Self-determination for health services
My day started at 8am, jumping into an ambulance in front of the Medical Relief Society, which is part of the Union of Palestinian Medical Relief Committees (UPMRC) in Nablus. From there I traveled with a team of 5 doctors and medics to Asira al Qibliya, to hold a makeshift clinic for residents of this village. Every month the team visits about 20-26 villages outside of Nablus to provide medical services to people who otherwise might never be able to access a doctor. This is a rural area and many are poor, but the occupation remains the largest factor for why mobile clinics are crucial. Most could not make it through army checkpoints to reach private services in the city. Even the ambulances are not exempt from difficulties, and many have been denied passage at checkpoints. At Huwwara checkpoint on the way out, we waited in a line of cars, then soldiers checked our IDs and searched the ambulance before letting us pass.
Once arriving in Asira al Qibliya we enter an empty building with 3 rooms, find a spot for the 2 large containers of mostly-donated medications, and start setting up chairs. After the first cup of tea, the waiting room is full and the team gets to work. Most are elders and women with children. For the majority of them, the 5 minutes they get with a doctor from the mobile clinic is their only access to health care at all. I sat in a corner of one examination room, where a doctor translated some stories for me. Some of the biggest problems in these rural areas are hypertension and diabetes for adults, and asthma, dehydration and swollen tonsils for children. Dental problems are abundant. It was a busy day for the team and they saw 120 patients by 1pm. Probably the most telling moment for me was when a confused man walked into the room, sat down and handed the doctor his ID card. The doctor looked at me and said, "See, he shows ME his ID card! He has a hard life." There is no need to prove his identity here, but having been harassed and questioned by soldiers nearly everywhere he goes, this man now expects the same everywhere.
Over the next two days I learned more about what it's like to provide emergency care in Palestine. An ambulance driver retells a story about transporting a woman in labor to a hospital in Nablus. She is a small woman and her stomach didn't show very much. Male soldiers at the checkpoint demanded that she undress so they could "inspect" her and prove whether she was really pregnant or not. The driver refused and demanded that they go get a woman soldier. They ended up waiting in the parked ambulance for over two hours before finally being cleared to go. The baby was born on a stretcher, just before reaching the hospital. Fortunately he and his mother were ok. Unfortunately this story is nothing compared to others I've heard, about Palestinians dying at checkpoints, unable to get to the ambulances waiting for them on the other side of the road. The UPMRC reports statistics of these occupation-related deaths on their website.
After listening to this story we jumped back into the ambulance again, this time to transport a dehydrated little boy from the clinic we were visiting in Sebastia to the hospital. As we handed over our IDs twice and shifted around so soldiers could inspect all containers and under the bench we sat on, I got my own taste of how difficult it is for people to access critical health care which is widely understood in the rest of the world as a basic right. A few women in the ambulance pointed to my passport, signaling that it was valuable in some way to completing the mission. For the rest of the ride they looked at me with sad and tired faces that said, "See, now you know what it's like here". These moments remind me of the huge responsibility I feel, and which will only become more intense, as I leave here and return to the US.
Yesterday my passport proved not as useful. Two internationals from Spain were also riding in the ambulance, as the mobile clinic headed to Madama for the day. The driver left the road and drove over rocks and hills to cut to the front of the long line at the checkpoint. We were asked to leave the ambulance while soldiers gave the most thorough search I've seen, even opening the containers of medicine. The doctors and the 3 of us internationals were instructed to put our bags on a conveyer belt inside a truck, to check for weapons. I know this is all to make life harder and not really a security measure, because I didn't do it and they didn't bother to ask twice. I watched as the soldiers searched the ambulance and questioned the driver, and my bag never left my shoulder.
