Cyber Bullies at Canary Mission Muzzle Free Speech – December 15, 2019

first published in Washington Report on Middle East Affairs

Washington Report on Middle East Affairs, January/February 2020, pp. 12-13

Special Report

By Dr. Alice Rothchild

IN AN ERA OF MALICIOUS social media campaigns, the Canary Mission stands out as a little known but highly effective organization that is a threat to free speech and political organizing in the U.S. Targeting graduate and undergraduate students, and professors, the website is designed to inhibit political speech regarding Israel on campuses, ruin reputations, and destroy professional careers through publishing malicious lies and unrelenting attacks.

The McCarthyite blacklist has become especially frightening because it’s being used by law enforcement in Israel and the U.S. Palestinian rights advocates have been interrogated and deported from Israel because of their Canary Mission profiles. Others have been grilled by the FBI or denied employment.

Recently, a graduate student with stellar qualifications contacted me when his/her education and future career were severely derailed by this shadowy website. (That graduate student asked to be absolutely anonymous since he/she is so traumatized and frightened by the experience.) As I researched his/her concerns, I discovered that I too was listed, portrayed as an anti-Israel conspiracy theorist and provocateur.

My personal page on the Canary Mission involves a long series of cherry-picked quotes from articles and tweets dating back to 2011, interspersed with erroneous interpretations designed to prove their point that I am a dangerous, lying, self-hating Jew.

The Canary Mission is an anonymous site that identifies and compiles a dossier on Palestinian rights advocates in academia, and harasses them through web and Twitter postings, tagging students, administrators, employers, and alerting the FBI to baseless, unvetted accusations.

The key qualifications for inclusion are public criticism of Israeli policies, support for the Boycott, Divestment and Sanctions (BDS) movement against Israel, and sympathy for Palestinian causes. Those listed are accused of racism, anti-Semitism, support for terrorism and worse. The postings, selectively chosen and misinterpreted, are expansive and frequently updated. This constant surveillance and cyber-bullying leads students to feel anxious and paranoid as they find themselves the subjects of online death threats, and racial, homophobic and misogynist slurs. The website focuses disproportionately on students of color and Arabs.

With over 2,300 profiles to date, the Canary Mission is having a chilling impact on campus activism and this intimidation leads to students and professors self-censoring their own speech and community activities out of fear of time-consuming attacks and threats to funding.

Several years ago, that graduate student tweeted hostile comments toward Israel during attacks on Gaza which killed some of his/her relatives. After the Canary Mission contacted the student’s school he/she was called in for a “talk.” He/she expressed regret, explaining the tweets, since deleted, had voiced youthful anger and grief, some of which were also mistranslated. After being “cleared” of suspicion at school, he/she received a call from the FBI who mentioned the Canary Mission, and also “cleared” the student. Next defamatory rumors spread around the school, along with a mass email. The vice chancellor put the student on administrative leave, and removed and investigated all his/her electronic devices.

Advised to come to a meeting with parents present, he/she finally got a lawyer.

After mixed messages from the school, denials, promises, threats of expulsion, and disciplinary hearings, the graduate student was suspended for three months due to a violation of code of conduct, required to take cultural sensitivity training and to issue a public apology. So far judges have ruled in his/her favor, but post graduate school acceptance was retracted and his/her educational and work opportunities are all in limbo.

In 2018, the Grayzone Project identified the Canary Mission’s domain owner as Howard Davis Sterling, a lawyer and passionate Israel-right-or-wrong supporter. Subsequently, a censored Al Jazeera film named an Israeli-American real estate investor, Adam Milstein, as the funder of the Canary Mission. Milstein denied involvement, but as a former employee of the recently defunct Israel Project, part of a network of groups that monitor and track Israel related campus events, he has certainly supported this kind of work in the past. The Forward recognized the Helen Diller Family Foundation, controlled by the Jewish Community Federation of San Francisco and the Jewish Community Foundation of Los Angeles, as major donors as well.

The Canary Mission is part of a multimillion dollar network of trolling and ­disinformation organizations including AMCHA, CAMERA, Campus Coalition, David Horowitz Freedom Center, Israel on Campus Coalition, Israellycool, Stand with Us, and Students Supporting Israel, that monitor social and printed media and webzines.

Their purported goal is to provide accurate information about Israel/Palestine and to fight anti-Semitism. Their actual goal is to muzzle and intimidate critics, suppress support for the BDS movement, and distract the general population from the serious human rights violations in Israel/Palestine. They effectively stifle dissent by equating criticism of Israeli policy with anti-Semitism, by stating that Jewish students feel “unsafe” on campuses, and by pushing administrators to take disciplinary measures against those who criticize Israel.

Even more disturbing is the fact that the Israel Ministry of Strategic Affairs and the Ministry of Foreign Affairs work internationally with front groups and social media trolls in a largely secretive campaign against BDS, ostensibly to “improve” Israel’s image. Using former members of Israeli security industries, the groups monitor and shape online discussions through strategic messaging and black ops techniques. (See Jonathan Cook’s article, pp. 8-11.)

The personal attacks on my Twitter and Facebook pages (like: “I hope you are raped by 10,000 Arabs, but no, you would probably enjoy it”) and the disruptive behaviors in response to essays and during my public speaking, and the death threats on Facebook that originated from Israel, are not clearly from Canary Mission, but are certainly in the tone and behavior of the Canary Mission or one of its sister organizations.

I have had one visit from the FBI (clearly a fishing expedition) and I am not sure what triggered that. I have not been recently professionally attacked as I am retired from my academic and clinical appointments and I am not employed by anyone, although I have certainly been targeted by Israeli hasbara groups (for instance leafleting my lecture on health care in the occupied territories with rabid anti-Palestinian literature for a Grand Rounds presentation), while I was working in clinical medicine.

In the U.S., while we worry about Russian influence, the president and rightwing groups are flooding Facebook and Twitter with deceptive, defaming messaging. At the same time, under the radar, there is an organized multimillion dollar influence campaign by the Israeli government seeking to impact public opinion and elections, hijacking public polls, directing social media messages with trolls that engage in well-organized digital astroturfing.

These practices threaten our free speech and destroy any semblance of civility in political discourse. Students and faculty who find themselves blacklisted have little recourse except to shed light on the organization and its destructive mission, (risking more vicious attacks), and to fight the consequences of blacklisting in our courts, (an expensive, slow process). My graduate student’s case is now creeping through our legal system. The website has been denounced by many in and out of academia, by J Street, a powerful lobbying group that defines itself as “pro-Israel, pro-peace,” and Jewish Voice for Peace, a national organization working for “peace, social justice, human rights [and] respect for international law.”

Zionism’s uneasy relationship to antisemitism – November 19, 2019

first published in Mondoweiss

A folk dance troupe in Kibbutz Dalia, January 5, 1945. (Photo: National Photo Collection of Israel, Photography dept. GPO)

I grew up with a deep love for Israel, the redemptive, out-of the-ashes, kibbutz-loving, feisty little country that could do no wrong, fighting for its life in a sea of hateful Arabs and Jew-haters. I learned that Jews were a people dedicated to worship and the study of Torah and this identity kept us alive during the centuries of antisemitism in Europe. If I was not able to dedicate myself to the religiosity of my davening grandfather, tfillin and all, I understood that as a people, we were deeply committed to healing the world and working for social justice, an equally virtuous and inherently Jewish task. After all, we were naturally good, or as my mother explained, Jews bore the responsibility of being chosen for a uniquely positive role in this world.

As the decades passed, this mythology shattered against the hard rocks of reality. One of the most difficult contradictions I now face is understanding the perverse relationship between Zionism and antisemitism. I was sold the story that political Zionism developed as a response to antisemitism and as a modern, liberating movement in the backward Middle East. But in 1897 as modern Zionism was born, it adopted the trope of the diaspora Jew as a pale, flaccid, yeshiva bocher, a parasite, an eternal alien, a nebbish. That Zionism embraced the idea that this pathetic weakling (who was often to be blamed for antisemitism) needed to be Aryanized into the bronzed, muscular Hebrew farmer/warrior tilling the soil in the Galilee is a chilling realization. The evolution of Jews as a people who lived by Torah and its commandments into a biological race with distinct characteristics, (the money Jew, the ghetto Jew, the swarthy, hook-nosed Jew) mirrors the worst canards of antisemites, European fascists, and white supremacists.

This story is complicated by the relegation of European Jewish communities to limited and disreputable professions and the societal resentment towards the “parasitic,” “non-productive” money lenders and peddler/merchant class. As modern capitalism developed, even socialist Zionists worried that there was some kind of an economic deficiency within the Jewish people which led to antisemitism that could only be cured by working the land of Palestine.

It should then not come as a surprise that the founder of modern Zionism, Theodore Herzl, looked at antisemites as “‘friends and allies’ of his movement.” Zionists and antisemitism shared a common goal: One group wanted all the Jews to emigrate to Palestine to establish an ethnically pure Jewish nation-state and the other group wanted to get rid of all their Jewish countrymen. Emigration was indeed a splendid solution to the eternal Jewish problem. As Professor Joseph Massad wrote:

“[Herzl] would declare in his foundational pamphlet that ‘the Governments of all countries scourged by Anti-Semitism will be keenly interested in assisting us to obtain [the] sovereignty we want’; and indeed that not ‘only poor Jews’ would contribute to an immigration fund for European Jews, ‘but also Christians who wanted to get rid of them.’”

Was this political solidarity related to class, whiteness, a form of self-hatred, ingesting the institutional racism of the day as one’s own? Was this was a marriage of convenience, distasteful but necessary, or a long-term strategy?

Delving deeper, I was not that surprised to learn that the assimilated, secular Herzl chose to leave his son uncircumcised, that he initially entertained the idea that mass conversion to Catholicism would be a good solution to the Jewish problem, that he celebrated Christmas with a tree no less. He reportedly said, “An excellent idea enters my mind — to attract outright anti-Semites and make them destroyers of Jewish wealth.” The Israeli peace activist Uri Avnery described Herzl’s writings as having, “in places, ‘a strongly antisemitic odour.’”

Leon Rosselson, a British singer, songwriter, and children’s book author, wrote in an essay in Medium,

“In his book, Der Judenstaat, published in 1896, he [Herzl] explains why: ‘The Jewish question exists wherever Jews live in perceptible numbers. Where it (i.e. antisemitism) does not exist, it is carried by Jews in the course of their migration. We naturally move to those places where we are not persecuted and there our presence produces persecution…. The unfortunate Jews are now carrying the seeds of Anti-Semitism into England; they have already introduced it into America.’

In a later chapter, he argues that the immediate cause of antisemitism is ‘our excessive production of mediocre intellects, who cannot find an outlet downwards or upwards — that is to say, no wholesome outlet in either direction. When we sink, we become a revolutionary proletariat, the subordinate officers of all revolutionary parties; and at the same time, when we rise, there rises also our terrible power of the purse.’”

When Herzl considered the language of the new state, he wrote of Yiddish: “We shall give up using those miserable stunted jargons, those Ghetto languages which we still employ, for these were the stealthy tongues of prisoners.” He had a similar disdain for the Jewish religion. “We shall keep our priests within the confines of their temples…. They must not interfere in the administration of the state…,” and envisioned a state without Jewish holidays or Jewish symbols. There is indeed a strong sense of self-loathing in these statements.

Another damning piece of evidence is the 1912 comment by Chaim Weizman, later president of the World Zionist Organization and first president of Israel: “Each country can absorb only a limited number of Jews, if she doesn’t want disorders in her stomach. Germany already has too many Jews.”

Or Israel’s founding father and first prime minister, Ben Gurion’s statement in 1922: “We are not Yeshiva students debating the fine points of self-improvement. We are conquerors of the land facing a wall of iron and we have to break through it.” He noted of diaspora Jews: “They have no roots. They are rootless cosmopolitans — there can be nothing worse than that.’” Ben Gurion was famously elitist and racist. He described diaspora Jews as “human dust, whose particles try to cling to each other,” and he called Mizrahim, (Jews from Arab and/or Muslim countries), backward and primitive, with Orientalist characteristics that would threaten the nascent state of Israel. Portraying Yemeni immigrants, he wrote:

“[Yemini culture is] two thousand years behind us, perhaps even more. It lacks the most basic and primary concepts of civilization (as distinct from culture). Its attitude toward women and children is primate. Its physical condition is poor. For thousands of years it lived in one of the most benighted and impoverished lands, under a rule even more backward than an ordinary feudal and theocratic regime. The passage from there to Israel has been a profound human revolution, not a superficial, political one. All its human values need to be changed from the ground up.”

Menahem Begin (R) with Vladimir Jabotinsky (C) in Pinsk, December 12, 1933. (Photo: National Photo Collection of Israel, Photography dept. GPO)

Vladimir (Ze’ev) Jabotinsky, the founder of Revisionist Zionism which was the forerunner of today’s Likud Party, was even more upfront in his reactionary affiliations. He supported the settler colonial and militaristic core of Zionism, openly talked about the need to fight the indigenous Palestinian population, and called on Jews to mobilize for “war, revolt and sacrifice.”

In 1923 he wrote Revisionism’s Bible, an article, “The Iron Wall (We and the Arabs)”:

“Every native population in the world resists colonists as long as it has the slightest hope of being able to rid itself of the danger of being colonized. That is what the Arabs in Palestine are doing, and what they will persist in doing as long as there remains a solitary spark of hope that they will be able to prevent the transformation of “Palestine” into the “Land of Israel.”…. Zionist colonization must either stop, or else proceed regardless of the native population. This means that it can proceed and develop only under the protection of a power that is independent of the native population –- behind an iron wall, which the native population cannot breach.”

