Shock corridor: Occupation just ain't healthy

Last update - 17:16 29/11/2006

Twilight Zone / Shock corridor
By Gideon Levy

A room on the surgical ward in Rafidia Hospital in Nablus, the largest hospital in the northern West Bank: The beds are empty, the mattresses have disappeared, trash is scattered on the floor, the curtains are torn and the remnants of a meal are in the kitchen. A similar sight is seen in the obstetrics and gynecology department of the city's Al-Watani Hospital. It's not pleasant to see a hospital that has been closed down - especially one in a besieged city that sometimes also comes under fire.

For three months now, the government health services serving Palestinians in the West Bank have been closed down. Dozens of rural clinics are no longer open and government hospitals are barely operating. Health-service workers who have not received most of their salaries for the past nine months - because of the boycott which Israel and the world declared on the Palestinian Authority government - have declared a strike, which has gotten worse: Since Monday the hospitals have only been accepting patients whose life is in immediate danger. Yet another hardship to add to the siege of West Bank locales, with their approximately 1.5 million residents, and the severe economic distress that afflicts them.

Five-year-old Ahmed Subuh is the only patient in the otherwise empty orthopedics ward in Rafidia Hospital. He fell and suffered an open fracture of his arm. He wanders the empty corridors, his arm bandaged and his family tending to him. The boy's grandfather is upset, his voice echoes through the halls: "Let the world see. Let Israel and the Arab states see what they're doing to us."

Has anyone heard about this strike? Is it necessary to repeat that the responsibility for the health of residents who live under occupation is ours? Or to ask again what vital health services have to do with the economic boycott Israel and the world declared on a government that was legally elected in a democratic election?

There are political circumstances surrounding this strike: The new director of Al-Watani Hospital, Dr. Husam Jawhari, a cardiologist, says that a government that is incapable of providing vital services has to go. But the main victim here is the ordinary citizen, and the main culprit is the occupier. "Israel is holding NIS 600 million of our tax money. That's small change for it, and it's our money. That could solve the problem," says Jawhari.

The exacerbation of the strike this week means that a woman in labor who has already managed to get through the cruel checkpoints on the way to Nablus will not be admitted to the delivery room at Al-Watani with a dilation of four centimeters. Six is the minimum.

The checkpoints on the way to Nablus are exhausting. Every five minutes you have to stop and wait, sometimes for hours. The maximum speed limit is one kilometer per hour, and that's on a good day.

The scene at the Hawara checkpoint, overlooking Nablus, is terrible: As usual there, a throng of people is crammed into something that resembles a cattle pen. A compassionate soldier gives right of way to mothers with babies who're caught in the chaos. A short line of cars with permits to leave waits, for hours on end. They say this is nothing compared to the Assira Alshmalia checkpoint, also known as Checkpoint 17, on the Nablus-Jenin road. And these are not crossings into Israel, but rather checkpoints between Nablus and Beit Furik, affecting only people going to work and back.

With all the focus on the bloodshed in Gaza, daily life in the West Bank has been forgotten. At the offices of the Medical Relief organization in Nablus, the medical director, Dr. Ghassan Hamdan, says that his city is on the brink of a humanitarian disaster. He foresees epidemics and needless deaths. The clinics in 65 villages are closed, which has dramatic significance: When Nablus is inaccessible these clinics serve as a substitute, albeit a poor one, for the hospitals on the other side of the checkpoints. But now the two big hospitals in Nablus are practically deserted, so most of the burden is falling on nongovernmental organizations like Hamdan's.

The irony: The boycott may end up pushing more of the population into the arms of Hamas, whose clinics are open. Most of the residents in the West Bank have some sort of medical insurance, but this doesn't cover strikes. People of means go to four private hospitals, where hospitalization costs $100 a day; others collect donations to get admitted. Three times more patients than usual are turning to Medical Relief for help, and the situation in Nablus is actually better than elsewhere, such as in Hebron. In Nablus there are refugee camps whose patients are treated by UNRWA. In Hebron there are no refugees and no UNRWA.

