The internationally acclaimed covid-19 vaccination success of Israel has another side, the consequences of which are being felt in the West Bank Palestinian territory where I work, and in the blockaded Gaza Strip where my Médecins Sans Frontières (MSF) colleagues are based.

Israel has managed to vaccinate 59% of its population, with 54% fully vaccinated. It’s administered more than 10 million doses in total.

Meanwhile, the supply of vaccines to the Palestinian West Bank and Gaza Strip barely scratches at the surface of the region’s needs. Last week Unicef announced the arrival of 37 440 doses of the Pfizer vaccine and 24 000 doses of the AstraZeneca vaccine to Palestine as part of the COVAX programme. Previously, Israel had agreed to donate 5000 doses to Palestine and 60 000 doses of the Russian Sputnik vaccine are also reported to have been sent via the United Arab Emirates. 

The latest COVAX shipment enabled Palestine to begin to roll out its vaccination campaign, but this stands in stark contrast to the progress Israel has made in its vaccination programme, which began in December. This disparity has emerged despite the fact that according to the Fourth Geneva Convention, any occupying power is responsible for ensuring the medical supplies of the occupied population, including “adoption and application of the prophylactic and preventive measures necessary to combat the spread of contagious diseases and epidemics” to “the fullest extent of the means available to it.”

I came to Hebron with an MSF team specifically to help with the covid-19 response. In December last year, when the second wave hit the West Bank, the Dura hospital where we are based was full of patients with covid-19. We cared for mostly older people, many with underlying conditions such as diabetes or other chronic diseases. Patients died. Patients with covid-19 have died in hospitals around the world, but when you see patients die on your watch, it’s particularly painful.

Since early February, covid-19 case numbers have been on the rise again in the West Bank and Gaza Strip. In Hebron where I work, this increase has been slow and steady for the past six weeks. I do not want to see any more patients dying of hypoxia. The vaccine was our team’s hope to avoid this, but it’s also become a source of despair.

A few kilometers away in Israel, most older and vulnerable groups have been vaccinated and they are moving on to vaccinating healthy adults and younger people who are less vulnerable, especially to severe complications. In the hospital where I work, staff have been offered the vaccine, but the available doses do not come close to covering all the healthcare workers, let alone older people and those with medical conditions that put them at greater risk of dying from covid-19.

We hear information about additional vaccines coming to Palestine from various donation mechanisms, but they are not here now. All the while, a half hour drive away, Israel has piles of vaccines and is moving on to vaccinating non-vulnerable groups. 

I am outraged, but my colleagues in Gaza are even more so. It has not always been easy, but the Dura hospital in Hebron where I have been working was able to get most of the supplies it needed for covid-19. The MSF team have also been able to provide on the job coaching and training to boost the capacity of staff to manage severely and critically ill patients who needed oxygen. In Gaza, however, they have much more severe shortages of medical supplies and pharmaceuticals because the blockade is so strict. Their capacity for treating patients with covid-19 is lower, so their need for the vaccine is all the greater. The recent COVAX delivery of vaccines is welcome, but it will not be sufficient to protect both the healthcare workers and the people most vulnerable to needing critical covid-19 medical care.

As a medic, I don’t care who sorts this out, only that the people who are the most vulnerable to covid-19 are prioritized.     

Matthias Kennes is a registered nurse and medical referent for the Médecins Sans Frontières (MSF) covid-19 response in Hebron, West Bank.

Competing interests: none declared.