Monday, July 8, 2013

One rock at a time 6-29-13 #19

I am sitting in Ben Gurion Airport watching all the Christian pilgrims leaving the Holy Land.  We are traveling on the Sabbath so we are avoiding the ultra Orthodox Jews and yes, I am doing my own racial profiling, but they look like goyim, have southern accents, are smiling in that unambivalent kind of way, and this is, after all, Israel.  So forgive me. Last night I shredded all my computer files, hid my camera memory card, placed anything from the West Bank at the bottom of my suit case under the dirty underwear, all in preparation for the are you Jewish enough and politically kosher testing that often occurs in the multiple layers of Israeli airport security.

As we approach the airport, we are stopped and the taxi trunk is searched.  Our driver explains this always happens when the driver is Palestinian (which is totally determined by the face, the accent, the look in the eyes, since the car has yellow license plates). In the airport, a sincere young man explains to me that someone may have put a bomb in my suitcase, (how about in my brain?) and wants to know if I know anyone in Jordan, but with my nice Jewish face and nice Jewish name, and a few gray hairs, I have no trouble.

I spent the last three days in the West Bank working/observing in three Palestinian Medical Relief women’s clinics in Qalqilya, Kufor Lakef, and Tulkarem, where medicine and occupation and the fragmentation of health care all come together. One doctor is a lovely Romanian woman who met her Palestinian husband when they were studying in Romania, another is a Russian with a similar story and the third is a West Banker who studied in Bulgaria, also with her doctor husband.  They all have children and challenging lives.  Tragically the first doctor’s husband was sitting on a balcony last year when it collapsed, leaving him a paraplegic.  The Russian woman, who is seeing all the men, women, and children who show up because the family doctor did not make it, introduces herself and then states, “I am not happy.”  I cannot tell if that is a comment about her impossible day or her impossible life.  I get the sense that the women who came here for love, all got much more than they bargained for, and their perseverance and dedication is impressive.  Last year, many clinicians were not paid for months when the Palestinians were punished for daring to ask for recognition in the UN.  That can be demoralizing as well as financially catastrophic.   “We cannot plan for our futures.”

The clinics are all a strange mix of first and third world medicine and the medical problems are like health care issues anywhere with an overlay of occupation and cultural traditions. The scale is prehistoric, obviously not calibrated, and the women are weighed with all their multiple layers.  How accurate can that be? There are many pregnant women and just about everyone pregnant or not pregnant, gets an ultrasound.  The ultrasound machines are all ancient, some covered with grime and gel, the doctors quite skilled but rushed, (no one has a full bladder which is imperative for a quality exam), the indications seem more social than medical. Women frequently present for vaginal issues, refuse a pelvic exam, then get an ultrasound and a script for yeast medication.  This seems somewhat dependent on how the doctor presents the need for an exam, but, from my first world vantage point, this is practicing gynecology without the data for a correct diagnosis. Mostly it feels to me like a waste of resources and a prescription for incorrect diagnoses and repeat visits. I also notice an overuse of antibiotics, a mix of patient expectation and best guessing. On the other hand, since patients pay for testing and for medications, the doctors are making financial decisions in terms of how to give the most care for the least shekels.  So it is complicated at best and I can see that the essentials are covered: pregnant women are taking folic acid and iron, they have prenatal records they bring to each visit wherever that may happen, IUDs are inserted using sterile technique, etc.

There are various protocols (women with IUDs are expected to have an ultrasound every six months), and problems related to the upcoming Ramadan, as women do not want to have their menses during Ramadan because they will not be able to fast while bleeding and then have to fast to make up after the holiday.  Progesterone and birth control pills are dispensed freely to bring on early menses or to delay menses according to where women are in their cycles.  A teenager is seen wearing a tee shirt, “Honolulu Wild Surfing is a Way of Life.”  I am sure he has never seen the sea and I want to cry.  A young boy comes in covered with healing chicken pox pustules and then the next patient is a two week old baby.  I jump up and say that we must put a clean drape on the table.  Chicken pox can kill newborns. The clinic has no scale to weigh the newborn, (critical data in terms of adequate weight gain and breast feeding), but the mother is clutching a scrap of paper with the baby’s weight taken two days ago at a Ministry of Health clinic.  Big sigh.  Another woman was seen at a Ministry of Health hospital, was told she had a urinary tract infection and given Xanax, an antianxiety drug rather than an antibiotic.  Another women made the probably arduous trip to a Ministry of Health clinic for a mammogram and was turned away after being told that mammograms are only done on day five of the menstrual cycle! (Really?) There are certainly big issues here with medical standards, quality of care, and coordination.

Most women wear colorful hijabs, some with all sorts of decorative sparkles, matching shoes and coats,(there is actually a lot of fashion going on),  a few are covered with a niqab which they flip back on entering the room, some come with mothers or aunts, or an occasional husband.  I study each face, the young often heavily made up and gorgeous, the prematurely older women mostly look tired and weary. One totally covered woman with a sweet, very pale face asks me, “How is America?  Is it comfortable?”  She wants to go live with relatives in Michigan. Exactly what can I tell her? There are tragic stories of long term infertility (very bad in this culture), labs of dubious quality, medications are costly and sometimes just not available. 

In the midst of one visit, a slick male drug representative drops in and dumps a pile of free samples on the desk; these will go to the very poor. At the mobile clinic in Kufor Lakef, one of the community based workers is leading a breast feeding support group.  (Yeah!) There are no prenatal classes (that is what mothers and grandmothers are for), no pain relief in labor, and lots of advice from village women, (like taking birth control pills for polycystic ovarian syndrome will cause infertility rather than treat the underlying disease). PMRS has piles of excellent patient education handouts and the doctors do their best given the time available. There are postpartum home visits if women do not live too far from the city.  At the clinic in Tulkarem, we are offered a steady stream of juice, water, tea, coffee, and finally a huge plate of hot manakish, delicious dough that is baked with zetar and cheese, piled in the midst of the charts and medical paraphernalia.

In our journeys to these three clinics, most of the checkpoints have hot, bored looking soldiers but we are not stopped.  At Anabta checkpoint at 9 am we see the traffic slowing as we approach the guard tower. The soldiers are setting up “slow down” signs, they are loaded down with all sorts of guns and gear ready for mortal combat amongst all these civilians trying to live their ordinary lives, and mostly we sit and wait for no particular reason.  Maybe because this is a good way to disrupt people trying to get to work?  After 12 minutes, we are waved through without even checking our passports.  I count 52 cars and trucks waiting in the opposite direction.  This is how the IDF maintains total control; because you never know when you will be stopped, turned back, for how long, etc, etc; planning anything is basically a crap shoot. 

Our last day with PMRS ends with a discussion and reflection on how to support the Farrah Rehabilitation  Center where my other colleagues have been working for three days with an amazing dedicated staff and devoted parents, and then we go to a “barbeque.”  This involves a bouncing ride to Beit Furiq, a rural village maybe 30 minutes outside of Nablus where the brother of one of the PMRS staff is building a magnificent stone house, all hand carved.  We wander around the unfinished three floors, gasp at the stunning views in all directions, and marvel at the love, skill, and craftsmanship that he is pouring into his future home.  He is an incredibly skilled stone mason. The house has already been spray painted by nearby settlers as part of their “price tag” policy.  They want him to know they are watching; they are offended that he is building on his family property, they may come back, burn his car, trash his house, who knows?  The family remains, undaunted by this threatening behavior.

