The politics of medicine

The Jerusalem Post spends an afternoon in a West Bank village with Physicians for Human Rights.

wb pysicians 88 224 (photo credit: Anat Nuriel )
wb pysicians 88 224
(photo credit: Anat Nuriel )
Villagers, who heard of the physicians' impending visit over the mosques' loudspeakers, gathered in the street even before the group arrived, and children waited eagerly for a chance to see the doctors from Israel On a quiet Saturday morning, two taxis pass the Israeli soldiers unhindered at the Tapuah junction, a checkpoint that separates Israel from the West Bank. Green hills covered by seemingly endless olive-tree groves line both sides of the road. Aside from the occasional Arab village spotting the landscape and the Jewish settlements dominating the hilltops, the land looks uninhabited and peaceful. It is a deceiving picture, for a tour of the villages proves that the reality is quite different. The passengers in the taxis are not strangers to what lies before them - beauty spoiled by political and religious differences between people. These differences have resulted in the passengers, Israeli (Arab and Jewish) doctors, nurses and pharmacists - all volunteers for the Physicians for Human Rights (PHR) - to feel the need to devote part of their Saturdays in West Bank villages with PHR's mobile clinic. Physicians for Human Rights, Israel was founded in 1988 by a group of Israeli and Palestinian physicians during the first months of the Intifada. Its goal is that all people, regardless of place of residence, have the right to health of mind and body. This goal has guided the non-profit organization to work with five main populations: residents of the Occupied Territories, prisoners and detainees, migrant workers and refugees, residents of the unrecognized villages of the Negev, and residents of Israel. They also speak out against policies that permit human rights abuses to continue. To date, PHR, whose office is located in Tel Aviv, has 1,500 volunteers, half of whom are from the medical field. The mobile clinic began its weekly trips to the West Bank in 1989. On average, hundreds of patients might be treated each week. The towns and villages that are visited usually lack adequate health services, forcing residents to travel long distances for treatment. The PHR bring with them medicines that are not available or are expensive in the West Bank. On this particular day, the group met in the Israeli-Arab town of Taibeh, and headed to the village of Yasuf, a few kilometers from the Kfar Tapuah settlement. Health care services are not available in the village. The nearest health clinic is in Salfit, seven kilometers away, and because of IDF roadblocks, access to it sometimes proves difficult. If treatment is not possible in Salfit, then patients must travel 18 kilometers to Nablus, passing two checkpoints before reaching their destination. So visits from the PHR are always welcome. At the entrance to Yasuf, on a narrow two-lane road, an ambulance waited for the guests, and led them to the municipality, which was set up as a makeshift clinic and pharmacy. Villagers, who heard of the physicians' impending visit over the mosques' loudspeakers, gathered in the street even before the group arrived, and children waited eagerly for a chance to see the doctors from Israel. Dating back to Roman times, the village's name is derived from "Youshop‚" the town that was originally on this site. Yasuf houses the tomb of a Roman king, an 800-year-old mosque, and ruins of the mosque tomb. A walk through Yasuf takes one down paths which lead to fields of olive and lemon trees. Houses, new and old, line the almost empty streets. Large coffee pots are painted on the front walls of several houses, indicating that someone in the house has participated in the haj (the pilgrimage to Mecca). The life of the villagers seems very simple, easy and relaxed. But in this village of contrasts, the past and present often collide. Life in Yasuf has changed drastically, and this community, numbering approximately 2,000, is facing hard times. Yasuf's residents are traditionally farmers who tend to their olive groves, but due to loss of land and ongoing conflicts with the area's Jewish residents, many have had to walk away from the professions of their fathers and grandfathers. As one woman explained while baking bread on a traditional outdoor oven, "The farmer's life is very difficult." Warmed by the oven while she made enough bread to last her family a week, she talked of her family divided between Kuwait and Jordan. She wanted to "finish the bread so that she could go see the doctors before they leave." This was typical of many people who take advantage of the rare visits by the doctors. According to Mohammed Musleh, an employee with the Palestinian Authority Ministry of Health, "The health care situation of Yasuf is very bad. Most of the people who have medical problems suffer from chronic diseases such as heart disease, diabetes, high blood pressure and orthopedic problems." He continued, "Drugs are very expensive and some drugs are not available in Salfit." This leaves one to wonder why there is no health clinic to serve the citizens of this village. Mayor Abdul Rahem Musleh spread his hands out in a gesture of frustration, "There is no money." Back at the municipality, the pharmacy sets up outside while the doctors begin to work in their assigned rooms, some accompanied by translators. The halls of the municipality quickly fill with patients while many wait outside. Brothers Nabil and Mohammed, one suffering from leg pains and the other from headaches, waited for two hours. They no longer farm, "since most of our land was taken, and the few dunams that we have left are hard to reach and work on because of the settlers." So they, like 70 percent of Yasuf's residents, work in Israel, leaving their homes at three o'clock in the morning and arriving at their jobs at eight o'clock, after secretly walking through olive groves and passing checkpoints. Between them they have 18 children. As Mohammed explains, "We are just trying to raise our children and give them good lives," but it has taken a toll on their health. As we talked, Nabil's wife, Soad, came out of the clinic. She was at the clinic that day to talk to the doctor about the pain in her back. She complained that her life is nothing but housework and taking care of the family. Her illness is mostly emotional, she says. When asked about her hope for the future, she shook her head and said, "Do we have a future?" Until the early afternoon, patients came and went, many receiving treatment and some leaving with just hope and encouragement. Dr. Michal Dekel, who works in Internal Medicine and Infectious Diseases at Ichilov Hospital, has been volunteering with PHR for one and a half years. Her assistant on this trip is an Israeli nurse who speaks Arabic. As Dekel looked on with genuine concern, the nurse gathered information from the patients, keeping their moods light with a joke or even a hug and kiss. Dekel feels very "frustrated that Israel and the West Bank are so close, only five minutes apart," but that traveling between them is so difficult. She says she "can't see a real reason why things are as they are. "In the villages where people are able to work on their land," she says, "there is no poverty. It is in the cities where they are not working in agriculture that you find the real problem. The younger generation is afraid to work in Israel because they compromise their safety, but often they are left with no choice because they want to help their families and build futures for themselves." On this day, 257 patients, including 65 children, attended the clinic, and 120 people went to fill prescriptions that they had received from doctors not connected to PHR. The doctors may not return to Yasuf for another year, so until then, life for the villagers will return to "normal." They will have to depend foir health care on doctors in Salfit or Nablus. Mohammed complimented them on their "good work," saying that he "feels grateful to them." He is more optimistic of the future then Soad. "We are, after all, one people and I am hopeful for a better future," he said. Dekel's sentiments were much the same: eventually "there will be peace, and we have to start to build a relationship between us. We are people and they are people. I want to show them that I am a person."