March 30, 2015 part two, Here Death, There Death, But Let Me Do Something Useful For People

The Wefaq Society for Women and Child Care founded in 2010, seeks to achieve gender equality and improvement for vulnerable children through economic empowerment and psychosocial support in one of the most challenged areas of the Gaza Strip.  We meet with the leadership and women involved with the organization over coffee as the electricity flickers off (there is no fuel for a generator) and the stories emerge in a warm, open, sisterly environment. (Consider that it is extremely hard for the staff to work when there are no functioning computers let alone functioning civil government.) The situation in the southern Gaza Strip is more difficult and more miserable than many areas, but largely ignored by the media, far from Gaza City.  The society has its roots in the Gaza Community Mental Health Program but we are told that Dr. Eyad el Saraj, (founder of GCMHP and for years the only psychiatrist in the Strip), urged them to be independent; they now have a department for women, children, building capacity, and media.  Another branch in the al-Shoka area, the most marginalized part of Rafah, offers psychosocial support in partnership with ActionAid Palestine, funded by Disaster Emergency Committee-DEC.


“We are here also implementing our project which is psychosocial empowerment, improvement for women and livelihood, a fund for small projects for women who have been bombed and domestic violence, and widows, divorced, and abandoned. Some of the women lost their livelihood during the war, left their sheep and goats and escaped to the center of Rafah during the war. Black Week started on Friday; they [Israeli forces] were trying to occupy the east area [of the Gaza Strip], they destroyed everything, animals, trees and more but the media doesn’t reflect the picture. Bombing and destruction followed us to the sea shore by F16s.   After [the people] leave the area they try to come back during a cease fire, but they were bombed during the cease fire, intentionally. Many died, injured, houses destroyed, they went to UNRWA shelters or to relatives.  They found after the cease fire, their sheeps and goats were dead, the only hospital in Rafah, Abu Youssef al-Najjar Hospital was bombed, (see:, the injured couldn’t reach, it was the center of occupation.  The hospital was bombed, so they died, so more casualties. This aggression to the hospital made big problem, bodies in the field, in the street.  To treat the injuries, they moved the injured to a private Kuwaiti Hospital, very small and very limited, no equipments.  The main hospital was closed, surrounded by soldiers.”


“The center has an emergency response plan, so once the war ended, Wefaq quickly responded in shelters, psychosocial program, intervention with people.  The staff went to the shelters, bring donors clothes, food, distribute them.  We are one of the members of the DEC emergency committee in community based organizations, (CBO) with UNRWA.  They formulated an emergency committee and started to respond, especially in the shelters and relatives’ houses.”

“People who are forced to leave especially in the eastern area were without anything, clothes, food, money, nothing; they escaped with nothing. Then it happened during the cease fire! [Israelis] attacked, there is no safe place in Rafah at that moment.  I was at home waiting for bombs. I live next to al-Shoka, my neighbor’s house was hit with a very big rocket; didn’t explode.  The civil defense removed the rocket, many cases like this.”  The women are laughing, gallows humor. “All Gaza like this.”

Another woman explains, “I was leaving my children home in Khan Yunis to bring help and needs for people in shelters. My children say to me, ‘Mom we are afraid, why should you leave us?’  I say, ‘Here death, there death, but let me do something useful for people.’  I was crossing Al Nasser Street while bombing happened ten meters away, another time in Khan Yunis, less than ten meters and the house, they bombed.” I ask, what about fear? “We are used to it, also it was Ramadan.  I have three kids, two in university, one in school. We are as adults, we are fearful, a frightening experience.” So Gazans are experiencing a terrifying unpredictable bombardment and they are fasting for Ramadan.

Another woman adds, “I was waiting for morning to begin. At night you don’t know when the bombing will begin.  Because of the psychosocial pressure, all categories [of people are] nervous. So violence start to be in every category, not just against female, many incidents in shelters because of the distress of the people.”   (Think New Orleans, Katrina) “Immoral males make it for them, the same for war or not with war, in harassment, sexual threats. The shelter has two to three WCs, how the female teenager can go to the WC? They didn’t have water to wash, they tried to get to relatives’ houses to shower.  Women delivered in the shelters, no medical care, there is no nurses or doctors.  There is no professional equipment. Female doctors were refusing to come to the shelters because they were saying, ‘My children, how could I leave my children?’”

“A mother delivered [in the shelter] but she hadn’t any clothes for baby or for her, so they hired for her the near houses to get some clothes, hygiene was very miserable, UNRWA services were not as proper as they should be.  Three days in Ramadan, UNRWA had no food in shelters, director of UNRWA said he has nothing in Rafah, and probably beyond.  The emergency response of them was to go to restaurants to get food for people. They (the volunteers and NGOs) opened the restaurants even in Ramadan to cook the food. We are trying to get better the situation. We don’t like to talk about war, opens too many wounds, everyone is hurt.  Whatever you saw on TV it is an instant, not as much as actual situation. The Syam family, they bombed their house.  They escaped to the street but there is no place secure, thirteen killed in the street by bomb, plus injured; random killing of entire family, kids babies, many innocent families.”

At this point, the women are crying, the women in charge and the women being served share the same experiences, the same pain, the same tears.

Everyone reconstitutes their fragile psyches and the interview continues.  “Projects here in our branch: we are implementing in cooperation with UNDP, the legal protection for victims of war after the aggression on Gaza for female victims.  We didn’t talk about the other section of the project in al-Shoka, we are implementing psychosocial improvement and livelihood training. [We focus on areas like] gender based violence, IT, young women leadership program for university graduates to prepare them for job opportunities, CBOs, (community based organizations), private sectors.  We also had already finished two months ago a working placement for 200 girls, they got jobs like secretaries, all kinds of jobs, income for their families and this empowers them.  NGOs and us try to change the idea and traditions of people by awareness regarding women’s roles, there is acceptance that the female get out and work, life is very difficult so women will continue working after marriage.”

“We teach life skills, English, sewing, embroidery, but some projects closed, handicrafts and sewing for two years closed, no funds. “Now we are going to make a partnership with Actionaid, new project of psychosocial support and vocational training and small projects. With children six to twele, at al-Shoka, we do drawing, play psychodrama, individual counseling, group counseling, home and school visits, family interventions to fix the relationship between the mother and children.  For low achieving children, there are many success stories in al-Shoka area.”

“Domestic violence, it is a huge problem. Wefaq works on this, in alliance, for combat violence against women.  The procedures we follow, first awareness for the woman about her rights, about gender, the violence and types of violence. We consider this as part of protection for women.  Then home visits for intervention, talks to men, awareness, the same awareness to the men. We do community mediation, separate from the mosque, with mukhtars, leaders, university teachers, social workers, political activists. It is part of changing the tradition of the society towards women’s issues; we encourage women to get independent economically (sewing and handicrafts) especially those who are exposed to violence. Who has the income has the [power of] decision, this is a very effective intervention.”

“We still have problem of early marriage, 13 and up, especially in a bad economy. Previously we start to modify their attitude, but now tradition to make the girl get married early because of economic bad situation. They returned to the idea to get rid of her, the older man has multiple wives.”  There have also been issues of brothers-in-law killing their dead brother’s wives because of money, because of inheritance. “We are implementing legal protection, victims of legal violence, about inheritance, alimony, in divorce.  It is a tyrant’s law. I have three children, divorced, have not seen them for two days, [tears again].  One-and-a-half years ago they were taken by force, I raised them for ten years, I still have my daughter, but they may take her in a few months.” More tears.  So this is woman who is very aware of her rights and her children’s legal rights, she has the support of Wefaz, she has a lawyer, and still her husband has married another woman and has custody of two of their three children. “We are struggling for these rights.  All of us are victims, suffering from one aspect or another, all women in Gaza.”

Another woman is tapping her fingers on the desk.  “We should lead the victim’s movements to help ourselves and to help others.”  I ask if there are safe houses for women and learn that an attempt was made, but the government refused. “The Hamas government, of course they took my children.” We learn that in the past, on occasion, “we refer to Arabs’ safe home in Arab homes in ’48 Israel, to get safe. Now this cannot happen, the border is closed. Hamas and Israel occupation are here and there.”

The center teaches health workshops, “we have health workshop weekly, about burns, about hygiene, but we need a whole program about women’s health.” I give them an Arabic version of Our Bodies Ourselves, sharing my world with theirs. “Why shouldn’t we as females make a committee for worldwide peace? We will make a strategic plan to stop war.  Arab women should work on this idea; the biggest loser is the females.”

The electricity is still off and I discover that some of the more religious women fast on Mondays and Thursdays.  “We get up to wash or iron at 5 am if there is electricity, maybe 12 hours per day, on and off.  Once I come to work, electricity in my house is on, when I back to home, no electricity.  We don’t feel we are alive.  We have tyrant husbands, they do not cook, wash clothes; they are not ready to help.  How will that change here, how to change the culture and attitude? But it is very difficult, women’s work is first step. Of course, the main aim of ours is work. We work hard on gender issue to change the ideas of people and attitude, men a little change, but they are moody in this aspect, not convinced.” I joke that I have heard that men always have PMS and one woman responds, “PMS on a 40 year cycle! May Allah take all men!” The laughter is slightly relief, slightly conspiratorial, slightly guilty.

One woman explains, “I have a terrible story. About twelve years ago I separated from my husband but we stay in the same house, [different bedrooms] just to make a name that I have a husband. In our society, he has no responsibility towards his kids, his house, about money, nothing.”

I ask, how do you help your sons to be different from their fathers?  “We are strong women.  I suffered with my older son, but he start to be older and wiser and he at university.  His father’s behavior made a weakness in his personality, but I intervened, I support him to get stronger and more responsible. Now he is a responsible person. We established this organization for ourselves and our daughters…. and our sons.”

“Daily we meet with about 10 to 12 cases of women victims and provide them with help.”  One of the staff is a psychologist and she feels her problems are small compared to others.  “Occupation circumstances make us stronger, still hard. But I have had enough of getting stronger! I am satisfied, fed up.   We wish you stand by us, this session is good even if it opened wounds; this society helps vulnerable women.”

I ask if guns are prevalent in domestic violence cases? “No guns, but other material for killing, honor killing, related to virginity, are poisoned or with a knife.  These are rare cases, men do get punished if government knows. But Hamas, don’t punish properly, may put him in jail, but are not changing attitudes.”  Two younger men come in, they are the accountants and their relationship with the women is friendly, joking around.  These women clearly enjoy the company of these men, but find the oppressive men in their lives unacceptable.

I turn to the woman who is worried she will lose her daughter post-divorce.  She says she has “a fun life with my daughter, take her to playground, to restaurants, massage.  My daughter misses her brothers, she is confused; what can I do? Try to make her not to think about the explosion in the future if she goes to him [the ex-husband].  He has another tyrant wife.”

“University trained women are desirable because they can contribute to economy in the marriage. Women are used for their money, we are cheating ourselves to say okay [with this].  We are sometimes part of the problem; domestic awareness is a complicated matter.  Mostly, when a woman marries, goes to husband’s family. Independent ones have apartment, no cultural problem with this.  But economic circumstances prevent this. The mother-in-law is practicing violence against who, women practice violence against women. It is about emotions, feelings of the mother that this new woman took her son, a kind of reflection of her inside emotions that this female came and took the son.  The young wife is in competition if her emotions get extremely jealous, this is another issue. Once it is normal for a mother to be jealous of the new bride, sometimes the new wife of the son herself practice violence against the mother-in-law. This is all related to awareness and balance, raising the awareness about domestic violence, gender awareness, how to develop attitudes towards gender and campaigns and community mediation.  None of this is taught in schools, I want to do this, amongst teachers and families, secondary schools, girls and boys, there are a lot of ideas for services, but no funds. We don’t even have electricity.  I am very tired, I have many ideas to develop the community but no funds.”

Talk turns to politics.  “America is the father or mother of Israel but we do not talk about people, we share you in your agonies, it is all about the government.” Then I was asked a most amazing but understandable question: “Is Congress all Jewish?” I launch into a description of the Israel Lobby, AIPAC, Christian Zionists and a quick rundown on how the US system works.  I am amazed to discover that the women have heard about Jewish Voice for Peace but they are unaware of the Palestinian call for boycott, divestment, and sanction of Israel.

March 30, 2015 part one, We Don’t Hate You, We Just Don’t Understand What You Are Thinking Of Us

Another sunny day in Gaza, another ride along the beckoning Mediterranean, another trip where the smell of raw sewerage permeates the car for miles.  We are heading to El Wafa Rehabilitation Hospital. El Wafa means kindness or truthfulness, and by the end of the morning I wonder if there may actually be an undescribed Palestinian affliction: too much goodness.

We meet with Dr. Basman Alashi, engineer, manager and now an extraordinary hospital director and Dr. Ayman Badr, rehabilitation doctor and medical director who received a BA in Rumania, a masters in Cairo, and who has finished his clinical exams for medical school but has been unable to finish his thesis as he has been trapped in Gaza without a permit. Moussa Abu Mostafa, a PhD student in occupational therapy, head of the rehabilitation team, joins us as well.

Dr. Basman, speaks with a formal sincerity and heartfelt openness; he begins by talking about the facility here, the hospital, lab, physiotherapy, occupational therapy, an elder section where folks with no family supports and the need for 24 hour medical care can live out their days at no charge. There is an outreach program to homes in Rafah and Khan Yunis, There are plans to open up other sites in other areas of Gaza. 90% of the wounded are “needy, poor, cannot afford a shekel for a taxi, so they stay at home, they have pride and they are not going to ask [for help], so we ask them if it is okay to ask what they need.”

But I want to know more about the war; El Wafa Hospital was repeatedly attacked and ultimately leveled.  For me this is unimaginable, I am trying to wrap my brain around bombing a rehabilitation hospital. We look at photos before and after: an extensive modern medical facility reduced to a massive pile of rubble. Dr. Basman explains that “in the days before the war, they felt something was going to happen, there was tension in the building, so they prepared an emergency plan for each patient. Do they need to stay with us or can we train their families, so a few chose to go home, seventeen cannot leave, and then the war started.”

The first day or two were okay. “Day three we were hit by artillery. [This is said calmly but this is a mind boggling concept, the Israelis are bombing a rehabilitation hospital, does this bother anyone out there in international justice land?]. “The hospital stood one kilometer from the border on vacant land.  We were hit in the middle of the night, no warning, just a direct hit to the hospital, to the fourth floor.  We had men on that floor but we moved them to the first floor for safety, so we had no injuries. We thought it was a mistake. Israelis know it is a hospital. It is clearly marked.”

“We just went through our daily activity as nothing happened, afternoon day three, another hit, larger than first four; at that time we went to Shifa Hospital for press release, talked in Arabic, English, French, Spanish, German, telling the world, this is unacceptable, we are connected under Geneva Convention, and so forth. Eight volunteers stayed with us as human shield. At night, I drove them to the hospital under fire; they gave me an ambulance, I gave them free access inside the hospital so they can report any activities showing to the world what kind of patients we treat, unconscious, cannot move, cannot feel, some of them sleeping for year or three, coma for ten days.”

“But we continued to use the media to express our concern that Israeli must not target the hospital. I asked Israelis if there is any evidence [of militant activity in the hospital]?  The army released classified pictures saying this is El Wafa Hospital and a red dot saying this is launching missile.  We looked at the “hospital”, this is not the hospital, this is three to five kilometers away from us. [FYI, according to international law, it is never okay to bomb a hospital].  We made another press release, showed evidence, showed how buildings are totally different so Israelis are misled.”

“But Israeli continued asking the hospital and the area to evacuate.  On 17th July, 9 pm we received a call, pretended to speak Arabic but Hebrew accent, asked us to evacuate the hospital.  We took it as a normal call because all of Shejaria received such a call. Five minutes later, a robo call to evacuate, five minutes later a call from Israeli army, you need to evacuate; we will start targeting the hospital in ten minutes.”

Five minutes later, bombing from artillery, the air, we lost power, no electricity, the 8,000 square meter hospital went dark. We cannot see our hands, we had patients that need oxygen, breath through a tube. At that time we decided to evacuate for the safety of patients and staff, ambulances were scarce.  So we moved them in regular cars, two to four per car, carrying them in bed sheets, just under fire and we are moving and ask everyone around the hospital to move these helpless patients that they do not even know what is going on.”

“We were able to move them safely.  The Red Cross, Gail, called saying I have special message from Israeli army, how much time do you need to evacuate the hospital? I asked the management and doctors, they said we are waiting for a special equipped ambulance to carry four patients, with oxygen. I called her and said I need two hours. She said, okay, I will convey the message to the army.  Fifteen minutes later she called back.  The bombing continuing at the hospital while she is talking to them, chaos and darkness.  We lose our sense of direction. What should we do if not trained to dodge bomb?  She called me back, I have another special message from highest authority from Israeli army.  They will not target the hospital.  But the demand was not fast enough to get to the lower command. I was emotionally upset, it is too late. She said I am just a messenger. I told her she should say do not target the hospital. Which side are you on? Israelis know exactly who we are.”

“On March 17, we moved to a maternity clinic, Sahaba Clinic in the middle of Gaza City, and moved from 8,000 square meters, to 800 square meters. We were not able to take any equipment and medicine, just running to save our lives and our patients’ lives.   With the help of God we evacuated safely.  The next day we need medicine, clothes, bumpers, sheets, etc. At that time I went to the hospital which was a war zone at 10 am to look.  The damage and fire was still on, severe damage to every floor. We could stay no more than 30 minutes, drones flying over us, bombs everywhere.  We felt safety is our main concern so we left. We were able to take some medications, enough for one to two days.  We left the area without anything else.”

“On March 18 we called the Red Cross to arrange escort to the hospital to protect us and not to be targeted.  Israelis target ambulances. The Red Cross refused because the Israelis refused to give them safety, so we stood without any equipment, without any medicine or machines that better the lives, a 30 year investment. We extend our hands to local and international organizations.  Many supported us, brought us beds, sheets, water, food, medicines, free, so we started from zero building up the hospital. We took care of patients as day care, also received new patients, wounded, surgery done [elsewhere] and they need rehabilitation.  We are the only comprehensive completed medical rehabilitation hospital in Gaza City.  There is few that does similar services, not as comprehensive as ours.  We receive patients from the Ministry of Health.”