The brother has a zareb, an oven that is a deep pit in the ground where he has created a bed of coals and then lowered down a many layered basket holder, each filled with aromatically flavored chicken, potatoes, carrots, and onions.  They cover this with a concrete top and seal it with dough along the edges.  After 2 ½ hours of baking, this is all opened up and we watch and taste and smell the magnificent meal as it emerges. Then we pile into the cars, shock absorbers challenged, gears grinding, and arrive at another family home where tables are pushed together and the barbequed food is added to an extraordinary array of bread, pickles, and salad and a most amazing Basmati  rice/almond/carrot/corn/onion thing all steamed in chicken broth dish.  (Big wow) The mood is generous and happy, we are repeatedly welcomed and fed and fed some more.  We soon discover there are no plate boundaries and more food than the crowd of guests and family can possibly consume. 

Three sisters live here with 18 children and two husbands.  The third husband left for another wife who could provide him with sons.  (Traditional society still hasn’t figured out that the sperm carry the “x” and “y” genes, but I digress.) His first wife is clearly a survivor; she opened a minimart, anchored herself in the bosom of her extended family, and raised her daughters.  Her face is both warm and proud and she looks much older than her 50 years. The men retire to the living room to smoke argila, talk men talk, and the women rearrange the tables and chairs for our coffee klatch and kanafe, a famous Nablus concoction. Children of all ages are constantly in and out, sitting in laps, taking care of each other, sharing candy, crying, laughing, playing.  There is lots of love and physical contact with the little ones.
Back at the airport, there is always a fascinating exhibit of large photos after customs and security, as travelers walk towards the food court.  This year, the exhibit highlights Israeli sports, “A story in pictures.”  There is the tribute to the eleven slain athletes in the Munich Olympics and lofty text about how sports are part of the “national ethos,” part of the Israeli culture of struggle and winning. The images are inspirational and multicultural: women swimmers and weight lifters, girls in hijabs playing football, various wheelchair athletes, coed rowing, but mostly strong, handsome, powerful men doing great athletic feats. This is the message the Israeli tourist authorities want us to leave with: a vibrant, struggling, modern, democratic country that knows how to win and win big.

On the other hand, I am thinking about the meaning of resistance: the kind that involves getting up every morning, taking care of your children, picking your olive trees, celebrating every wedding, waiting at checkpoints without losing your mind, refusing to bend.  I think about the Palestinians and Israeli supporters who are stubbornly working on the boycott, divestment, sanction movement, (McDonalds just announced that they will not open shops in the settlements); the students I met in buses and guest houses, studying English literature or communication at Birzeit University, getting their masters degrees, plotting PhDs in London, refusing to be hopeless; the film makers telling the stories over and over again. I think about the women coming for prenatal care, IUDs in, out, creating the next generation that will live on this land, deeply connected to place and history.  This is a powerful stubbornness.

I fully understand that the political and societal issues for Palestinians are vexing and complicated. Everyone I talk with speaks of the current political leadership with a mixture of disgust and cynicism and there is definitely a weariness and hopelessness present much of the time, but there is also joy and creativity and determination.   For me, being on the ground, bearing witness, and joining in solidarity work, this refusal to bend is really inspirational. 

Today, I notice that I do not have my usual gut gripping airport anxiety, maybe because I have chronicled this struggle each day, hit the cathartic “send” button, using my voice as the most powerful weapon I have.  My traveling partner is wearing a tee shirt she bought that is emblazed with “Free Palestine” and a big graphic of Handala, the symbol of resistance.  She has it on inside out so security will not find it in her suitcase, but she is standing proudly in line and I know it is there.  Another piece of resistance.  I deeply believe that every bit counts; this is about moving mountains one rock at a time; about using these rocks to build bridges rather than walls, about using our American privilege to support the people that are engaged in a struggle that is far more critical to the survival of everyone in this region than the sky diving, archery, and acrobatics highlighted in the image making that bids us goodbye. 

Sunday, July 7, 2013

Qalqilya: The Ariel Finger 6/25/13 #18

After seeing patients in a PMRS clinic in Qalqilya, a northern West Bank city located against the Green Line, I join Suhad Hashem, an extraordinary, feisty activist, for a “wall tour” of the city, the first city to be completely encircled by the separation wall in 2002.  This is my third tour in nine years and the “prison” has certainly evolved. We pass a shabby UNRWA hospital, and she informs me that the people of Qalqilya were given refugee status even though they were not technically refugees, because they lost so much of their land located on the wrong side of the Green Line in 1948.  They also have the only zoo in Palestine! (All sorts of metaphors spring to mind: the animals in a cage, the zoo keepers also caged; my bet is the animals receive better treatment.)

We walk towards the North Gate through a bustling souk filled with fruits and vegetables. From 2002 to 2005, no permits were given to allow workers to leave the city to work in Israel, a form of collective punishment to the entire population. In 2006, it became possible for workers to leave through this military terminal: metal corridors like cattle chutes, much barbed wire and fencing, a guard tower, then a security building, a total of eight turnstiles, and Israel on the other side.  5,000 laborers from all over the northern West Bank line up at 3 am to get through, every day.  This was all built inside of the West Bank, annexing 12 kilometers of Qalqilya to Israel.  The men must present permits, their bodies are checked and a handprint is taken every time.  Suhad has gone through this gate and found it utterly humiliating.  She reports that usually there are young female soldiers to increase the humiliation for the older Palestinian men.  The laborers are picked up by an Israeli bus, for Arabs only, (think Selma, Alabama), and then are taken to the Tel Aviv industrial areas, or to black market industries, or to sorry no work today.  The workers have no protections from trade unions and there are many stories of terrible abuse, but people are desperate for work, any work. At the Azzun Atma crossing, a different bus also stops at the Israeli settlement of Oranit but the settlers objected to the presence of Arabs on the bus, so the police enter the bus, take all the Palestinians’ IDs, throw them off the bus, and the men are forced to walk a distance to another site where their IDs are returned.  (What century are we living in? Liberal Zionist folks in the Tel Aviv bubble, is this OK with you? Apartheid anyone? )

Suhad reports that 50% of the Palestinian permit requests for access to their own land are rejected by the Israeli authorities, or permits are only given to one family member when it takes the whole family to work the land. Where the wall is a fence, it consists of barbed wire, a military road on each side, a trench and then more barbed wire, again more land seized to create a no man’s land.  Recently the Israelis have allowed Palestinians to farm right up to the wall area, so I see neat rows of crops and plantings now where there used to be rubble.  Before the wall, this was a major greenhouse area, Israelis shopped in Qalqilya, and there was a vigorous agricultural export business. That abruptly ended with the wall and that area is now a parking lot and the garbage strewn souk we are standing in.  Thus wealthy families have been reduced to poverty.  Suhad’s family owns land on the other side of the wall and she remembers the lush lemons and orange groves; it pains her now to buy these in the market because she cannot reach her own trees.

We walk down Western Street, once a vigorous commercial area, now dead, and visit the Asharqa School which has the misfortune of being located adjacent to the wall (the eight meter high, three meters under the ground concrete version).  She tells us stories of Jewish settlers dumping sewerage into the yard of (?another) school adjacent to the wall, and destroying part of the school yard. The children in these situations live with the wall shoved in their faces; they are the first to see the IDF incursions, the first to choke from the tear gas, and they have predictable psychological difficulties.  The Israelis have added electrical fencing on top of the wall and security cameras every few hundred feet. On the other side of the wall, the land in front of the concrete has been filled in and planted with trees so the wall is virtually invisible to those who choose not to see. 

