Saturday, August 4, 2007

"There were times I couldn't get to patients and they bled to death."

Interview with PMRS ambulance driver
Aug. 4, 2007

Today I got to interview an ambulance driver at PMRS who patiently tried to explain things to me in English. Following is the transcript from the interview.

Q: Can you tell me about your experiences driving the ambulance?

A: There are many problems, many stories. There are many times I go places and I can't get there because of soldiers. Sometimes I have to wait 1, 2, 3 hours at checkpoints. Sometimes I have to stay the whole night at a place when I am trying to transport someone.

Q: Can you tell me a particular story that happened to you?

A: There were times I couldn't get to patients and they bled to death. Like there was a patient at the Tulkarem camp that I was trying to get to; they had been shot in their leg and were bleeding. I couldn't get through to get them and they died. Every day I have a story, every day things happen…

Q: Can you tell me a little bit about why you do this work with all this?

A: We work in ambulances because we want to help. But there are many problems-with your family, in work itself, on the road.

Q: When you say "problems with family", what do you mean?

A: Well, if there is an emergency you can't go home.

Q: Are there any recent stories you can tell me?

A: Last week, I was trying to get through Hawara checkpoint and the total trip took me about 5 to 6 hours. I was at the checkpoint for 2 hours. There was a patient who had just had open heart surgery and he was going to the hospital for a check up. The soldier at the checkpoint said I didn't have the proper license to get through and made us wait in the hot sun. You know, this past week was very hot, and the soldiers made the ambulances stop in the sun; this was very bad for patients.

Another time, I was driving the mobile clinic and I was trying to get through a checkpoint. The soldier said I can't go through. I was arguing with them, and trying to tell them that I had doctors and medicine with me and I needed to pass. I had to get out of the ambulance. The soldier put my arms behind my back and slammed me into the glass on the ambulance. In the end, they would not let us pass through and we had to turn back.

I used to work with the Red Crescent ambulances. One time I was taking a patient from Tulkarem to Nablus for them to get kidney dialysis, because they do not have that equipment in Tulkarem. I left Tulkarem at 7:00 in the morning. It took almost five hours to get to Nablus because of all the checkpoints and tanks.

While I was driving, two tanks stopped my ambulance and blocked me. Two to three soldiers were shooting at the ground and they sky. They told me to get out with my hands up. Then the soldiers strip searched me; they made me take off all my clothes. The soldiers made me stay two hours in the hot sun. They turned off the ambulance, so there was no air conditioning for the patient. I kept begging them to let me go check the patient. Finally, they let me. When I went to check the patient's pulse, I realized that he had died. He was about 40 years old.

Thursday, August 2, 2007

"If you were in my place, you would do the same thing."

Interview with Emergency Program Director: Dr. Mohamad Iskafi
[written permission granted to use name]
Today I had the great pleasure of getting to do a follow up with the extremely busy director of the Emergency Program at PMRS, Dr. Iskafi.
[Photo Credit: PMRS]
Background of Dr. Iskafi

Dr. Iskafi was trained in Russia as a General Practitioner. In 1988 he joined PMRS, first as a volunteer and then as staff. When asked why he joined PMRS, he replied: ''I wanted to help my people... I prefer to work in this field instead of at a hospital because I had previously worried so much about how to help my people.''

Q: Can you tell me about the working conditions of you and your team?

A: There is a real risk to our lives because of violations, sudden attacks-we don't know what will happen from moment to moment. Our lives are at risk. Also, there is the daily suffering in the teams from crossing checkpoints on a daily basis. First of all, it's a moral suffering because according to international laws, we should not have to wait at checkpoints, but sometimes they makes us wait 15, 30 minutes, sometimes an hour.
[Photo Credit: PMRS]
Also, when we pass through and others have to wait, this is not good, because everyone should pass through and be free in our country. And the checkpoints mean that we are not free.