At the same time, his antisemitism was profound:

“Our starting point is to take the typical Yid of today and to imagine his diametrical opposite … Because the Yid is ugly, sickly, and lacks decorum, we shall endow the ideal image of the Hebrew with masculine beauty. The Yid is trodden upon and easily frightened and, therefore, the Hebrew ought to be proud and independent. The Yid is despised by all and, therefore, the Hebrew ought to charm all. The Yid has accepted submission and, therefore, the Hebrew ought to learn how to command. The Yid wants to conceal his identity from strangers and, therefore, the Hebrew should look the world straight in the eye and declare: ‘I am a Hebrew!’”

Jabotinsky flirted with the ideology of Benito Mussolini who praised him as a “Jewish Fascist” and was happy not only to work with Nazis but to espouse their totalitarian ideology. He established the New Zionist Organization and his Palestine representative ran his Yomen shel Fascisti (Diary of a Fascist) in their paper. Von Weisl, NZO’s Financial Director, told a newspaper that “He [Jabotinsky] personally was a supporter of Fascism, and he rejoiced at the victory of Fascist Italy in Abyssinia as a triumph of the White races against the Black.” Mussolini allowed the rightwing Revisionist Zionist youth movement, Betar, to have a squadron at his maritime academy.

When Mussolini decided to join forces with Hitler, he expelled Jews from the party. The Revisionists responded:

“For years we have warned the Jews not to insult the fascist regime in Italy. Let us be frank before we accuse others of the recent anti-Jewish laws in Italy; why not first accuse our own radical groups who are responsible for what happened.”

According to Lenni Brenner, author of “Zionism in the Age of Dictators,” by March 1933, Jabotinsky called for an anti-Nazi boycott and subsequently, Revisionists assassinated the Labor Zionist who had negotiated the Ha’Avara Agreement, (see below). But the relationship between the Revisionists and the Nazis remained torturous.

In 1939, a week before Hitler invaded Poland, Jabotinsky insisted that “There is not the remotest chance of war.” He planned to invade Palestine, landing a boatload of Betarim on Tel Aviv’s beach while the Irgun seized Government House in Jerusalem, and a provisional Jewish government was proclaimed abroad. After his capture or death, it would operate as a government-in-exile.

The Irgun, the Zionist paramilitary organization active in Mandate Palestine, was inspired and led by Jabotinsky until his death in 1940. After the war, the following document was found in Germany’s Turkish embassy: Proposal of the National Military Organization (Irgun Zvai Leumi) Concerning the Solution of the Jewish Question in Europe and the Participation of the NMO in the War on the side of Germany. It read:

“The establishment of the historical Jewish state on a national and totalitarian basis, and bound by a treaty with the German Reich, would be in the interest of a maintained and strengthened future German position of power in the Near East.

Proceeding from these considerations, the NMO in Palestine, under the condition the above-mentioned national aspirations of the Israeli freedom movement are recognized on the side of the German Reich, offers to actively take part in the war on Germany’s side.”

While Jews both inside and outside of Germany understood the grave dangers posed by the Nazi ascent to power, some Zionists viewed this as an opportunity to further their aims of colonizing Palestine. Despite an international boycott of Nazi Germany, in 1933 Labor Zionists signed the Transfer “Ha’avara” Agreement which ultimately resulted in the rescue of 20,000 Jews. Nazi Germany agreed to compensate those German Jews who left for Palestine after the liquidation of their property by exporting German goods of equal value to the country. The emigrants then received some of the proceeds from the sale of the goods. This led to an end of the boycott of Germany and a financial boost for their economy which was still mired in WWI reparations and the Great Depression. As Leon Rosselson wrote:

“Between 1933 and 1939, 60 percent of all capital invested in Jewish Palestine came from German Jewish money through the Transfer Agreement. Thus, Nazism was a boon to Zionism throughout the 1930s.

In 1935, the German Zionist branch was the only political force that supported the Nazi Nuremberg Laws in the country, and was the only party still allowed to publish its own newspaper the Rundschau until after Kristallnacht in 1938.”

The Nuremberg Laws excluded German Jews from German citizenship and prohibited them from marrying or having sexual relations with anyone of “German or related” blood. The laws disenfranchised Jews and removed most of their political rights. A Jew was defined as anyone with three or four Jewish grandparents, regardless of that person’s personal identification.

The German Zionist Federation, the Zionistische Vereinigung fur Deutschland, wrote an appeal to the Nazis in 1933:

“May we therefore be permitted to present our views, which, in our opinion, make possible a solution in keeping with the principles of the new German State of National Awakening….because we, too, are against mixed marriage and are for maintaining the purity of the Jewish group….

For its practical aims, Zionism hopes to be able to win the collaboration even of a government fundamentally hostile to Jews…. Boycott propaganda – such as is currently being carried on against Germany in many ways – is in essence un-Zionist, because Zionism wants not to do battle but to convince and to build.”

Another piece of evidence regarding the Nazi’s relationship to Jews and their plans for deportation (prior to their decision in 1942 to proceed with total extermination), was written by the SS chief, Reinhard Heydrich. In 1935 he published a statement in an SS publication. Francis Nicosia quoted it in his 1985 book, “The Third Reich and the Palestine Question”:

“National Socialism has no intention of attacking the Jewish people in any way. On the contrary, the recognition of Jewry as a racial community based on blood, and not as a religious one, leads the German government to guarantee the racial separateness of this community without any limitations. The government finds itself in complete agreement with the great spiritual movement within Jewry itself, the so-called Zionism, with its recognition of the solidarity of Jewry throughout the world and the rejection of all assimilationist ideas. On this basis, Germany undertakes measures that will surely play a significant role in the future in the handling of the Jewish problem around the world.”

Interestingly, in 1937 Adolf Eichmann, along with his supervisor in the Nazi party’s intelligence agency, traveled to Mandate Palestine, disguised as a German journalist, to investigate the feasibility of German Jewish deportation to the region and the functions of the Zionist organizations within Palestine. Eichmann also secretly met with Feivel Polkes, a representative of the Haganah (which became the Israel Defense Force) to discuss this plan. It is important to remember that Eichmann’s interest was in deporting Jews as efficiently as possible, not in supporting the development of a strong Jewish state that might threaten the economic fortunes of Nazi Germany.

In this New York Times review of “In Memory’s Kitchen: A Legacy From the Women of Terezin,” Lore Dickstein quotes the memory of a Terezin survivor who met Eichmann:

“Anny Stern was one of the lucky ones. In 1939, after months of hassle with the Nazi bureaucracy, the occupying German Army at her heels, she fled Czechoslovakia with her young son and emigrated to Palestine. At the time of Anny’s departure, Nazi policy encouraged emigration. ‘Are you a Zionist?’ Adolph Eichmann, Hitler’s specialist on Jewish affairs, asked her. ‘Jawohl,’ she replied. ‘Good,’ he said, ‘I am a Zionist, too. I want every Jew to leave for Palestine.’”

Covering Eichmann’s trial in 1963 in Jerusalem, Hannah Arendt reported Eichmann boasted of his esteem for Zionists,

“Eichmann’s first personal contacts with Jewish functionaries, all of them well-known Zionists of long standing, were thoroughly satisfactory. The reason he became so fascinated by the ‘Jewish question,’ he explained, was his own ‘idealism;’ these Jews, unlike the Assimilationists, whom he always despised, and unlike the Orthodox Jews, who bored him, were ‘idealists,’ like him.”

After the founding of the State of Israel in 1948, Albert Einstein wrote a letter to the New York Times regarding the visit to the U.S. by Menachem Begin, a leader of the Irgun, head of the right-wing nationalist Herut Party (which morphed into Likud), and later the sixth Israeli prime minister:

“Among the most disturbing political phenomena of our time is the emergence in the newly created state of Israel of the ‘Freedom Party’ (Tnuat HaHerut), a political party closely akin in its organization, methods, political philosophy and social appeal to the Nazi and Fascist parties….They have preached an admixture of ultranationalism, religious mysticism and racial superiority… it is imperative that the truth about Mr Begin and his movement be made known in this country.”

Children ride bikes on a kibbutz in Israel. (Photo: Archive Kibbutz Mishmar Haemek)

Amy Kaplan in her remarkable 2018 book, “Our American Israel,” noted that after the war ended, even non-Jews thought that the children of the Eastern European Jewish race were magically transformed, Anglicized, by the experience of being born in Palestine. Bartley Crum was a San Francisco born, liberal Catholic, civil rights attorney who was part of the Anglo-American Committee charged with determining the future of Displaced Persons languishing in camps post-war. Kaplan noted:

“Crum found evidence for this transformation of eastern European Jews in a ‘strange phenomenon’ that made their offspring raised in Palestine not only stronger from working the land, but also whiter and more Western than their parents:

Many of the Jewish children I saw were blond and blue-eyed, a mass mutation that, I was told, is yet to be adequately explained. It is the more remarkable because the majority of the Jews of Palestine are of east European stock, traditionally dark-haired and dark-eyed. One might almost assert that a new Jewish folk is being created in Palestine: the vast majority almost a head taller than their parents, a sturdy people more a throwback to the farmers and fishermen of Jesus’ day than products of the sons and daughters of the cities of eastern and central Europe.” [p. 31]

Another member of the Anglo-American Committee, James McDonald, visited a synagogue in Jerusalem and:

“…he was ‘struck once more by the variety of the faces of the boys. Had I not know where I was, or heard the Hebrew words, I would have sworn that most of them were of Irish, Scandinavian or Scotch stock, or at any rate of the ordinary mixture of the American middle west. Only here and there was there a face even remotely resembling the ‘Jewish type.’ He concluded that ‘Israel’s young Jews had no distinctive ‘racial type.’” [p. 32]

In 1951, Kenneth Bilby, journalist, noted while observing children from a kibbutz:

“They were even featured, sturdy, bleached by the sun. I would have defied any anthropologist to mix these children with a crowd of British, American, German and Scandinavian youngsters and then weed out the Jews.’ He viewed them as becoming less like “their Semitic cousin in the Arab world.” In the eyes of these visitors, as European Jews in Palestine became whiter – and more civilized- the Arabs among whom they settled appeared darker and more primitive.” [p. 32]

At Work 1950 in a kibbutz vineyard. (Photo: Kibbutz Mishmar Haemek Archive)

In Israel there has always been a hierarchy of racism grounded in white, Euro-centric supremacy. Ashkenazim discriminated against Mizrahim and Jews of color, and Palestinians faced the most bigotry followed only recently by African asylum seekers. Reactionary religious leaders have also espoused racist attitudes. A prime example of that is Rabbi Ovadia Yosef, the spiritual leader of the Shas party, who has compared Arabs to “snakes” and called for their “annihilation.” These kinds of attitudes have been prevalent in the more rightwing settler movements like Gush Emunim, Tehiya, National Union, and Mafdal which feature a militant Jewish messianism merged with hatred and disdain for the indigenous Palestinians

So why is it important to explore this messy and uncomfortable history? I would argue that first, in this era where the epithet of antisemite is hurled quite loosely at anyone with critical attitudes towards Israel, we must be honest about the foundations of Zionism and its relationship to real antisemitism. It appears that the early Zionists, both on the socialist left as well as the fascist right, held attitudes that were clearly antisemitic. This may have been cynical or amoral, but I think it goes well beyond a marriage of expediency.

If we have an understanding of the roots of the Israeli leadership, we can better understand the attitudes and policies of subsequent Israeli governments leading us to the current regimes. While the Irgun remained in the minority and did not take control until 1977 with Menachem Begin followed by Yitzhak Shamir, it was a powerful force in pre-1948 Palestine, assassinating British leaders and international negotiators like Count Bernadotte and inflicting terrorist attacks on indigenous Palestinians such as the Deir Yassin massacre.

The Haganah and Palmach, (who later became the core of the Israel Defense Force), were also paramilitary groups active in pre-1948 Palestine. I think of the famous quote by Moshe Dayan who joined the Haganah at the age of fourteen and became a celebrated military leader and politician:

“We are a generation of settlers, and without the steel helmet and gun barrel, we shall not be able to plant a tree or build a house… . Let us not be afraid to see the hatred that accompanies and consumes the lives of hundreds of thousands of Arabs who sit all around us and wait for the moment when their hands will be able to reach our blood.” [From Ronen Bergman’s “Rise and Kill First” p. 128-129].

This is the combative voice of the new Jew, the Hebrew reborn in the fight to colonize and create Israel from Palestine. It is not a voice interested in negotiation, tolerance, democracy, or respect for other narratives or backgrounds. Political history creates the social and cultural norms we see today. The U.S. is facing a national conversation about the contradictions between our mythology – the American dream of justice, equality, and freedom for all – and the fact that our national heroes were slaveholders and actually only had dreams for white, landholding men. Their lived experience and attitudes were the foundations for the cultural norms that characterized the most shameful aspects of U.S. history: destroying native peoples, enslaving Africans, owning their children, Jim Crow, redlining, discrimination in opportunities from the GI Bill to employment, anti-miscegenation laws, white nationalism, and the persistent bigotry and institutional racism that is still a major challenge in the 21st century. This kind of honest, painful discourse is critical if we are to turn our so-called democracy in a more positive direction. I would suggest that Israelis need to be having their own national origin conversation and mostly, they are not. This does not bode well.