Qalqilya has flooded twice since the wall was constructed and the rain and sewerage mixed together to create an awful soup, so there are now some grated drainage openings at the base of the concrete.  As we walk along the military road, trying to grasp the ugliness and consequences of this imposing prison, there are pools of open sewerage and the foul odor of dormant puddles.

Suhad speaks with a mixture of urgency and outrage.  The big reason for all of this land grabbing, she explains, is that Qalqilya sits upon the largest water aquifer in Palestine, (52% of the water in Palestine), and the Israelis want to control the water sources. (People say that water is more important than oil and gold in these parts). We are looking at the latest graffiti on the towering cement walls.  There is the famous one of a child in a bottle (Qalqilya) and a snarling pig (Ariel Sharon) and a giant hand with keys and chains dangling from the fingers. There is an elegant mansion opposite this site, (after all the olive samplings in the no man’s land), and the house is under demolition orders because it is too close to the wall.  The owner’s child died of a chronic illness because he was unable to get a permit to continue the child’s high level treatments in Israel. The authorities have punished the home owner and he is no longer allowed to be on his roof, (where he is able to look over the wall at the flourishing settlements and bypass road).  Suhad herself lost her 60 year old mother, a vigorous woman who had a heart attack and died when she could not get through the checkpoints to a high level hospital in Ramallah or Nablus.

There are two newer developments she explains with a pile of maps and lots of pointing and squinting into the sun.  The Israelis have built a tunnel from the walled city of Qalqilya to the walled city of Habla that goes under the wall. Life is further complicated for some Palestinians, like the village of Arab Abu Fardad, who live on land in between the loops that encircle the settlements,  keeping the Jewish settlers with full access to Israel and modern bypass roads and totally isolating the Palestinians who are living on “the wrong side”  of the loops of the wall. She then gives a detailed explanation of the bypass roads that have been built to link the settlements deep into the West Bank with Israel, (like the “Ariel finger,” I can only think, so which finger is that???).  These fingers are then linked up so that they extend all the way to the Jordan Valley on the east side of the West Bank, dividing the territory in two. The Palestinians trapped in these fingers of land and roads are under threat of dispossession; then have no water, no schools, cannot bury their dead, are severely restricted in terms of what they can bring to market, etc, etc.  In other words, they are being targeted for silent transfer: making life so unbearable that they are forced to leave in order to survive. Such a nice liberal democracy, this Israeli state.

We are now on the road towards the walled town of Habla which is three kilometers from Qalqilya.  Under international pressure, the Israelis not only built the tunnel, but also a gate that is open three times a day for 30 minutes to 1 ½ hours.  We get there at 5:30 and children, laborers, tractors, are gathering for the ritual of crossing over.  I can see the high rises of Tel Aviv in the distance.  Suhad tells us of a man who tried to cross, but the computer in the security terminal indicated that he was already on the other side (a soldier had failed to enter his data) and he was forced to prove that he was actually on the side that he was actually on.  (How is this different from mass psychosis?) She says if you argue, you lose your permit for one year, so everyone is fairly subdued.  The IDF arrives on the other side in a jeep and one man and two young women, fully armed for combat, get out.  One of the women has long blond hair cascading down her back, flowing out of her menacing helmet. They are laughing and kicking the locks and clearly taking their time while the prisoners on each side wait patiently.  They finally open the gates and tell us we cannot stand in the road (where the photographic opportunities are optimal).  When Suhad asks why not, the woman replies, “Because it’s the rules.”  I look at the size of her gun and decide now is not the time for an argument.  

In the taxi back to the service to Nablus, I ask Suhad where she finds hope.  She speaks eloquently of the power of survival, of refusing to leave, of replanting the crops, rebuilding the homes, educating the children. She also talks about the critical importance of international attention and pressure and the power the boycott movement, which is her other focus of activity.  Clearly, she does not have the privilege of despair.

Saturday, July 6, 2013

Nablus Resilience and Resourcefulness 6/24/13 #17

The drive to Nablus is uneventful, unlike the experience of two of our delegates who got stuck in a massive four hour happening at a checkpoint that involved many IDF and tanks and lots of waiting and cigarette smoking and no clear explanations. The Al Yasmeen Hotel, on the edge of the old city, seems to have perked up since our last visit, with many more guests and meetings, although, despite an attentive and friendly staff of attractive young men, and five separate attempts to book our rooms, they managed to screw it up anyway.  Small potatoes in the occupied territories.

I have been looking forward to my day with Dr Khadejeh Jarrar, the head of women’s health care from Palestinian Medical Relief Society.  We are going to three villages with a team from Medical Relief, UNDP (United Nations Development Program), a representative of the Palestinian Authority, and members from the local community councils to discuss how to create a more organized system of health care between three towns that are trying to collaborate.  Since I am always stunned by the disorganization of health care delivery in these parts, the NGOization of different compartments of care, and the consequences to patients living in this disjointed and confusing world, this should be interesting to see in action.

Nablus is a gorgeous old city built on the palm and up the fingers of mountains that hold it like a giant cupping of hands. The traffic is of the chest pain variety, there are billboards for all sorts of international companies (two happy, handsome guys drink Coca Cola, blond women with hair flying sell all sorts of products including sexy wedding dresses to the covered women in the streets), and Israeli military bases dot the hilltops.  There are mountains of pita bread and water melons on every corner and a clear feeling of being watched by the guys above us.

We head to the town of Burin, population 10,000, where part of the mosque is in area B and part in area C so there is a threat that it will be demolished, (this kind of humiliation and downright meanness takes real creativity). We enter the local community health center where the hallway is lined with mostly women who represent the community or work professionally in the clinic, plus the representatives of the previously named organizations.  The Director of the Burin Charitable Association seems to be chairing. The clinic is trying to provide services to the towns of Burin, Madama, and Asira al Qiblia. It seems that there is a lot of physical community support for the center, (painting, curtains, etc) but there are many complaints and conversations of the following types:

1. The doctor comes to the clinic two times per week, which is an inadequate number of days and which results in a stressed out doctor, crowded clinic, short visits, and inadequate care, patients get angry, urgent patients cannot be seen quickly and there is a high level of frustration. The UNDP representative explains that their role is to support marginal communities to get access to care and given the occupation, perhaps they can build on the capacities of PMRS and the Ministry of Health working together. The nurse suggests that many services do not need a physician and that, for instance, the clinic had figured out how to provide vaccinations.  If fact much of primary care that involves monitoring, height, weight, etc can be done by a nurse or midwife.

2. For pregnant women, there is no female doctor, no reliable ultrasound; Burin currently is seeing 35 pregnant patients, but they predict that number should be 75, so women are going elsewhere.

3.  There is a lack of available medications (I think back to my trip last October, when I was told there was no digoxin, a basic cardiac medication, available in the West Bank).  A patient who is on the council tells the story of her epileptic son who was unable to get his (not sure if free or inexpensive) medications from the Ministry of Health, she was told to drive to Nablus, so she just paid for it herself in a local pharmacy.  Another person discusses the lack of insulin to be found in the Ministry of Health pharmacies.  Once a medication arrives, it is distributed to all the Ministry of Health clinics but how does it get to the patients?  The clinic uses a computerized data base and can easily organize home visits and screening.  Another person talks about how time consuming it is to make a referral to the Ministry of Health and wonders if they could have direct computer access to their appointment system.  (I have certainly had many conversations back in the US non-health care system that remind me of this one.)

