Back-to-Back

A Red Crescent ambulance is searched at an Isr...
A Red Crescent ambulance is searched at an Israeli checkpoint at the entrance to Jerusalem from Bethlehem. (Photo credit: Wikipedia)

Palestinian hospitals in East Jerusalem are considered the most advanced in the oPt. They have specialist units for complicated heart operations, dialysis, radiotherapy and intensive neonatal care. In theory, Palestinian ambulances should be allowed to travel anywhere in Israel and the West Bank without being stopped for security checks. However, the reality is sobering.

Palestinian ambulances travelling from the West Bank are not allowed to reach Palestinian hospitals in East Jerusalem, without prior coordination. Patients cannot be accompanied by Palestinian family members, or even, on occasion, Palestinian medics. At checkpoints, they are required to transfer the patient from a Palestinian ambulance into an Israeli one, in order to reach the hospital. This is known as the back-to-back method, and it is still regularly denied. Patients are regularly kept at checkpoints for extended periods, often up to an hour.

In many cases, ambulances have been forced to turn back despite the patient requiring urgent medical attention. This gross injustice violates the patients right to treatment and can lead to prolonged suffering, deterioration of condition and death. Physicians for Human Rights Israel (PHRI) have collected data from ambulance crews of such cases. I have included some examples below;

Date, Description of patient, Delay (Checkpoint), Outcome:
19.01.06 – Toddler aged 18 months with eye injury – Delayed 15mins at Hizma CP – request denied, ambulance turned back.

03.08.06 – Man injured in road accident, multiple fractures – Delayed 1hour at A-Zam’im CP – back-to-back method despite prior co-ordination and increased health risks.

01.06.05 – Woman in advanced stages of labour – Delayed at A-Zam’im CP – gave birth at CP, baby died.

08.12.05 – Patient suffering from heart attack – Delayed at A-Zam’im CP for 25mins – request permitted only after PHRI intervened.

01.03.06 – Baby aged 20 days with pneumonia – Delayed at A-Zam’im CP for 40mins – request permitted only after PHRI intervened.

19.04.07 – Woman aged 80 with hip injury – Delayed at A-Zam’im CP for 40mins despite being in an ‘authorised’ ambulance – Permitted in a private ambulance, ‘writhing in pain’

02.07.07 – Man critically ill with fluid in lungs – Delayed at Tunnels CP for 1.45hours despite prior coordination – passage denied, returned the next day.

The time element is one of the most important components of treating a patient. The shorter the time until the beginning of care, the higher the chances of saving the patient. Moving and transferring a patient between ambulances can additionally lead to the deterioration of condition, particularly patients’ suffering from hip/spinal injuries. Trained medical professionals need to provide treatment on route to the hospital, not allowing them through checkpoints eliminates a critical aspect of a patients’ care.

Finally, giving check point guards and military officials the responsibility to decide whether or not a patient is in a life threatening condition effectively puts them in a position to chose who will live and who will die.

PHRI (2007) Emergencies On Hold: Entry of Palestinian Ambulances into East Jerusalem.
http://www.phr.org.il/uploaded/Entry%20of%20Palestinian%20Ambulances%20into%20East%20Jerusalem.pdf

Welcome to the Aid Industry!

UN FLAG

When studying for my degree in International Relations I spent a lot of time looking at international aid. Where it comes from, where it goes, why it goes where it goes, why it doesn’t go where it is meant to go, and why it goes where we want it to go rather than where the people who need it would rather it went.

One argument, which we explored in great detail (Emma, Chloe and Zoe!), suggested that the business of aid was too bureaucratic. Take the UN; it’s an umbrella organisation, providing funding to projects which are aligned to its aims, and coordinating funding to make sure it reaches its intended destination. It takes a lot of time to get things done because it has to prove its accountability to its donor governments. Everything has to be approved, somewhat politically neutral and in-line with international law.

Despite this, in certain situations there is an overlap of results, meaning time, resources and money are wasted as, for example, identical research is collected by multiple organisations. This is not just within the UN system itself. Taking it further, and looking at the work of the UN alongside human rights organisations, civil society movements, university students and academics, economists, NGOs, INGOs and state governments, it is not unreasonable to suggest that the world of international aid is in somewhat of a mess.