The Jabotinsky strain of politics which is repressive, anti-democratic, and at some level, deeply self-hating and othering, is a kind of national toxic masculinity. It is also an ideology that is the foundation of modern Zionism, a blend of bunker mentality, Islamophobia, and social Darwinism. This kind of politics gives the Ashkenazi Jewish racism towards Jews of color, Mizrahi, Palestinians, and African asylum seekers a historical context. This kind of politics makes an aggressive and dehumanizing occupation and settler movement possible, where the willingness to kill, main, and incarcerate Palestinians and their children is seen as unapologetically necessary for survival, where attacking “the other” as cockroaches and subhumans is tolerated and applauded by political leaders, where periodically bombing and strangling two million Gazans, creating an impossible humanitarian catastrophe, is just part of “mowing the grass.”

This latter expression refers to a cynical Israeli military strategy seen in the last three wars on Gaza and the Second Lebanon War that involves repeated large-scale but limited military operations as well as smaller assaults aimed at crushing the opponent, degrading the leadership and infrastructure and building deterrence. This attrition warfare has no clear endpoint; it is a foreign policy in itself characterized by the use of extreme force to weaken Hamas and Hezbollah, with minimal risk to Israeli soldiers, but without the total elimination of the enemy who is needed to control more extreme players in the region.

Just as I now know that the displacement and occupation that started in 1967 and continues to this day is a continuation of a process that started long before 1948 – the Nakba, or catastrophe, is ongoing – the fascistic policies of the Israeli government are grounded in the history of the creation of the state. Likewise, the post-1967 Israeli embrace of Christian evangelicals, (whose plans for Jews are conversion or a fiery death), mirrors the warm relationship that Zionists had with antisemitic leaders in Germany and Italy. And in a similar fashion, Israel’s embrace of Christian Zionists and repressive regimes from white South Africa to Saudi Arabia–as well as the Israeli love for our own dog-whistling, antisemitic president–is part of the same old pattern of joining forces with racist, authoritarian governments.

As it is often said, if we don’t know our history, we are destined and doomed to repeat it.

Can we talk about Zionism? -October 29, 2019

First published in The Brookline Chronicle

A Shabbos Potluck in Brookline with Dr. Alice Rothchild

Special thanks to Dr. Rothchild for transcribing her speech given Oct. 18, ’19 in Brookline and allowing us the privilege of publishing it.

Today I’m going to be discussing the recently published book, Reclaiming Judaism from Zionism: Stories of Personal Transformation. The book is a collection of curated essays by rabbis, students, academics, and activists, and includes my chapter titled: Choosing a different path. I am going to start with some definitions that I have gleaned from my own personal research and also from the excellent introduction written by Professor Carolyn Karcher who is the editor of this book.

I would define Judaism as a religion, centered on tikkun olam, on pursuing justice and loving the stranger. It is a body of sacred texts, rituals, and ethical precepts. This is very different from the definition of a Jewish macher (see Yiddish – big shot) in Boston who once said in answer to the question: “Can you be a Jew and not be a Zionist?” “You don’t understand, Israel is the religion.” Clearly I take issue with that.

Zionism, on the other hand, is a political ideology of Jewish nationalism, a belief that Israel is necessary as a safe haven after the Nazi Holocaust, that nothing but a Jewish state can protect Jews against anti-Semitism and the next holocaust. For many Jews, Zionism is the core of Jewish identity and the litmus test for being “in the tent.” I also think of Zionism as a response to the lack of progress in the emancipation of Jewish communities and the rise in anti-Semitism in Europe in the 20th century.

So let’s start with a bit of history. Political Zionism is a recent phenomenon. This is very different from my zayde’s messianic Zionism which was more a belief that the Messiah would come someday and everything would get better, but don’t hold your breath. This was often followed by a fatalistic shrug and more davening.

In the US in 1878, Christian Zionism exploded with the bestseller by William Blackstone titled Jesus is Coming. Justice Brandeis called Blackstone “the father of Zionism.” The first US Christian Zionist lobby effort occurred in 1891 where the assembled advocated for the creation of Jewish state in Palestine so that Jews could escape the pogroms and Christians could prepare for the rapture.

In Europe in the 1800s, the Jews of Central and Western Europe did not live in ghettos. They were emancipated after the French Revolution which started in 1789. They defined their identities as Austrian, German, French, etc. and regarded Judaism as a religion not a nationality. This was different for Russian Jews who lived in isolated shtetls and saw themselves as a people, a national minority, an ethnic group.

In the 1880s, Russian Jews began fleeing pograms and anti-Semitism and were encouraged to taking refuge in the biblical homeland, so by 1903 we see the First Aliyah to Palestine. Most Russian Jews, however, fled into Europe and the US and they were met with hostility and anti-Semitism, not of the Christ-killer variety, but a pseudo-genetic, anthropological, biological jargon that was used to justify group aggressiveness and the demonization of the other. As you know, this flourished in US and was used to justify slavery and the dispossession of Native Americans. It was all part of the highly popular eugenics movement. So, anti-Semites labeled Jews as a race and Jews accepted that classification and claimed they belonged to an “imaginary ‘Jewish race.’”

A primary figure in this movement was Theodor Herzl, a secular Viennese Jew who is said to have had a Christmas tree and an uncircumsized son. The Dreyfus case (1894-1906) in France, where a German Jewish officer was convicted of treason and then exonerated in a second trial, triggered anti-Semitic riots all over France. Herzl witnessed this and the election of anti-Semites in the Austrian government and became disillusioned. He decided the only solution to anti-Semitism was a Jewish nation and published a Zionist manifesto in 1896. A year later he organized the First World Zionist Congress in Basel, Switzerland stating that the presence of Jews in a country produces persecution and assimilation is impossible. This was the birth of modern Jewish Zionism.

In keeping with the times, these folks modeled the Jewish state on European colonialism. They envisioned a society of Jews under some kind of European protectorate that would negotiate possession of a “neutral” piece of land which would bring prosperity and modernity to the natives. They ultimately decided on Palestine as the most attractive to the Jewish masses, a potential “villa in the jungle.” Thus we see the merging of Zionism and Jewish nationalism with Great Power imperialism. This set the stage for the conflict between Jewish versus Palestinian (Christian and Muslim) nationalism.

From 1904-1914 the Second Aliyah occurred, Jewish settlers made up 5% of Palestine, and began developing institutions and infrastructure for a Jewish state which included plans to transfer the native population to neighboring Arab lands.

At the same time in Britain, the fundamentalist Christian, Lord Balfour, believed in transferring Jews to Palestine in order to hasten the second coming of Christ. During WW1, Ottoman Turkey sided with Germany (against British imperialism) and lost its Middle Eastern empire to Britain and France. So we see the merging of British imperial interests with Zionist goals. Britain got the League of Nation mandate to govern Palestine and Balfour lobbied the US for approval for a British protectorate in Palestine that would be a national Jewish home. In the US, one of the most prominent supporters was again, Supreme Court Justice Louis Brandeis. This led to the Balfour Declaration which declared that Britain supports a national home for Jews in Palestine as long as there is no prejudice against existing non Jewish communities. (italics mine)

Now it is important to remember that this all was very controversial in Jewish and British circles. People argued that a separate homeland would segregate Jews, that this reversed the ongoing emancipation and was anti-democratic, Jews were not a nationality, and anti-Semitism was not eternal.

It is interesting to note that the Bund (a forerunner of Workers Circle) was anti-Zionist, but mainly focused on workers’ rights and socialism. They viewed Judaism as a secular national identity. In the US, reform Jews believed that Judaism was a spiritual religion. They claimed that the US was their country, Zionism was inherently a political movement, and worried about the accusation of dual loyalty which had plagued Jews in the past.

Nonetheless, liberal Zionists promoted the idea that Jews could be liberal at home, but ignore the plight of Palestinians “over there.” They believed that Jews and subsequently Israel were creating an ideal democratic society and dismissed the dual loyalty issue. They said that Jews were Jewish Americans, analogous to Italian or Irish Americans with a home country they supported. But embedded in this belief system was an imperial mindset, a belief in manifest destiny. Zionist settlers were the pioneers and Arabs were the Indians. We were witnessing “a triumph of white civilization over savagery.”

In the 1930s, the rise of Nazism persuaded people that anti-Semitism was forever and that Jews needed a Jewish State to be safe. I think it is very important to analyze the language that was developing during these times. Political Zionists described diasporic Jews as subhuman; they used anti- Semitic tropes. Just think of the difference between the scruffy little Yid and the proud glorious Hebrew.

One of the most egregious examples of this attitude is seen in the language of Vladimir Jabotinski, the founder of Revisionist Zionism which was the forerunner of today’s Likud Party. At first he felt warmly towards Mussolini, the German Reich, and actively supported fascism.

“Our starting point is to take the typical Yid of today and to imagine his diametrical opposite … Because the Yid is ugly, sickly, and lacks decorum, we shall endow the ideal image of the Hebrew with masculine beauty. The Yid is trodden upon and easily frightened and, therefore, the Hebrew ought to be proud and independent. The Yid is despised by all and, therefore, the Hebrew ought to charm all. The Yid has accepted submission and, therefore, the Hebrew ought to learn how to command. The Yid wants to conceal his identity from strangers and, therefore, the Hebrew should look the world straight in the eye and declare: ‘I am a Hebrew!'”

For me, the fact that Zionism embraced the idea that this pathetic, scoliotic, weakling, diasporic Jew (who was often to be blamed for anti-Semitism) needed to be Aryanized into the bronzed, muscular, Hebrew farmer/warrior tilling the soil in the Galilee is a chilling realization. We can see that the early Zionists adopted some of the language of anti-Semites who increasingly defined Jews as a highly deficient race in need of a major cure – working and defending the land of Palestine.

I would argue that the evolution of Jews as a people who lived by Torah and its commandments into a biological race with distinct characteristics, (the money Jew, the ghetto Jew, the swarthy, hook-nosed Jew) mirrors the worst canards of anti-Semites, European fascists, and white supremacists. This is a very troubling origin story.

It should then not come as a surprise that the founder of modern Zionism, Theodore Herzl, and subsequent fathers, looked at anti-Semites as “‘friends and allies’ of his movement.” Zionists and anti-Semites shared a common goal: One group wanted all the Jews to emigrate to Palestine to establish an ethnically pure Jewish nation state and the other group wanted to get rid of all their Jewish countrymen. Emigration was indeed a splendid and final solution to the eternal Jewish problem.

Most people are also unaware that in 1937, Adolf Eichmann, along with his supervisor in the Nazi party’s intelligence agency, traveled to Mandate Palestine, disguised as a German journalist, to investigate the feasibility of German Jewish deportation to the region and to evaluate the functions of the Zionist organizations within Palestine. Eichmann also secretly met with Feivel Polkes, a representative of the Haganah, (which became the Israeli Defense Forces), to discuss this plan. It is important to remember that Eichmann’s interest was in deporting Jews as efficiently as possible, not in supporting the development of a strong Jewish state that might threaten the economic fortunes of Nazi Germany.

There is another interesting factoid: the transfer “Ha’avara” Agreement which ultimately resulted in the rescue of 20,000 Jews. Nazi Germany agreed to compensate those German Jews who left for Palestine after the liquidation of their property by exporting German goods of equal value to the country. The emigrants then received some of the proceeds from the sale of the goods. This led to an end of the boycott of Germany and a financial boost for their economy which was still mired in WW1 reparations and the Great Depression. As Leon Rosselson wrote:

“Between 1933 and 1939, 60 percent of all capital invested in Jewish Palestine came from German Jewish money through the Transfer Agreement. Thus, Nazism was a boon to Zionism throughout the 1930s.

In 1935, the German Zionist branch was the only political force that supported the Nazi Nuremberg Laws in the country, and was the only party still allowed to publish its own newspaper the Rundschau until after Kristallnacht in 1938.”

Clearly, in 1939 the Final Solution changed everything.

After WW 2, despite all the fears and controversy, the UN partition plan led to the creation of a Jewish state. After the founding of the State of Israel in 1948, Albert Einstein wrote a letter to the New York Times regarding the visit to the US by Menachem Begin, a leader of the Irgun, head of the right wing nationalist Herut Party (which morphed into Likud), and later the sixth Israeli prime minister:

“Among the most disturbing political phenomena of our time is the emergence in the newly created state of Israel of the ‘Freedom Party’ (Tnuat HaHerut), a political party closely akin in its organization, methods, political philosophy and social appeal to the Nazi and Fascist parties….They have preached an admixture of ultranationalism, religious mysticism and racial superiority… it is imperative that the truth about Mr Begin and his movement be made known in this country.”

All very troubling.

Now after the 1967 war, we see the rise of Fundamentalist Christian Zionism in the US with their generous support of Israeli settlements, and their belief that the Jewish state and the ’67 war were God’s will and the fulfillment of biblical prophecy. Liberal Protestants and Catholics embraced Christian Zionism as a form of repentance from Holocaust guilt. This all led to the growing belief that any criticism of Israel was inherently anti-Semitic.

I believe that the birth and growth of Zionism needs to be understood in all of its aspirations and contradictions.

In this book, Reclaiming Judaism from Zionism, Rabbi Brant Rosen, discusses a non-Zionist Judaism. He writes of Diasporism that after the destruction of the temple, Judaism became a religious system, a spiritual response to dispersion and exile, a worldwide spiritual peoplehood, multinational, multicultural. Power stemmed from religious belief not military might. He notes that Israel invests in global militarism because it is a state, not because it is Jewish. The militancy of the state counters that sense of permanent Jewish victimhood which is part of our cultural inheritance. He writes that much of Jewish culture and religious practice developed outside of national sovereignty. This is the focus for many younger, religious Jews today.