In Madama after the clinic ended I was able to sit and talk with Asad, one of the medics. He wants to get his Bachelor's Degree but is only paid 200 shekels a month for working with the mobile clinic, and after food and transportation from his village to Nablus, there is nothing left for classes. He explained the lack of funding also affects the care that Palestinians receive. Currently, he said, the Ministry of Health is not operating. This is most likely why the clinics in Asira al Qibliya and Madama were so packed full of patients lately, in this time that people have been describing as "quiet". During more serious closure the clinics have seen up to 1000 patients in a day, but today this summer it is only the presence of extreme violence that is comparatively "quiet". In many different ways the occupation is still working against the health of Palestinians - from the damaged economy, to closure and travel restrictions, to separating people from their land and water sources. The UPMRC, particularly it's mobile clinics all over the West Bank and Gaza, is doing its best to make up for this, and is therefore bearing the biggest responsibility for ensuring the health of the people.
Mobile and satellite clinics are not the only activities of this organization. Last week I was impressed by their sophisticated and grassroots analysis of health issues by visiting the UPMRC's Nablus Youth Center and a summer camp. During the beginning of the recent uprising (intifada) the UPMRC had hundreds of young volunteers. The center began as a place for them to get training in first aid and health education, and participate in some civic activities as well. Over time the center evolved into a hub of civic education that is open to all youth in the area, and teaches classes in computers, photography and media, singing, dancing, English, democracy, and gender equality. The various summer camps are for very young children, and are more fun than health-related. Currently the center has about 110-120 participants, between the ages of 14-22.
Dr. Sameh explained their mission to me, and how the civic education for youth is related to medical services. They believe that these activities with youth will create a more health and democratic-educated generation of leaders. Youth in the community are enabled to provide first aid but are also schooled in community health issues in general, and this is important to the mission of the UPMRC. It also serves as an outlet for the hardships of daily life. Civic activities become a place for youth to deal with violence and loss so they are not carrying it around with them. And because many Palestinians cannot access doctors, families and individuals must be knowledgeable about self-care and able to provide solutions within their homes and communities when the occupation forces keep them isolated. In this way, the youth center works with other community education activities towards a larger and more powerful goal of self-determination.
It's not just for providing medical and emergency services, but healthy people who are enabled to care for themselves, their families and communities, is what the UPMRC is all about. What is especially powerful about their work is that they include all factors in their analysis of health problems, meaning land theft, closure, the wall, violence, and other aspects of Israel's occupation of Palestine are never absent from any diagnosis. A baby doesn't simply die from dehydration. A baby dies because the village is isolated by settlements or the wall, the economy has been destroyed, previous water sources are now unreachable, her parents have little access to health education, and soldiers did not allow the family through the checkpoint to reach a doctor's office. By working towards self-determination and the health of the people of Palestine, the UPMRC is fighting the occupation every single day.
Once arriving in Asira al Qibliya we enter an empty building with 3 rooms, find a spot for the 2 large containers of mostly-donated medications, and start setting up chairs. After the first cup of tea, the waiting room is full and the team gets to work. Most are elders and women with children. For the majority of them, the 5 minutes they get with a doctor from the mobile clinic is their only access to health care at all. I sat in a corner of one examination room, where a doctor translated some stories for me. Some of the biggest problems in these rural areas are hypertension and diabetes for adults, and asthma, dehydration and swollen tonsils for children. Dental problems are abundant. It was a busy day for the team and they saw 120 patients by 1pm. Probably the most telling moment for me was when a confused man walked into the room, sat down and handed the doctor his ID card. The doctor looked at me and said, "See, he shows ME his ID card! He has a hard life." There is no need to prove his identity here, but having been harassed and questioned by soldiers nearly everywhere he goes, this man now expects the same everywhere.
Over the next two days I learned more about what it's like to provide emergency care in Palestine. An ambulance driver retells a story about transporting a woman in labor to a hospital in Nablus. She is a small woman and her stomach didn't show very much. Male soldiers at the checkpoint demanded that she undress so they could "inspect" her and prove whether she was really pregnant or not. The driver refused and demanded that they go get a woman soldier. They ended up waiting in the parked ambulance for over two hours before finally being cleared to go. The baby was born on a stretcher, just before reaching the hospital. Fortunately he and his mother were ok. Unfortunately this story is nothing compared to others I've heard, about Palestinians dying at checkpoints, unable to get to the ambulances waiting for them on the other side of the road. The UPMRC reports statistics of these occupation-related deaths on their website.