The Israeli Physicians for Human Rights organization is also reporting a dramatic increase in the number of people needing its services since the outbreak of the strike. Salah Haj Yahya, director of the organization's mobile clinics, says that the organization is having difficulty meeting the demand for health care. Every Saturday, he organizes a medical day in a different West Bank village. Last Saturday he was with his volunteer doctors in a town near Tul Karm. It was a gynecology day, but 250 men showed up as well, seeking a doctor. The previous Saturday, there were some 350 patients in a village outside Jenin; the week before, 500 people came to the mobile clinic in Beit Furik. Haj Yahya says he's never before seen such huge numbers of needy patients.

Dr. Hamdan already foresees a catastrophe: A serious shortage of vaccines and closed clinics means that children, especially in rural areas, are not immunized; pregnancies won't be monitored; and kidney-transplant recipients are more likely to suffer complications. Some patients have already died due to the lack of medicine and treatment, though exact statistics are not available.

Hamdan: "We are pleading for the boycott to end so that this urgent humanitarian crisis can be solved. The basic right to receive health services is being denied us. This right must not be tied to politics. I think that people have already died because of the strike. Maybe the danger of an outbreak of epidemics near the settlements will frighten the Israelis. I say this with all seriousness."

The director of Al-Watani Hospital, Jawhari, cannot get into the empty gynecological ward of his hospital. The door is padlocked and there is hardly anyone around. This hospital, which specializes in internal medicine, has 94 beds; this past week only 19 were occupied, mostly by cancer and cardiac patients in serious condition. Rafidia, where Jawhari had served as director until last week, and which specializes in surgical cases, has 165 beds. This week fewer than 40 were occupied.

Jawhari was transferred this week to the smaller Al-Watani facility apparently because of his outspoken positions: He thinks that a government that does not provide vital health services to its populace - and a foreign minister who isn't even able to travel to an Arab country like Oman - ought to quit. "If I'm a hospital director and I can't do my job, then I should resign. There's no shame in that."

This elegant doctor takes pains to emphasize that he is not a politician and that politics doesn't interest him. The directive to the striking doctors has been, he says, not to lose a single patient. The dialysis unit at his hospital, which has 15 machines and serves 98 local kidney patients, works four shifts a day. These patients have not been hurt by the strike, nor have the cancer patients receiving chemotherapy. The neonatal unit and the hematological institute are working. There is no radiation treatment anywhere in the West Bank.

Jawhari: "It's not inscribed on the patients' foreheads whether they're Fatah or Hamas, and it's not their fault who was elected. The elections were properly run and the results shouldn't adversely affect the health services. Before I blame Israel and the world, I have to take my own government to task. Our strike is directed against both the Palestinian government and against the world community."

In the past eight months, Jawhari has received only about a fifth of his salary. The more junior employees, who earn about NIS 1,200 a month, have received about half. "It would be a crime if I don't give medical care, but I deserve to be paid. My daughter called today from Bir Zeit and said that I have to pay her tuition. I don't have it. The public might be understanding, but the parents of a sick child cannot accept this."

Al-Watani is half-empty. A little while ago a man of about 40 was rushed in without a pulse. The resuscitation was successful and now he is in intensive care. Jawhari fears that his hospital will collapse completely. Arab donors from the United States have also stopped sending contributions: They say they are U.S. citizens and therefore are prohibited from transferring any money to the hospital. The American Care International organization is now cutting back on the aid it provides to the dialysis unit.

The hospital has merged departments: Male patients now lie near the women. Doctors show up for work, but only treat those seen as emergency cases. The paramedic crews, the cleaning workers and the administration are also on strike. They haven't been paid either. What happens if a person suffers strong stomach pains? Jawhari says that person probably won't come to the hospital, knowing it's closed. And if he comes and the doctors decide it's not an emergency, they'll send him home.

We pass through wards whose doors are unlocked. In one room, a boy who is a heart patient sits chewing on a corn cob. His face is gaunt and his belly is swollen. In the next room is a female cancer patient, unconscious. An oppressive silence prevails.

http://www.haaretz.com/hasen/pages/ShArt.jhtml?itemNo=794385