The worst case scenario sees people slipping through the net completely, and being missed by humanitarian organisations. This situation can be seen in part as a ‘governance gap.’ At uni, we suggested that avoiding governance gaps required greater coordination between donor governments, NGOs, the UN, local organisations and civil society movements. It seemed straightforward.

Now I’m a research intern, in Palestine, with an international government-based research organisation. I was talking to a colleague and I asked if we had any collaboration with the leading human rights organisation in Palestine. I had noticed that some of their research was similar to ours, and wondered if we had used the same sources. She seemed surprised at the question;

‘Welcome to the Aid Industry!’

Green Card, Blue Card, Wrong Card, Right Card.

Since the 1967 occupation of Palestine by Israel, Palestinian residents have held green-coloured ID cards, which gives them access to most cities within the West BankHowever, the much disputed capital city, Jerusalem, is inaccessible to green ID card holders because of the intimidating barrier wall surrounding it, volatile checkpoint rules and strategically positioned snipers for those who enter buffer zones.

Jerusalem is seen by the Israelis as their capital city, although it is not internationally recognised as such.Therefore, those living in the much-disputed municipal hold blue ID cards, the Israeli colour. Palestinian residents of Jerusalem who were living in the city at the time of occupation, were given a permanent residency status and blue ID cards. They therefore hold access to services and can cross the checkpoints when they need to.

However, friends and family in the West Bank cannot enter the historical city to visit them. Jerusalemites unlucky enough to have been out of the city at the time of the census were not given blue ID cards, or granted residential status, even if they had been for instance temporarily studying abroad, or on vacation. This has led to families and friends being split and broken for holding different coloured ID’s.

In some instances, green ID holders have been stranded on the blue ID side of the barrier wall. This is true of people throughout the West Bank who have live in between the internationally recognised ‘edge’ of Israel, known as the green-line, and the barrier wall itself. Because of the convoluted route of the barrier, particularly around Jerusalem, these people have become isolated, holding the wrong colour ID card for the area they have always lived in, or been forced to relocate to as 1947 refugees.

These green ID holders must apply for permits to be able to live in their own homes, as well as access the rest of the West Bank and return again after doing so. Some people can apply for permits which last several years, but others have to renew them within a few months. This a long and time-consuming process which requires personal information to be collected and still requires documentation checks every time they cross the barrier.

In Jerusalem there are approximately 1,600 green ID holders who cannot obtain permits at all. They are considered illegal by the Israeli authorities and are at constant risk of being detained and/or expelled to the West Bank where they will not be able to get back into the city to their homes.

These people are the most at risk of all Palestinians. They cannot access the services around them as they do not hold Blue ID cards. They cannot even call for an ambulance in an emergency as they will not be allowed to enter the hospital for medical treatment. To access any form of healthcare they must go into the West Bank and risk scaling the wall to get back into their homes.

97.5% of green ID holders on the Jerusalem side of the barrier reported it having a detrimental impact on their well-being. For refugees, this figure is 100% (surveyed by UNWRA).

Most of the world’s boundaries which separate countries, time zones, fishing sites and even human interactions, are imagined. They exist on maps and can be internationally recognised, but they can not be seen by the naked-eye. The wall between Israel and Palestine would be unsightly and unnecessary if it was built on the Green Line, the recognised boundary, but it would be deemed legal under international law.

However, because up to 85% of the barrier has been built within the West Bank and on Palestinian territory, it is not just an eyesore and an inconvenience, but an illegal measure of apartheid. It affects every Palestinian on a different level of severity; economic livelihood, access to basic services such as education, employment and emergency medical treatment, psychosocial well-being, community displacement and overall freedom of movement and choice.

O’ Little Town

of tear gas, Banksy and Jesus.

Quaint churches with rising steeples, sacred tombs, holy mangers and besotted tourist-pilgrims, our trip to Bethlehem last weekend covered all the expected sights. Starting at Manger Square, the central hub, we took in the Church of the Nativity on one side and the Mosque of Omar on the other. Once inside the Nativity Church we visited the grotto where Mary gave birth to her son and saw the lantern-lit manger. We watched an open-topped coffin being carried past as mourners attended a funeral. We visited the Milk Grotto where a splash of breast milk is said to have turned the red stone a chalky white. And we climbed onto the roof of a traditional olive wood factory and marvelled at the beauty of the surroundings.