“The war ended on August 23rd, the building we are in now belong to El Wafa Hospital but it is far away from the original.  We were planning to move the hospital to Gaza City and this building was planned for elderly home. This building was donated by a Palestinian doctor, el Alami, the land given by the government, so once the war ended we moved all our patients to here, at Zahar City. We shared with elderly care home, now half hospital, half elderly care center.”

“We start as a team rebuilding the hospital, equipment, medicine, 19 clinics from the hospital were destroyed. Here we are now 225 days later, we are back in business, not of choice. Gaza needs our services due to blockade, continue preventing Palestinians go outside to get medical help. This puts us in a harder position, despite we have no budget or resources, we must continue our services even if only with our hands and comfort them with our feelings and they continue to improve their life.  The world saw us through the eyes of cameras and many organizations support us…UNDP approved us to enhance, extend this building another floor so we can accommodate more patients.  WHO, UNRWA, UNDP, Interpal, Australian charity care, Malaysian came to our aid. I am not saying we are proud of what we are doing.  The specialties that we carry, none similar in Gaza.  People used to pay thousands of dollars in Egypt or Israel, but since El Wafa was here, they came to us for minimum charge.  El Wafa is specialty, unique in service, in equipment, no one is similar to its equipment.”

“Everything we will see is donated even the food, tubes, needles. Who supports the hospital is Palestinian people, no other continuous income, especially Muslims, part of being a Muslim is helping the poor.  10% of donations go to management, this is low.  The staff put in tremendous efforts, as a team and this is how we work, a tremendous effort to bring back the hospital.  20% of the staff lost their homes, many lived close to the hospital or Shejaria, close to the border.  Our staff during the war, they were at the hospital 48 to 72 hours a time, leaving their families. This is my duty, the others who are not direct services they stayed home. Once we came here, all came back.  We lost two staff at home. One was walking in the street, a man with three daughters, he stopped by the grocery store, bought figs.  He was targeted by a drone walking alone; Israeli did not distinguish from woman, man, child, resistance, young, or old.  [The other staff] her home was destroyed, she went to the UNRWA school [for shelter] and it was targeted. She was hit by shrapnel in her head, her brain was out, she was 21 years old, unmarried.”

“Our concern was how to serve patients, we all risked our life just to continue. We had one lady with cancer in her spinal cord, no sensation in lower part of body.  If a bomb hit her, she would not feel her body frying.  We cannot leave such patient, we cannot live with ourselves, feeling that we left a person who was breathing. As Muslims, serving patients is first, serving us is second.”

“Many patients cannot come this far in our new facility, outpatient services too far, no transport, so we have to go to them and it costs. Only in Rafah and Khan Yunis, the areas really devastated, some of them do not understand the extent of their injuries, very poor, they may not know how to treat them. Need to rehabilitate the soul itself, teach the wife and the family, show him the love. This is 50% of recovery.  We have one patient on chronic ventilators. Now he is child, 10 years old, he was injured with his family, missile in cervical spine, C2 quadriplegia.  He lost his father, brother, uncle, girl twin, and four cousins.  His mother was pregnant, they were farming, bombed from a drone.  Whenever Israelis see a group, sitting in the farm, they were just eating, drone targeted them.”

“[Another patient is] two years old, father was killed, mother was injured, he is in coma, not on a ventilator.  He has a deep brain injury, he is at home now.  He was moved to another house, their house was destroyed, we were following them; he has gastronomy tube.”

“The new building is U shaped, the right side is the hospital, the left side is the elderly, the middle is management, so all separate.  We still have a problem that our space is too small, so children and adults are mixed. We had 17,000 square meters before and a garden, this facility is 4,800 square meters.”  The old hospital was very high tech with a high level of care and included a gym, swimming pool, hyperbaric oxygen treatment, video conferencing.  “We lost a lot.  It is difficult that we lost all this but we are all optimists and we look at the positive side of any events, because we are rehabilitation, anything we face, we look at the positive side of it. The hospital destroyed completely on the 23rd, thanks God we are all safe. We sent a message: we don’t hate you, we just don’t understand what you are thinking of us.  We are just human beings like anything else, we live on planet earth; we all look alike.  The Israeli response was the hospital was a terror site, like all other bombings, they justify everything.”

We ask if there have been an independent investigations. “Officially no, but media did extended investigation, eight independent foreigners with full access to the hospital, they have not reported anything. There is no justification to target children, hospitals, [he lists all the buildings targeted]. The only thing is to terrorize people to leave. So then the young boys out of school and working, the girl married too young, it is circle of devastation.  If I don’t give the father a chance to work, that means a problem in the family, but Gaza still survive.  If Israeli came to the hospital for treatment, my glasses looking to him as a human being and to treat.”

“Some departments like urodynamics, diabetic food center, hyperbaric center, the only one in Gaza, are not up and running, patients are waiting.  The hyperbaric, limbs were saved, five year old wounds were healed; we cannot get another one. I cannot plan where I will be in two hours.”  He says that it is harder now to find donors.  The Islamic Bank in Saudi Arabia four months ago offered four million dollars if the Israelis will agree not to target the hospital and Gaza will remain stable, so no donation. Larger organizations and governments are not donating, but individuals still donate who “believe in cause of Palestine. There are also financial restrictions on wire transfer, so bank calls, we have a wire, we need a contract, where it is coming from, what it is for.  We need to show purpose, restrictions from banks outside of Gaza, it has to go to a certain group that is not labeled as a ‘terrorist.’ We see this as a challenge, we don’t have a choice, succeed or just die, we will continue.”

“Another part of the tragedy, of the siege: killing the victim is part of the crime but also forbidding the victim to say we are victims and are human beings.  This is a human feeling.” This is the other face of the crime.

The tour of the hospital starts with an ambulance that was targeted by a drone filled with nails, we see the entry holes in the back door and the exit holes in the front, (dear IDF soldiers, why would you send a drone attack to the back of an ambulance???); they have not been able to replace the fractured glass so the windows are covered with cardboard sheets.

330-1aAmbulance targeted by drone during Israeli attack, summer 2014


The first floor has a large room for physical therapy equipment; the area is clean and orderly.  The nursing stations and patient rooms are improvised but functional; Dr. Basman knows every patient and his or her story.  He greets the conscious patients warmly, there is a lot of joking around, moments of tenderness, a profound sense of caring.  The windows are open, a fresh breeze blows through the rooms, there is no antiseptic smell, families cluster around beds.  The most tragic patients are in various chronic states of unconsciousness and physical constriction from a variety of causes, motor vehicle accidents, cardiac arrest during labor probably due to a difficult intubation and an urgent C section, brain tumor.  But the patient who will always stay with me is the little boy, Hamad al Reify, with the high level spinal cord injury and quadriplegia.


When the electricity goes out, he has 30 minutes on his battery run ventilator. They have no cardiac and respiratory monitors so nurses sit near his bed monitoring him with their eyes and their hands. He has a tracheostomy, but is able to communicate and has an unbearably winning smile.  He jokes, he dreams, he was given some toys, but he sent them home for his sister.  The staff clearly love him.  Some IT type person has designed a mechanism that fits under his chin and allows him to change the channels on the TV.  Later we see him in a reclining type wheelchair, basking in the sun. If he is lucky, he will spend his life at El Wafa. The staff has not received a salary in the past six months.

Dr. Basman ends with a message to the world. “Gaza is fine.  What you see from the outside, it looks devastated.  But if you live among the Gazans, you won’t leave. I choose not to return to America [where he lived for a number of years]. We are human.  I am born here.  You don’t have a choice where you will be born, but I have a choice for whom I am.”

Too much goodness.

March 29, 2015, So If You Killed My Child, You Think You Are Strong?

One of the greatest casualties of the ongoing war on Gaza is childhood. The Gaza Community Mental Health Program Deir al Balah Community Center has an extraordinary exhibit of post-war children’s drawings that gives us a window into the loss of the sense of order and safety that comes when one of our smart bombs lands in your bedroom.

The drawings are breathtakingly painful and simple in their honesty, a child’s view of a world gone horribly wrong:



The delegates stare, take photos and are pulled into each drawing; some of us are weeping, some of us just floating in a sea of societal trauma.

Children chained together in front of a soldier with a whip, families lined up in front of a tank, bombers shooting birds out of the sky, pools of blood, lots of blood, bloody circles on people’s chests, over and over again, fallen trees, smiling men in kaffiyas waving the Palestinian flag, a dove holding a circle of wounded people facing a missile, apache helicopters dropping bombs, walls crumbling and crumbling, neatly drawn piles of rubble, fires, ambulances, more dead people, doves the color of the flag dripping with blood, lots of blood, naval boats bombing from the sea, tanks, planes, and soldiers with prominent stars of David, curled barbed wire, missiles landing on vegetable trucks, more tanks and planes and fire and people lying on the ground bleeding, four boys on a beach flying kites with bombs falling on their heads, a heart with the word Gaza written across it in black, white, green and red, split in half, pierced by two missiles bearing the Star of David.

Not only am I appalled by what these children have witnessed, but I am sickened (once again) that in this world, the Star of David is synonymous with military violence, grief, and death.

Dr. A. the only female psychiatrist in Gaza, explains to us that the children are six to 14 years of age and were involved in art therapy workshops to address their posttraumatic stress disorders after the war. She reminds us that behind every picture is a story and she is filled with these stories. Most of the children lived along the border towns. One of their fathers picked up a stranger looking for a ride and both were killed, he has two daughters and is also related to A.  The targeted assassination hit the wrong guy. One of the children wrote on his/her drawing: “So if you killed my child, you think you are strong?” Another: “I want to live in peace.” She admits, “I cried a lot during their therapy.” Another family, the grandmother was killed, the family was running in the street to the UNRWA school, rockets and bombs flying, a sister and a chicken were killed in front of the child and (s)he did not respond. “They get used to the situation.  A six year old witnessed three wars, this is normal. They get strength.”

She has treated 34 children and 24 are cured of their symptoms.  She has a collection of 300 pictures and we sit with her piles of paper. She tells us of Mohammed, an angry 11 year old, aggressive gun play, doing poorly in school.  He drew a child in bed, black shirt, jeans, blood on his chest.  He told her, “’This is Ahmad [his friend].  I saw him on TV he was killed.’ Now he is cured, at the last session he was playing with toys” and doing well at school. “The stories are overwhelming.  They taught me how to be strong.”  A very gentle soul, A. started as a general practitioner but was drawn to psychiatry, trained at GCMHP and feels that she is called to work with children on these challenging issues. She meditates to reduce stress and feels that “in Gaza there are a lot of opportunities to support people….I let go of hate. I have so much love.  I love Moses. I love Jewish.”

Our next stop is at the extraordinary Atfaluna Society for Deaf Children, a Palestinian NGO for Deaf Children in Gaza City working in the field of deaf education, vocational and community training since 1992.   Atfaluna is Arabic for “our children” and the center focuses on academic education for deaf students who were traditionally hidden away by their families and treated as mentally defective, and the building of human and vocational skills to prepare students for productive and independent lives.  They are famous for their gorgeous embroidery and furniture making program and we thoroughly investigate their craft store and make our contribution to the Palestinian economy and the school.  They report a dramatic increase in hearing loss in babies born since the last war. A scientific study needs to be done, urgently I might say.


The NAWA for Culture and Arts Association is a phenomenal children’s art and culture program led by Reema Abu Jabir, a visionary force of nature. She is the kind of person that makes me actually want to be a child in Gaza! Started after the 2014 war, Reema created a center to support and empower young Palestinians using traditional culture and arts, directed towards families in the Deir El Balah area.  They provide psycho-social support, early childhood education, professional development for educators, and preservation of Palestinian culture. As we enter, there is an immediate sense of calm; they chose the wall colors “to mimic a mother’s tummy” and each room is bordered in a traditional red pattern evoking palm trees. We visit the children’s library (there are no electronic or internet connections for the children per Reema), look at drawings and poetry and sayings: The famous political cartoon character, Handala, “bitter fruit,”  with his back to the world, Darwish and other poets,  “You can’t find the sun in a closed room.”  At the end of the morning and evening shifts, the children gather in a closing circle, chanting phrases like: “There is no sun under the sun except the light of our hearts.” “We need little things in life and if we are happy we will be kings.” “You and me, he and she, we will all be different. There is a difference between him and her though our lives are beautiful like flowers.” The children do increasingly complex rhythmic movements to the chanting and singing, engaging their minds, hearts and bodies fully. (I cannot resist pointing out how monumentally inaccurate it is to say that Palestinians teach their children to hate…just want this on the record.)


Reema explains that the children participate in much of the building with recycled wood, there is a lively art room, a family pays 10 shekels a year.  Reema believes in setting clear rules (these are children whose lives have turned upside down) and providing a clean, safe space, and at the same time, this center is a home; she is addressed as Auntie.  The center is open for all citizens, not just refugees.  We wonder how she keeps her focus and her strength, so much has been accomplished in such a short time.  She admits that she does get depressed and angry, fights with her friends, shouting and then apologizing the next day.  She goes to the sea to relax.

Reema’s next dream involves turning a 1700 year old monastery with a mosque downstairs in Deir Balah into a garden and children’s library.  We drive to the ruin which is in a very poor area and she is obviously animated and planning for the future. The children have cleaned the ancient stones and arches, the Ministry of Tourism has signed an agreement, money for restoration is being collected, and she is in contact with UNESCO for the restoration. The major difficulty is the lack of cement in Gaza which made donors a bit hesitant.  Reema says defiantly, “I am stubborn like a donkey, this is from my father’s side.”  The monastery is a mosque and a monastery and thus a reflection of the message of tolerance at the arts center. Reema complains that UNESCO asked her to get the building materials for the restoration. “Don’t ask me to get cement for Gaza!” And you just know that she will make this incredible project happen.

We chat with the cab driver on our way back to the guest house.  He says, “Welcome to Gaza! Take me in your suitcase to America!”

March 28, 2015, Sisterhood is still powerful

The Al Bureij refugee camp is located in the Middle Governate of Gaza on the eastern side of the main north/south road, Salah-ed-deen, which used to run from Khan Yunis to Erez check point, with Al Nuseirat camp on the western side. I am on my way to visit with Al Zahraa Society for Woman and Child Development which is located in Al Bureij. In the last few years, three women’s organizations spun off from the Gaza Community Mental Health program: Aisha, (which is the name of one of the Prophet Mohammad’s wives), in the center to north of the Strip, Al Zahraa (which means flower) in the middle, and Rafah Wefaq (which means accord) in the south. There were a number of painful organizational issues, but financing has been a major challenge. They got funds previously from PGS/Sweden and the Global Fund for Women.

Another delegate and I meet with the administrative leadership of Al Zahraa and then I meet with a group of women who are receiving psychosocial support, crafts and vocational training.  We sit in a small office, sipping Arabic coffee, and talking over the loud din of voices in the central areas of the building where women are working and talking energetically.  Although I have permission to write this essay, because I am reporting on personal, sensitive issues I am not using the women’s names and I have blended their stories to protect their privacy.

The main role of Al Zahraa is to support women from violence: physical, sexual, cultural, etc., to provide empowerment, awareness, and consultation, individual and group psychosocial support and links to organizations in society for further support and intervention.

If a woman suffers from a psychological disorder, she may receive treatment with organizations like the Gaza Community Mental Health Program (GCMHP) or the Palestinian Center for Dispute and Conflict Resolution.  Some vulnerable women get vocational training (like hairdressing) so they can get a job; there are negotiations with families to allow this, there is coordination with education ministries and universities for women to go to school.

The programs from this tiny agency are impressive. Female high school students are offered sessions on gender awareness and sexual education, hospital staff are trained to be sensitive to gender based violence and diagnosis; starting with the basic principles: Ask the woman who committed the violence against her and offer her personal and legal supports, consultation and referrals. The women have worked on changing discriminatory laws around the custody of children where women tend to lose that battle.  They have worked on the issue of honor killings.  I am told that men receive a reduced sentence in prison but if a woman is guilty of a sexual transgression, she is killed, often by her male relatives. Women are disadvantaged both culturally and politically.  They hold only 20% of political positions and are not in positions of power in the government or the political parties.

During the 2014 assault, the refugee camp, Al Bureij, which is on the border with Israel, was evacuated after shooting started, the most vulnerable as usual were people living in marginalized areas on the borders. Al Zahraa coordinates with other organizations to offer humanitarian and financial support for displaced people who are in UNRWA shelters. They also coordinate with Islamic Relief in coordination with civil society committees.  (We are offered small cups of coffee, juice and each of us given an embroidered purse as we talk. The feeding and the giving are so central to this culture, even when the needs of the givers are so great.)

While working as a women’s department under the umbrella of GCMHP, the staff realized that women were very focused on their children so the work was expanded to include women and children development, psychosocial support, working with Mercy Corp which is a large organization that partners with USAID.  I learn that a number of organizations refuse USAID support because they have to sign an agreement that they are against “terrorism” but they know that the definition of “terrorism” includes militant Palestinians but not Israeli aggressors and human rights violators.

I am very curious about the power dynamics and cultural norms of marriage in this society.  I am told that there are legal rights for married women but it gets complicated quickly.  A married woman is given a dowry by her husband which is supposed to function as a kind of insurance policy for the woman if the marriage goes bad. In real life, an unscrupulous husband sometimes takes the dowry money and leaves the woman with nothing, or a woman technically inherits money from her family but the family finds ways to deprive her of this right, that moment where culture, sexism, and economics clashes with law. Somewhat like the US when an abused woman goes to the police and often finds herself in even greater danger, if a Palestinian women goes to the police, she is at risk for punishment by her family, including divorce, and police mainly considers the cultural dimensions and often advise her to go to the Mukhtar, the head of the family or clan.  Some Mukhtars are fair to women, others not. There are, needless to say, no “Mukhtaras”. There are also male religious mediator/committees. I learn from the psychiatrist I am with that in the US there is project empowering women to be Mukhtars and some are actually functioning that way. Check out facebook: Faten Harb who lives in Gaza in the middle area for the Gazan version.