After listening to this story we jumped back into the ambulance again, this time to transport a dehydrated little boy from the clinic we were visiting in Sebastia to the hospital. As we handed over our IDs twice and shifted around so soldiers could inspect all containers and under the bench we sat on, I got my own taste of how difficult it is for people to access critical health care which is widely understood in the rest of the world as a basic right. A few women in the ambulance pointed to my passport, signaling that it was valuable in some way to completing the mission. For the rest of the ride they looked at me with sad and tired faces that said, "See, now you know what it's like here". These moments remind me of the huge responsibility I feel, and which will only become more intense, as I leave here and return to the US.
Yesterday my passport proved not as useful. Two internationals from Spain were also riding in the ambulance, as the mobile clinic headed to Madama for the day. The driver left the road and drove over rocks and hills to cut to the front of the long line at the checkpoint. We were asked to leave the ambulance while soldiers gave the most thorough search I've seen, even opening the containers of medicine. The doctors and the 3 of us internationals were instructed to put our bags on a conveyer belt inside a truck, to check for weapons. I know this is all to make life harder and not really a security measure, because I didn't do it and they didn't bother to ask twice. I watched as the soldiers searched the ambulance and questioned the driver, and my bag never left my shoulder.
In Madama after the clinic ended I was able to sit and talk with Asad, one of the medics. He wants to get his Bachelor's Degree but is only paid 200 shekels a month for working with the mobile clinic, and after food and transportation from his village to Nablus, there is nothing left for classes. He explained the lack of funding also affects the care that Palestinians receive. Currently, he said, the Ministry of Health is not operating. This is most likely why the clinics in Asira al Qibliya and Madama were so packed full of patients lately, in this time that people have been describing as "quiet". During more serious closure the clinics have seen up to 1000 patients in a day, but today this summer it is only the presence of extreme violence that is comparatively "quiet". In many different ways the occupation is still working against the health of Palestinians - from the damaged economy, to closure and travel restrictions, to separating people from their land and water sources. The UPMRC, particularly it's mobile clinics all over the West Bank and Gaza, is doing its best to make up for this, and is therefore bearing the biggest responsibility for ensuring the health of the people.
Mobile and satellite clinics are not the only activities of this organization. Last week I was impressed by their sophisticated and grassroots analysis of health issues by visiting the UPMRC's Nablus Youth Center and a summer camp. During the beginning of the recent uprising (intifada) the UPMRC had hundreds of young volunteers. The center began as a place for them to get training in first aid and health education, and participate in some civic activities as well. Over time the center evolved into a hub of civic education that is open to all youth in the area, and teaches classes in computers, photography and media, singing, dancing, English, democracy, and gender equality. The various summer camps are for very young children, and are more fun than health-related. Currently the center has about 110-120 participants, between the ages of 14-22.
Dr. Sameh explained their mission to me, and how the civic education for youth is related to medical services. They believe that these activities with youth will create a more health and democratic-educated generation of leaders. Youth in the community are enabled to provide first aid but are also schooled in community health issues in general, and this is important to the mission of the UPMRC. It also serves as an outlet for the hardships of daily life. Civic activities become a place for youth to deal with violence and loss so they are not carrying it around with them. And because many Palestinians cannot access doctors, families and individuals must be knowledgeable about self-care and able to provide solutions within their homes and communities when the occupation forces keep them isolated. In this way, the youth center works with other community education activities towards a larger and more powerful goal of self-determination.
It's not just for providing medical and emergency services, but healthy people who are enabled to care for themselves, their families and communities, is what the UPMRC is all about. What is especially powerful about their work is that they include all factors in their analysis of health problems, meaning land theft, closure, the wall, violence, and other aspects of Israel's occupation of Palestine are never absent from any diagnosis. A baby doesn't simply die from dehydration. A baby dies because the village is isolated by settlements or the wall, the economy has been destroyed, previous water sources are now unreachable, her parents have little access to health education, and soldiers did not allow the family through the checkpoint to reach a doctor's office. By working towards self-determination and the health of the people of Palestine, the UPMRC is fighting the occupation every single day.
posted by Steph at 11:50 AM
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