4. Several complain that there is no ambulance, no public transportation, and private transportation is expensive.  If someone fractures a bone or goes into labor, it is difficult to get all the way to the Ministry of Health hospital in Nablus.  One diabetic, hypertensive man called an ambulance which never came.  He was taken in a private car and died on the way to the hospital. It seems there is little coordination between the Red Crescent and the Ministry of Health. One elderly lady was hit by a settler and injured; the IDF told them she was stable, but the Red Crescent ambulance took her anyway.  Yesterday, a motor vehicle killed two people and injured four on the main road of Nablus.

5.  Then there is the special issue of the nearby Jewish settlements that frequently block access between the villages, burn farms and olive trees, grow wild pigs that get released into the Palestinian farms and cause massive destruction and no one knows how to get rid of them. The biggest complaint is the frequent Israeli settler attacks; the lack of available ambulances, the PA police are paralyzed and afraid to do anything, safe transport is desperately needed. I discover that the clinic does not even have a phone line.  

Everyone agrees that the health committees should empower the local people to demand their rights for quality services and PMRS supports this idea.  On the positive side, the Director of the Charitable society proudly shows off his computerized records for all the activities in the center: the monthly visits monitoring patients with chronic diseases, the educational consults for the kindergarten teachers, the cooking and breakfast programs, the theater that is being built, safety awareness programs, summer camps, the machine that is available for villagers to make honey. The PA representative is from the fire department and talks about the civil protection, safety courses, first aid and CPR courses, the volunteer teams that support the villagers during settler attacks, the training for evacuating the entire village in case of emergency. We visit a room filled with handmade soap, handicrafts and pickled fruits. This is a pretty impressive and well organized village.

Madama, on the other hand, is in crisis.  Their main source of water has been taken over by settlers and they are reduced to carrying water of questionable quality from a well in the town in large plastic buckets by hand or on donkeys.  We meet with the village council and besides the water disaster, contamination from the sewer system, and the prevalent infectious diarrheal diseases, all the complaints are worse.  Although PMRS and the Angelican Hospital both have clinics two days per week, they are on the same two days, there is little coordination between all the players, the Ministry of Health is hopelessly bureaucratic, there is little available medicine, and no capacity for supports such as fire departments and ambulances. The stakeholders at the meeting agree to set up a committee, create an action plan, and learn from the more successful experience in Burin.

Asira al Qiblia is the poorest and most marginalized of the three villages, a small, dusty, crumbling town. It seems that there are no health councils, paved roads, or water.  They suffer from daily settler attacks and attacks on their water system and infrastructure, so the villagers have lots of injuries and a generation of traumatized children. Of the 3,500 villagers, (350 households) approximately 100 families have health insurance.  They buy water at exorbitant prices, (a tank of 3,000 liters for 30 shekels which lasts 5 days.)  The monthly cost of water per family is more than their total monthly incomes and many have sold their cattle because of the lack of water.  In addition there are three nearby stone quarries so there is the issue of dust related respiratory diseases and allergies as well as large trucks loaded with stone.

This is where I tend to shake my head in utter despair, but instead we are all invited to one of the women’s homes for a feast. Palestinian resilience is always a source of inspiration for me.  The living room is filled with stuffed couches and chairs, and decorated with intricately embroidered pillow cases, lamp shades, and scenes of traditional weddings.  We are soon sitting around a long table facing enormous platters of mujadara (some kind of fabulous grain and lentil combo) and thin cigar shaped yalanji (grape leaves) along with the usual labneh (yogurt) flavorful salads, pita, pickled vegetables, water, Sprite, aromatic tea flavored with mint, and small cups of Turkish coffee and a crowd of women all encouraging us to eat more, (sounds of my grandmother).

These village women are warm and tough.  One speaks good English, went to college, and tells us that women in the countryside want to improve their lives and have projects like making honey, growing herbs, and raising sheep.  Many of the women attended university and many of their men are unemployed. In Asira on 1/14/13, 70 women formerly registered an organization called The Palestinian Foundation for Women; they are fixing up a donated house that has no water, electricity, or plumbing facilities, and they are creating a women’s center for training in crafts such as embroidery and knitting as well as how to use more modern methods to make olive oil soap.  She tells me most married women are working, particularly as teachers, and they all giggle and kvell about the new Arab idol from Gaza.  The older woman who cooked the vast quantity of food will not let us leave without doggie bags for the road and will not take no for an answer (like I do not have a refrigerator).  I give her a thank you gift of an olive oil hand cream made in Davis, California by a friend of my daughter’s and she gets out her local version in a plain white bottle but smelling fragrantly of almond and apricot oil which is pretty divine.  Despite the challenges this village is facing, it seems that the self esteem and integrity of the women is solid.  They are not looking for charity; they just want the opportunity to raise their families and live productive, creative lives which seems utterly reasonable.

Just as I am promising myself never to eat again, I discover that tonight’s social activity is a family dinner with one of the main organizers of the Farrar Center in Nablus where many of the delegates are spending their clinical days. A few hours later I am in the arms of another warm and welcoming Palestinian family, four lively children, a stunning view of the sun setting over the Nablus hills as lights start twinkling in the dusk, and of course a tasty dinner of overwhelming proportions.  We laugh and joke into the evening playing a (goofy, fast paced) card game called Uno.  Another resilient family refusing to be silenced in the midst of occupation. 

Friday, July 5, 2013

Lifta: Eracing History - 6/23/13 #16

I have seen many photos of the destroyed village of Lifta, which dates back 1,000 years and has tax records from the Ottoman Empire.  The photos show a famous, archetypal vista of fragmented houses, piles of stones extending into a valley at the edge of Jerusalem, but Omar from the Israeli organization Zochrot, (Remembering) has much to teach us.  He has us rotate around 180 degrees and look at a conglomeration of modern buildings extending up the hill.  These were all built on the land of the destroyed village of Lifta. He points out a little building hiding under a big billboard; this was once the school of Lifta and is now a Jewish school. So the village is far more than its famous ruins and actually encompasses much of the land around it. Close to old Jerusalem and on the road from Al Quds (Jerusalem) to Jaffa, this was a busy area for the locals, religious pilgrims, and tourists.  The village actually dates back to the Canaanites, and has Aramaic, Arabic and Hebrew roots. Lifta means “The Gate," (of Jerusalem).

The sign reads En Neftoah (Lifta), and Omar explains that Neftoah is a Biblical place somewhere around here and then the Israelis added “En” to Hebraicize the name as well as give it an ancient reference. We scramble down a steep rocky path, past a dusty construction site which is part of a new project to build a train track to Jaffa that will include bridges and tunnels through this area.  He points out nearby destroyed villages such as Biddu and JNF forests near the Jewish settlement of Ramot.  We see a mosque at the top of a mountain which was attacked by settlers who wanted to turn it into a park and synagogue. Facing the other way towards the construction is the site of Deir Yassin, now a Jewish neighborhood. Beyond that is Ein Kerem and other Palestinian villages all occupied and mostly destroyed in 1948 with the creation of thousands of refugees. There are also a scattering of Palestinian homes at the top of the valley that are now Jewish homes. The Knesset and many governmental offices, the high court, and even parts of Hebrew University are all on Lifta. I am in one of my feeling particularly hostile to ultra Orthodox Jews in general and settlers in particular moods (this is happening fairly frequently), and note that many boys with kippas, dangling payes,  and tzitzit bouncing from their shirts as well as girls in long skirts and long sleeved blouses are walking on these paths as well.  I can feel the bitterness in my throat and a twitching in my commitment to passivism.