But what is it like really for women here?  One spunky woman recounts her bachelor’s degree and two graduate degrees including study abroad, (plus she had passed the old age of 30), the indirect financial pressure she felt to marry someone she now realizes is unsuitable, and yet despite her professional job and tremendous accomplishments, she is still unable to decide where her children go to school because her husband has the final word in the family. She knows other women who were more directly forced to marry and after the honking cars, and huge plastic floral arrangements and nuptial feast for a ridiculously large number of relatives, there is immediately huge pressure to have children, preferably of the male variety.

Another woman whose husband is unemployed, (big problem in Gaza due to death of much of the functional economy), explains that if you are the only one earning a living, that actually gives you power in the marriage, although it may not give you happiness. Husbands often pressure their wives to stop working or feel stigmatized and shamed if the male in the family is unable to find employment or suffering from PTSD from war trauma or torture in prisons.

I ask, “Can a woman be raped in marriage?” and receive the quick reply, “Yes. According to religion you cannot say no.  The problem is that people misinterpret religion, but religion also says be gentle with the woman,” so people read the Quran and Hadiths selectively (note: as in all known religions).  Women also get that you-have-got-to-be-available message and thus fear that if they do not have relations on demand with their husbands, they will find a second wife who is more cooperative.

I push a little further and learn that incest and rape do happen (like in all other societies) but because the culture is conservative and religious it is actually rare. With the tightening of the noose around Gaza, the increasing unemployment and humiliation of the male population, women (as usual) bear the brunt of male rage.  Not surprisingly, honor killings in the West Bank and Gaza are up: eight in 2011, twelve in 2012, 28 in 2013.  I have also heard that honor killings are often reported as suicides or accidents so I suspect these numbers are artificially low.  Bureij Camp had the highest number of honor killings after the takeover of Hamas and in one particularly gruesome tragic story, a man in the camp cut off his daughter’s head and took it to the police station when she was accused of having sex with a man. It is also possible that some people may kill their daughters to prevent them from claiming their inheritance and UNDP has set up legal aid for women, opening the door for women for legal consultation and representation, and creating a massive awareness campaign.

In a less egregious example, one women shares the story of her brother’s wife who owned land in northern Gaza (here I am thinking that this land has probably already been claimed as a shoot-to-kill buffer zone by the IDF so there are so many ways this woman can get screwed). Through legal manipulations, she was forced to sign over almost all of the land to her brother with the caveat that when she is ready to sell her portion she has to sell it to said brother at below market rate.

And then I have heard all of these wicked witch of the west type stories about mothers-in-law and new wives coming to live with their husbands’ families and being emotionally tortured. (Oh but we have those in the US as well, just pointing that out.) I am told that this was more of a problem in the past but now a majority of men get married and live in an external apartment and get away from the nuclear family. In the emotional and cultural world, however, one woman confides, “there is conflict forever between the wife and mother-in-law.  If a woman is working and will not pay the mother-in-law, then the grandmother won’t take care of children, or if there is a large extended family and a flock of daughters-in-law, there is discrimination between them and this creates conflict, always there is conflict.” Another woman reflects on a horrific case where a mother-in-law and her daughters killed her daughter-in-law in Khan Yunis.  I am reassured that this is really rare.

I have noticed that there are very dark Palestinians in Gaza, (also Jerusalem and Jericho) and I wonder how racism fits into the culture scheme.  I learn that there is a term “slave Palestinian” referring to people who came from places like Sudan to work in the region and they have faced many decades of the usual varieties of racism.  Apparently someone asked a white male administrator about racism and he denied this problem exists, (another I am not a racist type?). I was told, “If you want to know about discrimination, ask a black person.” They are teased in school because of their hair, children sometimes throw stones at them, lighter skinned Arabs don’t interfere with cases of harassment by children. Although this is contrary to Islamic religion, white families shun black families, white families will refuse to attend the wedding of their son or daughter marrying a black Palestinian.  In another quirk, Palestinian men who get educated abroad, sometimes bring home their lovely white Romanian/Russian/name your country wife, which then reduces the pool of available white men so more white women are marrying Black Palestinian men leaving the Black women once again at the bottom of the selection pool.

Even today one woman reported on the difficulties her child is having in school where she is in a high quality school that is almost all “white.” 99% of black Gazans are poor, they very rarely get well educated, they rarely get employment.  They cannot afford to go to privileged or superior schools, teachers discriminate against these students who often drop out.  The majority who stay in school are girls, they often work as cleaning women for well off Gazans to pay for their educations.  They are more motivated to go to school but rarely can afford attending the higher level universities and struggle to find good jobs.

I also learn of families that are suffering from the toll of domestic violence, fathers, (who are often unemployed, depressed, humiliated, traumatized by war and prison and all of the things that stimulate male rage but do not excuse it) beating their wives and children. Wives are trapped in conservative families, afraid to report their husbands to the police, entire families desperately in need of a thousand interventions.

I am feeling a bit run over by now, and it is time to change rooms and meet with a group of 30 women who want to talk about…. Well I am a gynecologist, the niqabs are flipped up, women are obviously yearning for knowledge and thrilled that this doctor lady has just dropped in (along with a copy of Our Body Ourselves in Arabic).  We launch into an utterly frank conversation about everything anyone wants to know about the female body.  So we talk shamelessly without embarrassment about vaginas and yeast, ovaries, sex, birth control, over active bladders, back pain, how to make a male baby, menses; for me a totally fun sharing of questions and information, woman to woman, just the way I like to do medicine and these women are just like women everywhere in my experience.

I also am invited into the crafts room to admire the embroidery and other crafts, and soon I am handing over my shekels to become the happy owner of a very unusual shawl with lovely sandy brown to orange embroidery with bits of sparkle.  Everyone is beaming and laughing. We are all sharing our expertise, celebrating our connections, and our powerful sisterhood.

When I first entered the center I noticed that there was a (training) hair salon and I mention I would be honored to pay a visit to the salon.  The woman who clearly knows what she is doing, takes my hand and soon I am sitting in a chair with a cluster of women all offering advice, showing me wedding photos of them without their hijabs, hair movie star coiffed, and I am wondering, what have I gotten myself into? (For those of you who do not know me, my husband trims my hair every few months and that is the full extent of my salon experience.)  It seems the technique here is to clip up bunches of hair in little balls, take a hot dryer and take each ball and pull and dry it until every hair is very straight.  There is general admiration and a most universal conversation with the dark skinned woman who bemoans her African hair, the irritations from hair relaxers, the cost of extensions and braids.  Where am I?  I suggest that maybe she could just learn to love her hair?

I am informed that I really need to take care of my split ends! The beauty transformation is met with major appreciation and then one women suggests I really should do something about my unfashionable bushy eyebrows and faint mustache.  I am not about to go that route (I do stay true to my flower child roots) and suggest, how about make up? Soon my fashionistas are consulting about what color powder, creams, eye shadow and who knows what else are needed to complete my make over.  I go for the full effect eyeliner, lashes, kohl.  This is all met with that kind of connectedness and pleasure in the simple joys of sharing and laughter that makes sisterhood so powerful.

Alice after hair and make up at the salon at Al Zahraa Society for Woman and Child Development

A roller coaster day: I take my new face and light heart with two women to make a home visit at the camp to see a woman who lost her husband in the 2014 assault.  We walk into a moderately bare apartment she is renting, I sit on one of the mattresses along the wall; there is a poster of her husband, green head band, Kalashnikov ready.  She is 40 years old, has five daughters, two sons, three miscarriages and is still recovering from a C-section. We joke, she says she was once beautiful and even when married, men were interested in her.  A young teenage girl brings in glasses of Coke, a dumpling of a baby in yellow flannel squawks to be nursed.

When I ask her would she feel comfortable talking about what happened, the mood changes dramatically. The tears are flowing as her voice becomes very soft and whispery, she seems disconnected, I wonder if she is having a flashback. She says she tried to watch a video of her husband and felt suffocated. Her grief is fresh and powerful. She also has seven children and no means of support.

“I was very close to him, when I feel worried he always assured me he will be okay.  He was my cousin, very close, very worried.  I don’t sleep until he comes home.” When he died she was unconscious for four days in shock, her face contorts in pain. “Although I know he went to paradise, I miss him all the time, sometimes I talk to his picture.” She does not want me to take a photo of his poster because she is not ready to share him.

They were married when she was 18, he was 27, he was a farmer living on the eastern border of the Gaza Strip in Johr El Deek. When the shooting started, they were forced to leave their home. “Though I left the border area to be more safe, I was saying I will return back to my home. I was insisting to go home.  One day he said, ‘Let’s go.’ He went up on the roof to sleep as it was hot…. After a while he came down.  I was about to pray,” and she saw him floating down the stairs, “flying, his beard turned white, his wrinkles disappeared, his brown teeth turned white. I cannot understand what I saw. He came down, we sit with each with other, it was Ramadan.” She is speaking very softly. She made him and her kids breakfast and did not share it with them, just sat in front of the home; he came to her wondering why she did not want to eat and asked if she wants him to bring the food outside for her, she refused and accepted only a glass of water. Her face is almost trancelike. “After he finished, he went out.  I said stay. He told me he will hurry.  ‘Don’t be late.’  He hesitated twice and said, ‘I will not be late.’”

The electricity was out “as usual.  Suddenly I heard a loud voice and saw a big flash of light, I found myself beating my head.  The missile went directly to her husband’s head. The accident was eight meters from home.” At the beginning they told her that he was injured, she mentioned that one day before the accident he was nervous, talking about death.

“He was targeted by an Israeli airplane and the plane called the ambulance and told them not to rescue him or to pick up the body.” It took them a day to find his missing arm. As soon as he was shot relatives called and she wanted to evacuate him.  “I will carry him to the hospital even if I’m pregnant I could pull him.” A relative said no and she felt he was dead.

Her home was demolished 20 days later.

“I cannot describe, the children could not stop crying.  I told them he went to paradise. He was everything for us. They carried me to say goodbye to him, I was shivering.  They were in a hurry to bring him to the cemetery because shooting all the time, it was very fast.  They took me to the hospital and then took me to my family home.” She was then told to evacuate that home and she came to Bureij Camp and some cousins.  There was another shooting and she fled to Deir Balah area.

She reports that during the war, the IDF called people in Bureij on mobiles and told them to leave to Deir Balah. She heard a loud speaker warning and a direct call to her son.  When told to evacuate, he retorted “Why? I don’t want civilians to be affected! Really were you worried about all the thousands of civilians that you have killed. Do whatever you want.”

During the war she remembers planes flew over Gaza and dropped leaflets with the names of kill targets. After her husband died lots of leaflets included the names of those already killed, including his.

She is now renting in Bureij Camp. UNRWA paid the first payment, she paid the second. She doesn’t know how she will pay this month.  All she has are her children. She hears rumors that the government will build housing units. She does not know how to negotiate with her landlord, “the owner is shy.”   We leave her breastfeeding her baby.  What can we say?


March 27, 2015 This could be my reality.

The day started with a shock, it seems that today is day light savings time in Gaza (who knew?) and I have already lost an hour. This doesn’t seem quite fair, but the delegates hustle into the van in a befuddled sort-of-ready for the day. Marwan Diab, our guide and organizer extraordinaire from Gaza Community Mental Health Program, is wearing a running suit (it is Friday which is actually like Sunday in the US) and we are going on a tour of the Strip with Hamada Al Bayar, a wonderfully warm, sensitive, intelligent man from OCHA (UN Office for Coordination of Humanitarian Affairs) on their day “off”.


Hamada explains that OCHA focuses on the humanitarian impact of the occupation, siege, and military operations with an emphasis on civilians.  They just released a report yesterday:


Basically, last year was the worst year on every measure of humanitarian impact on the population of the Gaza Strip ever.  We are heading north toward Beit Lahiya as he explains that there are so many sad numbers from the assault in 2014 (2,220 Palestinians, dead including 1,492 civilians, of which over 500 were children, etc, etc), but echoing the young writers I met yesterday, “We are not numbers, behind each number is a big sad story.” We drive through Beach Camp where Ismail Haniyeh, the senior political leader of Hamas, lives and has been spotted jogging, which he does regularly.  Apparently Beach Camp started as a refugee camp in 1948 where refugees were pushed towards the sea as they fled the Jewish forces, the UN set up tents, and the rest, as they say, is history. (Ironic, given Israel’s fear of Arabs “pushing them into the sea” when you think about this.)


As we drive along the Mediterranean I see occasional fisherman in tiny boats with nets piled high, clusters of shacks on the beach, children draped over the metal fencing along the road competing with laundry and mattresses. Young men play in the water with their horses, some riding them into the water, some splashing them or just having a good time. Even horses need a break around here.


Across the street many buildings are splattered with bullet holes or crumpled under the impact of heavy bombing.  Hamada reports that at this time, 80% of Gazans are aid dependent in some way, the Israelis have succeeded in destroying the economy, industry, farming, fishing, exports, and the list goes on. If there were no UN agencies, the wellbeing of the population would be even more catastrophic with starvation, no education or health care. “We should be on a sustainable not emergency schedule.” Up ahead a mosque proudly dominates the view, two tall minarets pierce the sky.   This was reportedly financed by a Gazan economist who built his fortune on the tunnel economy; some wonder if the mosque is part devotion and part money laundering.


Hamada explains that the six billion dollars of international aid pledged to Gaza has not been delivered for a host of factors:
1. Gaza is too unstable for many host countries

  1. Host countries feel that anything that gets rebuilt will just be destroyed by Israeli military actions, check out history 101
  2. Donor fatigue, (big problem)
  3. Israel controls the entry of all construction materials as well as everything else and they are very restrictive
  4. Hamas and Fatah are in conflict and are not able to function as a unified government; in fact they sometimes undercut each other (big problem #2)


We ask what has happened to the hundreds of tunnels between Gaza and Egypt, and Gaza and Israel? In 2013, there were 5,000 truckloads of merchandise from Egypt monthly and now there are none, destroyed by Israeli military actions and Egyptian flooding, gas and bombing.  The tunnels to Israel were all military and are now gone as well. While the tunnel system created a huge corruptive black market, it was also critical to the Gaza economy and for the fuel to run the now crippled power plant.


Post war, 100,000 Gazans remain homeless or in shelters or with (stressed out) host families. 30% live in their damaged homes with makeshift arrangements using plastic, wood, and cloth often in very risky arrangements. (That is quite obvious just gazing out the window of the van.) Since the war, housing needs have doubled with 130,000 homes destroyed. The Gaza Reconstruction Mechanism was brokered by the UN and has given support for families with minimal damage to their homes.  Hamada reflects on the difficulties of surviving the war with an intact home versus a pile of rubble.  It was all so arbitrary. The lucky ones find it difficult to have something when their neighbors do not, yet it is also not possible for the intact home owner to offer space and support to all the family and friends in need.  It is a strange dynamic, a unique kind of Palestinian survivor’s guilt.

9bbombed out apartment complex in Beit Lahiya where people are still living


We arrive in Beit Lahiya, three kilometers from the Israeli border.  We can see three tall chimneys from the Israeli coal burning power plant and the wall that snakes along the border.  Beit Lahiya was once a rich agricultural area that has become too dangerous to farm due to its proximity to Israel and vulnerability to repeated incursions. In 2000, Jewish settlers and Israeli forces uprooted extensive citrus, guava, and mango groves for their “security needs,” so farmers at this point plant low crops that require minimal care and risk their lives to harvest the bounty.  Israeli forces have repeatedly bulldozed crops shortly before harvest in one of those over the top acts of cruelty. “Life has come to death.” Three kids sit blankly in a large tire in a field, families sit and smoke on the ground in front of their corrugated metal shacks; the area is largely abandoned because it is too dangerous to stay. The Israelis have extended the no go zone along the border from 300 meters to 1.5 kilometers from the fence and they shoot to kill, farmers often come to work their fields with their wives and children hoping to decrease their risk of dying while harvesting their string beans, strawberries, and potatoes.  That does not always work. Even if successful, there is minimal to no export business once again thanks to Israeli restrictions. We hear repeated bursts of gunfire, Israeli soldiers are making their presence known and some unfortunate farmer or young man is getting the message. The farmers rely on a water aquifer that has been seriously depleted and unless changes are made, Hamada states matter-of-factly, by 2016 there will be no water. (Should I put that more strongly: NO WATER.)


He also explains why there is little to no garbage collection in these areas.  Municipalities are poor and rely on fees, collection rates are down.  The price of fuel to run the vehicles has gone up. Often the staff goes months without their salaries.  I watch a donkey root around in a mound of garbage, children picking through trash, a little boy clambering up a pile of rubble to play and hang off the second floor of a partially crumpled building.


Back to the critical topic of water, Hamada reviews the stark reality.  95% of Gaza water is not drinkable.  90 million liters of sewerage pours into the sea daily, not only polluting the sea (which by the way folks on your beautiful beaches in Ashkelon and Ashdod, water knows no boundaries, just a thought) but wasting vast quantities of grey water that could be used for irrigation.


There are desalination plants but the water infrastructure has largely been destroyed by Israeli military action and the water filters are reportedly less than optimal, resulting in water with high levels of sodium which then combines with calcium and leaches the calcium out of the bones of young children who are now at risk for osteoporosis (along with everything else).


The US has worked to remove the unexploded ordinance (with their made in the USA labels), working through a word salad of organizations: the UN, UNDP, USAID, and PA.  No one gives directly to Hamas except Arab countries like Qatar since the blockade in 2007. This leads us into a conversation about Hamas which catches me by surprise.  Hamada says that Hamas has made it clear in diplomatic speak that it would accept a long term hudna with Israel and recognize Israel’s existence with a return to the borders of 1967 which is the basis for all the “peace talks” that have dribbled along since 1993. This has fallen on deaf ears since Israeli leaders have no intention of returning to ’67 borders, so who is obstructing who? But more importantly, what if Hamas came out and recognized Israel (forget the right to exist as a Jewish state stuff), denounced violence (which they have done in their actions/ceasefires in the past with minimal international acknowledgement), and recognized other agreements, ie., what if they behaved like Fatah?  Really folks, what has that gotten Fatah: a massive and growing settler movement, a heavily occupied and militarized West Bank, minimal access to Jerusalem. So this is actually not about Palestinian recognition of Israeli rights, but rather Israeli recognition of Palestinian rights. Think about it.