So how did all this play out in my life?

I would like to share a selection of readings from my essay in Reclaiming Judaism from Zionism:

Looking at my life’s trajectory, I have often wondered how I, a middle class daughter of striving, first generation Jewish parents, started to challenge many of the foundations of my upbringing. Clearly coming of age in the 1960’s with American counter culture as the wind in my sails and the Vietnam War as my own personal experience of US foreign policy, created space to think independently. Discovering feminism and attending medical school at a time when women were a small minority, professors routinely referred to their elderly patients as “girls,” and members of my nascent consciousness-raising group were gripping our plastic speculums and talking about redefining our relationships with men, gave me a lot to think about.

In terms of my Jewishness, I started my life in a very traditional American place. Faced with the activism of my youth, Israel’s increasingly belligerent occupation of the West Bank, Gaza, and East Jerusalem, multiple hard-to-defend wars, and a growing awareness of “cross sectional” issues around racism, police brutality, militarism, and US foreign policy, I was gradually forced to re-examine much that my family once held dear and to face the consequences of my actions. As an increasingly secular person, I also began to scrutinize the meaning of my Jewishness; the uncomfortable consequences of Zionism and my personal responsibilities in a world rife with contradiction, fear, and conflict. So how did all that happen and where am I now?

… My parents grew up a few blocks from each other, met at night school at Brooklyn College (Rosner sat next to Rothchild), and were both rebels in their outward rejection of speaking Yiddish as our mamaloshen and maintaining an Orthodox kosher home, and in their eagerness to embrace a modern American life with mowed lawns, a love of Mahler, and occasional goyishe friends. My mother read Women’s Day, a guide to being a good housewife, and along with chicken and challah on Shabbos, made orange jello molds with grated carrots layered at the top, a distinctly post-war dessert, the bland happy taste of the ’50s. At the same time, my parents managed to let me know that we were different, that we were from a distinct and endangered tribe. I marvel at that inherited sense of being at odds with American culture and society, of feeling so Jewish in a non-Jewish world despite rising economics and acceptability. I learned early that I was an outsider in the dominant American culture, that stories keep our history and culture alive and also create the learned truths about that history. I have also come to understand in my own journey, that people survive by telling their stories and that the victors in history most often create the prevailing and accepted narratives.

And I was deeply enmeshed in that Jewish story; there was my unlikely love of gefilte fish and my real talent for making matzoh balls, as well as the level of guilt and responsibility I felt for the world’s disasters. In sixth grade each student was asked to draw a picture of what he or she really wanted. I do not recall what my fellow classmates yearned for, but I do recall that my desire for “World Peace” was considered to be moderately peculiar. In college I met upper- class, private school girls who wanted to touch me, gushing, “I’ve never met a Jew before.”

… As a teenager, I was lulled into the liberalism of Adlai Stevenson and John F. Kennedy, but I discovered there were harsh limits. When I came home with an African-American boyfriend, my modern, liberal, pro-civil rights, tolerant mother warned me that if I married a non-Jew, then “Hitler’s dream would come true.” She begged me to understand what I would lose, never considering what he also might lose should he marry me. She cried and threatened to sit shiva, mourning my “death,” banishing me from the family forever. This was a powerful message to a budding 19-year-old exploring her own identities and passions; the threat of permanent expulsion from the enfolding arms of my childhood. In a painful and tumultuous evening, my mother morphed from ally to threat and I saw excommunication as a real possibility. Little did I know what lay ahead.

This is quite a heritage, a potent mix of trauma, memory, tribalism, and assimilation. As a family, we prided ourselves on our differentness and our ability to survive against the odds of anti-Semitism, pogroms, near annihilation, and the sweatshops and poverty of the Lower East Side of New York City. At the same time that we were thriving in multicultural, upwardly mobile suburbia, I knew in a strange, unconscious way, like Jews everywhere, that we were potentially all victims, we were in some way all survivors, and the world was an unforgiving place; the threat of another Holocaust lurked behind every international crisis, every unkind word.

… In the mid 1990s, fortified with a growing understanding of colonialism, racism, immigration, and Islamophobia, and increasingly disenchanted with the version of Israeli history I had learned in Hebrew school, I began an active search for the stories that I had missed. I began to listen to dissenting Israeli Jews, Palestinians, and other Arabs in the Boston area. I began to make invisible people visible to me, to confront the trauma and fear that I had inherited, and to hear and feel our enormous human commonalities; the common language of denial, despair, endurance, and recovery. I started to realize that the “troubles” in Israel did not start in 1967 with the Six Day War and the occupation of East Jerusalem, the Golan, West Bank and Gaza. I began to recognize the importance of revisiting the events of 1948, the year I was born and the State of Israel was founded; to hold both the story of my own people and the stories of the people who were killed, dispossessed, and displaced partly as a consequence of my own people’s tragedy, in my head and in my heart simultaneously.

… Early on I saw myself as a student of the conflict, bearing witness to the realities that I observed on the ground, working with dissenting Israelis and Palestinians.

…I worked with US activists and members of the Israeli left who were focused on civil, human, and political rights for Palestinians in Israel and the occupied territories as the fundamental basis for a viable, secure Israeli state. I watched the “left” in post-Oslo Israel shrink to desperately small numbers, and I observed Palestinian civil society coalescing around a commitment to nonviolent resistance to oppression. I began to understand as the Jewish settlements exploded in the West Bank and East Jerusalem with increasingly restrictive bypass roads, checkpoints, permits, and the snaking separation wall, and as the Israeli government declared the Jordan Valley a closed military zone, that the government of Israel (like all governments) was not going to give up power voluntarily. I watched with growing horror at the racist, right-wing swing of successive Israeli governments and the unleashed bigotry and aggression of Jewish settlers towards their Palestinian neighbors. It became increasingly clear to me that the expulsion, dispossession, and war against the indigenous Palestinians that started long before 1948 was actually continuing unabated, disguised in the language of the endless, stillborn “peace process,” Jewish exceptionalism, water, security, and the racist demonization of Palestinians. This growing understanding led me to fully embrace the international call for boycott, divestment, and sanctions against Israel as the most creative, powerful, nonviolent work that I could support.

[I’m now going to reflect on some of my experiences as an activist, speaking out on these topics. I trained and was on the staff for years at Beth Israel Hospital in Boston…]

… Other faculty gave talks on their various medical missions and experiences around the world–I wanted my time as well. In an earlier discussion with my department chief about visiting colleagues in Israel, he (an ardent Zionist who led delegations to Israel, especially focused on their emergency medicine and response to terrorist attacks), had said to me, “You are a danger to the Jewish people.” (Who knew?) Needless to say, my efforts to give a departmental presentation were unsuccessful until five years later when he left the department. I applied to the new acting chief, was accepted, and when my impending grand rounds was announced, the department received 100 emails protesting my appearance. I was asked to remove the word “occupation” from the title, (ultimately the presentation was titled: “Healthcare in the West Bank and Gaza: Examining the impact of war on a civilian population, a personal journey”), and warned to stay away from politics.

… At a John Carroll University political science class in Ohio, “Peacemaking in the Palestine Israel Conflict,” there were complaints from the local Hillel stating that Jewish students did not “feel safe” having me on campus and a major faculty meeting was held to discuss my upcoming event. Fortunately, the professor was supported by the university administration. Nonetheless, 100 students packed the class, including many from Hillel. The Hillel contingent was mostly silent during my talk, although some approached me individually afterwards. The most disturbing interaction was with the Israeli shalicha, (ambassador, hired by Jewish institutions to represent Israel and to shape the conversation about Israel in temples, Hillels, community groups, etc.). She aggressively attacked me as a “liar,” chastised me for “doing a great disservice,” and refused to “agree to disagree.” Loud bullying seemed to be her main strategy and the students watched closely.

… As expected, temples are the most challenging venue for me. This is where I feel I am up against the wide spread“McCarthyism” in the mainstream Jewish community. At a reform temple in Ithaca, NY, I found that when announcements were placed in the temple newsletter, if the speaker was left-leaning on Israel/Palestine, there was a disclaimer that stated that the speaker does not represent the temple community, thus setting the normative opinion. In a Bethesda, Maryland Reconstructionist synagogue, Erez Israel class, I noted that all the maps for the course and in the temple labeled “Israel” were actually the one state “Greater Israel.” When one of the older men took issue with my comment “the victors write history,” he said “We are not the victors, we lost six million times.” I could feel this sense that many in the class could not move beyond living in the Holocaust, living with a permanent victimhood as well as a lack of understanding and sympathy for “Arabs,” thus the dominant narrative became a blinder to seeing a co-victim’s reality. In an orthodox synagogue in the DC area, my film screening for a men’s club, which was organized by an orthodox human rights lawyer and Hebrew school teacher, was summarily cancelled by the rabbi.

Moving out into the Jewish community, the Sacramento, California, Jewish Federation newspaper, The Jewish Voice, refused to post an announcement for my film, as they deemed it an “anti-Israel event”. A few years earlier they had refused to announce my book reading, also claiming it was “anti-Israel.” In a vibrant Jewish community at the Beachwood Library in Ohio, I encountered a very conflicted audience, many unaware of the millions of dollars being spent on Israeli hasbara, the very aggressive control of “Israel messaging,” and the intense muzzling in the Jewish community and on campuses. One woman noted that we can have this kind of open conversation “anywhere in the US” but in Arab countries we would be censored, arrested, “sold into sex slavery.” I pointed out that actually I cannot have this conversation in most temples, Hillels, and Jewish community centers and that rabbis routinely cancel my appearances. She pointed out that the poster for my talk earlier in the day was offensive: it had the word “CONFLICT” in large letters and a picture of the separation wall, so “it says what side you are on.” I pointed out to her that, problematically, there is an actual conflict and the separation wall is an issue and an important symbol of the occupation. There was clearly a low bar for feeling threatened. The most disturbing moment for me came at the end when an older woman walked up to the women selling my books, and announced these “should be burned.” A gentleman behind her retorted, “That’s what they did in Nazi Germany.”

… At World Fellowship, a progressive family summer retreat in New Hampshire, a woman in the audience told me of her child attending a public school in New York City where they were studying indigenous peoples and as an example the teacher stated that the Jews were the indigenous people in Israel and they were being treated badly by the Palestinians. Her daughter piped up that she thought it was really the other way around. The girl was sent out of class to the principal’s office, her parents were called, and there was a stern warning about such talk. When the mother agreed with her daughter, the principal explained that that version of history was not allowed in New York City public schools.

… As an activist, I now relate to many communities: the more mainstream Jewish organizations look at me as the classic “self-hating Jew” because I value Palestinian life and aspirations as much as Jewish life and aspirations. Also because I see the increasing right-wing, racist policies of the State of Israel backed by the US as the fulcrum where real change must come, and this involves challenging the basic assumptions of political Zionism and Jewish privilege and majority rule.

The activist Jewish communities and younger Jews welcome my insights and join me in a call for democratic values and respect for international law, with the acknowledgement that Palestinians are now the oppressed people in this international equation, (along with Mizrachi Jews and African asylum seekers, but that is another story).

The good liberal Jews in the middle who are holding on to the idea that Israel can be Jewish and democratic and are not yet willing to face the deep contradictions within Zionist society, continue to squirm and support the human and civil rights movements within the US and Israel, calling for an end to the Israeli occupation without facing what I see as the core issue: Jewish privilege and its consequences.

Christian groups and particularly African-Americans, increasingly welcome “a Jew we can talk to.” as many find themselves aggressively challenged by their Jewish friends and rabbis when they raise the kinds of serious and contradictory concerns outlined here.

Muslim friends are relieved to find a Jew post 9/11 who embraces people not as stereotypes, but as fellow human beings with complicated and often traumatic life stories trying to move forward in a world that is so violently Islamophobic.

I believe that resolution of this conflict is central to the resolution of many of the tragedies that have engulfed the Middle East. I would urge us to start with ourselves. I have come to understand that it is critical to separate Judaism the religion from Zionism the national political movement; “Zionism has hijacked Judaism.” I would advocate defining a Jew as someone grounded in religion or culture and history, a set of ethics, a sense of peoplehood; all definitions equally compelling.

While Jewish Israelis have long looked down upon the Diaspora as not “real Jews” with “no right to criticize, because you don’t live here,” Diaspora Jews are reclaiming our legitimacy and our voice as Jews. We are delineating the racist ideology of anti-Semitism from thoughtful moral criticism of the policies of the country, Israel. Thus the treatment of and solidarity with Palestinians has now become the civil rights issue of the day for modern younger Jews who will be here long after the older post-Holocaust generation has moved on and no longer shapes the boundaries of intelligent discourse and definitions of normalcy. Mostly what I see is that Diaspora Jews are starting to own the Nakba, [the Palestinian experience of 1948, literally the Catastrophe], as part of our story. I believe that after centuries of powerlessness, how we as a community handle our new position of power and privilege is critical to the survival of an ethical Jewish tradition as well as a just resolution to a more than century-old struggle in historic Palestine that is being fought in our name.

Thank you,

Dr. Alice Rothchild

Email:, Website:, Twitter: @alicerothchild

Dr. Rothchild is a physician, author, and filmmaker on Israel and Palestine. She has been published in The Seattle Times, The Boston Globe, The Baltimore Sun, Jewish Currents, and The Electronic Intifada. She is a proud member of Jewish Voice for Peace (J.V.P.).