Omar explains that before 1948, Lifta included 10,000 dunams with 40,000 more cultivated and a population of 3,000 which was a big, wealthy town for those days. There were many olive trees and vegetables planted from seed and it was a lush and prosperous place. 50 of the 400 houses are left. Other villages such as Ein Kerem and Ein Hod were not destroyed and are now Jewish towns, but 95% of villages were completely demolished to eliminate the possibility of return. Strangely enough, in 1949 Jews from Arab countries were brought in to live in Lifta, (it probably looked a lot like home), but they left after a few years because the village was near the Green Line with the Jordanians on the other side and it was slightly dangerous plus these Arab Jews had no water and no electricity in their homes (Jews from Arabic speaking countries were second class from the start).  And did I mention that this area is crawling with Orthodox boys and girls and occasional older men with big hats and stern faces? (For me, this is how I know how bigotry feels.  My hostility is growing and I don’t even know any of these people.)

Almost immediately, various green organizations asked that Lifta be left as a park, a green spot in Jerusalem, but even today, most Israelis do not see the relationship between a park with graceful ruins and the Arabs that once inhabited them and are now deafeningly absent. As we scramble, walk, jump, trip around the stone paths and in and outside of crumbling homes, the sunset creating a shimmery streaking light, the extraordinary beauty of Lifta is painfully obvious.  The stones range from grey white to orange. There are wells and aqueducts, the original fig trees and lush saber cactus, ancient terraces, amazing architecture with graceful archways and floors built on top of each other dating from different centuries and now crumbling from age and neglect.  Each family also had a smaller house for baking bread. At the base of the valley we come across two pools with a predominantly orthodox group of youth playing in the water with a few guys in their underwear and girls in bikinis thrown in for dramatic effect. The first pool is cleaner and was originally for washing dishes, etc in the homes while the second pool, which is utterly disgusting, was for the animals to drink. Canals lead from the pools to water the various gardens below and each family had plots for figs and almonds, apricots, vegetables.  This seems to me like an approximation of the Garden of Eden. 

In 1947 the UN Partition Plan was announced and Jewish militias immediately started to occupy villages beyond the partition line.  (Remember this important tidbit, this is before the state was declared, the Arabs attacked, etc). Lifta and Jerusalem were supposed to be international zones, but clashes with the Irgun started in 1947 and in early 1948, Irgun fighters, (terrorists?) dressed as tourists came into a Lifta coffee shop and shot six people, wounding seven.  This created a wave of fear and the families living on the edges of town fled to East Jerusalem and Ramallah.  A month later the Irgun bombed all the empty houses and then started attacking every few days to weeks. The inhabitants were terrified and fled to Ramallah but 30 to 50 young men stayed with some meager ammunition and guns. The Haganah and Irgun attacked again and Ben Gurion famously declared that you can now enter Jerusalem (through the Lifta area) “without seeing any strangers,” (read Arabs).

The on April 9, 1948, 120 men, women and children were massacred in nearby Deir Yassin and the Jewish soldiers took a group of captured women on a “victory tour” around the city and then dumped them at the Jaffa Gate. The Arab population panicked and fled to Ramallah.  The Israeli forces declared all the fleeing home owners “absentees” and confiscated all the property for the state.

As Lifta decayed, it also became a home for squatters, the homeless, and drug dealers who have been pushed out by the police.  In the 1980s there was also a Jewish terror cell called the Lifta Underground, that was plotting to bomb the Al Aqsa Mosque and the mosque in Hebron. (Yikes!)  The mosque, one of the oldest buildings made of stone and mud mixed with ash, is cooler with a courtyard, trees growing stubbornly out of the stone walls and stairs.  There are two rooms in various states of ruin, the prayer room and the school. Palestinian groups still come here to pray and Lifta survivors living in East Jerusalem come to pray and clean up the cemetery. In many of the rooms with high arched ceilings the keystone at the top (which is critical to the architectural stability of the stones) has been removed, thus contributing to the future collapse of the ruin.

At one point as we walk soberly through one stately house after another, gracefully arching windows, floors sticking out into nowhere, Omar tells us to put away our cameras.  We peer across a roof and there is a gigantic construction site.  Haaretz reports that the Israelis are building a massive bunker and underground tunnel that will connect to the prime minister’s house and be a functional government in case of nuclear war.  Ultimately this will all be planted to appear as a garden. It seems that everyone around here is preparing for the apocalypse.  Security is a bit touchy about us taking pictures of this not so secret project.

There is now a plan to finish the destruction of Lifta and build a posh new Jerusalem neighborhood and while there is a campaign fighting this proposal, Omar predicts it will start in a few months.  When he says this I am seized with a wave of grief and rage, and start taking photos of every stairway, crumbling wall, olive press, desperately trying to document the world that may soon be erased.

Omar explains that Zochort started 12 to 13 years ago to document the Nakba and create a new memory of ’48. He reminds us that in the early days of the state, Ben Gurion asked academic researches to create a history that stated Palestinians made the decision to leave voluntarily and the researchers have done an excellent job creating that illusion.  Zochrot has researched 58 destroyed villages and has documented a total of 672 lost villages and small towns.  800,000 Palestinians were forcibly expelled one way or another and 100,000 stayed.   Omar was lucky.  His village was attacked, one donkey was killed, homes were destroyed, and the remaining houses were totally ransacked (sugar poured into the olive oil, flour spilled on the floor, deliberate chaos), but the families returned.  The village was located in the Triangle Area controlled by Jordan, but in the agreements at the end of the war, the Jordanians gave the Triangle Area as a gift to Israel, so by quirk of fate Omar is an Israeli citizen

Omar is proud that Palestinians continue to persevere and refuse to be erased from history and he is drawn to the work of Zochrot as part of that ongoing struggle to be seen and acknowledged within Israeli society.  My eyes sweep across the ancient beauty and dignity of this rich valley, imaging the bustling community that once lived here.  As a student of the Nakba, this is as close as I come to a pilgrimage to the Holy Land.

Wednesday, July 3, 2013

Wadi Aliam, the largest unrecognized village in Israel 6/23/13 #15

We are back on the highway with Thabet from Adalah and I am puzzled why Israeli authorities are putting so much energy into displacing the Bedouins. He explains that the Naqab (Negev) is half of Mandatory Palestine, 60% of Israeli territory and contains 8% of the total Israeli population. Currently 1/3 of the population of the Naqab is on 2% of the land and if all the Bedouin land claims were honored, that amount would be approximately 3.5% of the Naqab which is really not a big deal.  What this means is that land is a matter of identity, (the same love and passion for land is expressed in Hebrew as in Arabic songs) as well as colonization.  The Ottomans and the British accepted the Bedouin, but Israeli policy involves the claiming of land for Jews and the deArabization of that land. 

In 1948 some Bedouins were evicted from the Naqab and in the 1950s the state gathered the Bedouin into the “Sayig” designated area which was declared a closed military zone, and then declared much of the area as agricultural which meant they were not allowed to do any construction.  In the 1960s, the state become more aggressive and gathered Bedouin into a number of townships, punishing those who refused by declaring their homes as unrecognized villages. It should be remembered that the city of Be’er Sheva was founded in 1900 with the purchase of 200 dunans (approximately 50 acres) from the Hazazin tribe. 

We are about to visit Wadi Aliam, the largest unrecognized village in Israel, some 10-15,000, all under threat of displacement. The Israeli authorities have announced the closure of the schools starting August 23, transferring the children to pressure their parents to move.  The students are on a general strike.
We are meeting with the traditional leader of the local committee which is the political organization of unrecognized villages.