[Line of 56 cars waiting at West Bank checkpoint]

This is a kind of continued suffering and continual stress that will certainly lead to psycho-social problems. This makes us hate the occupation and the soldiers more and more, and this is not good for Israelis or for us. I know for the Israelis the problem is deep; it is a problem of state and security, but for us it's freedom, our state, free access to services, work, daily life, fun, everything.

Of course, the other thing I should mention is that we at Medical Relief, when we see the people who are suffering, we see they are in need of help, emotional support, so many things. When we leave them and finish our work, we start our evenings, we think of them. We think of their future life, of the poverty, illnesses, complications that could arise for them. This is also another kind of stress when you go home and think about your people. If you go there, you help them, but if you don't go, no one will help.

Also, you think about the projects; most of them are for a short period; 6 months to a year; no project is over a year. When we stop, who is there? This is a moral stress for us, especially when people call us to ask where we are. We explain, of course, that it's not that we don't want to see them, that it's a financial issue. Some people understand that and others don't understand.
[Che at one of PMRS clinics]
[However], people [in the community] know that we are there for them at any time; there is no limit to our working hours. Most people here volunteer here as well as work-for example the time they put in on Fridays [the only official day off in the week] and in the afternoons is volunteer work; it helps to support and strengthen our programs.

Q: Can you talk a little bit about the conditions faced by your ambulance drivers?
[Photo Credit: PMRS]
A: For example, two days ago, a PMRS driver was beaten seriously by Israeli soldiers in Jenin. This happens often. I have a list of the dangers faced by the drivers.

Q: As a supervisor, what do you do to help the drivers?

A: We do debriefing, we talk a lot. When we can, we go for trips. It all depends on everyone's time and our resources. We do what we can; we don't just leave them alone.
[Photo Credit: PMRS]
Q: Have you ever been personally targeted by Israelis for your work?

A: I have been arrested twice. The last time was during the last Israeli invasion in 2003. I have also been used by Israelis as a human shield.

The first time that I was arrested was in Ramallah City. I was the first one who entered the [presidential] compound to help the injured people and to help President Arafat. That was why they arrested me. I decided to take two seriously injured guys to the hospital in the PMRS ambulance. They were severely bleeding and in shock. We were arrested for the night and put under severely cold water for eight hours. Can you imagine? Two guys with shock and bleeding having to endure that?

Another time, they thoughts that PMRS had a relationship to two guys from England who had come to Ramallah and then done suicide attacks. I had to stay 1 day in the prison; they realized we had no relationship with these guys.

They took me also during the invasion as a human shield for four hours when there were checking buildings in Ramallah. They had decided to search the PMRS and neighboring building in Ramallah. They asked me, "Who is the leader here, who is responsible?", and I said, "I am." They took me then to use as a human shied as they checked our building and the one next to us. It was not easy, because imagine, if there was an actual exchange of fire, I would be killed because I was the one in front.

Q: With all of this going on, Dr. Iskafi, what keeps you in it? What keeps you going?

A: That is a strange question. If you were in my place, you would do the same thing. You would keep working. This is a matter of doing something; helping your people. It's a matter of feeling that you are responsible and you have to do something. You are not a Palestinian soldier, but you are a doctor, a health provider, and you should do something to help. And, there are the successes to think of, and the satisfaction of the beneficiaries gives you more and more energy to continue.
[Soccer practice in front of the wall]

Tuesday, July 31, 2007

Last night

Last night we watched a beautiful, huge orange moon rise, while we sat on our balcony, enjoying the cool air.

I woke up to the news that the IDF (Israeli Defense Forces) had been in our little village for most of the early hours of the morning. They raided houses up the hill from us. One of the houses was that of our good friend and his roommates who are here from America for the Arabic language program. They woke up at 2:30 to soldiers whose heads were covered with black fabric bags. Later, several other soldiers with black face paint followed. One of their roommates was already outside, made to stand there in his underwear after he tried to crawl to the other roommates' room to tell them he thought someone was breaking in. Mid route, when he was on the floor in the kitchen, he saw red lights on him and got up and had to go outside, where they made him wait.