Preparing for 2020: Advocating for justice for Palestine and beyond – September 13, 2019

First published by the American Friends Service Committee

The American Friends Service Committee conference in DC, September 7-8, Preparing for 2020: Advocating for Rights, Justice, and Freedom, was an excellent antidote to the stormy and frightening times in which we live. It is a measure of our failure to be more outraged than we already are that Netanyahu’s pledge to annex much of the West Bank to Israel (as if there was not already one apartheid state) barely caused a flutter of protest. Between Trump and Netanyahu we are all suffering from shock fatigue and a good dose of gloom about the future of the planet. I lie awake at night wondering, will it be forest fires, drought, floods, and wars over water, or maybe an old fashioned nuclear war that will finish us off. For folks with children and grandchildren, this is not a theoretical concern.

But there I was sitting in the calming simplicity of a Quaker meeting room at the Sidwell Friends School, listening and talking with a wide range of activists, organizers, and policy experts, and brainstorming about grassroots advocacy, at town hall meetings, primary caucuses, and party conventions. The positive energy, humor, honesty, and commitment were infectious and uplifting.

I had a number of important insights. When the “No Way to Treat a Child Campaign” started four years ago as a joint project of AFSC and Defense of Children International – Palestine, it was difficult to have a conversation on The Hill about the rights of arrested, detained, and imprisoned Palestinian children. Now, Bill HR 2407, sponsored by Betty McCollum, has 22 cosponsors. The bill requires “that United States funds do not support military detention, interrogation, abuse, or ill-treatment of Palestinian children…” Organizations like Human Rights Watch, B’tselem, UNICEF, and even the “Country Report on Human Rights Practices for Israel and the Occupied Territories (“Annual Report”) published by the Department of State noted that Israeli security services continued to abuse, and in some cases torture, minors, frequently arrested on suspicion of stone-throwing, in order to coerce confessions. The torture tactics used included threats, intimidation, long-term handcuffing, beatings, and solitary confinement.”

We are well aware of the impact of “The Squad” on discourse about Israel/Palestine. We are seeing Palestine, and especially Palestinian children, being brought into the discussion of human rights in the US congress, in the Jewish community, with younger generations, and with African Americans whose empathy and activism is heightened because of parallel concerns for their own children.

Which brings us to the topic of intersectionality. Intersectionality is about understanding who is closest to the pain and letting that be the guide for the vision of whom should be closest to the power. A number of speakers were clear that Palestine advocates need to step out for other causes like indigenous rights, anti-racism work, and protesting policies at the US/Mexican border. While activists once decried the phenomenon of PEPS (people who are Progressive Except Palestine), it is now clear that to be effective, we must be involved in a universal struggle for human rights. We need a collective liberation, which also means, by the way, no POOPS (Progressive Only On Palestine).

We were urged that if get out of our silos, the empire will lose; complexity is the tool of the empire. Understanding our own complicity and being able to challenge the oppressor within is critical. This means, for example, when organizing, avoiding panels that focus only on Palestine, always bring in other issues. There are no exceptions on progressive politics, especially if we benefit from that exception. As one speaker said, we must be PIPS (Progressive Including Palestine).

There was much discussion about what Israelis call “The BDS,” the boycott, divestment, and sanctions campaign that began with a call from Palestinian civil society organizations in 2005. “The BDS” is viewed by some as an anti-Semitic, anti-American monster, and legislation both on the state and national levels has been passed to condemn and criminalize the campaign, a reflection of the power of AIPAC and Christian Zionists. If you want to stay up to date, Palestine Legal tracks local and national anti-BDS legislation. While the call to boycott is actually protected by the First Amendment, it is a form of nonviolent political speech, we were urged to be strategic. If you are in a community where the word itself is toxic, then talk about human rights and companies that violate human rights. Talk about investing responsibly and avoiding conflict zones like Western Sahara, Crimera, and, oh yes, Israel. BDS is a strategy. Tell the story. Are you in favor of what is happening in Gaza or the continued growth of settlements in the West Bank? Do you not want to make money off of other people’s suffering? BDS urges people to move beyond words to action, and that is why it is so scary. And so effective.

The bottom line is that Palestine is about global justice, campaign designs are rooted in solidarity, in de-exceptionalizing Palestine. The issues in Israel/Palestine are about settler colonialism, racism, global military industrial corporations, multi-national surveillance and prison systems. These are universal issues.

The session that was actually fun (yes activists can have fun) was about bird dogging: confronting officials in public to raise awareness, get a photo op, a statement on the record, something that can be put out on social media. The advice was very sensible: Spread out in the crowd, dress like a supporter, look friendly, raise your hand fast, get in the Q&A line early, read the room, figure out how to connect your issue to other issues being raised. Then, get in line for a hand shake or selfie. When you shake the candidate’s hand, place your hand on the top of their palm, wrap your thumb firmly around their wrist and hold on for dear life. Disarm the politician by praising first or making your ask very personal. Then we all got to practice and role play while AFSC staff pretended to be the glad handing candidates we most want to hold accountable to take positions for justice in Palestine. And we were good.

If you want more information and inspiration:

Center for Constitutional Rights

Churches for Middle East Peace

Gaza Unlocked

Just World Educational

No Way to Treat a Child

We Are Not Numbers

And the just published book: Dreaming of Freedom: Palestinian Child Prisoners Speak

Talking about manifest destiny and settler colonialism, there is a map of the US that parallels the disappearing Palestine map

Anti-semitism and white supremacy August 25, 2019

first published in Mondoweiss

The epithet of anti-Semitism is being hurled fairly loosely these days whether it be Trump’s characterization of Congresswomen Omar and Tlaib’s policies or the State Department’s expansive definition of anti-Semitism as criticism of Israel or comparison of Israel to Nazi Germany (a comparison that has been made by a number of Israeli thinkers), or the local and national efforts to label the Boycott, Divestment, and Sanction movement of Israel as inherently anti-Semitic.

So how can we calmly and thoughtfully think about this swirling controversy? Most people recognize classic anti-semitism, the Christianity’s Jews-killed-Christ, Shakespeare’s Shylock, Nazi-graffiti-scrawled-on-a- synagogue types. Most people, (except those in the growing white supremacist, neo-Nazi movements), agree that these acts and beliefs are horrific and dangerous to a democratic society that aspires to tolerance and respect for minorities, whether it be the 7 million Jews, 3 ½ million Muslims, or 11 million Mexican immigrants among us, for starters.

I would like to explore the recent phenomenon, which is fracturing the American Jewish community, of equating criticism of Israel with anti-semitism, and the easily recognized and intrinsically linked relationship between a growing hatred of Jews and the public explosion of white supremacy in our country.

In the first half of the 20th century, the work of the Zionist movement to establish an exclusive Jewish state (in Uganda? Australia? Palestine?) was highly controversial, and only became a reality through a confluence of factors including the Christian Zionism of colonial British leaders, the appalling consequences of the Nazi Holocaust, and the UN’s attempts to address the desperate needs of postwar European Jewish refugees who were not welcomed in other countries. The underlying racism that allowed European Jewish trauma, aspirations, and history to be privileged at the expense of the indigenous population in Palestine was rarely acknowledged, or else justified in the name of Jewish survival. At the same time, the understanding that people who had lived in Historic Palestine for centuries, and their neighboring Arab brothers and sisters, would not peacefully relinquish land they felt was theirs, was defined as Jew-hatred rather than opposition to what is now understood to be settler colonialism. Zionism was sold as a redemptive Jewish liberation movement building a new and just society for a battered people in their ancestral lands. Palestinians were rendered invisible.

In 1974 the Anti-Defamation League (once a progressive group focused on exposing bigotry and intolerance towards Jews) defined the “new anti-Semitism” as criticism of Israel. Eight years later, after Israel’s disastrous invasion of Lebanon and the massacres in Sabra and Shatila, the Israeli government and a variety of think tanks and PR groups turned their attention to improving Israel’s image in the world (but not, I might add, its conduct on the ground). In 1984 the American Israel Public Affairs Committee (AIPAC) issued a college guide exposing what they saw as a dangerous anti-Israel campaign on campuses which was grounded in the idea that Israel was always the victim and criticism of Israeli policies, inherently anti-Semitic.

This McCarthyism crept into Jewish institutions and the epithet of anti-semite was used freely to silence and demonize critical voices. Israel created Ministries of Public Diplomacy, Diaspora Affairs, and Strategic Affairs that work with “front groups” in the US, and a host of generously funded Jewish Federations and groups like the Israel Action network, Hillel, StandWithUs, Committee for Accuracy in Middle East Reporting in American (CAMERA), Canary Mission, AMCHA Initiative, Israel Project, Israel on Campus, Israellycool, ACT.IL-Online community for Israel, etc., sprang into action. Today they provide “alternative” and cherrypicked “historical facts,” slick propaganda YouTube’s, websites, and apps, compile dossiers to blacklist and smear activists as anti-Semites and terrorists, threaten universities and public events, and work hard to keep Congress in line.

I review this history to show that attitudes do not happen by accident, and today they are magnified by the explosive power of social media which promotes a host of misinformation and conspiracy theories and encourages people to live in their own private echo chambers. Viewpoints are shaped by propaganda and belief systems- religious Jews yearn for the Messiah and some 60 million Christian Zionists await the Rapture. Both require that Jews “return” to Zion, albeit for very opposite reasons. Fears are easily framed and manipulated. There is rising anti-semitism fueled by a deranged president and the growth of a bigoted white nationalist alt-right that hates Jews, women, black and brown people, Muslims, immigrants, LGBTQI; anyone not part of their vision of an Aryan nation of armed, white, heterosexual men. Thus we see the bizarre phenomenon of neo-Nazis disparaging Jews while expressing admiration for the State of Israel, a good place to sequester these undesirables and at the same time, an admirable example of a powerful, well-armed state, grounded in ethnic purity, eager to do battle with Muslims in general and Iranians in particular.

Obviously, Jews are a diverse group of people; undivided support for the policies of Israel are seen largely in older generations and mainstream institutions. Jewish youth are much less attached to the country and its mythology, hence the frantic public relations activities on US colleges and Birthright Programs. Jews from Eastern Europe have a very different experience than Jews of color who often experience double discrimination. Israel is a contradictory place. It claims to be a democracy while passing a Nation State Law that officially legalizes Jewish privilege. It receives $3.8 billion in military aid per year from the the US and extensive political cover, exports massive amounts of military surveillance and technology to repressive regimes, while having magnificent orchestras, brilliant writers, scientific institutions, world class medical facilities, and historic religious centers.

At the same time, the country is guilty of major violations of human rights and international law, the ruthless incarceration of Palestinian children, and a brutal 50+ year occupation. I fully support the right of oppressed people to resist their oppression and I am appalled by sporadic Palestinian violent resistance and its consequences for Israelis. I am even more appalled, however, by the indiscriminate and disproportionate violence of Israeli forces and settlers that have made life unlivable every day for almost five million people under their control. Not only do we taxpayers make this all possible, but it is our democratic right to call out injustice when and where we see it.

Denunciations of anti-semitism must be credibly nested within opposition to white nationalism and the racism and Islamophobia that are its lifeblood. If we do not distinguish between valid critiques of the policies of the Israeli state and anti-semitism, we are allowing rightwing forces to weaponize anti-semitism, suppressing freedom of speech and open debate, and making the term, anti-semitism, ultimately meaningless at a time when it is critical to identify and oppose it.

My mother used to walk by a sign at a park in Brooklyn, NY, that read: NO JEWS OR DOGS ALLOWED. That was anti-semitism. My call for an end to the occupation of the West Bank and East Jerusalem, the siege of Gaza, and the racist policies of the Israeli government towards its Palestinian citizens, is not. The hysteria this discussion provokes is a mark of Jewish fragility not strength.

A response to Eric Alterman’s question: ‘Does anyone take BDS seriously?’ August 1, 2019

First published in Mondoweiss

Eric Alterman’s July 29 New York Times opinion piece asks: “Does Anyone Take the B.D.S. Movement Seriously?” Alterman argues that the BDS campaign (boycott, divestment and sanctions) is all symbolism without any real substance or economic impact and that support for BDS has become an empty progressive catch phrase. I feel compelled to answer his question because Alterman and I are looking at the same information and coming to opposite conclusions.

I will start with his flippant remark: “with each iteration of the B.D.S. ‘debate,’ the underlying issues seem to recede into obscurity.” He focuses on how BDS is used as a political tool in our increasingly dysfunctional Congress, rather than on the realities in Israel/Palestine.

Just to be clear, this is not about us. The “underlying issues” include the increasingly racist Israeli government that has made it unambiguously obvious that maintaining Jewish exceptionalism and privilege is a higher state value than the democracy and equality of all its citizens that is so eloquently stated in the Israeli Declaration of Independence. The “underlying issues” include a more than fifty-year-old occupation of the West Bank, Gaza, and East Jerusalem, the exploding Jewish settler growth in the West Bank, the catastrophic siege in Gaza that has brought the Strip to a humanitarian catastrophe, the brutal expulsions and home demolitions that are taking place in East Jerusalem as we speak. The “underlying issues” include millions of Palestinian refugees living without recognition of their internationally guaranteed rights and without a clear path to a viable future.

These issues have not receded anywhere and in fact are more obvious and more internationally understood than ever before thanks to YouTube, blogs, social media, human rights groups, and eyewitness reports that are readily available to anyone who wants to know.

