Creating people's geographies
Thanks to Richard Wiles for writing this heartrending Behind the Wall: ‘Medical Conditions caused by Political Decisions’. Wiles is a British photographer who regularly visits the occupied West Bank and has been writing regularly his Behind the Wall column (ICH; Window into Palestine).
Gandhi once astutely noted that the worst form of violence is poverty. In a similar vein, the occupation and economic strangulation of Palestine by the Israeli regime is preventing Palestinian development and causing health problems to fester. The withholding of tax credits (Palestinians own money); the restriction of movement and building of numerous checkpoints; the ongoing theft of land with the building of illegal settlements; and the prevention of entry or renewal of visas of Palestinians willing to help the local economy — developers such as Sam Bahour — is directly causing secondary violence on top of the overt military violence of the occupation.
As this piece from Wiles reminds us, Bethlehem is an occupied city. He reports on some glimmers of hope emanating from courageous and dedicated individuals who really have imbibed the spirit of the town’s most famous son. Meanwhile, also check out Gideon Levy’s Children of War (Ha’aretz, 2 Sept).
On Christmas Eve in 1952, a Swiss priest called Father Schnydrig was on his way to Mass at the Church of the Nativity. He had come to Palestine to celebrate in the birthplace of Jesus. He walked past a huge area filled with tents and saw a man attempting to bury a child. This was Dehaishah Refugee Camp. The man was digging in the mud to create a makeshift grave for his own son. His son had literally frozen to death. Father Schnydrig began to question his own place in Bethlehem and wondered how he could be in the city to celebrate the birthplace of Jesus whilst children were suffering so much within a kilometer of the church. Upon returning to Europe he began to fund-raise and soon opened Caritas Children’s Hospital in Bethlehem.
In 1978, Caritas opened a new building: it now has excellent facilities. Conditions at the hospital have improved greatly from an initial fourteen beds in the mid 1950s to being able to treat over 34,000 babies and children in 2006. Life has also changed greatly in Bethlehem over this time. Dehaishah’s refugees now live in houses instead of tents. Bethlehem itself is now an Occupied city.
Earlier this year a man walked into Caritas Hospital carrying a small baby in his arms from a refugee camp. The child’s feet were blue, they were frozen: this time the child’s life was saved.
Palestine in 2007 is geographically hardly recognizable from Palestine in 1952. Go back a further five years and ‘historical Palestine’ still existed. Now only around 12% of ‘historical Palestine’ is accessible to Palestinians. Caritas cannot even cater to all of this 12%. Children from Jenin, Nablus, and other cities in the northern section of the West Bank cannot get to the hospital due to travel restrictions, checkpoints, and the series of Bantustans which the Occupation is dividing the country into. Because of this Caritas can only treat children and babies from the southern West bank, the areas around Bethlehem and Al Khalil (Hebron). Despite this massive reduction in its catchment area, last year saw the largest ever number of patients treated at the hospital.
The effects of the Occupation are varied and widespread. Children injured by the IOF are not brought to Caritas as it has no emergency casualty unit, instead they are taken to state hospitals in Bethlehem. But saying that, a very high percentage of all children in the hospital have conditions which in some way relate to the political situation.
Walking around the hospital it is hard not to be impressed by the facilities and the standard of care, but another very striking thing is the size of most of the children. Children suffering from serious malnutrition are regularly brought into the hospital, but as I am taken around the hospital by some of the many dedicated staff they begin to explain to me about F.T.T. – Failure To Thrive. The majority of the children at Caritas are not from the cities of Bethlehem or Al Khalil but from the refugee camps and villages in the area. The environmental and social conditions in these areas are much lower than inside the cities. Poverty levels are higher, and subsequently diet suffers, heating is insufficient through the winter, and access to clean drinking water is also a major problem. One tiny child catches my attention as her huge brown eyes gaze at me inquisitively. After covering myself with a face mask, a gown, and gloves to prevent spread of infection, a doctor takes me over to meet her:
“Lama is from Al Khadr village. She is ten months old but has the growth parameters of a baby less than four months old. Her mother had no milk to feed her with so she simply couldn’t grow. Her parents haven’t been here in a month now.”
A lot of the children are suffering from gastro-intestinal problems, which can manifest itself as sickness and diarrhea. Such problems are common in children worldwide but in Palestine, as in many parts of the unprivileged world, children are dying from such conditions. Parents do not have the money to pay for hospital care so are often delaying going to hospital until it is almost too late. And as another doctor explained in some cases it is too late by the time children reach the hospital:
“A few months ago a man brought his son in. They had no money at all and felt ashamed to beg for help so they put off seeking treatment hoping the condition would improve with time. Eventually the family got very desperate as their child deteriorated and they took him to a Government hospital. When they got there the hospital couldn’t treat him as all doctors were striking, and they were sent here. The child died within a few hours of getting here, it was just too late.”