We wander, sweating in the hot and muggy sunshine, through fields of string beans, potatoes, corn, strawberries; there is evidence of the war everywhere. Hamada tells a story of a family he knew who gathered all their sons and daughters who were living in Jabalia and Rafah, the “high risk areas” in the north and south of Gaza.  They went to live in Gaza City where it was supposedly “safer” and then almost everyone was killed in a massive bomb explosion huddled in their safety zone. We hear these kinds of stories over and over again.


One delegate asks why are there so many beautiful reconstructed mosques, (along with all the ones bombed to smithereens) when that money could have been used for the poor nearby.  (The Catholic Church in Latin American comes to my mind: think Mexico, Ecuador….) Hamada explains that building and now restoring mosques is an important Hamas program, magnificent architectural buildings often with air conditioning.  “The mosque a place of heaven, the surrounding areas a place of hell.” These mosques are funded by mostly Sunnis from places like Saudi Arabia and the Emirates.  He states, “In my life, the human is more important than anything, there are many Hadith that say this.”


men living in apartment complex, Beit Lahiya

We continue our tour and stop by a massive apartment complex along the sea.  How can I possibly describe this?  The buildings are five to six stories high, partly skeletal walls and floors, partly heavily damaged apartments, vast segments collapsed at odd angles, a wheel chair is visible from one of the floors (how did that person get out?) and people are living in whatever they can salvage, laundry hangs from fragmented windows, there is a cluster of shacks in the storage facilities at the base of the building, donkeys and goats wander in and out of the rubble. It is an unspeakable monument to human suffering. Four young men come to talk with us and they are smiling, warm, arms draped across each other’s shoulders, one speaks English.  One has seven children and they are living in a storage area, they want us to know what happened to them and to tell the world their story. And then one of them says he has a joke: “We want to forget our pain.  If we had alcohol we could forget.” This seems uproariously funny and they all crack up… apparently living through an unimaginable war and surviving in something close to hell seems more likely than a bottle of forbidden booze.


Donkeys laboriously pulling carts piled high with chucks of concrete pass us over and over again.  Hamada explains that it takes 10 hours to crack up enough of the larger fragments of cement walls and rubble to fill a donkey cart. The men get 15 shekels for their efforts (divide by 4 for dollars) and these are taken to a facility where the smaller chunks are crushed and used to create (poor quality) bricks, filling the air with a fine dust that penetrates your lungs and turns the bushes grey.  This is called making a living and reconstruction in Gaza. There has been no research on the possibility of war toxics in the rubble, but one can only speculate. I suspect the Israelis used the same weaponry in Iraq and we have worrisome data on that.


We pass the massively leveled mosque in Beit Hanoun as Hamada explains that during the war, he moved his family to his office at OCHA, “I made my office my home.” Later he reveals that every time he comes back to these areas “I feel like it’s the first time.  My body reacts the same, the same stress, the same pain. It takes me four to five hours to get over it.  It is really hard to be a humanitarian worker and having family and seeing this… that could be my reality, when will it be my turn? It is really hard.” He was having dinner with his younger son who questioned, “What do you think of buying a new apartment? What if another war comes and our apartment is destroyed? So we should have a new place.” What can a father say? “He is still traumatized.  If I buy a new place it means I cannot protect him, but I am the same as him.” We drive slowly by the el-Wafa Rehabilitation Hospital. It has literally been completely leveled to the ground. I cannot help but wonder, so when is a rehab hospital, we are talking wheelchairs and crutches and damaged bodies, a legitimate military target?


News flash: It is not Daylight Savings Time until tomorrow. The gift of an extra hour today. It does not take much to please me, but there is some metaphorical message here, even in Gaza life is so upside down that there is a debate as to the actual time of day.


We are back in Shejaria and Banksy’s kitten, I am getting to the point that I can recognize one tragic bombed out site from another.  The challenge is of course to not lose that primary sense of horror. As barefoot wide eyed children start gathering around our Martian lunar landing, we are surrounded by total havoc. Neighborhoods with no infrastructure and no services, a largely invisible crisis of epidemic proportions. In the winter the rains came and what passes for homes were flooded, there were problems with flooding, rats, stray dogs, and the smells of unwashed humanity and unprocessed sewerage.  We learn there were five major foci of destruction in Shejaria during the war. This looks more like Dresden style carpet bombing to me.


Hamada explains that there is no functional Hamas government. I think of the bombed out Ministry of Finance for starters, the year of no Hamas salaries, the three months of no PA salaries. It is hard to get anything done if no one is paid and there is no concrete, yes?  Officially there is a government of national consensus in Ramallah but no working system here. The Hamas social movement provides substantial social services and systems, medical, educational, and humanitarian in nature and that actually is part of the shredded safety net around these parts.


We drive through a busy market in Shejaria filled with the pungent smells of fried food, red-yellow-blue-green umbrellas like circus tops over rows of fruit stalls.  At the barber shop, the barber is applying his straight edge razor to a customer.  The souq is bursting with cheap clothes and products probably from China and there is a background cacophony of loud honking from the kamikaze drivers and motorcyclists.


To head south, we change to a greyhound style bus, Abu Olba for Tours and Travel, an ironic name for a place where you really cannot go anywhere.  There is a feeble air conditioner which is so appreciated; we head off to Rafah.  The bus is filled with staff from GCMHP, some of their families, and us, Marwan is playing MC.  We all introduce ourselves, sing songs from our respective traditions, (blues, protest, Farouz), munch on hummus sandwiches and Thai spiced nuts, relax and have a good time, which is welcome after such unrelenting sorrow.


 river of raw sewage running into the Mediterranean

But we cannot exactly leave the reality. Driving along the coast, we pass by Wadi Gaza where the river of sewerage flows into the sea and the stench is unbearable, the crowded Nuseirat Camp on the left, into Khan Yunis.  We pass through the site of the former Jewish settlement, Gush Katif, which occupied 1/3 of the Gaza water front until 2005 and see the remaining rows of orchards and palm trees.


Our driver explains that during the war, 14 buses were destroyed, seven of his family members were injured and eight of their houses were destroyed during an attack on a Gazan militant that has never been confirmed as successful in hitting the target.


We tour through Rafah close to the Egyptian border where over 500 tunnels were destroyed in 2014 reportedly by Israeli F16s bunker buster bombs and Egyptian gas, water, and explosions; we can see Egyptian military towers and a mosque.  Rachel Corrie was crushed by a bulldozer in the area in 2003 trying to protect the Nasrallah home from demolition.  As I have mentioned, prior to the closure of the tunnels, this area had a huge infrastructure, industrial areas, and a spirited tunnel trade ranging from cars and cows to weapons.  A young man states: “We are not terrorists, we are ordinary people.” 126 people were killed in Rafah during the bombing of the market in 2014. I am beginning to understand the flags waving here and there: Yellow: Fatah (many more than expected), Green: Hamas, Black: Islamic Jihad or Salafist (rare).


We stop by an area in eastern Khan Yunis with a local crisis team and like the day I toured the area with PMRS, are confronted with just extraordinary destruction, poverty, and despair, rows of caravan houses, an older woman gesturing: “We do not want food or houses, we want our rights!” and another very wrinkled elderly women following us to the bus, begging and begging, clearly beyond desperate. We are all shaken from this confrontation and emotionally weary.  As we have nothing to offer, this is feeling like occupation tourism and a number of us are very uncomfortable.  The challenge of course is not to glaze over and to learn to sit with that immense discomfort and then do something about it.


Our final stop is the beach, a lovely area next to a beach restaurant type place, clusters of plastic chairs and tables on the sand, families enjoying their Friday off, soccer games, laughter.  There is something so calming about the smooth sand between my toes and walking along the water, (I can almost feel the e coli migrating up to my knees) as I try to keep my long skirt from getting soaked (it did) without breaking the modesty expected of me.  Only young men are swimming. I talk to a young Gazan woman who says she comes to swim at 5 am because she does not like to swim with her hijab on.  I walk back and forth, enjoy some actual physical movement, climb up some concrete blocks to check out a small port area, rows of small blue, yellow, and red motor boats, nets piled high or drying in the sun.


There are a couple of supercilious camels on the beach, available for photos and rides.  I love how they fold their legs under their bodies, totally awkward and graceful at the same time.


The male species here is unclear how to relate to a cluster of uncovered western women mingling with really gorgeous Palestinians who have mastered that subtle technique of looking extremely modest and extremely alluring all at once.  They do take off their heels to walk in the sand, subhanallah. But soon they are too uncomfortable with all the stares and camel ride offers and it is really time to go home.


March 26, 2015 part two, We Are Not Numbers

Because Gaza is so isolated with the long standing blockade and constricting siege, visitors are often asked to multitask as sherpas, bringing suitcases filled with needed medicines, children’s books, toys, gifts from relatives living in the US (connected by SKYPE but without the human opportunity for physical contact), chocolate in utterly inadequate quantities, and other assorted gifts as acts of solidarity and support.


So I find myself stuffing 20 copies of Gaza Writes Back into my bulging suitcase and an envelope from the publisher, Just World Books, to the editor of this remarkable collection of short stories by young Gazans who write about their experiences during Operation Cast Lead. Refaat Alareer joins me the first night in the Marna House restaurant, a lovely place to meet, talk, and inhale the sweet perfumes of hooka.


I am well rewarded for my efforts. He refers me to Maisam Abumorr, the Gaza coordinator of We Are Not Numbers, a project established by a US freelance writer, Pam Bailey, to develop young Gazans who aspire to be writers in English.  Maisam invites me to a discussion with a group of college students at the WANN office which is provided by an NGO, Euro-Mid Observor of Human Rights.  I learn that this NGO has just published a report on the use of Palestinian civilians as human shields by Israelis during the 2014 invasion entitled Israeli Matrix of Control.


Maison emails me “a few topics that you might want to discuss with our group” and I am totally intrigued at the level of sophistication and their interest in my Jewish and medical background.  (How are your stereotypes about Gaza doing?)


1) In the preface of your book, Broken Promises, you acknowledge how hard it is to reach beyond “the choir” when writing about Palestine. What advice would you give us, Palestinians in Gaza, about how to best tell our stories so that people beyond the sympathetic activist community will read and absorb?


2) What kind of messages and stories were most effective in opening your own eyes, as a Jew, to the perspective of the “other”? We’d love to hear some examples.


3) You are trained as a physician. When, how and why did you become a writer as well?


4) You also are a filmmaker. Many people think video is much more powerful than the written word. How you view the advantages of both, and the continuing role of written stories?


5) Now that you are in Gaza, after the war, what do you think are the most common myths about Gaza that we need to help dispel through our stories?


The room is crowded with over 30 students, men and women, and I decide I will just launch into my personal journey, invite questions and see what happens.  The hour and a half is an extraordinary sharing of information, attitudes, and controversies that range from how to write well, what is inspiration and how to hone your craft, to issues of publishing, social media, and  websites. We debate the history of the region, the use of language to shape ideas, the role of writers in society; the students are thoughtful, passionate, and eager.  The most interesting moment for me comes when we discuss what does it mean to resist oppression, how to honor the right of all oppressed peoples to resist, is violent resistance ever effective, what is the cost, and how the voices of powerful writers are important components to a resistance movement.  We ended with the potent understanding that in the age of the internet and social media, writing is a formidable method of not only informing the international community and changing the political conversation, but also actually breaking the siege of Gaza.


The good news is that this program is looking for writers to mentor students and review their work and I leaped at the opportunity to join the mentorship program and perhaps contribute in some small way to the personal growth of a young Gazan writer and to the political challenges that we face now together.

We Are Not Numbers website

March 26, 2015 part one, Sunshine, sand, and post assault dysphoria

In another universe, driving along the coast of the Mediterranean would be one of those vacation dreams filled with fresh fish and relaxing moments baking in the sun, but we are driving to Khan Yunis, a city in the south of Gaza, and in particular to the eastern villages of Serij and Abueteama which bear the unique tragedy of leaning up against the Israeli border. Nahed, a high energy well-spoken administrator from Palestinian Medical Relief Society, the largest medical NGO in Palestine, is taking us on a tour of their facilities and the realities in the post war south.

First we pass the “harbor” where rows of colorful boats are docked, victims of the crippling siege and the shrinking safety zone for fisherman. The Sea Road takes us from the middle area to the south, past the glorious blue water beckoning deceptively to our right. The Mediterranean is at once a liberating vision of life beyond Gaza, of potential escape and freedom, and at the same time, an impenetrable wall of the prison.

The road is intermittently paved and dirt, we see the now familiar houses turned to rubble, massive bomb craters, the empty aspirational “4 Seasons Resort.” A river of raw sewerage drains into the sea just adjacent to a solitary swimmer. The smell is sickening. We speed past empty farmland, a colorful resort designed for the staff of The Open University where classes are offered online for Gazans that want a degree but must continue to work. Young boys are running around in the front of the UNRWA Al Balah Elementary School, we pass shacks of corrugated metal, plastic, hanging rugs, ?favelas anyone. Boat skeletons, wandering sheep, scattered silent “resorts,” post assault dysphoria

Nahed is narrating and answering our questions and I ask her something I have asked over and over again here.  I cannot find anyone who admits to supporting Hamas, in fact most Gazans I talk to are disgusted with Fatah as well as Hamas (not to mention Netanyahu, Obama, the list is long). I rarely see green flags or the occasional political poster. What is going on? Her response is brilliant in its simplicity and honesty.  Many Gazans, particularly post the 2014 assault, do not support Hamas leadership and are deeply unhappy with the current disastrous state of affairs in terms of the basic functioning of society. But if someone were a Hamas supporter, they would not tell me for the following obvious reasons.  I am already aware that the Gaza strip is crawling with collaborators, vulnerable young men recruited during stints in Israeli jails or in exchange for permits for medical care in Israel.  But more importantly, if someone’s opinion or photo inadvertently ended up on facebook or a blog post or some mainstream or social media, they would be vulnerable to a targeted assassination by Israeli forces, so this silence is a matter of survival. (Big ah ha moment).

The driver turns away from the sea into the Israeli Beach Camp, site of a former Jewish settlement evacuated with an implosion of national handwringing by the Israelis in 2005.  A cluster of modern apartment buildings comes into view, a gift from the Arab Emirates to Palestinians from border areas who lost their homes in 2008. They moved in last year, that would be six years of homelessness. The ride is becoming more of a jolting chiropractic experience, past rows of plastic greenhouses, olive groves.  It is starting to get really Mediterranean hot as we arrive at the PMRS mobile clinic, a small three room wooden house adjacent to a similar structure for social support sessions. Funded by Oxfam and Belgium, one general practitioner, two nurses, one lab tech, and a social worker come twice a month, seeing a collection of patients, doing very basic primary care (like there is no exam room), acute mostly non-serious illnesses, (lots of skin disease and scabies, hypertension), education (evacuation in case of attack, basic first aid). The services are all free, mostly women with resigned looks on their faces wait with their children.  We can see the no go “buffer zone” and nearby Israeli border.  A spy balloon hangs over us and in the moon scape of houses toppled over, shattered into massive fragments, the detritus of life’s minutia emerges from the rubble: pink snow suit, comb, electrical socket.  The birds are singing their little hearts out and thistle and a cheerful yellow flower spread over the landscape, the life force in action.

The rutted roads take us to Alzana, the sight of even more destruction, which at this point is a really challenging concept. There are families living in tents, people who were once farmers and fisherman and businessman. A sea of white hijabs emerges as high school girls in dark blue uniforms and backpacks walk home, faces smiling, laughing, just kids doing their thing. PMRS has a much more comprehensive clinic here and provides the only health care for the area. I have seen these clean, competent clinics before, staffed with dedicated doctors, nurses, and health workers, making a lot out of much-less-than-adequate.  The most striking observation for me is the wall in the hallway and the exam room riddled with bullet holes.  Israeli soldiers shot through the front door and through a window, it seems they were trying to take out a dangerous otoscope and the nearby scale. Attacking a medical facility generally falls under the category of war crime.

We talk with a warm ob-gyn, she is seeing more anemia, malnutrition, miscarriages and premature labor.  There is a problem with early marriage of the 15 year old variety and not much contracepting. Women prefer birth control pills, but that does require a functioning pharmacy supply system and the ability to get to said functioning pharmacy. The clinic offers rehabilitation and has seen a marked increase in cases since the war, compounded by the consequences of the siege such as late care and lack of follow up due to financial and physical barriers. PMRS is taking care of 250 patients in the eastern village of Khan Yunis.  Most of the victims are women and children and most of the disabilities are amputations of arms or legs due to war trauma. In past years, Palestinian society looked upon disabled people as shameful and hid them from sight, but PMRS has done a powerful campaign to integrate people with disabilities into normal society and to provide physical therapy and occupational therapy. Little cups of bitter Arabic coffee appear.

The challenges are immense: electricity is erratic and only available for a few hours per day.  What happens to people who depend on electrical beds, electric wheelchairs, elevators, medications that require refrigeration? Some folks are so poor they cannot afford transportation to the clinic, or so uneducated and overstretched by large families that PMRS makes many home visits, bringing the care to them. PMRS is committed to honoring the rights of all people to health care access. This program started in 1994 with Medicin San Frontier and focuses on direct care as well as advocacy for disability rights. The other compounding issue is that in the past, international donors were much more interested in funding war injuries than congenital disability; care and attitudes followed the financing.

