Dr Andrew Rouse

I have been to Zionist occupied Palestine on two occasions.

On the second occasion, March 2007, I went with a small delegation of doctors.  The delegation was sponsored by, “The Dove and Dolphin Charity”.  This charity tries to support Gaza based health and welfare initiatives.  On this occasion we were to provide a course of lectures and undertake informal meetings with doctors, medical students and other health service professionals.

Q.  What did we find in Gaza?

A.   “The good, the bad and the ugly” [read more]

The Good:

By the time I arrived in Gaza City I was demoralised; the security checks and pat-downs, the heat, the abundance of guns and the miles and miles of destroyed buildings had gotten to me.  be attending.

Therefore it was therapeutic and wonderful to be met by a small delegation of the most enthusiastic people imaginable.  They were aware of our teaching time table and wanted to inform us that they would

Over the course of a week we each gave an evening tutorial and an afternoon lecture and visited hospitals, medical schools and clinics.  In the few remaining hours we visited the homes of several of our hosts and places of personal interest.

The medical students were pure joy.  Well informed, articulate, energetic but understandably concerned about their training: How could they get high quality training when, not only were they denied paper, books and training materials, but also denied access to external trainers and had no hope of being allowed to attend training in hospitals outside of Gaza.  More importantly, “How would they be examined?”  Would the Israelis allow external examiners through the blockade.

The doctors, were as enthusiastic and some as bigoted as those in England.  The attendance was high.

One afternoon I gave a lecture in the grand hall of the university (now I understand in rubble after being targeted in Operation “Cast Lead” It was World Water Day,  Just as here in England reports and  project proposals were handed out .  I still have them in my desk and sometimes, when despondent I look at them and reflect on that time and that hall full of people who, even when starved and bombed, made the effort to carry out research, reflect on my good fortune  and find myself cheered up.

The Bad:

Another afternoon, by chance I came across the water quality laboratory of Gaza’s public health service.  I introduced myself to the director.  He was well trained having earned two higher degrees in Europe.  He explained that the major water problem arises because most of Gaza’s water is derived from thousands of wells – yet the lab had resources to test just several hundred.  Worse though was the fact that over the years these wells been sunk deeper and deeper and as a result salt laden Mediterranean seawater and industrial toxins were leeching into drinking water.  Many wells were very contaminated; well over the safe drinking limits.  The tragedy is that a US sponsor had donated modern equipment and supplies to the lab (I saw it – safely encased in bubble rap – stored in a side room).  It could not be used because Israel would neither allow the equipment company technician to visit and set-up the equipment nor would they allow a Palestinian to go to Germany for training.  A further problem was that laboratory supplies entering Gaza were regularly impounded for many months – often until they were date-expired and degraded.

On a similar theme, one afternoon when returning to our rooms we found a gentleman waiting for us.  He was a Palestinian medical equipment technician and had been trained in Europe.  For many years he was the Gaza representative for Siemens.  However, he reported that in the last few years, his job had become untenable because the Israelis were restricting the importation of medical equipment and disallowed the “exchange part” trade.

Inability to get spare parts was a recurring theme.  In a health clinic I found X-ray developers waiting for parts; on a visit to the eye hospital I was shown two useless ophthalmoscopes; useless because replacement diodes for the coloured light emitters were unavailable.

I and a colleague visited a Government health clinic; a group of seven trainee/ registrar GPs were holding a seminar on Yaws, a sexually transmitted disease.  A strange priority for Gaza I though – the explanation was shortly forthcoming.   Like doctors elsewhere in the world many Palestinian doctors spend several years in specialist training.  Traditionally trainee GPs followed the British syllabus. However, about 10 years ago, because of Israeli clampdowns at the border restricting access of British examiners, we British stopped supporting this training.  As a consequence Palestinians gained support of the Egyptian Medical Academy and adopted the Egyptian syllabus.  This affiliation, until recently, had been a success and trainee doctors had been able to exit Gaza through the Rafah crossing and sit exams in Cairo; an exam which does require knowledge of yaws!  Unfortunately in recent years even this “freedom” to present for examination has been restricted by the Israeli clampdowns.

A relatively bright note:

At another clinic things were significantly different.  Nearly everything was painted in pale blue.  This was a United Nations supported clinic for refugees (refugees of the Nakbha and their dependents).  A mother and child clinic was being held and I was shown around.  As a doctor with an interest in vaccination I showed obvious interest and was given detailed instruction on all aspects of immunization.  In fact I conducted an unofficial audit as a result of which I have no doubt that the vaccine coverage rate of 99% is true – and puts our British performance (at least 10% lower) to shame.

The Ugly:

And then it was time to leave and get ourselves through the mega- complex border crossing at Eres.  At this state-of-the-art facility, border guards take all backpacks, suitcases hand bags etc. and tip the contents into bins and rifle through them.  After pronouncing them safe, the bin bags and contents are given back for repacking.  This is a long drawn out, not least because there are no tables and chairs, and allows ample time to talk with the few other travellers.  One was a surgeon.  For years this surgeon had travelled weekly between Gaza and Ramallah.  He was at pains to say that until recently, Israeli police, guards and border agents had come to know him and facilitated his travels.  But during the last 2 years this had all changed.  The trip was now so difficult; checkpoint waits had become so long, documentation demands so capricious and high that the surgeon suspected that it would not be possible for him to continue.

And so ends my narrative.  I would visit again but this will have to wait upon the arrival of the Palestinian spring.

Dr Andrew Rouse is a public health consultant and a guest contributor at Facilitate Global.

more:  http://www.doveanddolphin.com

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