This child died from acute gastro-enteritis, he was just six months old. Had he been taken to hospital earlier he could have been treated successfully.
Since the international blockade on Palestine began last year, imposed by the world’s leaders of so-called ‘ freedom and democracy’, staff at Caritas have found the situation has deteriorated greatly, and at an alarming rate. Doctors at state hospitals had not been getting paid and eventually took up strike action in protest so many more children were getting passed on to Caritas. Parents have no money so their diets and those of their children have suffered greatly. One child was brought in suffering severe vitamin B-12 deficiency which is unusual in babies here according to the doctors at Caritas:
“B-12 is found in meat and vegetables which very young babies do not eat. Her father was a policeman so had not been getting paid since the blockade began, he could not provide food for his family, so his wife during pregnancy had lived on not much more than bread and black tea. By the time she gave birth she herself was suffering severe B-12 deficiency and as she began breastfeeding this was made more acute in her new born baby as there was no B-12 in her milk. We see this a lot – mothers who cannot produce good milk because of their own dietary suffering which is in turn passed onto their children.”
Many of the children here suffer from some form of anaemia, another condition directly related to poor nutrition. One child I saw had 80% iron deficiency anaemia. Iron is vital in the first few months of life for amongst other things development of IQ and this child has been found to be suffering from incorrect psychological development as well as physical problems. So these are some of effects of the policy which Bush and Blair promoted last year because they didn’t like the democratic choice of the Palestinian people:
“We found things got a lot worse after the Intifada began and again since last years blockade things have deteriorated greatly. Nutritional care has suffered a lot. Mothers cannot produce milk so are using powdered milk but it is being diluted so heavily because of the families poverty levels that it has virtually no nutritional value. It is also being made with dirty water.”
Another very evident factor at Caritas is a disturbing lack of parents in the hospital with their children:
“We find this to be another major problem, particularly from the camps and villages around Al Khalil. This baby here for example is from Yatta (a town south of Al Khalil). She has Short Bowel Syndrome, a twisted intestine. She also suffers from various nutritional deficiencies, anaemia, and FTT. She has been with us since just after birth and her parents have not been to see her in over two months now. Yatta is a very poor town and her parents simply cannot afford the transport to get here, they have other children to feed at home…”
Walking around the hospital I see rooms and rooms full of tiny babies suffering from conditions in some way related to social conditions and poverty, children whose eyes light up when I walk in at seeing a new face. Some smile up at me with the beauty of new life, others cry almost constantly. One baby is so tiny I am sure she must have been born very prematurely but as we look through her notes we find that in fact she was born after a full term of pregnancy. She is now four months old but seems no bigger than a bag of sugar. The doctors go on to tell me of other children brought in, carried in their fathers arms, carried in like babies, but in fact these children are not babies but three, four, or five years old. They simply cannot grow – this is FTT at its most severe.
In the winter, children such as the child described earlier with frozen feet, are being brought in with temperatures as low as 32 degrees (Fahrenheit), particularly from the camps and villages, because their houses have insufficient heating, or in some cases no heating at all. Not all children brought into Caritas can be treated at the hospital. The hospital has built strong links with hospitals inside Israel and some children are sent to hospitals there if they cannot be treated at Caritas. This is particularly the case with major operations. But this procedure also faces many problems. Endless paperwork must be completed and then the child will be put into an ambulance: but this ambulance is permitted to travel only a few hundred metres up to Bethlehem checkpoint. It can go no further. It can go no further because it is Palestinian. Even ambulances are not allowed passage through the checkpoints to hospitals in Israel irrespective of paperwork. So at the checkpoint a child will be unloaded from the ambulance and an Israeli ambulance will wait to collect the child to continue the journey. And once the child is safely in the hospital inside Israel where are his or her parents? They are invariably stuck behind the other side of the Apartheid Wall to their child, unable to get permission from the Occupation to themselves visit and care for their sick children during their hospital treatment. In one recent case from Caritas a baby in an incubator was held up at Bethlehem Checkpoint for a couple of hours before the soldiers finally allowed him to be transferred to the waiting Israeli ambulance.
The doctors at Caritas have also, since the start of the Intifada, found incredibly high numbers of very young children suffering from a rare strain of cancer behind the eye. They have been unable to pinpoint exactly what is causing this and it is not being found in neighbouring countries which leads the doctors to believe it is possibly a chemical toxin being used by the Occupation. They have been researching the possibility that it could be caused by tear-gas but have so far been unable to categorically prove this theory. Premature birth and miscarriage as a result of shock caused during IOF attacks is also widely seen.
The work of all the staff at Caritas Children’s Hospital is admirable. The faces and tiny, weak bodies of the patients are heartbreaking, wanting eyes looking out of shallow faces pleading for help. Palestine diminishes day by day. It gets smaller and smaller. It cannot thrive and its children suffer from a Failure to Thrive. It cannot develop, and its children illustrate that fact through their continued development of poverty related illnesses. These are medical conditions caused by political decisions.