Speaking of international donors, we are back wandering in the rubble and ruins of this neighborhood and Nahed takes us to a community of donated caravans from Australia. There are rows of numbered trailers, a la Katrina, and we are invited to tour the “homes.” Each trailer seems to have three “rooms” and a bathroom, we see piles of mattress, tiny neat kitchens, and evidence that families are crowded together in small spaces.  One frustrated man gestures to his “house.”  As we enter, the stench of sewerage is overpowering.  The toilet has overflowed, and a thin layer of dirty water coats the bathroom and has spread into the kitchen.  (Did I mention that people eat and sleep on the floor?) It seems that when the caravans were built there was no real sewer system put in place, and whatever hole in the ground the sewerage drains into is now full and backing up into the home. This seems like some kind of monumental error of judgement.  Suddenly a man, perhaps in his 30s, starts yelling at us; he is angry that another group of (white) international humanitarian types is touring this encampment and we have not brought any solutions, money, plans to fix the disaster.  Nahed apologizes to us as we rapidly retreat, but it is clear to me that he should be angry, that I am from the country that funded and supported this catastrophe, that perhaps I should be ashamed that I come and stare and take photographs, and I can offer him nothing but my voice which is far from useful when your kitchen smells like a cesspool.

We head off to the PMRS clinic in Jabalia Camp, much better equipped, multiple programs and specialties, where we interview a dedicated physician, trained in Russia and Belgium and committed to providing care to a desperately poor population battered by Israeli assaults, poverty, chronic disease and the internal dysfunctions of Palestinian (non)governance. The health care (non)system is a disconnected patchwork of institutions and providers from the Ministry of Health, NGOs, UNRWA, and private clinics. They do not communicate with each other and patients often bounce between systems. He notes that the situation “is not too bad.  If there were no external players we would be okay.”  He also adds that under the current “situation” he cannot ask his patients to stop smoking, “It is better to smoke than to hit your child.”

March 25, 2015, What do you say to a mother who has lost everything? Jump into the sky.

Today I return to the Aisha Association for Woman and Child Protection to learn more about the impact of war on women and their families. I am joined by a social worker, a translator, and six women who are engaged in a group therapy/sharing session that is the beginning of their work with this extraordinary center.

Afaf Abu Ajwa is from Shejaia and “before the aggression I was very happy.”  She has seven sons, three at university, one working as a teacher, one an engineer, and one in high school  Her close family and relatives all live nearby and once the war started, she was afraid her sons could die “at any time…all suffering from the bombs.”  It was hard for her to leave her house but because her house was half concrete and half aluminum, people repeatedly advised that she leave for safety. “I faced death every day but where I go? Every place I will go suffers from the same problem I suffer from.” Her two sisters sitting next to her at the conference table both agree and argue with her as she speaks; these are three tough, outspoken, defeated women.


“On the black Sunday, [July 2014] it was not a night, it was a suffering from Israeli occupation when they hit our houses, kill our children.” She uses the word Yehud and Israeli interchangeably; I do not blame her.  In her world they are synonymous.At about 7:00 pm, Yehud bombs hit the house continuously like the rain, and they start light bombs, burn the house, and light up the street. It was Ramadan and she put iftar on the table but they were not able to eat.  Although she has diabetes, (spending about 400 shekels a month for medications), she still could not eat. Today she starts crying as she recalls her husband urging her to eat so she will not lose consciousness, but she was “just looking at my child as if it is the last time I will see them…one second to lose one relative of yours.”  Bombs hit her house, but she didn’t know what to do.  She went to the bedroom; her husband shouted to come back to join her sons. The room was immediately totally damaged. Ultimately the family asked the Red Crescent to come and rescue them, but the Red Crescent refused because the Israelis would not permit the ambulance passage.

“If we stay in our house we will die and if we leave our house we will also die.” Her neighbor opened the door for her and her young sons and as they fled the Israelis immediately bombed the street. Her husband and other sons were in their own house, two sons came over to the neighbor’s and the Israelis bombed her home again. Her husband “he start shouting and tell me not to be afraid.   I thanks God that my sons are still alive” and from the neighbor’s house they can see the damaged second floor of her home; there is no safe place, there are 30 people in one room, houses are crashing down on other inhabitants, “Yehud becomes crazy,” When glass falls on a newborn, the grandfather grabbed the baby and started to run in the street.  He was killed and the baby injured.  80 people in her neighborhood died.  She used to save money for her son, but now when she wants to save anything she asks, why save, another war is coming.

As the memories of that time explode into the room, Afaf is getting more angry and outraged, her voice rising with a fierce sense of fury and hopelessness. With bombs all around, her husband was ready to leave, but there were no ambulances, no Red Crescent, “there was no hope to live; the streets were crowded with women and children.” Her husband asked her to shout for people to go out with them, “it was like ’48 nakba.” Women fled without their hijabs, many were in pajamas, blood was everywhere.  She injured her foot running towards an UNRWA school for shelter, but once she arrived she realized she had lost one of her sons.  She ran back to Shejaia but this time the place was totally different.  “There were no humanity, people dead in the streets, like Sabra and Shatila, (two refugee camps in Lebanon that were the sites of horrific massacres in the 1980s).  She saw disembodied hands, bodies without heads, a dead woman clutching her dead child, eight women crushed under a house, their faces frozen in fright. The bombs were dropping, she found her son dead.  One neighbor had a long haired son who was lost during the escape, people assumed he was a girl and it took over 2 weeks to match his severed head with his damaged body. Afaf suffered from extreme shock, “I start to ask God to take revenge of who is the reason for what happened, no humanity, in five years, three aggressions. Where are men’s and women’s rights, Palestinian rights?”


“If there is woman’s rights, how can they leave us in the shelters in this bad situation, it is impossible for a five year old child to live through three aggressions. Israel didn’t fight just one people, they fight humanity.  It is our right to struggle for our land, I ask the world to stand with us because Palestine is for us. And the right of return is our right, and we have to achieve it soon.  We don’t have a house, and mice walk on our bodies, in our clothes, we have no work, no life. Our children were totally frightened, they stopped playing, they just play Israeli occupation and Arab.  What can we say? How do you think if we do not have job or house, or water, from where can we get money for rent, clothes or to eat.  I am still living in the [UNRWA] shelter which isn’t suitable for a viable life… We want to leave now, give us our rights. We don’t want food or clothes, we just want our rights.”


Afaf’s sister, Samar Abu Ajwa says that everyone has a different story. She and her husband (who I think is the brother of Afaf’s husband) and their children, lived in a single room for 15 years, saving money and borrowing 15,000 dinars to finally build their own house.  “Thanks God we can build a house…I just live in my house for one year, and then the aggression came.  Around my house there were no houses, after my house there were farms.  Six bombs hit the farms around me.” She is now weeping uncontrollably, describing her enormous level of fear, her sisters hold their heads in their hands. “My brothers ask me to go to live with them but I told them, no, it is my right and it is my right to live in my house.  My house is near the border with Yehud, I can see Israeli jeeps.  I went to live in my brother’s house on July 20th, I left the house, my brother coordinate with the ambulance to come and take us and the neighbors and to leave with us.  My neighbor was in a car with his family and the bomb hit them, the car totally burned with the people inside it.


“I went to my family [parent’s] house and with the first cease fire, I go to Shejaia, I used to go with one taxi but this time I used three taxis.  When I arrived at Shejaia, there was no Shejaia. There were no people, no houses, no trees, nothing but blood all around. I just want to see my house, my sister asked me to go back, but I refused.  I didn’t know where it is, I start walking over damaged housing looking for my house, my dream house. I just live in it for just one year; can you imagine, fifteen years in one room and when I have my house, it is damaged, it is suffering.   My little child asked me about his toys, I don’t know what to tell him. He said that he  want to die, he is three years old. He asked me when I die, don’t cry please.  What Israel did in this war, they turned a child into a soldier and women became unafraid of anything.  Where can I go, now I am living in a nylon place, they are living in a plastic house, [ie a tent]…Do Americans [not] prefer Arab people, because American control the world?


The third sister, Etaf Farahat is also from Shejaia; she left the house when it was too difficult to stay.  There were 30 people in her home, they wanted to leave; it was Ramadan and everyone was fasting.  “The houses around were totally empty, but we don’t know where to go, we stick together to the last moment at 8 am July 20, Sunday. We were at home, bombs were exploding all around us, in the streets and houses.  The bombs hit our house, a huge part of the [building was] damaged…One room is okay, there were 13 persons in one room like the one we are in, they don’t know how to go, how to drink water, how to eat, how to do anything. They were too much children, (15 children), four families, four sick people, one suffered from diabetes and she lost consciousness.  The entrance of my house was totally damaged, my husband doesn’t know what to do.  There is a huge number of people in the house, death all around.”


“At 4 am July 21, my husband Zohair Farahat start to say allah akbar, so people can hear him so people can leave the house.  At this moment his mother was with them, she is 80 years old and it was hard for her to run and leave the house.  Etaf’s sons refused to leave the grandmother alone, so they carried her and started to run in the road while the bombs were falling.” Her hand gestures are becoming more expressive and dramatic and I can hear the fear and rage in her voice. They saw bombs all over, people lying in the street, limbs missing.  They walked over bodies and blood. They couldn’t see each other, “can’t see, just hear bombs and shouting of people.”  They found the ambulance and Red Crescent cars at the beginning of Shejaia but cannot reach them; the ambulance carried the injured people but the bombs also hit the ambulance so the driver and the injured were dead.  They continued to run and shout their names, they couldn’t see anything until they reached a taxi area.


By the time they arrived at the school/shelter they were wearing bed clothes, pajamas, and some women had improvised hijabs and skirts.  “We do not have money. We have no food. We didn’t eat for Ramadan.  We found thousands in the UNRWA shelters, injured and dead. Some people looking for their children; they were dead. They went to the hospital and stay around the hospital in the garden, about 50 days in the garden, Shifa Hospital. They sleep in the hospital.  Her daughter was in the university, her sons were shocked because of the blood.  They stay in the entrance of the hospital and just look for relatives dead or injured.” Her voice has an insistent, steady rhythm recounting the mounting disasters; her sisters look increasingly saddened and weary. “When aggression ends, they count 47 of her families and relatives houses totally damaged with no place to build.  We still live in the UNRWA shelters, Tal Al Hawa.  We do not have money, house, anything, about 15 relatives in one room in shelter. The food is canned food, I have two sons in university and four in schools, husband not working, I lose everything.  I don’t know how to live and now everyday we just eat rice for past three weeks.  [I see all the women nodding in agreement.] “We bored with rice, we didn’t take money for rent, and we lost the house.  We want to leave shelter but we don’t know where to go, and people who leave the shelter they give them rent for one month. I just want for you to look after the money for rent, how to get child to school.  We just want to live, no more wars. We just want to live like countries around the world. Why we are living just like this, different from people around the world?”

Zahra Ereif’s husband Mohammed who is the son of Fatma, the older woman at the table, died in the war.  Her child sleeps in her arms as she begins to speak. “I was living in Shejaia, I had very happy life, five children, the oldest in 3rd grade, the little one is four months. I graduated from journalist department [at university]; I would love to watch the news. At the beginning of the aggressions,…husband also watching news, she felt something different will happen today.  What? My husband wanted to see his father in his farm, the brother-in-law was also in the farm. My husband want to buy something for the child, I was still pregnant, I told him that it’s aggression do not go out.  He said it is safe, my father just came, bringing figs. He told me that he will come in five minutes.


He went to the farm and found a friend dead.” The tears come flooding and at this point everyone is reaching for tissues.  “The bomb hit his father, his father dead and he want to help him but the bomb hit his knee.  People come to tell me what happened.  They said that my husband has gone, but people tell me that that the grandfather died.” The grandmother is now crying. “My husband was injured, I has full of hope that my husband was just injured,” Tears are streaming down her face.  As people became aware of the deaths, they came to tell her.  “They took me to the hospital and I went to the fridge to take his body.  I was shocked.  My children start to ask where my father? Where my grandfather? After July 12, bombs hit around them, my child ask why? Why the aggression happened? What we did? Why they took our father and grandfather?  My little child thought father traveled and will come back.”


“On July 20 the aggression become harder and ambulance came to take them.  We didn’t take anything with us, we just left our house. People said what are you doing in the house, leave Shejaia.” During a ceasefire, “I went back to the house, half of our house was damaged. My  child used to say where is our dad. When we went back to our home, they ask about their toys and about their rooms, if their father will come to take them, when will we see grandfather, alhamdulillah,.  They were totally frightened by what happened to them. Ever since we tell our child what happened, my little daughter didn’t understand father had died, until now, she think that he is traveling. My son, thinks his father is in paradise with grandfather, he is in heaven and they are just suffering from their loss.  My little daughter four months, when she grown the first word she will speak is where is baba?” Zahra has repaired her house and is living with children.  “Who will look after my child? Many questions, no answers…I lost everything in my life.  God give me patience”


Shadia Al Sabagh was living in a rental apartment at the beginning of the war; the owner of the house was wanted by the Israeli Defense Forces. At the first day of Ramadan, a rocket landed nearby and her husband asked her to take her child and go to her family. “I was living in Salateen in Beit Lahiya and while they were breaking the Ramadan fast, “Israel bombed a garden around my family house, my brothers took their wives and leave the house.  I went to live with my sister’s house. Once I was walking with my child, no one in the street, bombs were all around. I didn’t feel comfortable in this house, [interpreter explains there were interpersonal stresses and conflict within the family including physical violence]. I become nervous and start to hate my  child.  I asked my husband to take me from this house to a shelter, Al Set Soura Shelter.  After two weeks my father-in-law came to the shelter, hit me and I leave the shelter with my child.  My husband hit me and broke my arm; he treat me badly. My mother asked me to go back to my husband.” [The social worker interjects a comment here, not sure what.]

Shadia is now in a UNRWA shelter, “the bathrooms are dirty, food came to the school at 11 am and they ate in the afternoon, canned food. The shelter used to buy it but now they bring rice. [It seems that everyone is mostly living on rice and they are so done with rice.] The shelter wants her child to attend a different school than she is used to. “I don’t where to go, I buy poisons to kill myself many times, my child become bad in school, no longer get high marks.  My husband takes drugs [tramadol] and beats me always. My furniture burned and the owner of the house gave me no money.”


Fatma Erief lost her son and husband in the war. Her face is lined and weary and she weeps in great waves of pain.  She was living in Shejaria, “bombs all around, we were afraid to go to the bathroom.  We were living in one room. We were totally frightened, [this is the same house as the earlier interviewees] On July 12 bombs falling, we feel that this will hit us, bombs from sky and from the ground. Many people died around my house. When my husband and my son want to pray in the mosque, I told them not to pray due to bombs.  He said, no I want to go.  In the morning when he want to go to mosque, he was wearing a white galabeya.  “I told him he looked like a white flag and planes will see him.  I ask are there many in the mosque, he said says yes. He left my life to his God.  I was preparing for the dinner [after fasting all day for Ramadan]. A bomb hit my husband in the farm, my son was just looking for his father.  I go in the streets, didn’t know what to do. People brought my husband and son, people making ululations. People take me in the ambulance. During the ceasefire, we went to our house, it was partly damaged.”


The three sisters are resting their heads on the table, heavy weariness pervades the room. Fatma talks about being alone, how the people she depends on have passed away, how she didn’t take anything from anyone. “Who will take care of all the children? Now they don’t have anyone to take care of the family.”  She has 20 grandchildren, a son with metal in his arm from an accident who is unable to work.  She suffers from hypertension.  In the winter “we suffer from nylon over the roof, cold in the winter, rain in the house.  I ask God to let Arab countries help us.”  She wants her grandchildren to go to university. “Who will take care of them? God give me life, our lives are totally damaged and meaningless.” Three of her neighbors, older women, drank gas and committed suicide.  She shares a joke, “Gaza is like heaven, there are no jobs,” but adds, “Death is better than this life.”

There is quiet and as I absorb these stories, I worry that I have intruded into these incredible women’s deepest traumas and I have nothing to offer.  In fact, it is my tax dollars and a country that claims to speak in my name that has destroyed their families and their lives.  My sense of utter inadequacy clings to my tongue as I look at their tear stained faces, but I manage to offer my deepest sympathies and promise to tell their stories (at this point shout is probably more where my heart is) and bring Gaza home. I brace myself for some angry comments, demands for aid, anything, but suddenly the mood changes and the women are smiling, thanking me for coming, listening, embracing me as one of their own.  It is almost more than I can bear. They will be back next week for more speaking bitterness, maybe some individual counseling, job training, and they thank Aisha for standing with them in their time of unbearable need.

Feeling pretty depleted, I return to Marna House and join some of the delegates for a drive to Beit Hanoun, the northern most city tucked into the eastern shoulder of Gaza, just adjacent to the Israeli border, ie., not a good place to be these days.  We drive through death defying traffic, a constant game of playing chicken with folks who already feel they have nothing to lose. There is pavement and rocky dirt roads, donkeys trotting along with massive piles of grasses, flowers, and produce, multiple rotaries, mountains of rubbish.  We pass Salahadine Street, a route thousands of years old from Morocco to Turkey, industrial areas, a huge building with bags of cement (Gaza gold), sheep trundle across the road, there is a bombed out juice factory, (juice? really?) massive bomb craters and piles of harvested rebar that is painstakingly straightened and reused. Everywhere Palestinians are living their normal lives, going to school, in the markets, walking the streets, sweeping the dust, mundane life goes on despite the post-apocalyptic surroundings. We pass one of the UNRWA schools being used as a shelter, clothes and rugs, hanging from the balconies, the smell of unwashed bodies. There are 29 of 89 UNRWA schools still be used as emergency housing.

We pull up to a massive scramble of crushed concrete jutting out at all angles, house after house crushed into deformed  skeletons of a former life, hills of dirt and sand and toxic military waste, garbage, “You’re very welcome to Beit Hanoun.”  We park in front of Banksy’s famous cat; a British graffiti artist who is rumored to have arrived via the tunnels and painted an enormous kitten on a slab of vertical concrete, a wall to somewhere, a bullet hole in the cat’s neck.  He knew that people would repost a photo of a cute kitten a million more times than a hungry displaced Gazan child.  We are soon surrounded by those very children, barefoot, dirty, ragged clothes, beautiful open faces, blank stares, borderline terrible teeth, sullen teenage boys flirting with us uncovered wild Western women. An Arabian horse gallops across the horizon, donkeys graze in open fields, a truck with a familiar jingle, oh my God it’s Fur Elise! Ice cream? No this is the water tanker making the rounds.  There is no running water here. A horse trots by with a cart piled with fragments of concrete to recycle. Someone asks if I am Israeli. An older man, face dark and creased with some kind of leg deformities sits cross legged on a mattress surrounded by some of his family.  He is mostly toothless but has a warm smile and a twinkle in his eye.  He has two wives and 42 children and grandchildren.  A UN prefab “house” is tucked in the concrete rubble, what kind of bombs create such massive destruction?

