A trip to Bethlehem by Rachel Pope and colleagues
Many of you have been out and about. In the two previous blog entries today, Joshua Schulman-Marcus, a medical student from New York describes his week in New Delhi and Brazilian medical students Rafael Bastos and Carolina Costa from Universidade Federal de Juiz de Fora give the highlights of a recent educational trip to Wales, UK. And below Rachel Pope and her classmates, Christopher LaFond, Pavan Mankal, Rachael Keefe, and Soliman Yaqub from Medical School for International Health at Ben Gurion University, Israel, tell us about a day they have just spent in the West Bank. They conclude by saying, ” Health care is indeed a common ground for all of us, and therefore, a viable way towards peace.” Well said!-Rhona
Bethlehem wall
I just got back from a very full day in the West Bank with four of my classmates, my newfound super team. We went to meet a physician who humbly preaches peace through health care. He generously gave up his free day to introduce us to the complexities of health care in the West Bank. We met him in Bethlehem over a cup of tea and he explained that he wanted to show us the difference between two types of health care that exist in the city: government-sponsored and non-governmental organization (NGO)/charity- sponsored. We could predict what would be different between these two, as is often the case in several countries around the world, but what we did not predict was what was the same: the sincerity and eagerness of the staff in both places to take care of the community despite political obstacles.
Bethlehem in the West Bank, is a border city adjacent to Jerusalem in Israel. The two cities are literally separated by a wall that was built in 2002 in effort to reduce violence and trafficking of suicide bombers. Although Israelis cannot legally enter a large-part of the bustling city, as foreigners, we were able to fairly easily. On the other hand, sections of the city such as Rachel’s Tomb (one of the holiest sites in Judaism) are walled-off to prevent the Palestinians access. The lines of politics, economics, and social structures are obvious as many cope with the disintegration by placing giant photos of light-hearted facial expressions on the wall itself. Close by, the government hospital was extremely open and hospitable to us, explaining as much as they could about their facility. They explained that they have all of the departments needed, except for a neurosurgery department. They have a capacity of 120 beds, staffed by 95 nurses and 45 physicians, to cover a catchment area of approximately 170,000 people. They are supported by a health insurance program funded by the Palestinian Authority costing $200 a year for a family of eight. The hospital staff reported that it has most of what it needs in terms of medications, but there are often shortages that severely limit their ability to provide care. For example, if a patient needs chemotherapy and the hospital is lacking just one of the three medications to be included, they cannot treat the individual. Similarly, they do not have machines for mammography, CT scans, or bronchoscopy, and often have to wait for weeks for the arrival of replacement reagents to be used in the laboratory. They also do not have third generation antibiotics and are not permitted to have any nuclear medications because of the potential threat of using them to create explosives. Although directed and run by Palestinians, they are under supervision by Israel. In the case of a problematic case that cannot be treated in the hospital, the patient is transferred to an Israeli facility in Jerusalem or elsewhere and the costs are absorbed by the Palestinian system.
A few physicians graciously toured the hospital with us, leading us through the crowds which they said “were nothing compared to a week day.” They explained that despite limitations in funds and resources, they are doing their best. In several cases, nurses practically operate as physicians because of their work load and level of responsibility. Despite the lack of triage system in the emergency room and only six available beds, the staff eventually takes care of every one. One physician introduced us to two pediatric patients who needed to come to the hospital for their treatment because of the risk of expensive equipment and medication being stolen at home or for other administrative reasons, but lit up when he opened the door to the glowing play room they they had clearly lovingly put together, complete with toys and Christmas lights.
Next, we visited a pediatric hospital run by a catholic organization and were thoroughly impressed. The hospital was founded by a priest who witnessed a sick child’s death in Bethlehem and felt that no child should go without care in the place of Jesus’ birth. The gentle and fluently-Arabic-speaking nurse showed us around the top-notch facility that would put many of our hospitals in the US to shame. Every child seemed to be attentively cared for and even the mothers are provided with a place to stay while their children are admitted. Here, all costs are provided for by the organization, including the wages that are predictably higher than in the government hospital. Unlike the government hospital who also recognizes the need and importance of preventative medicine, this organization can actually afford to do outreach in the community as well as host a nursing school within its compound. They send a mobile clinic to a nearby village on a regular basis. Children with rare diseases even get treatment, however, when they need special care like particular surgeries, they also need to transfer patients to Israel and often encounter a prolonged procedure to cross the border including permission for the parents to accompany. After our tour, the nurse took us to the roof and showed us the amazing view of the city and surroundings. The gray and solid wall that runs through the land, reminded us of the division of people, of culture, of language, and of the world. We looked on together as a group and talked about the prospects of peace and how far off it all seems. Later that night, we saw multiple groups peacefully protesting in a nearby city. One group demonstrated while bearing candles in the dark and holding signs about patients dying while waiting for peace. Their protest alone gave us hope that health care is indeed a common ground for all of us, and therefore, a viable way towards peace. Rachel Pope, Christopher LaFond, Pavan Mankal, Rachael Keefe, and Soliman Yaqub rachel.pope@gmail.com
Bookmark on delicious | Digg