The Occupation Kills Slowly and Quietly:

From a doctor's point of view

An interview with Dr. Abd al Rauf Hijazi about the medical days that took place in April in Beit Sira and Beit Liqyia, Palestine.

M: Based on the two medical days, can you tell us, from your professional perspective, what is the situation there?

Abed: These two villages have been closed for months. There is a closure around them. The army blocked egress from each village by piling earth at the entrances. It has been months since they received medical supplies. Beit Sira residents did not see a doctor for three months. There is a nurse, but no doctor. The doctor used to come from Ramallah. In Beit Liqyia a doctor had come from Ramallah just before the army incursion there.  Afterwards he could not return home, and so he remained in the village.  There is also a nurse from Nablus, who is also stuck in the village and cannot return home. These are villages under siege. The shelves in the pharmacy are empty of supplies.

M: What was the situation before the war?

Abed: the Palestinian Authority (PA) provided medical services. I do not think they functioned very well. There were medicines - not the newest - but people received proper treatment.  All the forms were on Palestinian Authority paper, and I understood from the patients that they were treated well.   The people I met had a high level of health awareness and knew what they required.

M: It is important to hear this because just this morning on Israeli radio someone spoke badly about the PA. He said the system did not function and that the PA did nothing of benefit to the people. There is a growing attempt to de-legitimatise the PA.

Abed: They received medicines. The forms were all in order.  There were prescriptions.  They conducted procedures like blood tests, ultra sound and even operations. I found some patients who had received complicated orthopaedic operations in the Ramallah hospital. So I can say that the system functioned until it was destroyed. In the clinic I even saw an ultrasound machine, meaning that the family doctor functioned also as a gynaecologist.  The clinic is in a pretty good shape.

The current situation caused many problems for people who are sick and cannot see a doctor. All our involvement started because Zaquariya (of Beit Sira) tried to take his sick daughter to the doctor in Beit Liqyia and Israeli soldiers shot at them, so he returned. People canít even pass from one village to the next. The second problem is that for the chronically ill there is a real shortage of medicine.  For example, there was one diabetics patient who did not look well, so I asked Salim (nurse) to take a blood sample.  This showed that her blood sugar level was over 500. We thought we must change her dosage, but then discovered that she had simply run out of medicine altogether. It is really sad to see that she had no medicine.  The story is the same with heart patients who ran out of medicine.  They know what they need, yet their situation worsens every day.

There is one very sad case in Beit Liqyia.  This is a young married women with children, who has breast cancer. She was treated in Hadassah hospital and now she needs chemotherapy, yet she is stuck without the treatment. She asked us if we could get her the treatment.  She was willing to pay, and lives only half an hour from the hospital.

There are also asthma and heart patients who are in a life-threatening situation because a patient who needs an operation, or who has a heart attack, is lost.  Since ambulances are not allowed in or out of the villages, such a patient would die. This is very sad.

The most needed medicine is for patients who are chronically ill of asthma, heart disease, and diabetes. Also there is a great shortage of antibiotics. There are many infectious diseases among the children. In these situations, if a child does not receive treatment his life is in danger. Imagine how the parents feel if they cannot help their children. The cases we saw have nothing to do with the fighting; this is mostly negligence.  These two villages are quiet and did not involved in the fighting.

M: Did you come across problems with children that you do not usually see?

Abed: The most common problem is with babies who need milk substitutes. If they do not receive what they need, they contract diarrhoea and begin to lose fluids - and then they cannot be helped. I have heard that for the next medical aid day in Nablus, we have been asked by the organisers specifically to bring milk substitutes and baby food. For babies who do not receive proper milk it is like a life sentence.

M: Could you tell us how the delegation reached the villages?

Abed: We reached the petrol station near Beit Liqyia by car, and from there we continued on foot with our equipment and medicines.  Once we had climbed over the piles of earth left as a blockade by the army, people from the village awaited us on the other side and took us in their cars. We saw the army a short distance away. Next to the village of Beit Liqyia there is a hill with an army post and a tank. The people from the village told us that at the beginning of the Intifada the army closed the entrance with cement blocks. A Palestinian moved these blocks aside with his truck in order to enter the village, but was shot at.  Since then, the residents have not attempted to pass with their vehicles.

M: Was it a problem that the delegation consisted only of men?

Abed: No.  Within Palestinian society there is no problem for a male doctor to treat women. There was never a problem with that.  It is accepted. There is trust because there were never any problems.

M: You donít need these visits in order to know how the situation is - I assume you see many cases in Hadassah as people come there from the Occupied Territories.

Abed: Not many people come to the hospital.  People cannot reach the city.  How could they when they are under closure?

M: This means that the army and the government are fabricating when they tell us they let people through the checkpoints in cases of medical emergency.

Abed: as far as I know very few people - almost none - are able to pass through. Only Palestinians from East Jerusalem can reach Hadassah Hospital.

M: What is the atmosphere among the hospital staff? Today hospitals are among the last places where Arabs and Jews are in daily contact.

Abed: What can I tell you?  Personally I donít talk about the situation.  I tried a few times and it was a waste of time, so we donít talk about it.

M: Do people know about the volunteer work that you do?

Abed: They donít know.  There is no reason for them to know, and it is of no interest to them.  I am speaking generally; of course there are a few people with whom I can talk.

M: In your opinion, are doctors mostly activated by their professional identity or by their national identity?

Abed: When a patient comes to us there are no divisions. The problem is that now Palestinian patients are prohibited from coming to us. (The division is made beforehand). In the treatment, there is no division between Jew and Arab. Other than that I didnít check, but I donít believe many Jewish doctors would go to help in the Occupied Territories.

M: Do you think it is better to focus on one place or to go to a different location in each medical day?

Abed: It is ideal to go to where we are most needed like Nablus, and to go back there as long as they need us. But we canít forget those who we have already seen. An emotional connection has been made.  If you go somewhere you have to return there, unless you shut your eyes and say "I will not go at all, so I will not have to go back."  It is important to strengthen the professional and the human ties - such ties are always made.  I hope everything will soon be better.

M: How did you feel about the delegation, about the fact that you were all Arabs of 1948?

Abed: The war strengthens the feeling of unity between us and the Palestinians in the Occupied Territories. The Israeli Arabs in this situation feel that the other part of their People is trampled on. We are not taken into consideration. No one in the government says Ďa part of the People in Gaza and the West Bank is in our country so let's not be so rude to themí. This doesnít happen, so we also feel humiliated. It gave us a sense of solidarity.

M: Is there a sense of fulfilment from this volunteer work?

Abed: Yes, very much so.  At work I usually feel that if I donít arrive one day, another doctor will fill my place.  But here we are much needed.

(Michal Zak conducted the interview on 15.4.2002)