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2) July 30th, 2005 Occupation and Abuse

3) August 4th, 2005 Self-Determination for Health Services

My day started at 8am, jumping into an ambulance in front of the Medical
Relief Society, which is part of the Union of Palestinian Medical Relief
Committees (UPMRC) in Nablus. From there I traveled with a team of 5 doctors
and medics to Asira al Qibliya, to hold a makeshift clinic for residents of
this village. Every month the team visits about 20-26 villages outside of
Nablus to provide medical services to people who otherwise might never be able to access a doctor. This is a rural area and many are poor, but the occupation remains the largest factor for why mobile clinics are crucial. Most could not make it through army checkpoints to reach private services in the city. Even the ambulances are not exempt from difficulties, and many have been denied passage at checkpoints. At Huwwara checkpoint on the way out, we waited in a line of cars, then soldiers checked our IDs and searched the ambulance before letting us pass.

Once arriving in Asira al Qibliya we enter an empty building with 3 rooms, find a spot for the 2 large containers of mostly-donated medications, and start setting up chairs. After the first cup of tea, the waiting room is full and the team gets to work. Most are elders and women with children. For the majority of them, the 5 minutes they get with a doctor from the mobile clinic is their only access to health care at all. I sat in a corner of one examination room, where a doctor translated some stories for me. Some of the biggest problems in these rural areas are hypertension and diabetes for adults, and asthma, dehydration and swollen tonsils for children. Dental problems are abundant. It was a busy day for the team and they saw 120 patients by 1pm. Probably the most telling moment for me was when a confused man walked into the room, sat down and handed the doctor his ID card. The
doctor looked at me and said, "See, he shows ME his ID card! He has a hard life." There is no need to prove his identity here, but having been harassed and questioned by soldiers nearly everywhere he goes, this man now expects the same everywhere.

Over the next two days I learned more about what it's like to provide
emergency care in Palestine. An ambulance driver retells a story about
transporting a woman in labor to a hospital in Nablus. She is a small woman and her stomach didn't show very much. Male soldiers at the checkpoint demanded that she undress so they could "inspect" her and prove whether she was really pregnant or not. The driver refused and demanded that they go get a woman soldier. They ended up waiting in the parked ambulance for over two hours before finally being cleared to go. The baby was born on a stretcher, just before reaching the hospital. Fortunately he and his mother were ok. Unfortunately this story is nothing compared to others I've heard, about Palestinians dying at checkpoints, unable to get to the ambulances waiting for them on the other side of the road. The UPMRC reports statistics of these occupation-related deaths on it's website, http://www.upmrc.org.

After listening to this story we jumped back into the ambulance again, this time to transport a dehydrated little boy from the clinic we were visiting in Sebastia to the hospital. As we handed over our IDs twice and shifted around so soldiers could inspect all containers and under the bench we sat on, I got my own taste of how difficult it is for people to access critical health care which is widely understood in the rest of the world as a basic right. A few women in the ambulance pointed to my passport, signaling that it was valuable in some way to completing the mission. For the rest of the ride they looked at me with sad and tired faces that said, "See, now you know what it's like here". These moments remind me of the huge responsibility I feel, and which will only become more intense, as I leave there and return to the US.

Yesterday my passport proved not as useful. Two internationals from Spain were also riding in the ambulance, as the mobile clinic headed to Madama for the day. The driver left the road and drove over rocks and hills to cut to the front of the long line at the checkpoint. We were asked to leave the ambulance while soldiers gave the most thorough search I've seen, even opening the containers of medicine. The doctors and the 3 of us internationals were instructed to put our bags on a conveyer belt inside a truck, to check for weapons. I know this is all to make life harder and not really a security measure, because I didn't do it and they didn't bother to ask twice. I watched as the soldiers searched the ambulance and questioned the driver, and my bag never left my shoulder.