Such villages are not on any maps, some existed before 1948, some are the results of previous dispossessions and now they are under threat again. Thabet explains that since 1948, Israeli policy has included:

1. Concentrating Bedouins into small reservation areas and restricting their movement (think Native Americans)
2. Urbanizing the Bedouin in the name of modernization without any respect for their identity and culture and destroying a traditional way of living
3. Finalizing land claims.  Of the 90,000 pre 1948 Bedouins, 10,000 remained after the war and the population has grown to 200,000 people who claim 3.5% of the Naqab.  Since the 1948 dispossessions and transfer to the different reservations, the Israelis have created seven planned towns for those who lost land or live in unrecognized villages; this will involve the destruction of 20-25 villages, uprooting 35-75,000 people, and the loss of land claims.  The Bedouin look at these townships as refugee camps and strongly prefer agricultural villages with livestock and herds.

He notes sadly that the Bedouin are not being given any options, while Jewish Israelis are welcome to live in cities, towns, kibbutzim, moshavs, or individual farms and get full support.  Some Jews from Tel Aviv are attracted to the rustic rural life and are setting up individual farms in the Naqab with full governmental services provided.

As we drive down Route 40, a modern highway, on our left are clusters of shanty towns and on our right  is sandy, rocky, uninhabited desert.  We are 30 kilometers from Gaza and that side of the road has been totally cleansed of Bedouin towns and is now a firing area for the military.  I see a sign that says: “Beware of camels near the road.”   

Tahbet explains that villages are made up of a tribe with clusters of clans subdivided into families.  The Bedouin want to keep these relationships intact and will never violate tribal law, even if it conflicts with Israeli law.  I am horrified to learn that many of the unrecognized villages are located adjacent to the most poisonous chemical/industrial parks in Israel.  We turn onto a rocky bumpy pot holed (I can’t really call it a road) towards Wadi Aliam which is built adjacent to a gigantic electrical plant. Massive high voltage electric towers and wires crisscross over and in between patches of houses as far as we can see.  (Isn’t that supposed to be a major health hazard?) Again the painful irony is that none of these houses are actually connected to the electrical grid.  There is a certain cruelty to this whole mess.

We learn that the 50 year old tribal leader we are meeting, Sheikh Ibrahim Abu Hafash, like many Bedouin, used to serve in the IDF under the belief that serving their country would result in a better future, (just look at the benefits for Jewish soldiers) but they returned to their poverty and villages without water and electricity and nothing changed.  This man was wounded in the service of his country and is now one of the leaders of the Islamic movement of the Naqab.

We are soon seated in a square of long red rugs and pillows on the ground in a large tent on hard packed dirt, with the same arrangement of plastic sheeting supported by wooden planks, the cooking pit, but also a sink and what appears to be a gas burner in the back. A refreshing breeze cools us a bit and the meeting with the sheikh begins with the rituals of coffee and tea.  His face is sun brown, he is wearing a long grey robe, and tells us the village includes 50,000 dunams and 20,000 people and the state provides no services except a school which is under threat.  In 1953, Bedouin in the surrounding areas were gathered up and put in an area called The Fence where they stayed from 1953 to 1988 without interference.  Then the Israeli Land Authority announced that the Bedouin were illegally occupying the land where they had been transferred by the government.  This was followed by a long and tortured court fight, deceptive legal maneuvers, multiple judicial decisions which ended with the decision in 2002 that the Bedouin could stay until a new agreement was reached.  The government has shown no interest in agreements and lots of interest in removing them. He says that a few days ago, a few Jews came and asked the Bedouin, “to be loyal.”  He replied, “We are as loyal as we are treated.  The state treats us as a knife in the back, so how do they expect to be treated?” The Israeli media also joins in the lies and distortions.

Much of the battles are around water for which the Bedouin pay the highest amount and then are responsible for building the infrastructure to carry that water.  International solidarity groups have helped install solar panels so they are generating their own clean electricity. In addition, the IDF has designated their land for training, a military area with no shooting.  He claims that the Israelis want Bedouin in the IDF so they can be the human shields in the front lines, but now less that 1% serve and they are looked down upon by their communities.  

Suddenly, it is time for the Muslim prayers and the Sheikh leaves us. Four Muslim women in our group ask if they can go to the mosque and the answer comes back in the negative; shortly thereafter, our Muslim sisters are praying at the back of the tent. Thabet explains that Bedouin society is very traditional and patriarchal; women are totally separate from men but derive their influence through their relationship with their husbands.  The community can meet at the communal tent where we are sitting, but not in people’s homes. One third of Bedouin are polygamous with up to four wives, each with a separate household, and the number of wives is a mark of prestige. There are usually 10 to 15 children per family, (each a blessing), but families up to 40 are not unheard of. Nonetheless, society is changing and the majority of Bedouin in the universities are female.  The women have associations involved with weaving, embroidery, and other traditional crafts.  In Be’er Sheba, all the demonstrations are led by women.  Israeli policy has forced women into the streets. As we leave the tent, he points out a huge gas storage facility in the middle of the town, again another major health hazard.

We are back in the van and I am marveling how people can survive under such harsh conditions, what kind of toughness emerges living in the desert, what will happen as they struggle to survive in such a racist and unsympathetic country.  Thabet continues the discussion, some pertinent pieces of information strike me:

There is already a bill in the Knesset to make the road we are on a military road and this will effectively criminalize all the Bedouins who refuse to leave; they are known for their resilience and stubbornness
Every Sunday, the sheikh, his wives and many children demonstrate in Be’er Sheba reminding people they are here to stay.

In the town of Alssir, part of the southern district of Be’er Sheba, the Bedouin inhabitants have already been displaced a number of times, many have served in the IDF and although they are technically part of Be’er Sheba, they receive no services and live under the dangerous high voltage wires.

When rockets from Gaza were landing in this area (which has no shelters), the sheikh laughed and said, “He’s asking about rockets? I am looking for water.  I was a soldier in the Israeli army, I served my country.” When it is time for Allah to take him, he is ready.

When reviewing the volume of health risks to this society, lets not forget the Dimona nuclear reactor which  is 30 miles away. Thabet remembers a time when they were told the reactors were “textile factories,” but no one was allowed to investigate due to massive security.

Adalah takes many petitions to the Israeli supreme court and often wins, but implementation is always a problem. It took the state six years to build a Bedouin school which consisted of a row of caravans.
He predicts that in five years all these villages will be cleared and Jewish towns will be built as part of “developing the Negev,” but there is obviously enough room for everyone, this is the same process going on in the West Bank in area C.  These areas are the ancestral lands and villages of the Dirat tribe that existed long before 1948. Bedouin are people of the desert, they have had their own villages for 300 years, they wander with their herds, but then return to their villages.  Maps from 1945 show fertile cultivated Bedouin villages.  Now not only are they being asked to prove their ownership, but if they do, they are offered 17% of that land.  The Bedouin are not interested in compromise.

We stop and drive up a small hill that in another perverse irony has several huge water storage tanks (that do not feed the surrounding villages of course).  Sand storms dance across the vista below. In the distance we see another important piece of this puzzle, the Nevatim military air base that has plans for expansion.  The location of this area is critical to prevent any demographic contiguity between Gaza and the West Bank. (Take a big “Ah ha” moment).

Shortly thereafter, the only Bedouin MK in the Israeli Knesset, a lawyer and former mayor active in the Islamic movement, Ibu Arar pulls up in his car wearing western dress, short hair and a beard, neatly pressed shirt. Standing in the wind with the highway below and the water tanks above, more sand storms, like mini tornados, dance across the clusters of villages. He talks about all the expected issues regarding the racism in Israeli society, the treatment of Bedouin, the discriminatory laws in the Knesset, and notes ironically that the state is spending twice as much money to expel the Bedouin as it would to recognize them. He asks, “If Israel can’t make peace with its own citizens, how can it make peace with Palestinians outside?” His family was displaced in the 1980s to build the military airport, the villagers were promised 10,000 dunams to move and they received 7,000. His allies in the Knesset include Meretz, a few MKs from Labor and the Arab parties, 20 out of 120 parliament members.  His is a lonely battle.

