanon, Syrian refugees
are ineligible for government
health care, meaning a covid-
outbreak would leave them with-
out care.
Along Syria’s border with Tur-
key, the WHo is “extremely con-
cerned” about the impact the cor-
onavirus will have on displaced
populations, said Hedinn Hall-
dorsson, the WHo’s representa-
tive in Gaziantep, Turkey.
People in the area are already
living in appalling conditions that
“make them vulnerable to respira-
tory infections, overcrowded liv-
ing conditions, physical and men-
tal stress and deprivation due to
lack of housing, food and clean
water.”
Specimens from suspected cas-
es are being transported across
the border to be tested in Turkey,
he said. But covid-19 kits are ex-
pected t o arrive next week in Idlib,
where an outbreak of the H1N
virus i s already taxing resources.
The area has just 148 intensive-
care units and 153 ventilators, he
said. Should the virus become
established in a place so primed
for it to spread aggressively, they
will not be enough.
Another camp where an out-
break of the coronavirus could be
devastating is al-Hol in northeast
Syria, where 65,000 people who
fled the final battles against the
Islamic State are living in what
amounts to a tented prison in the
desert. There are no testing facili-
ties in the Kurdish-controlled en-
clave where the camp is located
and few facilities to cope with any
outbreak. But the remote camp
would be especially hard hit be-
cause it offers only the most basic
medical care, aid workers say.
[email protected]
[email protected]loveluck reported from london. liz
sly in Beirut, sudarsan raghavan in
cairo and Hazem Balousha in gaza
contributed to this report.be slowing the appearance of the
virus within their fences and
walls.
Access to Gaza, for example, is
tightly controlled by Israel, which
has largely sealed the enclave’s
crossings to Israel and Egypt. Aid
workers there are using the time
to prepare for what they view as
the virus’s inevitable arrival.
“There is no reason to believe
the virus will detour around
Gaza,” s aid Gerald rockenschaub,
head of World Health organiza-
tion operations within the Pales-
tinian territories. “We have to be
ready.”
The Palestinian ministry of
Health is focused on an aggressive
program of isolation to keep the
virus from gaining a foothold in
the enclave of 2 million people
and eight refugee camps. Without
enough kits to test all arrivals,
anyone returning from outside —
at this point, mostly patients who
had been seeking non-coronavi-
rus-related medical treatment in
Israel — is quarantined for two
weeks within converted clinics,
schools and hotels.If an outbreak does begin,
Gaza, which suffers daily rolling
blackouts and unsafe drinking
water, is ill-equipped to respond.
There are only 60 intensive-care
beds in the territory, 70 percent of
which are in use. officials have
built an emergency 38-bed field
hospital. But efforts to bring in
supplies are faltering as borders
close around the region. The
WHo’s normal two-day supply
route from Dubai via Jordan now
takes two weeks. Supplies of vital
equipment, particularly respira-
tors, are hampered by collapsing
global supply chains.
“We had gotten respirators
from Italy, but now we cannot,”
said Abdel Nasser Soboh, the
WHo’s Gaza chief.
In all the camps, slowing the
spread will be critical. Gaza could
handle 300 cases in three months,
Soboh said, but not 300 cases in a
week.
“That is when we might get to a
state where a doctor has to decide
who lives and who dies,” he said.
The region’s legacy of war, with
the fighting still raging in many
spots, means that health and hu-
manitarian workers have little toborhoods in the capital, Sanaa,
Aden and other cities.
Nearly 900,000 Libyans forced
by fighting to shelter in schools
and other temporary centers are
in need of humanitarian assis-
tance, according to the United
Nations. Some 1,800 mostly Afri-
can migrants are held under bru-
tal conditions in state-run, over-
crowded detention centers with a
lack of access to sanitation facili-
ties, food or clean water.
In Iraq, humanitarian groups
say they fear for the 1.5 million
civilians displaced in battles to
defeat the Islamic State. Packed
across camps or cramped apart-
ment blocks, many have limited
access to food. What clean water
they have is needed for cooking,
not hand-washing.
In all countries of the region,
overcrowded prisons are a major
worry, as illnesses typically
spread like wildfire through cells
crammed beyond capacity.
“The detainee population is
particularly vulnerable to infec-
tious diseases,” said James mat-
thews, a spokesman for the Inter-
national Committee of the red
Cross in Iraq. He said that the
organization had distributed hy-
giene kits among the country’s
prisons in recent weeks.
War-shattered Syria is perhaps
the biggest concern, particularly
the northwest of the country
where fighting continues be-
tween government forces and reb-
els despite a fragile cease-fire.
Nearly 4 million people, most of
them displaced from elsewhere in
the country, are crammed into a
sliver of territory along the Turk-
ish border, which has s urpassed
Gaza as the most densely populat-
ed part of the middle East.
overall, 11 million Syrians have
been displaced by the nine-year
war, half inside Syria, half living
as refugees across the middle
East, including in Turkey, Jordan,
Iraq, Egypt and particularly L eba-
non. All are vulnerable to the
worst effects of the pandemic.
“When the virus hits over-
crowded settlements in places
like Iran, Bangladesh, Afghani-
stan and Greece, the consequenc-
es will be devastating,” Jan Ege-
land, s ecretary general of the Nor-
wegian refugee Council, said this
week. “There will also be carnage
when the virus reaches parts of
Syria, Yemen and Venezuela,
where h ospitals have been demol-
ished and health systems have
collapsed.”
Health experts hope that the
relatively young average age of the
displaced will help keep the d eath
rate low. (In some centers, more
than 60 percent are children.)
And for now, no camp outbreaks
have been reported. In some cas-
es, the camps’ very isolation may
refugees from A
Fears grow for Middle East
refugee camps, migrant centers
“There is no reason to
believe the virus will
detour around Gaza.
We have to be ready.”
Gerald Rockenschaub, head of
World Health organization operations
within the Palestinian territories