In Madama after the clinic ended I was able to sit and talk with Asad, one of the medics. He wants to get his Bachelor's Degree but is only paid 200 shekels a month for working with the mobile clinic, and after food and transportation from his village to Nablus, there is nothing left for
classes. He explained the lack of funding also affects the care that
Palestinians receive. Currently, he said, the Ministry of Health is not
operating. This is most likely why the clinics in Asira al Qibliya and
Madama were so packed full of patients lately, in this time that people have been describing as "quiet". During more serious closure the clinics have seen up to 1000 patients in a day, but today this summer it is only the presence of extreme violence that is comparatively "quiet". In many
different ways the occupation is still working against the health of
Palestinians - from the damaged economy, to closure and travel restrictions, to separating people from their land and water sources. The UPMRC, particularly it's mobile clinics all over the West Bank and Gaza, is doing its best to make up for this, and is therefore bearing the biggest responsibility for ensuring the health of the people.

Mobile and satellite clinics are not the only activities of this
organization. Last week I was impressed by their sophisticated and
grassroots analysis of health issues by visiting the UPMRC's Nablus Youth Center and a summer camp. During the beginning of the recent uprising (intifada) the UPMRC had hundreds of young volunteers. The center began as a place for them to get training in first aid and health education, and participate in some civic activities as well. Over time the center evolved into a hub of civic education that is open to all youth in the area, and teaches classes in computers, photography and media, singing, dancing, English, democracy, and gender equality. The various summer camps are for very young children, and are more fun than health-related. Currently the center has about 110-120 participants, between the ages of 14-22.

Dr. Sameh explained their mission to me, and how the civic education for youth is related to medical services. They believe that these activities with youth will create a more health and democratic-educated generation of leaders. Youth in the community are enabled to provide first aid but are also schooled in community health issues in general, and this is important to the mission of the UPMRC. It also serves as an outlet for the hardships of daily life. Civic activities become a place for youth to deal with violence and loss so they are not carrying it around with them. And because many Palestinians cannot access doctors, families and individuals must be knowledgeable about self-care and able to provide solutions within their homes and communities when the occupation forces keep them isolated. In this way, the youth center works with other community education activities towards a larger and more powerful goal of self-determination.

It's not just providing medical and emergency services, but healthy people who are enabled to care for themselves, their families and communities, is what the UPMRC is all about. What is especially powerful about their work is that they include  all factors in their analysis of health problems, meaning land theft, closure, the wall, violence, and other aspects of Israel's occupation of Palestine are never absent from any diagnosis. A baby doesn't simply die from dehydration. A baby dies because the village is isolated by settlements or the wall, the economy has been destroyed, previous water sources are now unreachable, her parents have little access to health education, and soldiers did not allow the family through the checkpoint to reach a doctor's office. By working towards self-determination and the health of the people of Palestine, the UPMRC is fighting the occupation every single day.

PHOTO captions (click on picture to enlarge):
Receiving care when the UPMRC's mobile clinic visits the West Bank village of Asira al Qibliya.

A family fills prescriptions at the makeshift pharmacy at the mobile clinic in Madama. Most of the medication is donated by NGOs.

2) July 30th, 2005 Occupation and Abuse

In the domestic violence movement, we talk about the cycle of abuse often, because it describes the often-predictable way that violence occurs in a relationship. There are a few stages. First, tension builds and it is clear that violence will happen soon, and perhaps any little thing can set it off. Then there is the violence or more obvious abuse. This could take many forms, like hitting and punching, verbal insults, public outbursts and humiliation, or maybe periods full of restrictions on mobility or isolation. Afterwards there is the "honeymoon period", when the abuser tries to play off the violence by apologies or explanations, or making promises (whether they are kept or not). Then tension builds again and they cycle starts over. These periods can last for long or short times, depending on the circumstances. The main point here is that interpersonal violence and abuse is not about random acts, but is a complicated scheme and a cycle. It's also important to remember that there is no excuse for this behavior - abusers make a choice to do these things and they don't happen by accident or coincidence.