But we are actually here to see an amazing group of young men doing a form of acrobatic gravity defying skydiving called Parkour.  They mostly wear black sweatshirts with PK GAZA: Gaza Parkour and Free Running. They dream of starting a school to teach their skills, of buying a video camera to record their feats, of entering Parkour contests all over Europe. They understand that jumping off of buildings, flipping backwards, forwards, twisting their supple bodies in various gravity defying acts is actually a positive channeling of their enormous energy and macho aggression.  When too much of a crowd interferes with the show, not much entertainment actually happens here, they insist we drive to Shejaria, the devastated city that was described to me by the six women this morning.


I will not attempt to put into words the experience of walking into a nightmare, massive amounts of concrete rubble, floors collapsed onto each other, bomb craters many stories deep, in every direction. Young children clamber over this military jungle gym, living on the edge of serious injury and death. The eleven young men seem unfazed and soon, totally against my better judgement, I am holding on to the powerful hands of various young men, hosting my aching back and tired knees onto a ragged pile of rubble so that we all can have an excellent view of incredibly brave, athletic, crazy Gazans leaping across shattered roofs, tumbling and twisting  through the air to precarious landings covered with rock fragments and jutting rebar.  Their skill and energy is captivating, their hands are soon oozing blood. They explain that when they jump, they feel like birds, forgetting the war, exercising their powerful male power, connecting with Parkour groups all over the world.  Just watch: (photos and youtube thanks to Seema Jilani)

March 24, 2015 part three, Passport toilet paper

There is a photo hanging in my home of a juicy looking orange hanging from a tree; the fruit is pierced by a large screw, a brutal metaphor for the reality that is Gaza and one of many powerful photos and paintings by Mohammed Musallam, a 41 year old artist born in Gaza.


We are driving north, past Jabalia to his home in Beit Lahiya, 15 kilometers from Israel. He and his brothers have rented an apartment distant from the border where the family flees in times of war; last year there were 50 people crammed into the one apartment.  We turn down a dirt road, his home faces a large empty lot, homes destroyed in the 2012 war.  In 2014 his next door neighbor was bombed and killed, another lost his legs. In 2008 IDF came into Mohammed’s house for 10 days, destroying things, cutting up his paintings; he shows us a canvas that still has the foot print of an Israeli boot, “the most moral army in the world.” You must understand how dangerous art can really be.

We enter the high walled gate into a Garden of Eden filled with irony and political satire, a meat grinder is part of a planter with a row of cactus and succulents, a mishmash of found objects, mostly dolls and children’s toys creates a collage that is at once a tribute to childhood and to its destruction.  The air is filled with the perfume of jasmine, grapes and figs are growing magically in the midst of desolation, and a collection of lively chickens cluck in a large coop.  Mohammed is both passionate and impish, outraged at the world around him, filled with social and political commentary.  He has made a candle holder out of a teargas canister, a chandelier where the bulbs are replaced by candles.  In 2008 the Israelis cut all the electrical cables and things have been pretty dicey since, the local electrical station was bombed in 2014. He has electricity three to six hours per day and has gone for 30 days without electricity.  All the food in the refrigerator rotted, needless to say. He could use a generator but fuel is too expensive. He photographed a toilet, the toilet paper is made of a roll of Palestinian passports, the passport covers are used as armrests on a chair, birds’ nests nestle in bullet holes.

His children range in age from three to twelve, the five year old insists on sleeping with her parents and the kids have had issues with bedwetting, a classic PTSD symptom. He remarks, “War is terrible when you have children.” He studied in Nablus and Cairo and is three months from his PhD, but unable to get the critical permit to Egypt. He paints and teaches fine arts at Al Aqsa University. He struggles to get permits to do exhibits in Europe.


Mohammed’s mother lives on the second floor, his family on the third, and he has a studio on the ground floor where we sit. His wife has an Algerian passport but chooses to stay.  “It has become normal.  I find beauty, happiness, family, there is no choice, this is not courage.” We nibble a sweet fruit combo and enjoy his lively children, the youngest has a devilish personality and keeps her parents busy. As we explore the wild jumble of found objects and striking paintings, Mohammed says, “We are normal, we are people… we are a small country, we have to live together, there is no choice.  He has a gallows sense of humor: “six hours of gas, six hours of electricity, 60% of our salaries, six days every two months the border is open.”  Six is their lucky number. He worries, “Israel feeds hate, creating militants.  I am an artist.  I don’t want to fight.” He finds in his art both the intense paradoxes and the beauty around him. It is a terrible shame that he has to struggle to share his talent, his humor, and his passion with a world that desperately needs more men like Mohammed.

For more info:

March 24, 2015 part two, Happy (late) Mother’s Day Pink Bunny

When the taxi stops in front of a large institutional looking building, the Palestine Avenir (is that Avenue lost in translation or what?) for Childhood Foundation, Cerebral Palsy Center, I should have suspected this would be an extraordinary experience from the start. Outside in the sandy park fronting the building, three children in wheelchairs are strapped into a playground spinner/merry-go-round/round-about thing (you know the one that abled children run around and then leap onto for a ride, hopefully not splitting open their chins like my daughter at that age). These children are screaming and laughing like ordinary children and that is indeed just the point.  Besides this there is a brightly colored swing/contraption modified to hold a wheelchair with a heavy rope suspended from above such that the differently abled child can thrill to the joy of rocking up and down with the wind in her hair.


We are greeted by Ahmed Alkashi, the Director, who our delegation organizer Gerry refers to as an angel.  He is the kind of man with a twinkle in his eye, radiating a combo of competence, love and energy, or in my world, a real mensch. The USAID funded school is focused on getting ready for Mother’s Day which they have delayed for several days to coincide with our visit!  No problem!  This is Gaza after all and not much runs on time.

Ahmed explains that the children are separated by IQ, 70-80, 80-95, etc., and if less than 70 they are given extra support so that they can qualify for the school. Ultimately some of them are able to be mainstreamed into the Ministry of Education schools. The facility is clean and thoughtfully wheelchair accessible, two elevators transport students up and down.  We pass the outreach and portage program (ie they get the kids to and fro), and a number of small classes that have two to three dedicated and specially trained teachers.  The students have a variety of levels of disability and mobility issues.  One class is making gifts for their mothers, they are wearing stars with the words, “My mother is my source of happiness.”  There are a total of 150 students and 43 teachers.  It turns out that in Palestine, there is no Father’s Day.  Every day is Father’s Day I am told, and I am not sure if that is primarily honorific or just plain patriarchal.

We pass a staff meeting where parents are working to integrate their child into regular school and establish a good follow up plan.  We poke our heads into an office with a social worker, a dabke class, speech therapy, a library, a gym with weight training to build muscle strength, physical and occupational therapy, with students from Al Azhar and Islamic University.  The facility appears very well run and there is an unusual warmth, respect, and kindness that is palpable in the relationships we observe.

But the big surprise has yet to start.  We are ushered into a large hall with several hundred students, mothers, a few fathers, teachers, and several DJs.  Loud rhythmic Arabic music is booming as we are seated in a separate long table as the honored guests. The mistress of ceremonies speaks passionately about Mothers with poetry and Quranic verses.  “Heaven is under the feet of the mother.” “The mother is not small, she is the whole world.” A child in a wheelchair recites a Quranic verse about mothers and another relates a Hadith from the Prophet Mohammad (peace be upon him) about how the most important person is your mother, the second most important.. your mother, the third…your mother, and the fourth..(finally)… your father.


“Mother always looks after the children, we should be in gratitude.” The flowery tributes continue as mothers beam in the audience, the music blasts on, the director gives a speech, (“There is no handicap, there is only a society that is handicapping them.”) An entertainer plays goofy games (this is reminding me of an over the top Bar Mitzvah), the children get up and do synchronized dances and singing which reveal an incredible amount of practice, coordination, and enthusiasm. People are really having fun and soon I am in a circle dance, pushing a young boy in a wheelchair with a large pink bunny wiggling ahead of us.  Oh and I forgot to mention the two clowns, one sporting a truly bizarre orange Mohawk spiked hairdo. I am beginning to feel that we can really learn a lot from this school and the loving acceptance of all the differently abled children.  This is also a dramatic contrast from ten years ago when I first learned that children with war related disabilities were celebrated, but congenital problems were considered shameful and those children were often hidden from society. The educational system here has certainly made an enormous amount of progress in this regard. I think of all the ridiculous racist comments I have heard about how Palestinians don’t love their children or don’t treat their women respectfully. A day in this school for children with cerebral palsy should put the final kabash on that ugly bit of propaganda.

The celebration ends with an impassioned, tearful speech by the woman MC’ing, condemning Israeli attacks and reading a poem to all the mothers who lost their children in the latest war.  The music turns mournful and many eyes are starting to tear up. At some point as a profound mix of rage and sadness fills the room, she calls up a young woman, early teens, who also lost her own mother in the war.  At this point the child is sobbing as well as many in the audience. I do not know if this is a form of community tribute and support or an incredibly re-traumatizing moment.  Ultimately she is embraced, we hear “God will provide,” and the anguish that underlies this remarkable tribute to love and resilience, embraces the room. I learn later that the school has stepped in to support this young woman along with her immediate and extended family. Mother’s Day, once an international feminist call for peace, celebrated here in a time of war after war.

March 24, 2015 part one, The Most Massive Child Abuse In The World

UNRWA, the United Nations Relief and Works Agency for Palestinian Refugees in the Near East, has been given an impossible task.  Originally a temporary agency to assist and protect the 750,000 Palestinian refugees created by the war in 1948 with Israel, the refugee population has grown to over five million in Syria, Lebanon, Jordan, West Bank, and Gaza.  Despite the catastrophic conditions in Gaza, UNRWA this week is actually focused on the Palestine refugee camp of Yarmouk in Damascus, Syria, where more war and dispossession and humanitarian crises face an already beleaguered population.

But we are in Gaza and it is a bright sunny day as we head off to several UNRWA facilities, starting in Gaza City.  A quick review of the UN Gaza Situation Report for April 3, 2015 (check UNRWA website and yes I am running behind in the blog effort but last week was a lot like this week and that is the problem), will give you a sense of the challenges ahead:

  • According to the report, movement and access restrictions continued to fragment the occupied territory, undermining Palestinians’ livelihoods and impeding their access to basic services. “Continued occupation undermines the ability of Palestinians to live normal lives. Were these factors removed and related policies changed, international humanitarian assistance would not be necessary here,” The Humanitarian Coordinator concluded.
  • UNRWA continued its exceptional food distribution during the reporting week, with a total of 21,970 families having already received food parcels of flour, oil and rice…The distribution to approximately 35,000 families (bolding is mine) aims at ensuring sufficient access to food for refugees in Gaza; it also serves to inject essential commodities into the local market. The food parcels are provided in quantities according to family size…The distribution comes in addition to the regular food assistance provided to approximately 868,000 refugees and the daily rations that UNRWA is providing to more than 7,000 internally displaced persons sheltering in 12 UNRWA Collective Centres across Gaza.
  • During the reporting week, US $667,199 in funding from the Japanese Government was paid to 199 affected families across the Gaza Strip through local banks. In January 2015, UNRWA was forced to suspend its cash assistance programme supporting repairs and providing rental subsidies to Palestine refugee families in Gaza. This week’s payments do not change the fact that only US$ 175 million has been pledged in support of UNRWA’s emergency shelter programme, for which a total of US$ 720 million is required. This leaves a current shortfall of US$ 545 million.

  • To date, some 60,000 Palestine refugee families have been able to complete the repair of their damaged homes with assistance provided through UNRWA. A further 10,760 families whose homes were totally or severely destroyed have received one TSCA payment typically covering four months subsidy; over 1,300 displaced refugee families have yet to receive even one installment. Of the families receiving TSCA, over 7,600 families also benefited from the $500 reintegration grant. A further 1,270 families whose homes incurred major damage benefited from the reintegration grant. However, more than seven months after the announcement of a ceasefire, not a single totally destroyed home has been rebuilt in Gaza. The GRM, a temporary agreement between the Governments of Israel and Palestine concluded in September 2014, currently allows the entry of building materials for repair but the process for rebuilding totally destroyed homes remains yet to be agreed upon. Whereas import of construction material is banned by the Government of Israel but possible for UN-led projects following a lengthy approval procedure since 2010, the UNRWA shelter self-help programme is completely reliant on the GRM.
  • to date 9,061 Palestine refugee houses have been considered totally destroyed and 5,066 have suffered severe, 4,085 major and 120,333 minor damages. Also, to date, the Agency has only received funding to reconstruct 200 of the 9,061 houses totally destroyed.
  • Youth female unemployment rates amongst Palestine refugee women in the Gaza Strip skyrocketed to 83.3 per cent in 2014, according to recent statistics from the Palestinian Central Bureau of Statistics. Across the board unemployment levels in Gaza sit at 43.9 per cent, the highest rate on record.

  • Whilst the eight year Israeli imposed blockade may have devastated the economy and caused chronic unemployment, it has not blocked the imagination and innovative business ideas of young people in the Gaza Strip. UNRWA continues to pilot its social enterprise, the Gaza Gateway, as part of an ongoing commitment to enhancing employment prospects for young Palestine refugees in Gaza, an initiative that is designed to help young IT graduates gain work experience and employability training, and create new opportunities within the devastated Gaza economy…
  • (the report reviews a series of important UN programs and initiatives…)
  • UNRWA continues to support and provide for the basic needs of 7,072 Internally Displaced Persons (IDPs) living in 12 Agency-run Collective Centres across the Gaza Strip.

So, the largely invisible to the western world humanitarian crisis is mind boggling, especially if you consider the budget of the Pentagon or the amount of money Americans spend on health care for their dogs, but we are going to focus on health care in Gaza.  Dr. Ibrahim Mohd el Borsh graduated from Tripoli, has a Masters in Public Health from the Jerusalem University branch in Gaza. He and a female physician, Ghada al Jadba, are briefing us; UNRWA focuses on the immediate needs of the refugees, about 70% of the Gaza population, as well as on human development and protection of the rights of refugees.  The UNRWA health program provides primary care to 1.2 million refugees here. Dr. Ibrahim’s colleague is a refugee but she lives in Gaza City, 60% of Gazan refugees live outside the camp, ie., people do leave when they can economically accomplish the cost of housing, etc.

324-1aDr. Ibrahim Mohd el Borsh and Dr. Ghada al Jadba, physicians working in UNRWA health centers

UNRWA has 21 health centers, “the main component is mostly maternal and child, then chronic diseases like hypertension, heart disease and diabetes. 25% of the population is women in reproductive age; also [because of] political challenges, instability, fertility rate high (4.3 per woman in reproductive age), this is a very high maternal morbidity and mortality. Living in this difficult situation makes those women vulnerable, the situation affects them more, with poverty, low social status; they need more care.  UNRWA provides ante and postnatal care, physical exams, labs, ultrasound.  Midwives, medical officers, and obstetrician-gynecologists rotate to the health center.  The women also receive postnatal care, with a visit one week postpartum. Women are discharged a few hours after delivery,” [Heads up: discharged to what? A shelter? Partially destroyed home? Shack with no water and erratic electricity and a crying newborn?]  Another reality check: on the family health team: the physician sees 80 to 90 patients per day, the nurse 40 per day, the midwife 20-30 per day. (Just do the math for length of appointment and remember that sessions usually end between 2 and 3:00 pm).

324-1bmother and daughter at an UNRWA clinic in northern Gaza

Anemia is a major problem (probably a reflection of malnutrition and lack of adequate supplementation combined with frequent pregnancies). Family planning is “a priority, not that successful, despite measures.  IUDs are preferred, [along with] pills, condoms, and [depo-provera] injections.” It is hard to change cultural expectations regarding family size and the desirability of having many children when people have little else on which to rely and children are expected and celebrated.

Pediatric care is critical as “45% of the population is under 18. This is a fragile community with high dependency needs, the siege affects them. Collective punishment is the most massive child abuse in the world due to siege, crowding, infectious diseases.” Fortunately there is “100% vaccination coverage, but people feel insecure. Vaccines protect their children, but sometimes there is a delay in procurement, mothers come daily asking for vaccines.  Even during the war they came for vaccines, H. flu, etc, prevention for TB, MMR injections.” There are breast feeding counselors, and most women nurse exclusively for six months, this is encouraged by the society.

Mammography has long been a challenge, there is a center at the Ministry of Health with good screeners. “We have agreement with them to refer suspected cases, but is not screening [program due to] budget problem.”  For those nonmedical folks out there, screening and early detection is the main benefit of mammography. I have noted minimal emphasis on preventive health care when a population is focused on food security, housing, etc., although there is some screening for risk factors for cardiovascular disease and diabetes, (both higher than expected in this population but diseases that I consider partially induced by the stressors of occupation, poverty, and lack of traditional exercise in an agricultural society).  Smoking is a big problem; however cessation programs are “one of the future goals.” It seems that they have started with smoke free health centers and at this point most doctors do not smoke.  (Halleluiah.  It used to drive me crazy, not to mention provoke bronchospasm, when I attended medical conferences with Palestinian MDs.)

Funding is an enormous issue. UNRWA has most essential medications, provided according to WHO guidelines. The private centers provide more expensive new medications, the UN is trying to upgrade their supplies.  Of course newer medications are not necessarily better medications, but they are definitely more expensive, but that is a struggle for another time. The medications are imported from pharmaceutical companies in Amman Jordan. There are also societal attitudes of shame towards mental health disorders, problems with drug addiction, and pharmacies that are not well regulated.  (I certainly have been able to get prescription medications in Palestine by just walking into a pharmacy and saying I am a doctor; that sector feels very third world.)