The Church of the Nativity
The Church of the Nativity

After lunch (falafel ofc) we went to see the other side of Bethlehem, literally; the Israeli West Bank Barrier. We had driven past it earlier in the day (being over 700km long it is hard not to do so), but wanted to see it up close and look at the famous graffiti along it. On approach you cannot mistake the sheer size and scale of the wall; endless concrete blocks in straight rows up to 8 metres high, it is domineering and unsightly, think Berlin only taller and longer, much longer.

Along the bottom however, also in stark similarity to the Berlin Wall, brightly coloured images, slogans and drawings immediately caught the eye; from the vast and recognisable work of Banksy, to a single scribbled word; ‘hope.’

grafitti along the barrier-Bethlehem
Grafitti along the barrier- Bethlehem

Along the wall was a sign and an arrow, ‘Banksy shop 200m,’ of which we followed accordingly. However, as we drew closer, we heard shots being fired in the distance accompanied by a strong smell of what we thought to be petrol. Before we had a chance to react, a Palestinian man called out to us to come and wash our faces from an outdoor water pipe. We did so, but the smell had gotten into our noses and lungs and was starting to burn our eyes. We didn’t have time to panic before we were ushered across into a small shop, which our party filled completely. Inside we were offered cologne to inhale to get rid of the fumes, strong coffee and tissues (at this point I had make-up streaming down my face which added to the stinging in my eyes!).

Our ‘rescuers’ informed us that the Israelis had fired tear gas into a group of protesters on the other side of the wall. We were far from the intended targets, but the strong winds had carried the fumes across and into the civilian area. I do not wish to get political here but after experiencing the effects from at least 100 metres away, the idea of any report of tear gas used at close range on children makes me feel physically sick.

Palestinian spirit and deterministic nature is readily found, despite the hardships and tribulations its people face on a constant basis. In Bethlehem we heard stories of repression and suffering and found ourselves in a potentially dangerous situation. But we also saw evidence of passion and dedication and experienced kindness and humility.

We covered all the expected sights, and some of the unexpected too.

As a final note;

Nativity scene featuring Separation Wall
Nativity scene featuring Separation Wall

This image (above) is an example of an olive wood carving. On the right hand side is the typical nativity scene featuring Joseph, Mary and the baby Jesus. On the left hand side are the wise men and their camels, bringing frankincense and myrrh.

However, in a wonderful irony, they are halted from reaching the stable due to the wall in between them.

Make Hummus Not Walls

Image

I can’t admit to taking this photo, although I do hope to do a tour of the graffiti along the barrier wall sometime in the next three months. Make Hummus Not Walls is found in Bethlehem, where we intend to travel on Sunday all things permitting. From where we are based in Ramallah, most places of interest are brisk walk or at least a service taxi ride away.

This post is intended to be a bit of a food critique. Or maybe the opposite as so far I have been unable to criticise any of the food we have eaten here. Perhaps it is just that my bland English tastebuds are so overwhelmed by the different tastes and flavours that I appreciate whatever I am given, but I really think it is more than that.

Falafel and hummus are of course the most popular foods in the region. But these are no Tesco eats, these are little bundles of warm, crispy goodness doused in creamy hummus. The olives are as fresh as they come, and although I am yet to try any grilled halloumi, being the cheese addict that I am I know it will be amazing.

I haven’t yet sampled any Arabic coffee, although I have been getting used to Palestinian tea minus milk. Instead, Nana mixed mint and sage leaves with traditional Twinnings to create a fresh-tasting tea with tons of sugar. The other popular drink here seems to be lemon and mint, the girls haven’t stopped talking about this since tasting it in Jericho a few days ago.

This afternoon we went for a ramble around Ramallah, visiting fruit and veg markets, sock and slipper stalls and picking up a rug for 10 shekels, which translates to roughly £2. We stopped for lunch in a small cafe along one of the main streets and attempted to order falafel and humus for the table. Alas, we somehow ended up ordering about 20 small plates of food; vegetables, cauliflower, hummus, pitta and half a chicken, each. We ate as much as we could but were defeated miserably ‘man vs food’ style. Embarrassed to leave such a large amount of waste, we asked for boxes and took the chicken carcasses home to make soup (and feed Willy the dog).

Hummus in Ramallah
Hummus in Ramallah
Hummus, veg & half a chicken
Hummus, veg, chips & half a chicken