I'm not trying to say the occupation and Israel's state violence against
Palestinians work the same way as domestic violence. They are both separate things and in many ways completely different. But since I've been here a few things have been happening that keep directing my mind towards cycles of abuse. First is that I can't help but to see every single person I meet as a survivor. Here, just about everyone has a story of violence, and living under military occupation certainly has its psychological effects. I am drawn to the work that I do in domestic violence because I admire other survivors and their strength. They are my biggest inspiration. I couldn't name it until I had been here for a week, but I'm finding that I feel the same way about Palestinians - comforted and inspired by their strength and ability to live on, and feeling the warmth and understanding that comes when survivors meet and gather. It's powerful.

Second, I can't stop noticing parts of Israel's complicated master plans
that Jeff Halper of the Israel Committee Against House Demolitions calls the "matrix of control", and thinking to myself "that's what abusers do". This matrix is a way to see how all the layers of the occupation work together (physical control, bureaucracy, and violence). The problem can't be defined as just the wall, just the violence of soldiers, just the settlements, or just the checkpoints and roadblocks. Instead, these tools work together in order to control every aspect of Palestinian daily life - jobs, education, health, economy, resources, mobility, psychology... everything at once. And in these master plans, I feel that some major themes in abusive relationships are also here. For example, humiliation - trying to break someone's spirit or pride by subjecting them to searches at checkpoints, or destroying someone's ability to support their family. Isolation - ruining support networks by separating families, friends and neighbors with barriers like the wall.  Changing rules - not knowing the right or wrong way to go about anything because someone else is always making and changing the rules on you, depending on how they feel that day. And threats of violence - whether someone has been killed, injured, tortured, their home has been demolished, or they just know someone this has happened to, the message here is that anyone could be next, for little or no reason.

These tools are not all used by just the government, just the military, or
just the settlers. Much of it is subtle. In the US we hear random short
bites on the news about violence on the situation here, and we sometimes think about those incidents only in the context of themselves. I've been thinking about how the policies and actions of the Israeli government work in conjunction with the media and their worldwide public relations campaign in a way that muddles our understanding of what is happening here, or attempts to justify certain events. In this way we are encouraged to focus our attention where they want us to, and not see the whole picture - the whole matrix - as one master plan. But this is also part of the plan! The key here is that, like in interpersonal relationships, these events are never random, and we have to look at the whole cycle to understand it. All abusers make choices and know exactly what it is they are trying to do. This includes occupiers and colonizers.

The other day we talked with a woman, who told us how therapy is taboo and hard to find here, but she took advantage of it though when she was living in the US for a while. I can't imagine what it would be like not being able to let out that frustration and pain in some productive way. When people tell me their stories one after another, I imagine walking around in a land where everyone has Post Traumatic Stress Disorder and little outlets. This is probably why the youth organizations I've visited have seemed so precious and crucial. The singing, dancing and drama groups allow youth a place to vent their emotions, and I imagine it feels powerful and relieving in the way that survivor support groups do back home.

People often ask survivors why they don't just leave abusive relationships. The answer is never as easy as the question sounds, and it always shows a real lack of understanding of how abuse works. There are many factors involved and, as we can see through the cycle of abuse and matrix of control, there are always plans in place to keep people exactly where they are. Would you ask a Palestinian "why don't you just move somewhere else?" After listening to the emotional and often poetic ways that people talk about their land, their families, their struggles, their desires to live on, I can't imagine how awful that would feel. The solution isn't as easy as giving up some land and transferring some settlers in hope of curbing violence. It's not about Palestinians giving in and accepting whatever measly portions Israel offers. I believe the solution is to interrupt the whole cycle and dismantle and stop the abusers entirely.

For more information on the "matrix of control" check out: http://www.merip.org/mer/mer216/216_halper.html
and
http://www.mediamonitors.net/halper1.html.