The soldiers eventually understood that this apartment was full of American students, but they held them, with at least two men pointing their guns at them-at their kitchen table until 4:30 while they raided all the other apartments in the building-a family with a small baby among them.

The soldiers finally realized that they had the wrong house, went next door and took 3 men, blindfolded them and drove away in their vehicle. One of the town's roads had been closed off. Our roommate watched the road closure and the military vehicles from our balcony, having been woken up by a text message from our friend.

As I walked to work this morning I thought about my friend and his roommates. I thought about the young family in the building. I thought about the 3 blindfolded men and their families. I thought about the great, kind man we interviewed this weekend who had simply lost years of his life when he was held in administrative detention-charged with nothing-held in the desert for two years. I thought about how the occupation seems to permeate everything.

[Israeli jeep outside of Habla]

Sunday, July 29, 2007

The Wall-Qalqiliya

In this post, I will simply try to explain the now infamous Wall. Although the wall goes all around and into the West Bank, I am going to focus on it in Qalqiliya. It is a lot to digest, and in fact, I have worked on this posting for some time now.

Last weekend we went on a tour of the wall by an employee of PMRS. She generously shared with us her personal stories, as well as showing us parts of it. It also was where we went on one of our first weekend trips; an earlier posting of mine talks about walking the wall with kids from Qalqiliya.

Qalqiliya is now entirely surrounded by the wall. It affects everything about this once vibrant town. I think one of the most important things that I want to express about what I saw there is that, coming from Oregon and Washington, I know the feeling of a place with water, and with plants everywhere. As soon as I first drove into Qalqiliya, I could see that this place used to be like that-we saw very rich soil.

It was an amazingly green place, before the wall-and there are still several greenhouses, all the way up to the wall-you can imagine really how both the greenhouses and farmers' land used to be. I can only imagine the feeling of watching all of your work torn up, replaced by a contiguous wall and fences, where you can only pass between certain hours and with certain permits. This farmer, for example, told us that the soldiers had just told him that he needed a special permit for his horse.

~Backing up a little bit: What is the Wall?~

A good basic source of information about the wall is from the Stop the Wall Campaign: The Palestine Monitor has a great primer on it as well: This site has photos of the wall in Qalqiliya from the air; it is a great way to see the difference in one year in Qalqiliya-and to see how much of the land became inaccessible:

While the pictures of the concrete wall are certainly the most dramatic, the concrete wall is only part of the story. The Wall also consists of ditches, razor wire, footprint tracking sand paths, military roads, cameras and checkpoints. It cuts through land belonging to Palestinians, cuts families off from each other, and it is positioned immediately in front of businesses, schools, and families' homes.

[Here is a photo from a school where the wall was built immediately outside its gates-it says: "It's not legal to build a wall by our school".]

I think one thing that really grabbed me is that the tour guide told us, with obvious hurt in her voice, that Qalqiliya used to be a place where there was a great peace between Israelis and Palestinians, and Israelis would come to get their cars worked on or to buy plants. She told us that it used to be a city of peace. But that it was the first city to be targeted by the wall project. With justifiable anger, she said it proves to her that the government of Israeli isn't interested in peace, but in confiscation of land and water.

[This is a chart of the water lost due to the wall; click on the image to make it larger]
Qalqiliya rests on the main aquifer for the West Bank-the Western Aquifer. The Palestinian Hydrology Group notes that the Wall is rendering 50 wells inaccessible by the communities. ( Wells in the West Bank are especially important because Israel prohibited any well drilling for Palestinians with the 1967 Occupation.

Here is a picture of an aquifer in Qalqilyia hidden almost completely by sight and certainly inaccessible to Palestinians.