We pass the town of Nevatim, population 2,500, a (segregated I might add) Jewish settlement from India.  Thabet gets agitated when he points out there are three signs along the road to a small Jewish cemetery and not one sign to any of the many villages for the living.  He talks about the politics of fear, fear of the other, of Iran, Hezbollah, Hamas, Abu Mazin, there is always a new target.  “Fear is the centripetal force that binds Jews together.”

Thabet reminds us that the Bedouin are stubborn and strong and will continue to fight. He states the Arabs are part of the Israeli landscape and have learned to, “Play the game.”  They are very encouraged by solidarity groups and they are also not split by borders.  For instance, half his family lives in the Jabalya Refugee Camp in Gaza. He has an 85 year old aunt and he has not seen her in 15 years. He was once arrested for sending her 200 shekels a month, “supporting the enemy.” His family are refugees from Ashkelon. I am so inspired by his final insights: “We perceive the homeland as one place and we are willing to share.  I am a minority in terms of numbers, but I have a majority mentality, all Palestinians, all Arabs. But the Jewish majority has a minority, siege mentality.  They can militarily win, but they still have no sense of security.”  The new post-Nakba generation is not afraid, they have nothing left to lose.

Monday, July 1, 2013

We shall not be moved: Bedouins in the Negev 6/23/13 Sunday #14

Today we take the long drive south to the Naqab (Negev) to tour with Thabet Abu Ras of Adalah: The Legal Center for Arab Minority Rights in Israel,, to meet with Arab Bedouin communities facing displacement.

I am always learning from the landscape and I am familiar with the renaming of everything Palestinian (that has happened since 1948), but today I learn a new twist to this linguistic erasure.  Along the highway, we see signs in Hebrew, English, and Arabic.  It turns out that the Arabic names are actually transliterated from the Hebrew, thus engineering a process to create a different word in Arabic, deArabizing the names of historic places.  Thus Jerusalem in Hebrew is Yerushalayim and in Arabic a transliteration of Yerushalayim, rather than Al Quds which is the Arabic name for Jerusalem.  If you think about this, the messaging is that not only are Palestinians invisible, but they are actually immigrants and were not really here before the State of Israel got around to naming everything.

We meet up with Thabet, a political geologist and director for the southern office of Adalah, waiting along the highway with two interns.  The land is fairly flat, bone dry, and clearly desert. We turn off the modern highway to the unmarked, unrecognized village of Araqib, bumping over an unpaved road of rocks, packed sand and deep potholes, past rows of recently planted Eucalyptus trees on one side and a cemetery and cluster of Bedouin tents and shanties on the other.  We stop at a large, flat topped tent made of wide sheets of plastic and wooden supporting planks and sit down on the ground on the oblong created by long rugs and pillows.  We are introduced to the Sheikh and to the Haia Noach, the executive director of the Negev Coexistence Forum for Civil Equality ( . The Sheikh is wearing a long black robe, Arab headdress and when his cellphone rings, it is a familiar tango jingle.

As we are served bitter coffee prepared in a pit in the center of the floor, the Sheikh explains to us in vivid detail, the many “crimes against humanity” that have been committed against his village which has been demolished 52 times and rebuilt 52 times. In 1999, the Israelis started crop dusting his fields with poisonous chemicals, and repeated the process five times. The chemicals affected the fields, animals died and there was an increase in miscarriages. “Where was the UN protecting human rights?” he asks. We are invited to download a video of the village before and after the crop dusting from a computer that is plugged into an electrical socket tacked to a supporting beam.  He suggests that it is the racism in the Israeli medical system that has hindered any research into this medical catastrophe.

On 6/2/10, Israeli forces arrived assisted by helicopters, dogs, and horses, and leveled the village.  He calls this, “A Nazi crime.” His thick brown hands gesture as he speaks.  He describes the demolition where houses were leveled, and food, milk, medicine destroyed, 4,500 fruit and olive trees and grape vines were uprooted. “We are people. We have zero unemployment.  We live from the fields.”  He says it is amazing that the Israelis want to change them from independent farmers living in the desert to poverty stricken factory workers controlled by Jewish bosses in reservation towns.  Another round of coffee and tea.  Six months after the village was demolished, 40 trucks arrived and removed all the rubble and the court ordered the Bedouins to move into their cemetery.  The Israelis killed 100 sheep and 16 Arabic horses.  Currently the only secure place for the families to live is the cemetery we passed on arriving, and they live there without water or electricity.  “The dead protects the living.” The Israelis then planted the Bedouin land with rows of Eucalyptus trees, the Ambassador Forest, and foreign ambassadors are encouraged to plant trees here in the name of their countries. The sheikh was visited by the South African ambassador who condemned these policies and refused to plant a tree. With bitter irony, a large water tanker arrives and starts watering these fledgling trees, but there is no water for the people, in fact, Jew and Arabs are forbidden to provide water to the Bedouin; the Bedouins were fined by the courts for police costs involved in the attack.  Another water tanker arrives.

The sheikh states he has documentation to prove the Jewish National Fund is responsible for this tree planting on their historic lands.  Having lost their lands, he asks, “Where do we live?  How do we eat?” They also have no roads or schools. The children have to travel to a distant town of Rahat, “a failed refugee city” and the families continue to dig wells in search of water.  He questions, “Would Israel do this to a Jewish citizen?”  In fact, individual religious Jews have been acquiring farms in the area and the government provides them with full support. “Israel treats us like we are a security threat like Iran.”The sheikh states there are currently 58 cases in the Israeli courts against him, all for the crime of sitting on his own land. He urges, “We want to live with Jews, the criminals are the government and the police.” Many Israeli NGOs support the struggles of the Bedouin. For instance, Adalah petitioned the Israeli supreme court to stop the crop dusting, the material used was Round Up, made in the US

The sheikh’s son, Azziz, explains that the village of Araqib was first demolished in 1948, but the people stayed and asked for recognition.  They were mostly ignored until 2010 when efforts to totally demolish the village got serious. He describes the soldiers arriving at 4 am, demolishing 65 homes, 4500 olive trees, leveling the village. Before that there were 573 persons, “Before we were employed, working cultivating the land, wheat in the winter, olive oil, cheese, milk, all organic. “  Every family had small side jobs; he and his wife had 400 chickens and sold eggs, bringing in 600-700 shekels per week. Now the Bedouins have been changed to slaves, working 12 hour days, missing their wives and children. The Prawer Plan which was designed to regulate the settlement of the Bedouins in the Negev and ignores concepts in International Law such as transitional justice, semi-nomadic property rights, and native rights, “Means to kill us.  We shall not be moved. There is no option.  If we leave, we will die.” The police are threatening to destroy the cemetery which was built in 1914.

We are introduced to Haia Noach who talks about advocacy and awareness campaigns.  She has been arrested a number of times for protecting the Bedouin.  She states most Israelis do not want to know, deny the occupation and racism in their society.  The Prawer Plan is a new frontier for a conflicted area: taking control of large tracts of land by planting trees through the JNF, creating industrial zones and army bases on expropriated land. The discussion of the morality of forestation projects is now at a standstill and hundreds of thousands of trees have been planted. There is even an evangelical group that is planting one million saplings with the JNF to hasten the apocalypse.  She reminds us that that the land laws that allow confiscation if land is not occupied for a certain period of time were unknown to the indigenous population, that Bedouins often lack titles, or only have traditional titles that are conveniently ignored, and the courts are snarled with cases and counterclaims. She is hoping for a legal break through as there is a growing awareness about the rights of indigenous peoples.  Quietly I think to myself, “Insha’allah.”  

