Working with the Palestine Medical Relief Society in Tulkarem

Posted by Peter Sporn

5 January 2010

Today, the second full day with the HaHRP delegation in Palestine, I went to assist in providing medical care to patients at the Palestine Medical Relief Society clinic in Tulkarem. A small city of 60,000 people in the northwestern section of the West Bank, Tulkarem sits at the border with Israel, hemmed in and divided at its western edge by the Israeli Apartheid Wall. The Palestine Medical Relief Society (PMRS) clinic in Tulkarem is located near the city center, above a dress shop, whose manikins in brightly-colored garb line the staircase to the clinic entry. It is a modest facility, run by Dr. Mohammed Shaban, a specialist in chronic diseases (similar to a family physician or internist in the U.S.) and a dedicated, cheerful staff. I was accompanied by another member of our delegation, Dr. Ellen Isaacs, an internist and cardiologist from New York.

After introductions and a brief orientation from Dr. Shaban, he, Ellen and I began seeing patients. We worked as a group, with Dr. Shaban translating to and from Arabic. Together, we saw a whole range of patients, mostly adults and a few children, some well-known to Dr. Shaban, and many new, including patients who had come to the clinic to be checked the “doctors from America.” At least half of the patients who came had respiratory complaints, which suited me fine, since my specialty is pulmonary medicine. Out of about 15 patients we saw, 5 (3 adults and 2 children) had bronchial asthma, which was poorly controlled in all of them. While a variety of factors may have contributed to their difficult-to-control asthma, I learned from one of the patients about a major problem in Tulkarem that adversely affects them all. Mr. O.A. (not his real initials), a 43 year-old journalist who has never smoked (unlike most Palestinian men his age), reported suffering from chronic wheezing and breathlessness, despite being on a combination of medicines that should work well for his asthma. In fact, he had already been prescribed (and was taking) a trio of inhaled medicines nearly identical to those used to treat severe asthma like his in the U.S.

Mr. O.A. explained, however, that he lived downwind of the Gishuri chemical plant, which released chemical pollution into the Tulkarem air that continually exacerbated his condition. He also explained that many people living near the Gishuri plant suffered from respiratory ailments. He told me that the plant had been built by the Israeli company years ago in Palestinian territory at the edge of Tulkarem, after it was determined that it would be too toxic for it to built within Israel. Later, after finished with our patients and being treated to a delicious lunch by the clinic staff, we were taken on a driving tour of Tulkarem by our PMRS driver, Abdul (not his real name). Abdul drove us by his house, which sits just across the road from the Gishuri plant, and from the Apartheid Wall, which runs along the outer perimeter of the factory. When I got out of the van to look at the plant (see picture at right), the foul and irritating chemical smell was strong indeed. While I have no idea what the chemicals were that I smelled, the strong sulfur and organic odors left me with little doubt of their toxic potential for the respiratory system, and likely other body systems as well.

Back at the hotel in the evening, a quick Google search revealed that the Gishuri facility was built in Tulkarem in 1984, after the company was denied a license to build it inside the Green Line in Telmond, Israel because it was considered too dangerous for the environment and human health (according to the Wafa News Agency, cited in a report by the Ecumenical Accompaniment Programme in Palestine and Israel; http://www.eappi.org/en/news/ea-reports/r/article/4566/between-a-wall-and-toxic.html). Since the plant began operating in Tulkarem, in addition to sickening the nearby population, it has devastated much surrounding farmland due to the toxic effects of airborne and effluent chemicals on trees and crops, and seriously polluted groundwater. And Gishuri is not the only factory built by Israel in the Tulkarem district that has polluted the area. Other factories include for a solid waste recycling facility and an oxidation plant, both relocated from inside Israel, and a liquid fertilizer facility, all built in the nearby village of Irtah since the late 1980s (PENGON/Anti-Apartheid Wall Campaign; http://stopthewall.org/latestnews/819.shtml). Each of these facilities has severely affected health and the environment in the Irtah region.

A little more about our experience at the PMRS clinic. All the patients we saw and their family members were very grateful for our care. And after we finished seeing Mr. O.A., a cameraman suddenly appeared, and Ellen and I were interviewed for the local Tulkarem TV news. I expect that means even more patients will come to the clinic to be seen when we return tomorrow morning. I’m looking forward to it.