Yes, the Israeli economy is humming, but as the Israeli government allies itself with repressive regimes from Saudi Arabia to Russia and builds its reputation as a major exporter of surveillance tools, border walls, and military machinery, it will become increasingly difficult for American Jews to happily hum along. Alterman ignores the utter failure of decades of “peace talks” and UN Resolutions. He chooses not to see the major corporations, the pension funds, the governments, the universities, the performers that are boycotting Israel because of concern for the wide range of well-documented human rights abuses. He is blind to the major social movements like Black Lives Matter that are allying themselves with critics of Israeli policy because they recognize racism and police brutality when they see it.

Alterman complains that supporters of BDS do not recognize “Israel’s right to exist,” and quotes Omar Barghouti, one of the leaders of the BDS movement as saying “no Palestinian — rational Palestinian, not a sell-out Palestinian — will ever accept a Jewish state in Palestine.” Language and clarity are critically important here. I would argue that states come into existence out of a confluence of many factors: aspirations, wars, migration, colonization, treaties, etc., etc., but Israel does not have any more of a “right to exist” than Ecuador or Malaysia. Settler colonialism and manifest destiny do not have credibility in the twenty-first century. There is no such right. That argument is a veiled accusation of anti-Semitism which is used to silence critics of the policies of the Israeli state.

It is also important to pay attention to Barghouti’s full statement in which he describes the rights of the indigenous Palestinian population, the system of racial discrimination that exists, and his opposition to any exclusionary state, Christian, Muslim, or Jewish. Because I listen to and work with many Palestinians, I can say quite clearly that it is extremely unlikely that any native people would welcome the creation of a state in what was recently their homes that excludes their inalienable right to self -determination.

In fact, Barghouti’s call for a democratic secular state is something we would all support in every country in the world…. Except Israel. This is a problem.

I hear that Alterman is tired of the “regular earful about the importance of B.D.S” that he gets as a college professor, a columnist for the Nation, and from his college-age daughter. He sees these earfuls as “a purity test of sorts for progressives,” which I think gets us to the real problem. Progressives who support civil rights and women’s rights and LGBTQ rights want a carve out when it comes to Zionism, the national political movement that supports the creation of a state which was born out of the settler colonial movements of the European empires as well as the horrors of the Nazi Holocaust. This national political movement is used to justify policies that create severe harms to Palestinians. I would argue that it is also deeply corruptive for Jews who carry out these repressive actions and who historically have flourished in multicultural and (gasp dare I say it) Islamic societies. The Israeli government is involved in a massive project of self-ghettoization and this is very dangerous.

Additionally, for decades, Palestinians have lived under internationally-recognized occupation and siege, have experienced repeated military incursions, high rates of injury, PTSD, and depression. They live with severe restrictions of movement of goods and people including health-care providers and clinic and hospital supplies, high rates of child incarceration and administrative detention (detention without charges or trial), food insecurity, and aggressive displacement and home demolitions as most recently and vividly seen in East Jerusalem.

They cannot be expected to live under these conditions without resisting their oppression. This would be true for any of us. Despite the level of violence that they experience on a daily basis, mostly from the Israeli Defense Forces and other Israeli security forces as well as Jewish settlers, Palestinians have been widely condemned for any violent resistance. It stands to reason that when over 170 Palestinian civil society organizations ask the international community to nonviolently boycott Israel in order to pressure the government to change policies that are clearly harmful to Palestinians, we, the international community should focus our attention on honoring that request.

So BDS is not: “Like vegetarian diets and carbon-neutral living… something that is vital to espouse, but much less important to explain, let alone carry out.” Professor Alterman, finding a resolution to these issues and injustices, respecting the needs of Jewish Israelis and Palestinians as equal human beings, is one of the more critical challenges facing our society. Boycott, divestment, and sanctions is a creative and time-tested strategy to create political and social change. Your daughter says this is important. Listen to her.

Getting in, and getting out, of Palestine – June 19, 2019

first published in Mondoweiss

Installation at the Walled Off Hotel in Bethlehem, Photo by Alice Rothchild.

In late March and early April 2019 I traveled to Jordan and the West Bank (Palestine) with two colleagues, Sonia Dettman and S. Komarovsky, first to attend the Lancet Palestine Health Alliance conference in Amman and then to explore and better understand the lives of refugees and the workings of UNRWA, with a focus on the status of refugee health. This is the final essay in the series.

Friday, March 29, 2019

Traveling while Palestine

The night is filled with the anxiety that any interaction with Israeli security triggers; we are leaving for the Allenby Bridge crossing from Jordan into Israel/Palestine at 6:30 am. Of course daylight savings time starts in the middle of the night, so we lose an hour and the call to prayer occurs three times starting at 4:30ish, probably because it is Friday. I am awake almost hourly checking to be sure I have not slept through the alarm, which I have never done in my life. The death toll in the occupied territories is rising. Gazans are preparing for the year anniversary of the Great March of Return on Land Day tomorrow. Israeli reservists are being called up. Netanyahu is facing the election in a few weeks and I worry he thinks he needs a war. The Palestinian Authority is once again out of money and has cut salaries in half because the “Zionist entity” refuses to release its taxes. Welcome to Israel.

We leave all of our suspicious material on Palestine, human rights, and any evidence of an interest in justice in an extra bag in Amman to retrieve on our return, and arrive at Allenby Bridge at 7:30 am. The Jordanian officials sip tea, smoke cigarettes, poke and prod their computer, and hand stamp forms back and forth without any sense of urgency. Exit fees are paid, children squirm, and we wait for enough people to arrive to fill a bus. Finally, with just enough low-level chaos to cause a rise in blood pressure, we are on our way, after the Jordanian official calls out each of our names and hands us our passports. I am sure that violates some HIPPA type rule about privacy, but what do I know about international relations?

The landscape drifts into military installations and desert as we approach the rushing brown stream that was once the mighty Jordan. More stop and go and we cross the bridge into the hands of Israeli security. Blue and white flags flutter. Guard towers are covered with camouflage netting, plainclothes men wander back and forth with fingers on the triggers of their automatic weapons. I flunk the metal detector due to my new and improved knees and go sit. And sit. A man repeatedly talks into his shirt. Finally a woman takes me in for a vigorous pat down and sweep of the metal detector which reveals that my knees (and my boots) actually contain metal. (Like I said.)

I am reunited with my passport and wait in the chaotic, uneasy crowd for the luggage to emerge from the x-ray screening. At passport control I am asked why am I here? (Visiting a friend in Tel Aviv). Why did I come from Jordan? (Medical conference). Am I a doctor? Am I Jewish? (Yes.) Israeli? Any Israeli relatives?

A brief wave-through by the Palestinian Authority and three hours from start to finish, into the hands of hungry service (pronounce ser-vees) drivers. This is all an upgrade since my last visit, but still qualifies as a third world experience. We need to catch a bus to Jericho which requires buying a ticket. As we try to board the bus, we discover we need to pay a luggage fee as well. (Who knew?) Back to the little ticket man where he tries to scam me out of 39 shekels by making me pay for the tickets again. I explain, calmly, not so calmly. A lovely man says it all in Arabic. Ticket man yells, I yell. He grabs my tickets. I reach into his glass booth, grab my tickets and my money and run to the bus. (Welcome to occupation and shattered nerves.)

From Jericho, after another encounter with the PA, passport screening, papers stamped and passed from official to official, luggage unceremoniously removed and then returned, we head north to Nablus to visit old friends. The service does not leave for a half an hour, until all the seats are full. As I gaze out the window, I am flooded with emotion. Massive Israeli date palm plantations and carpets of green vegetation sweep by. The distant hills are hazy, the sand hills massive and stark. We pass a sign for Na’ama herbs (Israeli), more stark desert, and purple-blue mountains in the distance. The signage is in Hebrew, Arabic, and English (the Arabic being a transliteration of the Hebrew), but only Israeli settlements are identified and Palestinian towns are geographically invisible.

More bursts of wildflowers. I am told the tiny yellow blossoms are called Yasmeen. The landscape is striking, large milk-chocolate chunks of rocks, Israeli vineyards covered in netting, goats munching on the lush vegetation. The Judean Hills are in their peak greenery as our ears pop and we wind north. Blankets of purple flowers, signs to the Jewish settlement of Ariel, Jerusalem, Tel Aviv/Yafo. Past rocky terraces and a massive industrial park and the settlement of Ma’ale Efrayim, and the Palestinian village of Osarin, as we hurtle along route 60 to Nablus. Huwara checkpoint, a jumbled shadow of its former major military installation, with two IDF soldiers, lolling about, fingers on their triggers. We pass through a town, shops, sides of goat and sheep hanging on hooks, and finally into Nablus, a sprawling city surrounded by hills and military installations.

After a warm and loving visit and an immense amount of good food (including melt-in-your-mouth cheesy kanafe), we head south in a taxi (this being Friday when everyone goes home and travel is challenging) to Bethlehem and Aida Camp. A bird flutters low on the highway and I hear a thud. The driver winces. My heart sinks. The scenery tells a story if you know how to read the language. We pass charming villages, a mosque in Madama with a golden dome and a tall thin white minaret. Tura winery (Israeli obviously). Caravans, (of Jewish settlers) on hilltops and signs for settlements. We see an IDF jeep with a group of soldiers facing a cluster of Palestinian boys crouching in a ditch. Over two hours we encounter five more IDF jeeps, each time the cab driver says, “Israel, very dangerous, very dangerous.” Two more wineries (Gua’ot, Psagot) on occupied land. Palestinian mega mansions and wide swaths of Jewish settlements spilling down hillsides. A Palestinian quarry. A large red sign warns travelers on the roads to unnamed Palestinian villages, “This road leads to a Palestinian village. The entrance for Israeli citizens is dangerous.”

Gradually there is more concrete separation wall marching across the landscape, tall concrete slabs, concrete topped by a wall of wire fencing, on the right, then the left, then both sides. In Hizma the concrete is right up against the highway. The road dips under a bypass road. A little boy tends sheep next to two IDF soldiers and a jeep. The settlement of Ma’ale Adumim totally dominates the landscape, covering the crest of miles of hills. A large key is mounted at the Azaria rotary, dead cars are piled in the strip between lanes, garbage and poverty is everywhere. We pass signs to Al Quds University (in Jerusalem) and then enter Wadi Al Jeer, a major vertiginous highway built by USAID, also called the Container Road. Also thought to be US funding for an apartheid road. We pass the container checkpoint with guard towers and soldiers, pass a Palestinian Authority soldier, and into cluttered and charming Beit Sahour, Bethlehem and nearby Aida Camp.

Outside the camp we have a planning meeting at a recently opened bar, Rewired, which throbs with music and hip young people drinking wine, beer, and signature cocktails. This is new. And now I would really love to fall asleep, but every few minutes an Israeli jet screeches across the sky and dogs howl as if protesting the military occupation of their land.

Wednesday, April 3, 2019

Getting out

I have finally succumbed to the level of exhaust, perfumed cleaning products, and cigarette smoke in these parts and I am actually wheezing (bought an asthma inhaler for 15 NIS (about $4)) and now laryngitis has set in and I can barely talk. Perhaps the Mossad is gripping my vocal cords.

At 10:30 am we leave our welcoming hosts in Doha, the neighborhood next to Aida Camp. Although we already had breakfast, we are offered fried eggs as the taxi pulls up, Allah forbid we might go hungry. At 11:30 we arrive at Allenby Bridge and begin the tedious dance of the vehicles. We wait until our driver finds another taxi with yellow plates that allows us to go directly to the Israeli checkpoint and skip the Palestinian Authority, not that they have much authority at these borders anyway. Then we get on line. There are two lanes as far as I can understand, one for trucks (there is a steady stream of large trucks, especially cement mixers) and one for the rest of us. We inch along behind tour buses and yellow plate cars and taxis. Other tour buses are parked in a lot near the checkpoint and periodically the soldier/traffic director stops our line and invites a tour bus or two to cut ahead for the 20-minute-long screen, mirrors under the bus, various doors open. Did I mention the tour buses are all empty and it is getting hotter and hotter, this being the Jordan Valley?

Alice Rothchild

Our taxi driver is getting agitated, he steps outside to smoke a cigarette, talk with other fellow sufferers, and plot his strategy. He gets inside, abruptly backs up and gets into another lane. A cement truck backs away, a grey van, “Allenby Serves,” cuts ahead, maybe VIP? Cars with some sort of business designation also jump the line and don’t seem to get checked. We move closer to the checkpoint, then soldier/traffic director makes us back up to let another empty tour bus in line. Truck after dusty, sandy truck passes us in the left lane. A military vehicle covered in metal grills and is driven by a female IDF soldier scoots by.

At 12:10 pm we reach the vehicle and passport check. The girl soldier with the bullet proof vest actually asks, “Do you have any weapons?” Really??? And we are on our way to the next hurdle. The taxi zooms through striking desert hills and wildly-sculpted mountains with a thin fuzz of greenery here and there until we arrive at a terminal building for Israeli passport control. We pay something like 166 shekels, get some pieces of paper, and get on another line.

A very large crowd of folks from India arrive just before us (maybe pilgrimage to Baha’i temple in Haifa?) so the room is suddenly filled with men and women and a collection of wiggling children and babies in brightly-colored long dresses and tunics, red, blue, orange, green patterns, full skirts and scarfs. The men wear white skull caps.

