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冲突环境下卫生系统对 COVID-19 大流行的应对:来自巴勒斯坦的政策反思。

Health system's response to the COVID-19 pandemic in conflict settings: Policy reflections from Palestine.

机构信息

Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland.

Council on Health Research for Development, Geneva, Switzerland.

出版信息

Glob Public Health. 2020 Aug;15(8):1244-1256. doi: 10.1080/17441692.2020.1781914. Epub 2020 Jun 17.

Abstract

As the COVID-19 pandemic spreads, concerns are particularly serious in conflict and humanitarian settings. Tackling the pandemic in those countries is challenging due to the fragility of socioeconomic and health systems. Palestine is one of those countries that is facing compounding challenges, instability, fragility, living conditions, poverty, and mobility, all of which are caused by multifactorial etiology. The Pandemic shows triple tragedies; virus (COVID-19 Pandemic), ongoing Israeli occupation (Politics), and Intra-Palestinian divide (Policies). Yet, Palestine's response to the pandemic is outperforming many countries in the region. The early preventative lockdown measures in the West Bank found effective and not overwhelming the already over-stretched health system. While in the Gaza Strip, the response was slow. Prisoners, labours, besieged people, socioeconomic-disadvantaged classes, and refugees were put at additional high risk. Nonetheless, measures taken were unconsolidated in both regions largely due to the political factors. A little collaboration and inter-agency task forces in preparedness and response was observed, and the mechanisms and governance remain ambiguous. A consolidated and evidence-based nation-wide plan is required, whereby state and non-state actors have a clear and transparent exit strategy. A new thinking approach to promote the public health system and evidence-informed policies in Palestine is an urgent national priority.

摘要

随着 COVID-19 疫情的蔓延,冲突和人道主义环境中的情况尤其令人担忧。由于社会经济和卫生系统脆弱,这些国家应对疫情的挑战巨大。巴勒斯坦就是面临着多重挑战、不稳定、脆弱、生活条件差、贫困和流动的国家之一,所有这些都是由多因素病因引起的。大流行带来了三重悲剧:病毒(COVID-19 大流行)、持续的以色列占领(政治)和巴勒斯坦内部的分裂(政策)。然而,巴勒斯坦对疫情的应对表现优于该地区许多国家。西岸的早期预防性封锁措施被证明是有效的,并未使本已不堪重负的卫生系统不堪重负。而在加沙地带,反应则较为缓慢。囚犯、劳工、被围困的人、社会经济弱势群体和难民面临着更高的风险。尽管如此,由于政治因素,两个地区采取的措施都没有得到巩固。在准备和应对方面,合作和机构间工作队很少,机制和治理仍然模糊不清。需要制定一个有凝聚力的、基于证据的全国性计划,使国家和非国家行为体都有明确和透明的退出战略。在巴勒斯坦,需要一种新的思维方法来促进公共卫生系统和循证政策,这是当务之急。

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