Saturday, June 29, 2013

Symbolism meets solidarity: the Saturday mobile clinic 6-22-13 #13

Blog Saturday 6/22/13 Symbolism meets solidarity: the Saturday mobile clinic
I have to interrupt this message:  Last night around midnight, the streets all over Palestine erupted with joyous crowds, cars honking in a delirious cacophony. A young man from Gaza, Mohammed Assaf, was voted the winner of Arab idol and either Abu Mazen or UNESCO (not clear) named him an Ambassador of Good Will. A victory for Palestine, and I might add, a victory for the entertainment industry and adoring women everywhere.

Bright and early, three of us take a service (a van that takes multiple passengers) to Khalil (Hebron) through open checkpoints and ominous but quiet guard towers.  We meet up with Dr Othman, a dentist and Dr Hassan Abu Amro, an optometrist trained in Saudi Arabia, in preparation for traveling to the village of Idha, eight kilometers from Hebron, just along the Green Line. We are traveling to the Saturday Mobile Clinic with Physicians for Human Rights Israel and Palestinian Medical Relief Society. We start with familiar stories. 

Idha is surrounded by three Jewish settlements including Adora and Telem. Because of permits and checkpoints, travel in and out has become extremely difficult. The quantity and quality of their water is problematic due to the large allotments going to the neighboring settlements, and the village is plagued by rats which can be seen jumping amongst the vegetable stands. Poverty is on the increase and the separation wall has wreaked havoc with the economy and people’s personal lives for the past five to six years.

In desperation, the villagers started collecting garbage, metal, car parts, and burning tires to get the metal and sell the metal to the Israelis.  The burning garbage and tires created a massive, toxic smog and predictable health problems. Combined with the polluted water, PMRS is seeing more diarrhea, asthma, miscarriages, diabetes, hypertension, and smoking. “That’s stress.”  PMRS and Red Crescent clinics, the private sector and Ministry of Health Hospitals cannot handle the community’s medical needs. Hassan also notes that no one wants to talk about cancer but the Dimona nuclear reactor is near Hebron.  Israelis nearby receive some kind of prophylactic pills (?thyroid) to reduce their risks, but nothing is offered to the local Palestinians. 

More fragments of conversation: Yesterday 15 settlers with guns blocked a nearby road, threw stones and were protected by the IDF for two hours. This also happened in Beit Ommar.
The IDF is becoming more aggressive (how can this be possible?) and are training dogs to attack when they hear certain words like Allahu Akbar (Did you pray today?)
There is a proposed law in the Knesset to make it legal for settlers to fire on Palestinians (which of course they are already quite adept at doing), a sort of legal white washing stand your ground.
Both men are thoroughly disgusted with the Palestinian leadership and elite power holders. They are “thieves;” they have stolen international aid money and will steal more if Kerry reinvigorates the (useless) negotiations and aid programs.
Nabil Shath, a Palestinian negotiator, recently explained to his Israeli associates that the PA is spending more money on Israeli security than on Palestinian health and security combined.

Hassan is warm, obviously intelligent and insightful. He worked in Saudi Arabia for 17 years, and lived in a special compound so his wife and four children had more personal freedoms than those outside the compound.  If they left, he had to drive his wife; she had to cover herself, etc. They came back in 2000 because he felt there was going to be a state and he wanted to serve his people, but now he worries, “For my kids and their lives, their futures.  What should I tell them? Sometimes I stand stunned. Am I going to create more hate? But still they can see what is on the ground.” His 23 year old son, trained as an electrical engineer in Egypt and now unemployed, feels totally frustrated and wants to leave.

We drive into the village and see large bales of hay and huge mountains of charred metal fragments.  For reasons that are not entirely clear to me, the mobile clinic is being “honored” by a large number of fully armed Palestine National Security forces who line the streets, direct the vehicles, and line up for photos with clinic staff. We crowd into a large room and on the stage there are municipal and PA dignitaries, Saleh who directs the mobile clinic from PHR Israel, and Alan, one of our doctors, sitting in front of a large photo of a smiling Arafat. We hear a history of the town and a thousand thank yous in Arabic and Hebrew as a large crowd of patients gathers outside.

And then we start seeing patients.  How can I describe this? A local family doctor who will be my interpreter and see obstetric patients, a nurse from the US, and I set up our “office” in a classroom.  We have a real exam table, an ancient ultrasound machine, and I have brought a flashlight, large bottle of Purell, various surgical instruments (to remove IUDs, sutures, etc), and a measuring tape.  I suddenly realize there are no drapes (not unusual) but even more striking, no gloves and no speculums and no basic lab work. A challenging moment for a gynecologist.  (The gloves are finally located.)

And then the work begins, a veritable flood of women in hijabs, blue, black, plaid, sparkling decorations,  and long jilbabs, buttoned up to the neck and long sleeves, one naqap totally covering a lovely woman’s face.  She flips it back when she enters the room.  I try guessing ages and realize that everyone ages prematurely under the stress of poverty and occupation.  The heat is oppressive, and we are dripping with sweat.  I feel for the women who are covered.  The women present alone, in twos and threes, some with small children, some argumentative, some focused, and everyone has an earnest story and a long list of medical issues that frequently include back pain, abdominal pain,  vaginal discharge, symptoms of urinary tract infections and hot flashes.  There are questions about irregular bleeding, pain on intercourse, infertility.  Everyone who is not trying to get pregnant has an IUD.  I try to reach across the language and cultural barriers; instead of, “Are you sexually active?” I ask, “Are you married?” I already know that many women take hormones to delay menses when they travel to Mecca.  I am listening carefully, empathically, woman to woman.   There is no medical charting, no vital signs, no prevention, but soon we are in a rhythm of brief history taking, strategic exams, lots of education and empathy, and then a wild search through the available donated medications and decision making for referrals for a variety of testing.  I am sure many symptoms are stress related and there is no simple treatment for that. My basic strategy is: Is this very serious? What is the most likely diagnosis given an utter lack of adequate information? What is the most we can do quickly here?  The hardest part for me is the women with menopausal symptoms.  I have always wondered how women covered in multiple layers deal with hot flashes and it is a challenge to give culturally appropriate advice. And of course we have lots of antibiotics and antifungals, and steroid ointment, but no free hormone therapy and I have no idea what is available in local gynecology offices.  I have heard there is a rich herbal tradition in Palestine, but that is way beyond my US first world experience. 

Hours later, the clinic is over and the women still waiting are angry and disappointed, but turned away by PA soldiers with guns.  I have seen 24 patients and the entire staff has seen over 700.  I feel a bit run over and my pregnant colleague is looking more than tired. The organizers are pleased and we are hosted by the village with chicken, rice and Turkish coffee with more officials and more men with guns.

The power of working in this Saturday clinic for me, year after year, is hard to explain. Symbolism meets solidarity.   There were women who actually received appropriate care and I found one woman with a breast mass and one with a pelvic mass who definitely need further care. But more importantly, the women understand that a doctor from some faraway place came to their forgotten village to provide care and see them as deserving human beings. They are not invisible.  I am also working in solidarity with the Israelis (Jewish and Palestinian) and the West Bank clinicians who are swimming against the cultural and political tides of their own societies and I want to stand with them as well.  It is really the most concrete thing I can do.