When I finally get to passport control the older Ashkenazi officer looks at me with a smile and with a contemptuous colonial shrug says “Indians.” He might as well have muttered, savages.

I smile back and sail through the checkpoint (deeply appalled but masked in my white Jewish privilege), track down my luggage and get into the bus. At 1:05 pm the bus pulls out of the military camp and into Jordan.

We pass some Jordanian security five minutes later and at 1:15 two Jordanian security guys board the bus and collect all of our passports. Two Israelis are told to get off, something about needing a visa. The bus moves past the checkpoint and we pass a man in a sand yellow truck with a large weapon mounted on the roof. We travel through desert, collections of houses, and date palms and arrive at Jordanian passport control at 1:25. It takes 35 more minutes to work our way through the various lines and windows and then we are off to Amman. Two-and-a-half hours, not bad given the possibilities.

My traveling companion with the smart phone tells me Jewish settlers just shot to death a young man at Huwara checkpoint in Nablus and the soldiers let him bleed to death as they watched. It was filmed by folks who are sure to upload it to the internet should you want to watch the gory details. Another youth was injured but survived. The settlers allege the youth had a knife, although they have proven to be a deeply unreliable source of information when it comes to knives. There are somethings that are so unspeakably haram that it is hard to write without a moment of deep silence and horror. I think about the two young men who undoubtedly have experienced a life filled with Israeli military aggression and may or may not have felt defeated and hopeless enough to take revenge on the people who have tortured them. I think about the grieving mother, the enraged father, the traumatized brothers and sisters, another life lost to Israeli occupation, and the audacious fascistic brutality of the settlers who steal Palestinian land and kill Palestinians with impunity.

Hours later we enter Queen Alia Airport and breeze through all the levels of security, ticket lines, passport control, X-rays. No one is rude or brusque, no one takes me aside to interrogate me, no one wants to unwrap my halvah to check it for explosives. The whole experience is remarkably civilized and a striking contrast to Ben-Gurion airport where two years ago after harassing me for working in Gaza (“Why Gaza? There are starving children in Africa, you know”), they took my computer for an hour “for security.” Then they confiscated my husband’s entire suitcase “for security,” leaving him to stuff his belongings in a blue plastic bag as he headed home. How that kind of behavior is related to keeping Israel safe is utterly unclear to me and it doesn’t do much for their shrinking reputation as the villa in the jungle, a little piece of civilized Europe in the savage Middle East.

Beautiful resistance, and teenage angst, inside Aida refugee camp – June 9, 2019

first published in Mondoweiss

Entrance to Aida Refugee Camp, Bethlehem, with key symbolizing the right of return. photo by A. Rothchild

In late March and early April 2019 I traveled to Jordan and the West Bank (Palestine) with two colleagues, Sonia Dettman and S. Komarovsky, first to attend the Lancet Palestine Health Alliance conference in Amman and then to explore and better understand the lives of refugees and the workings of UNRWA, with a focus on the status of refugee health.

“Here We Will Stay,” a poem by Tawfiq Zayyad

In Lidda, in Ramle, in the Galilee

We shall remain

Like a Wall on your Chest.

And in your Throat

Like a Shard of Glass, a Cactus thorn.

And in your eyes

A sandstorm.

Dr. Abdelfattah Abusrour has devoted his life in the Aida refugee camp in Bethlehem to creating what he calls “beautiful resistance,” developing theater, dance, photography, playing, and other activities to build cultural expression and resistance for children, youth, and women. We are sitting in his cluttered office, the walls covered with inspiring poetry, and pictures of the Palestinian poet Mahmoud Darwish, Pope Benedict (who visited the camp), and Pope Francis, Malcolm X, Martin Luther King, Mahatma Gandhi, Nelson Mandela and Albert Einstein.

Abdelfattah established the Alrowwad Cultural and Arts Society 21 years ago and despite enormous and repeated financial crises, it has grown into a vigorous and inspiring program that is now housed in an old and a new building. The staircase is lined by the portraits of important cultural figures: Fadwa Toqan, Edward Said, May Ziadah. There is a brightly painted, welcoming children’s library and computer center, and a meeting area and to-be-developed museum of Palestinian artifacts upstairs on the third floor.

Abdelfattah Abusrour enters the new Alrowwad Cultural center in Aida Camp. Photo by Alice Rothchild.

Abdelfattah has faced political challenges for himself as well. In 2014 he made a welcoming statement to Pope Francis who stopped to pray at the separation/apartheid wall. Later in the afternoon, when Abdelfattah attempted to return home to Jerusalem (his wife and children have Jerusalem IDs), he was told he was forbidden without explanation. When he asked why, the soldiers replied, “You know why.” After a long legal battle he found that the charges were (something like) having undue influence on the people, making a statement against the state, and organizing an illegal activity. Two years later, the Israelis dropped their case and classified the file, but he suspects that they were unhappy that the pope had stopped to pray, exposing the oppressive concrete barrier for all the world to see.

Pope Francis at the Separation Wall in Bethlehem. (Photo: Consortium News)

We walk down the muddy street, passing the falafel and shawarma restaurant. Abdelfattah takes us on a tour of the new partially completed building. Women’s handicrafts and a recipe book, (Bethlehem: Beautiful Resistance Recipes, also available on Amazon), are displayed in the lobby and there is an office for Project Cuba. Dr. Mohammed Abusrour (trained in Cuba) mostly does home visits and works at Caritas Children’s Hospital, but he has an office here as well. Downstairs there is a large wood-working and laser carving machine where the furniture and finished cabinetry for the center are being built, as well as art projects and signs created with the laser machine. The rooms lead into a cave which was once behind Abdelfattah’s parents’ house. Here is where the family hid in 1967 and 1973 and some day it will be a museum and performance space. He talks of creating possibilities as well as jobs for the camp.

Upstairs there is a functional educational kitchen which will also be a restaurant, a 14-room guest house that now houses 35-40 beds, each room named after a Palestinian cultural icon. Still to be realized, Abdelfattah shows us the large empty room that will be the educational media program that will host opportunities in film production, written, audio, and visual journalism. We are impressed that there is an elevator, but with unreliable electricity it is not yet safe to use.

We climb the stairs to the roof, which will also be a performance space and have solar panels, and take in the sweeping views of the camp, grey concrete buildings crowded together and topped with black and white water tanks, loose wires, tangles of metal, metal saucers for TV reception, laundry hanging off porches, greenhouses and raised rooftop beds, a thin white minaret, all crowding up against the eight meter high concrete separation/apartheid wall that snakes around and through the camp. Just beyond that are the red roofs of the Jewish settlement of Gilo. The progress in the new building is impressive but much needs to be built, all dependent on raising adequate funds. The dream is that this building will employ 45 people and be self-supporting financially, insha’allah.

Aida refugee camp from the rooftop of Alrowwad. Separation wall is visible in background. Photo by S Komarovsky

Abdelfattah talks about Alrowwad as a mission-oriented program that creates activities in response to the needs of the community. He says that every form of resistance is legitimate, but he considers giving children and young people every possibility to live rather than to die for the country. He feels that it is essential to inspire hope and promote life and create change that they can be proud of, rather than to dictate a code of behavior related to a political party or thinking that the only way to resist is through armed struggle. He is trying to coordinate his programs with others in the camp, but there are lots of conflicts in philosophy and priorities, as well as the egos and funding of each group. This obvious leads to much repetition in programs, an issue that we see is repeated all over the West Bank and Gaza.

Alrowwad women’s empowerment group

Ten women from Aida Camp join me and Sonia Dettman, a social worker, for a women’s empowerment and education session in the big open activities room in the old building of Alrowwad, surrounded by a row of sewing machines used in the women’s embroidery group. Most of the women are older, though I find it very difficult to estimate a woman’s age in the occupied territories as women age quickly with the political and life-stressors and large number of pregnancies. Once again our relatively brief comments and explanations produce lengthy, loud discussions, laughter, teasing, and sisterly interactions. We cover some of the obstetrical and gynecological concerns that women deal with everywhere, from birth control pills, breast feeding, premenstrual syndrome, to weight gain after menopause, hot flashes, and hormone replacement. I learn that olive oil is good for sore nipples (confirming my belief that olive oil is probably good for almost everything). Women are often afraid to speak honestly of their inner secrets because of fear of gossip within the enmeshed and usually interrelated camp families. Also if you can’t keep your own secrets, I am told, how can you be trusted with each other’s secrets?

Teaching women’s health at Alrowwad. Visitors Alice Rothchild (center right) and Sonia Dettman (center left).

The women worry about their children, their constant use of violent video games, the bad effects of social media. Everyone seems to have an iphone, for better or worse. They discuss children who are anxious, hyperactive, and easily angered. As Sonia probes further, one mother says that the children are angry because the IDF comes frequently to the camp, shooting tear gas and bullets. In fact, an 18-year-old volunteer medic from Deheisheh camp, Sajed Mezher, was killed less than a week ago while trying to care for a wounded Palestinian. Manal, our organizer and translator, starts to cry. Sonia talks of the need to have groups for the children after traumatic events, where they can vent their feelings and share their pain with their peers. Clearly the staff also needs such support and we talk with Manal after the program about the need to care for the caregivers, something that rarely happens in resource poor, high risk areas where everyone shares the same levels of trauma and the trauma occurs on an almost daily basis. I learn that the beautiful Lajee Center garden, with its sports field covered by high netting, is no longer safe for children as the IDF soldiers shoot tear gas and bullets into the children’s park. The netting is frayed from tear gas canisters. It seems that there is no limit to human suffering here.

The women impress me as strong and smart, and particularly fierce when it comes to their children, proving once again that mothers are the key to the survival and resilience of Palestinian refugees.

Pigeon pose and teenage angst

Nahil Bandik, a Beit Sahour yoga instructor, and Cynthia, a nun from India who lives in Bethlehem, sit serenely in front of a row of women, with two little boys squirming on the floor in the corner of the Women’s Unit at Alrowwad Cultural Center. The instructors are teaching a form of sitting yoga that is perfectly geared for the seven women attending, three in long abayas. We all sit on plastic blue chairs, focusing on our breathing, as Nahil moves us to a place of deep relaxation and then walks us through a series of stretches starting with our heads and leading to our toes. Bending my neck sounds like ground glass, but I can feel the stiffness in my shoulders and back gradually releasing. Other women say they feel relaxed enough to go to sleep, calm, happy to have separated from the tension of the camp. Nahil talks about taking this peaceful feeling with us as we face the stressors outside. I drop my shoulders which tend to hover close to my ears and take a deep breathe. I wonder what would happen if everyone in this crazy place started releasing their tensions and sore muscles, experiencing an inner peace and openness.

As I write this note, children upstairs are doing a yoga lesson with saffron-clad monks visiting from the French Buddhist center founded by Zen Master Thich Nhat Hanh. And downstairs, teenagers are thumping, and kicking, learning dabke with a young man who looks almost weightless as he takes them through the intricate steps.

At 4:00 I join ten young women (15 to 23), half wearing hijabs, for a girl empowerment workshop. As with the older women, every one of my comments triggers a lengthy, loud, somewhat combative conversation, with lots of hugging and expressive hand gestures. The drama level is high. Not surprisingly (given the age level) most of the hour is spent discussing body image issues, too thin, too fat, weight in general, dieting, hair growth, acne, premenstrual syndrome. I urge them to think about what makes a woman beautiful, what are the messages from commercials and TV.

One answers, “Men like their women fat, but when the mothers come to pick a bride, they pick a thin one.” One responds that there are many ways to be beautiful. They all nod their heads in agreement about the negative impact of commercials.

There are many questions about hormones and I am asked to review the hormones in the body and describe what they do. One knows what an adrenal gland is for, so I suspect they have had some biology education. Most have had urinary tract infections and are drinking lots of water. At the end there is a question about vaginal discharge which provokes a spasm of giggling. Unfortunately the hour is shortly over and we haven’t gotten close to sexual education. I hand out my list of culturally sensitive Arabic websites focusing on women’s bodies and sex, and most everyone is suddenly quite interested, taking photos of the list on their phones.

The pressing question at a Palestinian health gathering: How to illegally collect sperm from prisoners – June 4, 2019

first published in Mondoweiss.

In late March and early April 2019 I traveled to Jordan and the West Bank (Palestine) with two colleagues, Sonia Dettman and S. Komarovsky, first to attend the Lancet Palestine Health Alliance conference in Amman and then to explore and better understand the lives of refugees and the workings of UNRWA, with a focus on the status of refugee health.

Home visit #1 Al Azza Camp, Bethlehem

Palestinians in the occupied territories face a challenging and chaotic health care (non-) system with care provided by the Ministry of Health, UNRWA (for refugees), the private sector, and numerous NGOs. There is little cross communication, drug representatives encourage doctors to use the newest and most expensive (though not necessarily better) drugs while the UN provides generic drugs from the WHO essential medications listing. Pharmacies sell medications without prescription and there is little quality control in laboratories. The patients face accessibility and financial challenges, often very short visits (in UNRWA clinics the average doctor visit is 4 minutes), and a bewildering array of choices and bad advice.

In Aida Camp at the Lajee Center, with funding from, Health for Palestine is trying to address some of these issues with an innovative program that trains community health workers, or CHW’s, who identify and follow high-risk patients with diabetes and/or hypertension, the two main causes of morbidity and mortality in Palestine. With physician direction, the CHW’s clarify and monitor patients’ medications and compliance and build on their personal relationships to improve patients’ health.

