Working in the occupied Palestinian territories
Feroze Sidhwa spent his elective working with the Palestine Medical Relief Society and reports on it here. He has also written a related article on food security
Feroze with the ER staff at Ahli Hospital
This summer I volunteered in the occupied Palestinian territories at al-Ahli Hospital and with a non-governmental organization named the Palestinian Medical Relief Society (PMRS). Both are located in Hebron, the largest city in the southern West Bank and the only Palestinian city with Israeli soldiers and “settlers” permanently based in the heart of the city.
One of the many Israeli roadblocks the mobile clinic circumnavigates every day
At Ahli I spent most of my time in the ER. Patients presented with a wide variety of emergent problems, the most interesting being work-related trauma and occupation-related gunshot wounds and psychological problems. The physicians and nurses trained me to carry out simple procedures: suturing, irrigating soiled wounds, taking ECGs, etc.
At PMRS I worked with a Dr. Ibrihim. PMRS runs several projects, including two mobile clinics, one of which Dr. Ibrihim leads along with a Dr. Nisreen, two nurses and a driver. The clinics travel to villages in the southern West Bank and provide free primary care. They bring with them a small pharmacy; whatever drugs a patient needs cost 10 shekels (about $2.50).
At 8 am each day we left the PMRS office in Hebron and headed for a village. Once there, we set up an examination room and a waiting room in any free building; the village mosque announced that healthcare was available, and the “waiting room” quickly filled.
Dr. Nisreen took care of any ob/gyn complaints in a separate room. Dr. Ibrihim and I worked together: he called the patient into the room, and I took their vital signs while he listened to their chief complaint. I reported their blood pressure and heart rate, and then he directed me: “her eyes, please”, “his ears, please”, etc. I reported only the abnormal findings, moving patients along as quickly as possible.
The vast majority of adults we saw were over 50-years-old; they came for management of chronic conditions like hypertension and diabetes mellitus. Most of these patients had received a physical exam and a new supply of medications the last time the mobile clinic had come to their village. If the clinic didn’t come or if they missed it they simply went without. It was not uncommon to hear an elderly man or woman say that he and his entire family had eaten nothing but bread and tea for the past month.
The children we saw were mostly 14-years-old or younger. The vast majority had infections, usually respiratory but often gastrointestinal, dermatologic or ophthalmologic. Fungal infections and intestinal parasites were quite common. About half of these children showed signs of anemia; one-third to one-half were malnourished and underdeveloped. Given their diet I assumed most were vitamin A deficient. A slight majority had shoes, virtually none had clean clothes. (See my article on Palestinian food security for actual statistics.)
Spending six weeks in Hebron taught me more about people than about medicine. The odd (but very human) capacity for victims to become perpetrators, for perpetrators to become victims, for victims to be perpetrators vis-à-vis their oppressors, etc. is on display nowhere so much as in Palestine. I saw firsthand what people are capable of doing to each other and the lengths to which they will go to help each other. Learning to suture scalp wounds was useful. Watching a family of fifteen comfort their mother as we sutured her scalp without so much as local anesthesia was memorable.
Feroze Sidhwa
2nd year medical student
University of Texas Health Science Center
San Antonio
USA
Sidhwa@uthscsa.edu