“Infant mortality per 1000 live births in Gaza in 1960 was 160 and it has now dropped to 16.5.” The US stands at 6, Israel at 4, while Afghanistan is 122, Egypt 24, Syria, (probably before the civil war) 15, and the West Bank 14.5 to give you a sense of the distribution by country and level of health care. UNRWA does growth and development monitoring and finds 10% of children have birth problems, iron deficiency is present in 50% of children under three.  To add to everyone’s troubles, poverty and unemployment is also high, university graduates frequently cannot find employment.

Attention is paid to psychological and life cycle support, but “psychosocial increased so much, increased domestic violence, gender based violence in each health center, main category is women and children.  [We see] multiple symptoms that are not organic diseases, are depression, we work with GCMHP for more challenging cases. There are big challenges. The environment is poor, sanitation, all this affects health, endemic parasites, enteric fever, another burden, life expectancy is up to 73,” which can create new age challenges with few resources at the end of life. Just for starters, think accessibility and mobility.

Tramadol addiction is another big issue, people wonder out loud whether Tramadol was introduced by Israelis, did it come via tunnels, what is true? “Why not, not, most of tunnels are now destroyed, a lot of medicine entered Gaza illegally; many of the adolescents are addicted.  I hear the same thing in the West Bank, they [Israeli authorities] encourage the use of these drugs in Jerusalem and the West Bank.”  Since the destruction of the tunnels during the 2014 war by Israeli and Egyptian forces, “now everything is worse. 100,000 people worked in these tunnels, got construction materials and could build. [There was tax collection] from Hamas, now unemployment is much higher, there are no cheap medications or cheap goods, so increased suffering. UNRWA started having more demands for medications and other needs.”

UNRWA realized that with scanty resources, it is critical to be more efficient.  “We have adopted in service delivery, went from fragmented to family teams, Dr Akhiro Seita, [Director of UNRWA health programs] developed this…[with the] family team approach, we have health teams: a medical officer, a practical nurse, a midwife, [each team] meets the health needs of a specific number of families. We are now more efficient, have more relationships, [better] use of resources, and more effective and higher quality.  The doctor knows the family well; there is high staff satisfaction and community satisfaction.  [for official UNRWA statement see:] Most of the centers, (17), have electronic medical record, knows everything by one click, so this helps family team, the modernization of health care.

UNRWA does “not have our own hospitals, but we go to Ministry of Health, like Shifa Hospital [which was bombed during the 2014 war], most patients have insurance, but the waiting time is very long, so we decided to contract with other hospitals, NGOs, for some surgeries and all deliveries.  In that setting, “70% [of costs] are covered, 90% if abjectly poor.”

We ask about murders and crime rates, “They are low but maybe rising.  Hamas is clever in controlling.”

“In July 2014, we don’t know how we survived, very difficult, we kept most of the UNRWA centers open except if they were restricted by Israel or Hamas.  Like Beit Hanoun, Shejaia, all other centers stayed open, 65% of the workers came under difficult situations.  They were provided with UNRWA cars [which were not really protected from Israeli bombardment despite international law], gave healthcare to refugees and anyone. I have three kids, 17, 14, 10. I was leaving them alone, my husband is a vascular surgeon in Shifa Hospital and he cannot leave the hospital these days. I had to go to work to manage health care and the shelters [UNRWA schools].  I was responsible to provide for them; we had to provide food, safe food, avoid epidemics, surveillance, medical person in each center.  We recruited nurses, an emergency appeal; we highlighted the emergency: hygiene, water supply, lack of electricity, no water or hygiene or sanitation.  We were afraid of cholera and made the community in the shelter to be responsible for these issues, with strict surveillance and we prevented an outbreak.”

“It was like a nightmare, not sleeping due to bombing, I was afraid, no safe place in Gaza.   Even the hospitals, UNRWA, health centers, we were not protected.  When we go out, we left our children not protected, we do not know, anything can happen.  People came from the shelters to the health center, they needed psychological support, many of the Ministry of Health hospitals were closed; they were threatened.  Two health centers in Beit Hanoun [the IDF] bombed the center, we lost eleven staff members in UNRWA and many injured and many, hundreds, lost their houses during the war, and they were displaced to relatives or to school and they still come to health center to serve their people.”

Just checking in that you have not glazed over at the enormity of this catastrophe as well as the decency and bravery of the health care providers who are also victimized by the same bombs as their patients.   The challenge is of course to stay human in the face of inhumanity. I keep trying to imagine what if this was happening to me and my family and where else in the world are there people with similar kinds of stories thanks to the destructive power of our global military/industrial wars for power, oil, hegemony, fill in the blank…

Ghada continues, “The children have had three wars and continuous instability.  The first of the war, my children were afraid of every sound, by the end they were no problem, fed up.  Nothing we can do, waiting, expecting everything, praying all the time, afraid when parents left for work. The most difficult in life this war, all these innocent people killed without any reason. Take care of each other, it’s a joke, frustration, depression, not a big difference between us and the other people.  You don’t know if you will wake up the next day or lose your family members.  I went to shelters and saw people who lost their family members. I met eight year old child and he is sole survivor from Shejaria, [which was completely dessimated].  He was smiling, too shocked, he was injured.  We have a lot of them, 1,500 orphans after this war.  They need a lot of care.

No one care about those innocent people, and even the international community.  Israeli claim they are democracy and they kill innocent people.  What about the international community? [We had] massive destruction, many people lost all of their family and houses. The most difficult war since 1948, worse than Nakba, more aggressive, more violent, more inhumane.  During the war half a million displaced from their homes, 300,000 in UNRWA schools. How much the load on UNRWA staff?  So the nightmare of the war itself and those people now under our responsibility.  Two nightmares.” She says, “Dr Seita called daily.”

“No one expected the war would last so long.  Some sharp pain you cannot tolerate for a few minutes, difficult if it continues for days.  This is what happened in Gaza. My son is twelve years old; he was following news on the mobile, reports every ceasefire. I was trying not to be depressed in front of them.   No one cared about that kid.  There was a bombing next to us, near our building; we were so afraid.  A family neighbor was hit, the family of his best friend, he was crying, first time I saw him [cry].  He started to imagine his friend was killed, called him but he didn’t reply, but he was not in the house.”

“We know Hamas and Israel, I will not talk about them. But what about the international community?  They were just waiting and doing nothing, you must not forget what happened in Gaza, but there is no money for reconstruction. And in the news, maybe another war in the summer.  Beit Hanoun, looks like earthquake hit it.  So we struggle, there are increases in skin diseases, no showers, scabies increased, lice, we bought shampoos.”

“We need people like you to make their voice higher, we are isolated from all the world, even from Palestine, we have a lot of disappointed stories, millions.  It would be a disaster without UNRWA,  We educate 250,000 students, we are free at health care and drugs, good quality of care with dignity.”

We continue to a field office, passing tuk tuks loaded with chairs, merchandise of all sorts, street vendors with hanging columns of yellow bananas and pyramids of oranges and potatoes,  pass the Islamic University, the newest medical school in Gaza after al Azhar University. Dr. Ibrahim recounts a funny story that when he was once in Japan, (learning about family centered care) he was a minute late and his Japanese colleagues called the police.  They are clearly unfamiliar with the concept of Palestinian time.

324-1cRefugee children leaving UNRWA school in northern Gaza

The senior medical officer at a health center in the North near Jabalya, Dr. Anad, meets with us for more conversation.  Some additional vignettes:

  1. We meet with a family health team: two doctors, two practical nurses, one midwife, the doctor is smoking, the facility is clean and orderly, their records are improving, they encourage patients to make appointments rather than come and wait.  There is a big blue and white sign: “Great Thanks Go To Greek Government and People.”
  2. We see patient education materials particularly focused on mother/baby care and diabetic foot care.
  3. Most of the cars we see came through the tunnels at the Egyptian border.
  4. A pack of Marlboros used to cost 9 NIS but the price went up to 25 once the tunnels were destroyed.  It may have been a black market economy, but it is clearly cheaper than no economy.
  5. Dr Ibraham reveals that his own house was partially destroyed.  Three meters away, a neighbors house was bombed and he suffered from collateral damage. He lived for 50 days in his mother-in-law’s house.
  6. The thirteen story Albasha Towers was bombed leaving 70 families homeless, we pass a massive crater, the site of the towers.
  7. In Gaza people suffer from Hamas or Fatah.  “We don’t want either.  We need civilized people.  We cannot fight the Israelis. Peace is the solution. Yesterday in Rafah there was a demonstration focusing on the suffering of the civilians due to lack of electricity. Hamas shut down the demonstration.”  The doctor reports that he has four hours of electricity per day and also uses a generator.   As I have mentioned, these generators use fuel which is very costly and are loud and polluting.

324-1dpatient education poster at an UNRWA clinic on the topic of diabetic foot care

As we drive I notice this kind of reckless apathy, pedestrians walk right up to moving cars, people seem totally fearless, cars challenge each other inches apart, traffic rules are kind of optional, I wonder if there comes a point where there is no fear left and death seems fatalistically just one smart bomb or one screech of the breaks away. I repeatedly hear some variant of the feeling that death may be fast or slow, but either way, in Gaza it is coming soon.



March 23, 2015 part four, I want you to see what is beautiful!

Through some personal connections in Detroit, I end up calling two cousins who live in Gaza City, planning to share with them my documentary film, Voices Across the Divide, which features some of their family, and to deliver a small gift from the Detroit branch of the diaspora.  Two well-dressed men arrive promptly at Marna House where I am staying; we sit together while I nosh on humus and lentil soup, although they do not eat, and soon they are inviting me for dinner the following evening.

(side note: while I am writing this at 1 am the hotel has just lost its electricity and it is really dark.  Where is that flashlight?)

After an arduous day, I plan to be “off” in the evening, but there are some moments that I need to share with you, if only because they contradict any preconceptions 99% of Americans have about those terrorists in Gaza who want to run Israel into the sea when they are not busy strapping explosives to their babies.

So, a man in a dark suit, with a warm face, thick black eyebrows and mustache, (I will call him Ahmad), arrives to take me to one of his family members.  It turns out he works in the Ministry of Health and had something to do with the granting of our permits to Gaza. He has advanced degrees in business administration.  (I never did actually figure out in this family who was related to whom but let’s just say they are all related or engaged and soon to be married.) The first striking thing about walking the irregular streets of Gaza at night is that there is no electricity; generators parked on the street roar and grind, burning hundreds of dollars of fuel to illuminate an apartment here and there or, just imagine, your refrigerator.  This is a real problem if you only have electricity 4-12 hours per day and forget about internet or TV, checking some tidbit on your smart phone (they do like to do that) or completing your engineering or English literature report for university due tomorrow. This also means that no elevators are working in case you are elderly or obese or disabled.

The apartment of relative #1 is richly decorated with lush green curtains and decorative upholstery, I am warmly greeted by Ahmad’s cousin who owns a toy store downstairs, and his playful, sniffling one year old son, sweet wife, new baby, mother, sister, and fiancé, a nurse at Shifa Hospital, (bombed in 2014) who offers me a cigarette. The conversation is all about family, the recent engagement party, the upcoming wedding.  I look at their photos and videos, they look at mine. When I show them a photo of my daughter’s chicken coop in Seattle, the response of these city folk is a big chuckle and “They look like angry birds!” Apparently phone games are more common than our clucking egg laying friends here). I drink Coca Cola and then tea with mint and protest the fancy glazed cake with all sorts of sugar frou frou that they have bought in my honor.  I guess in Gaza it is always best to eat dessert first. This visit is notable for its generosity and warmth and for its profound ordinariness, a normal family sharing a pleasant normal evening, lots of laughter, with a guest from a faraway land that they cannot possible reach.

We walk several irregular blocks, using the flashlight from Ahmad’s phone, past occasional clusters of young men and racing cars. I briefly consider the risks of being kidnapped, (I am told not by Hamas, but perhaps by some aberrant militant group in need of ransom money).  I am immediately embarrassed by such thoughts, but you know, it is really dark and I do not have a clue as to where I am going.

We hike up to Ahmad’s house, creep up irregular concrete stairs, which he has rigged with special bulbs that run off a battery and he proudly shows me the Rube Goldberg contraption that provides his home with regular electricity. His attractive and friendly wife is wearing ear muffs, (no hijab) because the newly acquired apartment is cold and bare, save for some plastic chairs and a table. A twinkly 1 ½ year old boy sprints and hops around the apartment at break neck speed.  He has some fascination with all things electrical or panels with on/off switches.  The kid is in constant motion and has a totally engaging smile. I love him instantly. He vaguely understands how to play ball, dances to some Disney song from years ago, but cannot stay still long enough to watch me perform my epic The Itsy Bitsy Spider. Maybe I have lost my touch.  I try sitting on the floor to no avail and soon name him Little Monkey. Ahmad’s wife serves coffee and we talk more about children and the lack of electricity, and how things felt during the war.

Apartment # 3 is a brief car ride away and this time there is a great leap forward in the number of relations, but let me say, the older wife looked beautiful in a turquoise hijab and heavily embroidered black and turquoise Palestinian dress, the men tended towards suits or some level of respectability, there were a lot of businessmen types, a lawyer who cannot practice since he has no recognized papers or credentials, and the two youngest college students could have stepped out of Harvard Square. There was much talk about how each person ended up in Gaza, was it a laissez passe, a travel document from Egypt, crawling through the tunnels, expulsion from you name the Arab country, some trained in the US, in any case, everyone is now trapped in Gaza and angry and frustrated about that, along with the lack of electricity, the wars, the crazy dysfunctional politics.  People want to talk about how much ISIL has nothing to do with Islam, how Islam is a religion of peace and tolerance; how Jews and Palestinians can easily get along and have in the past. There was a lot of reminiscing about the good old days of shopping in Tel Aviv and Israelis getting a good deal in Gaza City. When they found out I was Jewish, everyone was warm and accepting.  “You are shining, you are beautiful, you look like…(I think she was looking for something culturally appropriate here)…a menorah!” People support the BDS call and were in general utterly disappointed with the elected and non-elected leadership.   Everyone is sick of war and dreams of travel.

The mother who is also a teacher has made a classic totally over the top food for an entire army Palestinian kind of meal: pre-meal frozen strawberry/lemon/sugar/vanilla thing (their own strawberries), then drink water, juice, and approach the bulging table cautiously.  Large platters piled with some kind of fried, breaded? chicken cutlets with garlic/olive oil/lemon sauce, rice and strips of beef with toasted almonds and delirious spices and some yogurt type sauce, two different salads with greens from their garden, divine thick French fries with parsley, some other meat ball (maybe or was it chicken) baked in a sauce…. And so it went.  I find a total of three different people heaping things on my plate if I let my guard down for an instant. I am assured that everything is healthy and they never throw food away, they eat it tomorrow.  And would I come out to the porch to sniff and admire all the herbs and petunias that are having a party out there too?  The mother explains she no longer cooks fish (spoiler alert, the entire Gaza Strip is on the sea coast and a major source of livelihood used to be fishing) because the fish are now all too small and polluted. Thank you Israeli navy and the ever shrinking fishing zones.

This family’s daughter is gorgeous, diminutive, helpful, and a university student studying IT. Her hair is thick and beautifully coiffed. The son, also very deferential and polite, has a thick bush of vertical hair ? a bit Elvis in the early years without the greasy kid stuff and everyone teases him.  He likes to be different. He feels very cat like, ready to pounce into action, his phone constantly ringing.  Because of the electricity shortage, friends call each other whenever anyone has internet and then everyone goes over to that apartment.  Sort of like electricity Bedouins I muse.  I am almost moved to tears when he tells me he is an architect student at university and I say to him, “How can you study architecture when you have no concrete?” He is filled with ideas to make Gaza a more beautiful place, to get rid of the boxy concrete buildings, he wonders if I have ever seen Central Park in New York City, he google mapped it and felt totally inspired.  I tell him about Olmstead’s Emerald Necklace in Boston and he is eagerly awaiting the next burst of electronic juice to get on the interweb.  He dreams of studying in Italy or Germany, “the birthplaces of architecture.”

His college friend who trained at the American International School in Gaza and looks like he could be from Minnesota, drives us all home in a clunky old van, through the dark brooding city.  He asks me when I will be free.  He earnestly explains that he wants to give me a tour of Gaza, the port, the beaches, “all the beautiful places” that no one ever sees. Now that would be really lovely.

March 23, 2015 part three, Patriarchy, addiction, poverty and the crushing culture of violence: The constriction of women’s bodies and minds

The UN OCHA data is blunt: The 2014 military operation in Gaza left 302 women and 582 children dead, 10,870 wounded, (2,120 women and 3,303 children), and more than 450,000 people displaced from their homes, mostly women and children.  That humanitarian catastrophe was compounded by a severely distressed society strangled by years of blockade and siege, increasingly more fundamentalist Islamic culture and religious practices, and dramatic restrictions in options for everyone.

So how does that look up close and personal? Mariam Abu al-Atta, management administrator, and Israa Al Battrikhi, project coordinator, welcome me to the Aish Association for women with husbands who are mentally ill or addicted; these are the living and breathing families who have literally fallen off the curve. Fourteen women wait for us at a U shaped conference room with one girl and one boy snuggled close; the women are sketching on paper with colored pencils as part of their intake process. I estimate the age range is 30 to 50, although I could be monumentally off as women not surprisingly age prematurely under occupation and repeated trauma.  Everyone wears a hijab, most of the faces are not covered, everyone has a chance to tell her story and in subsequent weeks there will be group and individual sessions, various counseling, legal advice, job training, and other supports offered. At some point, almost every woman begins to weep, clutching tissues, and towards the end even our interpreter also bursts into tears. I am glad that even she has a limit to what she can absorb before losing her professional distance. Despite the lively persistent voices, the occasional twinkle in an eye or laughter (“maybe it would be better if our husbands just stayed in bed sleeping”), the amount of accumulated suffering in this room is stunning.

I will summarize some of the themes that develop, though every woman’s story is intimately her own.

  1. Many of the men were diagnosed with mental illness either before or after marriage (don’t worry he will get better) and this was often compounded by drug addiction and disabilities, some related to work accidents.  Tramadol seems to be the drug of choice although there is some hashish as well. Many also had seizure disorders and a variety of mostly head injuries due to repeated falls, leading me to wonder about how diagnoses are made, the adequacy of treatment, and medical and psychological follow up which obviously in a health care system that is repeatedly assaulted and in a chronic state of collapse, is likely less than optimal.