Stop the Wall reports that in Qalqiliyia alone 8,160 dunums (2,040 acres) of land have been destroyed by the wall. Also, in Qalqiliya alone 31,520 dunums (7,880 acres) of land had been separated from the community-that means that the land is now on the opposite side of the wall from the community.

Our tour guide told us about her family-about the very personal impact of the wall. Her father died this year, and his one wish was to see his land again before he died. He was not able to pass through the checkpoints to do this.

[Here a farmer passes, while other farmers negotiate with an Israeli soldier]

~Economic Impacts~

As far back as two years ago (2 years after the wall was completed there), unemployment in Qalqiliya was reported as 63%. At this time, 3,000 of the most able residents had fled the town. (Middle East International- Our tour guide told us that since the construction of the wall, 600 shops have closed in Qalqiliya. It was obvious from being there that it was a highly economically depressed region-and that it didn't have to be.

One person we talked to told us how two houses had burned the night before, because no Palestinian fire trucks were allowed in and the Israelis wouldn't come. After some time, they allowed the Palestinian fire fighters in, but it still took hours for them to allow the truck in.


One of the foremost evils of the wall, especially as related to social structures and emotional health, is that it separates people from their family members and neighboring villages. The ride from Qalqiliya to Tulkarem, for example, used to be 25 minutes. Now it takes at least an hour. Crossing from Qalqiliya into Habla took us at least an additional 10 minutes each way because of a flying checkpoint that had been set up.

Home demolitions are also a impact beyond stress that I could ever imagine-especially because I have already lived in about 11 homes in the past 31 years, unlike most Palestinians, who have the same homes for generations. Also, extended families stay together in homes that often grow to accommodate all the members. On July 19 of this year, Israeli forces occupied Qalqiliya and demolished houses. In 2005, Palestinians in the area had received orders that stated that they did not have "housing permits" and so their homes were slated to be demolished. (

~Health Impacts~
[sign at gate in Qalqiliya, notifying residents that the gate will be open between certain hours-the spaces to fill in the hours are blank-and that if there is an emergency they should contact someone-the line for that someone is blank]

Sometimes it is easier to note the acute health impacts. For example, in 2004, a two year old child named Hashem died when he was unable to recieve emergency medical attention. He was from Ras Atieh, a village that was sealed in by the wall. After the child developed a fever, his dad tried to get him through the checkpoint to Qalqiliya, but the gate was closed. The family had to go around to another village, Azzun, to meet an ambulance to go to Qalqiliyia. (

One study I've looked at found that "the human being looks and views the Wall as a stimulant and classifies it as a prison", which triggers the same psychological symptoms as a prison would. This study, which was done in the Qalqiliya district by the Palestinian Counseling Center, found a high relationship between both feelings of loneliness and emotional withdrawal and exposure to the wall, as well as rates of somatization and exposure to the wall. (

The best report I've read about health and the wall is from HDIP-a program related to PMRS. It's called Health and Segregation, and it really was one of the main motivators for me to come here to try to witness and help (

Our guide told me how she had wanted desperately to get her mother to treatment in another part of the West Bank for a heart attack she had. Because of the closures she was not able to do this. She asked me, "Can you imagine, sitting there watching someone die, when you know there is treatment that is not very far away, that you just can't get to?"

~PMRS in Qalqiliya~
[A picture of a site visit by funders to the group in Qalqiliya-faces of group participants are blurred out, so only faces of donors or staff are visible.]

In my first post, I mentioned that I had the awesome opportunity to see the Women's Group in Qalqiliya, and it was amazing. Like many other programs I've been able to get to know with PMRS, I have to say I am totally impressed by the organic, community level planning of their programs. I don't have very much time left here, so I anticipate that the next weeks will be busy as I work with the psychology team at PMRS to determine how they would most like to evaluate their programs. I have to say, it feels hard to come in as a student evaluator, when really I am just in awe of how they function, and feel humbled daily by thier ability to continue so powerfully and creatively each day.