[West Bank, July 27, 2007] On Wednesday July 25th, the most numinous encounters occurred, because of being in the right place at the right time.
After Palestinian American Professor and justice and peace activist, Mazin Qumsiyeh spoke at Sabeel’s http://sabeel.org 2nd International Conference: 40 Years in the Wilderness…40 Years of Occupation…
I spoke with one of the coordinators of the event seeking a connection to any pediatrician in the West Bank who would speak with me, as my original contact person had failed to coordinate such an interview for me.
Omar was radiant as he informed me, “Oh, you are in luck! Just yesterday Dr. M. graduated with his medical degree and he is here today!”
After introductions were made Dr. M and I sat in the Bethlehem Peace Center and he told me, “This is my first Sabeel conference, I have been busy attending Al Quds University in Abu Dis. Without checkpoints I could get there in twenty minutes, four and five years ago, it would take four hours, and sometimes I was not even allowed through the checkpoint. Nowadays, I wait 10-30 minutes to get through."
Dr. M trained in public and private hospitals in Ramallah, Hebron, Jerusalem, Nablus and Bethlehem and will soon begin another internship specializing in neonatal care. “They will pay me about $100.00 a month…I have been in school for six years.
“One horrible case was a baby from Jericho who was referred to a hospital in Jerusalem because their local hospital could not admit them due to the strike, so he needed to get to Jerusalem for treatment, but the permission did not arrive for three days and the babies elevated bilirubin caused permanent brain damage. Because of the USA and EU sanctions for the election of Hamas, no salaries were paid and that led to the strikes in the hospitals. Full monthly salaries have just been paid for the first time since the 2006 elections. Only the emergency rooms were always open and only for severe emergencies with minimal admissions to the hospitals.
“In Jerusalem there is available advanced care for more complicated cases then we can treat in the West Bank. But, the permission for the patient to go there usually takes three days to a week.
“Most common for the children is upper respiratory infections secondary to the poor sanitation, crowded conditions and lots of people smoke inside the homes. It’s illegal to smoke in the hospital for visitors, but they still do. I have seen many cases of neonatal sepsis and respiratory tract infections; and lower respiratory tract infections are the more serious. Smoking is an important risk factor for reactive airway disease and asthma. Other common problems in children in the West Bank are iron deficiency anemia, dehydration and malnutrition.
“Full term infants are usually in the normal range of weight and length, but many premature infants are born with many problems that become chronic. In the emergency rooms there is always a pediatric resident available as pediatric cases are significantly higher than any other age group.”
I asked Dr. M if he could connect me with any other physicians to tell me more, and as is typical of Palestinian hospitality and graciousness towards the stranger, he immediately made a phone call that led me to my next interview.
In a private West Bank pediatric hospital, Dr. Rafat-Allawi, of Bethlehem and four General Practice residents spoke to me for the forty-five minutes that was their break time in a 116 hour week that required them to be on call at forty hour stretches. The residents were paid $1,400.00 a month, twice what physicians are paid in the public government hospitals.
Dr. Zafer Al-Qaisi, is from Jerusalem, Dr. Mohammad Abu Yousef and Dr. Sufyan Amro are both from Hebron and the lone female, Dr. Ninn Hafiri is from Beit Jala.
Dr. Yousef: “Three days ago, I had a critical cardiac patient that required transport to Israeli hospital, as we do not have the facilities or specialists here to treat critical cases. I had to apply for a permit; permission to travel with the child in the ambulance to Jerusalem, but was refused as the Israelis claimed I was a security risk; a threat to the state of Israel.”
Dr. Amro: “Yes, a threat with his stethoscope! I had a patient that was one week old with severe heart disease and needed to go to Jerusalem for emergency care. The mother, a paramedic and I traveled with the baby in the ambulance. At the checkpoint, the Israeli soldier; a female laughed and told the mother in broken Arabic, ‘You cannot pass through until you admit you are a prostitute.’ The mother did not understand what she was saying and why the soldiers were laughing and joking as her baby was blue, but she said what the soldier demanded and we finally were let through. I do not know what happened with that baby and this harassment at the checkpoints is not unusual. At the checkpoints it is usual to wait 3-4 hours and because Palestinian ambulances are not allowed through, we must hire Israeli ambulances for transport. They charge 1,800 shekels [450.00 USA dollars] and the parents cannot even make that much money in a month of work.”
Dr. Allawi: “The other alternative from going to Jerusalem [a few miles away] is to take the children to Jordan for care, but that trip can take two days. Before the intifada, we were able to go to Jerusalem, but not since. Yesterday, I had a child in renal failure and there is no pediatric dialysis available in the West Bank. It took over twelve hours to locate a hospital in Israel to take him, but it was too late and he is dead.”