  1. Many of the men steal from their families, lie, even sell their UNRWA coupons, and connive in various destructive ways to support their drug habits.  This leaves women responsible for the household without any economic means.


  1. The children also suffer from more than the average level of disease burden, probably related to the high level of marriage to first cousins and other close relatives, (big problem in Gaza where few can get a permit to leave and check out the rest of the gene pool) the unhealthy environment and toxic load from war (may of the young children have already lived through three major assaults), malnutrition, and lack of quality care.
  2. When women marry (often in their teens, some with extreme family pressure), they tend to move into their husband’s already overcrowded homes where grandparents, (think controlling mother-in-law who cannot see any fault in her son), multiple other siblings and their growing families are vying for a shrinking amount of space without privacy or healthy boundaries, jealousy and competition abound.  I think of the animal experiments where rats or was it fish or hamsters….are placed in shrinking cages until all end up attacking each other.  Well guess what happens to humans, especially when you throw in some addiction, war, death, and PTSD?


  1. Every woman reports verbal abuse, physical beatings and sometimes sexual assault from husbands, brothers-in-law, fathers-in-law and verbal and physical abuse of their children whom they try unsuccessfully to protect. One woman’s arm was bandaged due to a fracture after being pushed down the stairs.


  1. Poverty is rampant with husbands who are unable to work, families already stretched economically, and a reliance on the social affairs department. Women have sold all their nuptial gold to survive. There is no backup plan.


  1. The women are clearly depressed, one thinks of suicide, but then she thinks of her children, “We are not a normal family; all I want is one room that I own.” Even now, her children “only get one meal per day, using UNRWA coupons,” which her husband tries to sell. Many talked about wanting to educate their children in university and the difficulty in financing those dreams. Some see their children turning violent, out of control, addicted, and mirroring their fathers. The mothers desperately want to save them from that fate.


  1. The war in 2014 led families to move repeatedly, face extraordinary financial hardships, some babies were born, some were lost, families face marked reductions in electricity and drinkable water.


  1. The last woman had a daughter who married a man who became a drug addict. The daughter fled back to her family and hired the Palestinian version of a coyote who smuggled her and her five children through the tunnels to slip onto a boat to Italy and freedom.  The ship sank and the family was lost.  At this point we are all weeping.


When I sink into stereotypical thoughts about tyrannical Arab families and dominating mother-in-laws, and the repressive role of fundamentalist Islamic family relationships, I quickly remember the sexual abuse of children that has poisoned the Catholic Church, the 25% of women in the US who report sexual abuse, the rampant rape of women in our armed forces and college campuses, the appalling prevalence of domestic violence in our lovely enlightened Western societies, not to mention the unspoken crisis of domestic violence amongst ultra-orthodox Jewish families from Brooklyn to Jerusalem.  Let us not judge. What we do know is that the more crushing the economy and political landscape the more oppressed and constricted the lives of women will be. This is the task for feminists and all people who understand the intersections between war, patriarchy, psychological illness, domestic violence and the cultures that make this all possible.  The dedicated women of Aish are taking the first steps on a long and challenging journey and deserve our sisterly support.

March 23, 2015 part two, Kindergarten: see German definition: Children’s garden



Wejdan Diab, Marwan Diab’s sister, welcomes me to the Meera Kindergarten in Gaza City where the walls are painted Disney bright; I spot many photos, and murals of dolphins, giraffes, a windmill in Holland (?) with a pond and a duck, dress up clothes including large yellow and white flowers, dabke outfits. The school has morning and afternoon shifts. It all looks quite “normal” but this is Gaza where gardens of any kind are actually quite hard to sustain.

Wejdan’s face has this disarming blend of joy, laughter, and intense tragedy. Behind the raucous din of children playing, singing, and rote repetition as teachers and children shout to be heard, she shares photos of the destruction of the school during the last war: broken glass, bullet holes, and fractured building parts.  She explains that if a child is six years old, he has already experienced three wars, or perhaps his mother was pregnant during the first one.  “It was very difficult for all of us, every day thanks God I am alive.  The bombing was terrible everywhere, my kindergarten was partially destroyed, including windows and doors.”

In July 2014 the Israeli forces repeatedly bombed the city of Shejaia, east of Gaza, to Dresden-like conditions. Sixty survivors sheltered at the kindergarten, the traumatized children destroyed many of the toys, were tormented by nightmares and bed wetting, but Wejdan and her staff worked hard. “I wanted the children to be safe, we made arts and crafts to help children.  They had no toys, these children are suffering.” The survivors brought bits of toys from under the rubble and they painted them, a guitar singing, a child living in a tent drew her toy on fire, one placed her doll’s head in the center of a picture surrounded by death.

Every day the kindergarten staff made parties for the children, brought in clowns; some children refused to go outside, some were afraid of the sky or particular noises, but they are now getting better.  And then there are the kids who lost their parents, one father who was a journalist was assassinated by an Israeli missile. He was covering a multi-missile attack in Shejaia which included attacks on two ambulances and rescue workers.  A quick look at the internet reveals this: [ ]

His child brought the father’s helmet to school and “drew the father at paradise eating apples.” The journalist was active in the school, teaching the students to use cameras and be reporters. Wejdan’s heartbreaking collection of photos are stored in a big plastic folder, Mickey Mouse and Friends on the cover with Daffy Duck and Goofy. Wejdan urges me to follow the kindergarten on facebook: meeragaza. [FYI dear reader, it is 9:00 am at the Marna House where we actually have running water, guilty hot showers, a decent restaurant….and the electricity is flickering on and off. I lose internet connection with each disconnection; the simplest things are most challenging.]

Wejdan takes out a plastic folder stuffed with papers; she conducted a survey when the fighting ended and sent the letters to the fathers and mothers of the children.  We scan through the letters as I feel the heavy weight of human suffering in its most intimate details: These are the experiences of kindergarteners.

After war, is anybody injured? Anybody having bad feelings? Is anyone is scared? What happened to homes?

Answers: Cannot sleep. God I do not want to die. We hold her. When she sits alone she talks to herself about dying. The home was destroyed and she is afraid of bombing. She doesn’t want to go alone to any room. Noises frighten her and there is a lot of crying.  A lot of stories in their minds and they are talking about what they see on TV and the dead and the bombing. Daughter has strange behavior, stressed, nervous, sad, afraid the war will come again. She says that maybe the teachers will not be able to help the children, only feel safe with mother and father. Nightmares, going to the doctor because of bad feelings. Kitchen is destroyed, living room destroyed.  Bed wetting, crying, afraid at night

Wejdan is counterintuitively cheerful, chuckling while recounting the horror. “I left my home near here. There is an Islamic University branch nearby and maybe it will be attacked.” She joined her relatives at her family home. And then she adds: “All the children are suffering, 170 children were at the school,” some were unable to talk, became mute and their hair fell out.

I am ready for quiet sobbing in some small dark place, but we take a tour of the school where the children are energetic, lively, curious, and each child who experienced some horrific trauma or loss is invited to come up and shake my hand.  I do not know if they understand why. The brightest moment comes with a high spirited performance of a kindergarten dabke troupe, the boys and girls are in costume, beautifully synchronized, high stepping, waving their arms, music blaring, celebrating their national heritage.  I feel the nurturing of samoud and a kind of determination to endure that will serve these children well in this most traumatic of places.

Wejdan invites Kareema Raian, the mother of the murdered journalist, Ramy Raian and the grandmother of two children who are at the school to talk with me. Kareema’s eyes betray a sense of deep sadness and loss and the tears come quickly.  She explains that her son was going out to take pictures of the Israeli destruction, to expose the truth; she prayed, “allah akbar,” and begged him not to go.  He pinched her cheek and “that was the end.”


Kareema explains that they were told there would be no firing from 3:007:00 pm “so they said you can take stuff from the markets, so he went to the market.  He has no gun or anything, he is journalist only and when he take pictures, the plane killed him with 17 other people, three of them from one family.” She sits in her black abayahand hijab, dark lines under her eyes, and talks about the other people killed, one had a pregnant wife who later named her newborn after the infant’s dead father. Her hands twist at her tissues as she recalls Ramy’s wife calling him for lunch and “he said no, I want to take pictures, alhamdulillah. I will eat with the other journalist.”  An hour later he was dead, but she first thought he was injured, there were multiple phone calls, people coming to her home, and then her nephew saw the murder on television. She has no electricity, but that morning she dreamt that he died and saw him in a white jacket. “I prefer I dead, not him. He didn’t smoke, he was polite, he had two boys and two girls.”  She married him off at 17 because he was an only son and she wanted grandchildren.  The five and six year olds come in to the office, somewhat subdued and clearly still swimming in loss. Old souls already.

And the Israelis are already discussing the “next war.”

March 23, 2015 part one, Running on Empty

I first met Dr. Mona El-Farra several years ago in Washington DC and I have followed her work and reports primarily through the Middle East Children’s Alliance. The taxi takes me to the Red Crescent Society main hospital through grid locked streets, aggressive nail biting moments that remind me once again that in this part of the world, there is very little personal space, especially when it comes to cars. Mona and I find a book lined office to talk: she has a head of thick black hair, a white and red patterned scarf, pearl earrings, and a turquoise bracelet. There is a fierce look of determination about her, but I sense an immense fatigue in her eyes. She lost nine relatives in the recent war.

323-1aDr Mona el-Farra and me at Red Crescent Hospital in Gaza

She explains that during the Israeli attack, the hospital was bombed. “I have been negatively affected by the bombing. I am fine but it was a very hard time, but there is a feeling of uncertainty, it may happen again.  Besides that I am trying to travel to see my children in the UK, I have been invited to three conferences, but no permits, so I am stuck, maybe a trip to Seattle in May.” She will miss an upcoming conference in Ireland; there is a totally understandable stress and tension in her voice and I am trying to imagine the reality of a physician’s life trapped in Gaza and assaulted by repeated military attacks and human tragedy.

Mona takes phone calls while we talk, the man who is sharing this office with us is smoking. He is in charge of fighting illiteracy, a daunting concept when so many schools have been damaged or destroyed.


323-1bposter of literacy campaign at Red Crescent Hospital in Gaza

Mona explains that she is the deputy chair of the Palestinian Red Crescent Society of the Gaza Strip and the director of Gaza projects for the Middle East Children’s Alliance. She is also a prominent human rights and women’s rights activist born in Khan Yunis, Gaza.

“The current situation is miserable, on the edge of collapse, there is no reconstruction, thousands of families need homes, water is difficult and salinated and of poor quality, next year there will be no water in the aquifer, so the problem is building. 96% of the water is currently unacceptable for drinking this year, there is no regular electricity, only 2-4 hours per day.  After the war, the hospital got donations for a generator, but there is not enough fuel.” They need the generator to work the MRI machine 24 hours per day and this is very expensive.

She continues, “400,000 children are traumatized after the attack due to eye witness experiences according to the UN and UNICEF.  I see that those kids, age five to 16, who are suffering this trauma, were eye witnesses of the attack, are the future youth, those kids will be the future negotiators.  When Israel hits Gaza, it hits the psychological well-being of those kids. They will either be very, very radical, filled with hatred…so hatred and lack of peace.” [Netanyahu, are you listening?] She describes the terrors that these children have seen: “war, killing of parent, home bombing, running in the streets, killing of civilians.  They currently need programs like MECA, Play and Heal Program of MECA, clinics for kids and families for psycho-social support, so this is the extra burden.”  She admits to feeling strained with a lack of resources, “Nobody takes care of me, I suffer extra systoles, high blood pressure, no one cares for me. I need a break, needs rest for one month. It was not good before the attacks, so now there is more work.  To help people, lots of pressure.” Her supports are her friends but they need support too.  “For example, I am trying to leave.”  Amazingly, she had the chance to leave during the war on her British passport, “but it was my duty, but after attack I couldn’t leave.” She tried to get a permit via Erez checkpoint but was refused for “security reasons.” “This is the case for 95% who try.”

Mona remarks that she is managerial, “but during the war I saw patients, the bombing was heavy across the road from the hospital, it was affected, I came daily to emergency, all kinds of staff who could get here,”  Some worked 24 hours, some did a tele medicine service for patients who couldn’t reach the hospital. “They talk directly to the doctor for advice and this worked, we had many calls, then we received injured patients.” They worked in cooperation with Shifa Hospital which was overloaded, equipment was not working, issues around MRIs, CTs, xrays. Patients who were injured were discharged from Shifa, and came for follow-up care of their injuries to Red Crescent.  The team as well went to chronically ill patients who lacked medications, who needed help at home.  They made field visits under fire, in ambulances went to see diabetics and cardiac patients. Some areas had two to four hours of electricity, some mobile phones were functional and in other areas there was no telecommunication.

The second week, Israel started a ground attack in Shuja’ieh (or Shejaia depending on the map) in the northeast.  “75,000 people left their homes under intense attack, like a flooding of people.  It reminded people of 1948, early in the morning, people killed in streets, rubble, they went to schools for safety, came to the hospitals for medical help.” She coordinated with the UNRWA schools, started doing clinical medicine, there were 700 cases per day. “I worked as GP, gynecologist, dermatologist, asked other centers for volunteers, but we were well organized.’

The trauma and bitterness poured from her troubled memories.  “A child age seven on the second day of [the attack on] Shejaia came with blisters on his foot, walked a long way, hungry and thirsty.  He came to the clinic with his parents, a nurse accompanied his mother to the MRI machine, his mother was watering plants and was hit.”

“A child age five came to the clinic, with a head injury, we asked his name, ‘unknown.’ He was  comatose, whole family died.  Anything about him? We don’t now, the whole house destroyed, even which house he came from, he did not survive.”

“There are1800 orphans just from the last war.”

Dr. Mona’s face deepens with sadness. Her cousin in Khan Yunis, Abed Melek, a 65 year old farmer, ran into the street with his grandchildren when his house was hit. “He was killed, four children killed in their pajamas, five adults were killed, another ten were injured in his family…. I have story of myself which reflects the situation of Gaza, no place was safe. When shelling was heavy in my neighborhood, I went to stay with friends.  Then there was shelling in their area, people were running from place to place, but I went to the hospital daily, running with clothes on your back.  Diabetics did not take their meds.” I feel like I am sinking under her grief and her stress. “People had no IDs, there were unbelievable bombs, shaking, maybe sound bombs, no white phosphorus.  This time there was a warning rocket on the roof, [but] this can kill people. Another Khan Yunis cousin was given 15 min notice and then the house was demolished.  A nurse here from Red Crescent Society Gaza hospital, her daughter, son-in-law and two grand-children died, she still suffers.  Two of the staff lost homes completely, a nurse and an administrator.  All of them ran from place to place, so not enough food, suddenly you have 40 people in your house.  MECA responded directly. I bought food and clothes and was later repaid by MECA.”  Mona got food, milk, biscuits, blankets, and water tanks and coordinated with MECA volunteers.  She found that the markets trusted her even without paying.  During the cease fire, she went to schools for school activities with children, music, but she also distributed while there was shelling in Gaza, Beit Hanoun, etc, using the Red Crescent car.  When medications ran out, MECA said, “Buy what you can from pharmacies.”

Mona finds “Netanyahu no worse, they are one politics, very bad to look at Israeli society…I don’t like to call it war, humanity failed, civilians were attacked, there was slaughter, thousands were injured, handicapped, women and children killed, all of these are people.  It was crazy, no outcome, during the attack people supportive of Hamas, defending them, so Israel is stupid.  At the moment, people are unhappy with domestic issues due to lack of reconciliation with Fatah. [Any way out?] But not for the time being, this land should be for all, this is not easy and it needs a lot of work and lots of organizing for unity to Palestinian people and for Israel to admit what happened in ‘48, with racist and colonialist state like Israel it will be very difficult. We need one state, one vote, the middle east is chaotic but things change, like the collapse of the Soviet Union, [but] the children now will not be good negotiators [later].

As if that were not enough, Mona states, “19 health workers were killed in the Gaza Strip, clinics, ambulances were destroyed.  If you want to talk about international law, even if there was one militant in a school, you must respect international law.  Schools with displaced families (like Jabalia) where attacked, [displaced people] fled only to die inside the school, now 10,000 people are living in schools. MECA supports kindergartens.” After the big massacres, Mona “went to Shejaia during a cease fire, I could smell death everywhere, destruction, [she sighs deeply].  Our role is to continue to support people, I am MECA director, but I need someone to support me, we all need a break, a break from thinking it may happen again, it will be the end of Gaza.”

And then there is the environmental catastrophe. “Water reservoirs were hit in the north and this affected water in Gaza, electric plants, schools for disabled, streets, and there is no reconstruction.  Because of the instability re: the next Israeli attack, international donors will not give.  My home, shattered windows, I didn’t live there for one month.  I moved to another area also dangerous and the nearby buildings were hit.  I couldn’t sleep, worked twelve hours, stayed with friends, communicating with MECA with thanks for their generosity, it was lifesaving.  The schools used the MECA water unit, the MAYA project, a desalination project, supervised by engineers. All Gaza drinks desalinated water.”

“This is not about people who were killed, it is about us who were waiting for death every minute. I do not pray, I used to walk, (had pneumonia), I feel low.  I usually fight depression with walking, but my toe hurts, I had bronchitis, there is a lack of electricity, with no lights at night I do not feel safe.”

Somehow, Mona finds the strength to continue to worry about all the needy people around her.  It seems that women jailed in Hamas prisons, have no access to medication. She hands me two scripts, I can decipher two meds for yeast and BV. Could I possibly see if we brought in any of these medications? The women are in jail as thieves collaborators, whatever, “but they have their rights, men have no medicine either.”

I free associate to that bizarre and frightening comment made by Dov Weisglass, advisor to then prime minister Ehud Olmert, back in 2006 about putting Palestinians on a diet , but not letting them actually die of hunger. Well folks, Palestinians are now facing starvation, not only economically but also emotionally and spiritually, and the compounding tragedy is that their dedicated, exhausted health care providers are starving with them as well.