Today we join Dr. Bram Wispelwey – medical director, Sara Alazza – community health worker, Mahmoud Tayseer – nurse, and Henry Louis – data coordinator, for a home visit in Al Azza Camp. The camp, also called Jabreen Camp, is an “unofficial camp,” a spillover from Aida Camp, where one or two families (one being the Alazza family) squatted on land just across from the Jerusalem/Hebron road, and the rest is history. There is one main road and a maze of narrow muddy streets leading to two to three story apartments, concrete walls with graffiti and peeling political, prisoner, and martyr’s posters. Children tussle and play in the streets, big ones carrying little ones, calling “Hello! Hello!” at the obviously strange visitors.

We stop at the home of a 77-year-old woman who is sitting in her tiny living room with her elderly husband, 38-year-old daughter and two grandchildren. The older girl understands English and is very concerned about keeping her grandmother healthy. The baby is coughing and snuggled against his mother, obviously congested and unhappy. We sit on three couches, the walls are decorated with Palestinian embroidery and a TV. The woman, wearing a loose green dress and a hijab, is obviously overweight and very happy to see the health team. Mahmoud takes blood for a glucose and hemoglobin A1C, a measure of the three month average glucose level.

As we await the results, there is a lively conversation about her insulin. Bram has a warm, engaging manner that embraces the entire family and they clearly love and appreciate him and the entire team. He explains that both sugar tests are elevated but her blood pressure is good. He gives her a choice between changing her insulin dose or adding a metformin pill. After more back and forth, she opts for the pill. Lajee can provide her with a two-month supply from donations. The granddaughter wants to know about diet and Bram suggests decreasing sugar, white rice, and bread. Her blood pressure medicine costs 75 NIS per month (roughly $19) which is difficult for the patient, but she chooses not to change to three different pills which she could get for free from UNRWA. She offers us tea and coffee, the family is engaged and animated and the patient has a warm smile and a twinkle in her eye, glowing from Bram’s attention. Clearly she enjoys all the visitors and is also doing better at controlling her diabetes. Relationships are part of the therapy.

Home visit #2 Al Azza Camp, Bethlehem

The next patient is related to one of the community health workers and is hypertensive and pre-diabetic. We climb up slippery steps in the drizzling rain, potted plants in buckets on each step, to the second floor. Her living room is bigger and everyone is immediately talking and laughing. She has four daughters and two sons and the youngest daughter is a high-spirited trouble maker in school. We chatter about grandchildren and family squabbles. Her glucose testing is good and her blood pressure well controlled. Bram reviews her medications, advises that she stop taking aspirin and changes her dose of metformin. He notices her finger is swollen, she had fallen on the steps to her apartment.

There is more discussion: She has been seen once by a doctor at the Shams UNRWA clinic, but goes monthly for her free medication. The round trip costs 30 NIS which is difficult for the patient. Another member of the team, Neshat Jawabreh, is a nurse and program manager who will communicate with her UNRWA doctor later. Bram explains that he meets with physicians at UNRWA, they understand the limitations of their care and see the project as raising the standard of care. He frames the project as collaborative with UNRWA and knows that patients generally don’t trust UNRWA services. He hopes to partner with UNRWA in the future, to expand the e-health program for better communication. People working on this project also hope to build a successful program that is locally run to encourage UNRWA and local authorities such as the Ministry of Health and other health organizations to take responsibility. “So if we build it, show it works, then UNRWA and the Ministry of Health will come to us.” This is what happened with the water purification program at Lajee that is now maintained by UNRWA. Tea and sesame biscuits arrive with the usual exhortations to eat, eat. There is more discussion with the patient about the data on aspirin use.

Henry explains that he enters data from the community health workers into an app that tracks multiple aspects of the care, the KOBO program that he used previously in a Community Health Worker program in southern Syria. For instance, he knows that the average length of visit is 20 minutes, with a range of five minutes (for a quick medication check) to one hour. Sara, the CHW, says she was educated at Bethlehem University and explains that there is a 50% unemployment rate in the camp. Bram adds that the camp is full of “super smart, educated young people” who do a superb job as CHWs.

The Arabic coffee arrives (with the usual exhortations) and more lively, warm conversation. The Lajee Center gets donations of medications from a Beit Jala pharmaceutical company and local pharmacies. UNRWA medications are free unless they are “stocked out.” Patients have a variety of sometimes erratic sources for drugs, but with this program, medication duplication has been reduced and compliance markedly improved. As I said, relationships are part of the therapy.

Home visits #3 Al Azza Camp, Bethlehem

We meander down narrow winding lanes, “paved” with irregular concrete, and I try to imagine a man with severe chest pain or a woman in active labor hurrying to the hospital, a patient on crutches or in a wheelchair negotiating this impossible place. How close could an ambulance park?

Home visit to a 59-year-old. Photo by S. Komarovsky.

The next patient is 59 years old and surrounded by her daughter and numerous grandchildren and cousins. Bram exclaims, “You look so much younger!” and she smiles happily. The main entertainment is a very active little boy who is fascinated by i-phones, photos, and quickly snuggles into any willing lap for a hot second before he dashes about again. The TV is on without sound, and clothes dry on a large rack in the corner. There is a floor-to-ceiling pile of mattresses against the wall. The woman is overweight, dressed in a long dark abaya, lively and engaged. Her bare toes peek out of the hem of her dress. Her blood pressure is elevated but her glucose is in good control and Bram gives her an energetic thumbs up on the diabetes control. At the beginning of the program, her hemoglobin A1C had been very elevated.

She explains she had chest pressure and a rapid heartbeat and pulls out a plastic bag, dumping a large pile of paper records on the floor. Bram scans through them and pieces together the story: She had symptoms and was seen at a private hospital, the Arab Society Hospital, where she underwent a very first world cardiac workup (including a cardiac catheterization which was negative, alhamdillilah). Ultimately the doctors decided the symptoms were secondary to thyroid disease. The patient says she is taking her medications daily and she wants Sara to come every day. Ironically because she worked at UNRWA, she has private insurance. A young woman brings out a tray of orange juice.

Bram decides to add amlodipine to her blood pressure regime and once he figures out what it is called in Palestine, says that she can get it from Lajee or UNRWA. Sara is clearly totally familiar with each patient and their families, knows their medical histories and is obviously loved. The patient is effusively sharing her fondness for Bram and they are both smiling and beaming warmly together. Again, lots of laughter. The coffee appears and we sip, taking in this ritual of welcoming and feeding.

The daughter tells Bram that the hyperactive little boy was just diagnosed with anemia and he checks his pale lower eyelid. He is getting a workup at UNRWA and Henry agrees to follow up on the testing. As we debate the probabilities of iron deficiency (unlikely) or some variant of beta thalassemia (likely), the patient offers us lunch. Like I said, relationships are everything.

Returning to Aida Camp, we see a young teenage boy walking down an irregular, muddied, hilly street holding a long, red plastic tube, whacking the ground as he goes. It takes a minute for me to realize that he is blind and is using this whacking method in lieu of having a proper white cane. I wonder how he manages to negotiate the buildings with all their stairs and steps between rooms, the debris and trash that is everywhere. Later I google “school for the blind” and find Al Shurooq School in Bethlehem. I wonder if he had the opportunity to study there. I google white walking cane: $12.99 on Amazon. But then again, Amazon doesn’t deliver to the West Bank.

Community Health Worker meeting: “What is the best condition for the sperm to be in?”

Ten community health workers, one man and eight women plus my two colleagues and Bram pull up chairs in the small chilly meeting room at Lajee Center, the overhead heater blasting on and off, for a discussion of women’s issues. The CHWs have been trained on the basics of diabetes and hypertension and the hope is that their knowledge base will gradually expand. My hope is that while they are sipping tea and listening to patients talk about their lives and medical concerns, the CHWs will hear of gynecological complaints and know if and when they should call the doctor.

On the white board I write:

Vaginal bleeding [from puberty to menopause]

Vaginal discharge

Urinary tract symptoms

Sexual issues and pain

The topics trigger a wave of nervous giggling. I ask how much do people know? Are these issues taught in school? Biology class? At home? And heads shake, “La, la, la.” Someone volunteers that they learn everything on the first day of marriage. That seems a little late to me so I take a deep breath and begin.

Teaching about the female body in Palestine is always an astonishing experience as every statement I make tends to generate lengthy discussions, lively arguments, obvious embarrassment, and endless curiosity. The students are always engaged and clearly thirsting for information. I begin to understand each woman’s personal concerns (menstrual cramps were of major interest), the enormous gaps in their understanding, and common beliefs in the culture. I was very impressed at how open the women were despite the presence of several men and the fact that most of the women were not married. When I asked if we should ask the men to leave, they all said no.

Alice Rothchild gives a frank training on women’s health issues. Photo by S. Komarovsky.

Here is a sampling of the questions that came up:

Can showering during your period cause breast cancer?

In our culture we want to get pregnant once we get married. Should we not shower after intercourse?

How long between when the sperm comes out does it take to fertilize the zygote?

Do twins have two eggs and the same sperm?

Why do you bleed after delivery and for how long?

Can you take oral contraceptives to prevent menses during the Hajj?

Can you take hormones to continue menses after menopause?

A question about “fibroid cystic ovaries” that leads to a gyn anatomy lesson and a discussion of ovarian cysts and uterine fibroids.

The most painful and revealing conversation came with the statement: “In our political condition here, men in the prison get their sperm out, illegally, to get to the women. What is the best condition for the sperm to be in?” The room is serious and quiet for the first time. We discuss the basics of sperm donation, but done in conditions which are obviously not optimal, how cold, how warm, how fast the semen needs to be delivered, the challenges when smuggling sperm out of a prison. We review the basics of insemination (they use a syringe). I look at all these eager concerned faces, knowing that a high percentage of men in the camp will spend time in prison, mostly for the crime of living while Palestinian, and try to imagine these men, the marriages interrupted, the yearning for children, and the desperation that leads to this practice.

When we come to sexual concerns, I distribute a list of links to Arabic sexual education, including the Arabic version of Our Bodies Ourselves and a website created by Palestinians in Haifa. The giggling and nervous curiosity spikes as I talk about how important it is to understand sexual relations before that anxious high stakes wedding night, the fact that good relationships involve intimacy and pleasure, that men need to be educated as well as their partners. I am met with some incredulous looks. I urge the CHW’s to explore these websites, talk with each other, and get more comfortable with their own bodies and sexuality. They also need to deal with their own embarrassment in order to work in a professional manner with intimate information they may learn. They are the eyes and ears of the program; women may tell them of symptoms they will not reveal to the male doctor.

I review the importance of knowing what is normal and what is abnormal and stress the issues around menopause and postmenopausal bleeding which they are likely to confront with the overweight diabetic hypertensive women they are seeing.

Bram promises to follow up with CHWs and determine if they are able to translate this basic session into meaningful medical monitoring on topics that are often surrounded by shame and a lack of education. The CHWs collect their pages of notes and prepare to go home. I hope they go directly to their computers…if there is electricity and internet and an iota of privacy, this being Aida Camp.

UNRWA Clinic in Deheisheh Camp: “If you like to work, it is not a problem.”

We walk through bone chilling rain to the Deheisheh Camp and its elegant new UNRWA health center which opened eight months ago, funded by Saudi Arabia. The center is attractive, modern, with an elevator, curving stairs to each level and modern clinical offices, and clean, attractive areas for registration, pharmacy, laboratory, physical therapy, and radiology. It is largely empty, probably because of the discouraging weather.

We meet with a medical officer and a midwife, nurse, and psycho-social clinician. The camp’s population is 17,000 with an additional 2,000 refugees from outside the camp who also attend the clinic. We hear themes that are familiar: the family based health teams, the cooperation within team groups, the use of e-health medical records, the focus on pregnancy and pre- and post-natal care, as well as non-infectious chronic disease (diabetes and hypertension). Each physician sees 70-80 patients per day, with three to four minutes per patient.

The physician is clearly dedicated to his work and has been at Deheisheh for several decades, going from a cramped three to four room clinic to this snazzy new building. He explains that many camps are getting new buildings, including Aida, (which has never had its own clinic) where a boy’s school has been knocked down and a clinic and school are being constructed. Currently patients from Aida are expected to go for UNRWA care in Bethlehem, one kilometer away, as well as Shams Health Centre for Non-communicable Diseases in nearby Deheisheh Camp.

The staff explain that there are no specialists in the clinic so they care for every disease imaginable. Difficult cases get referred to contract hospitals, cancer cases go to the Ministry of Health hospitals; UNRWA provides a year of insurance to patients with cancer. Infertility is not a covered benefit; patients have to pay for private care. No one is referred to Israel and camp residents cannot get permits to go to the high level Palestinian hospitals in East Jerusalem. The physician has been allowed to go to Jerusalem once in the past 20 years. The distance is 20 kilometers by land, but light years in reality. Preconceptual, antenatal, and postnatal care are a priority. UNRWA pays for a percentage of the delivery costs in contracted hospitals.

When the US cut funding, everyone was affected by decreases in budget, services, referrals, and supplies. The clinicians have no knowledge of the intricacies of the funding mechanisms, “Not our business.” Despite the massive stressors, the physician has a warm, engaging, relaxed manner. Like many physicians, he trained in Romania and came home with a Romanian wife. He planned to be a cardiac surgeon, but decided that he needed to serve his people in the camp. “If you like to work, it is not a problem.” During times of crisis (intifada, war, Israeli incursions), he even slept in the clinic. “It’s my people.”

The midwife reminds us that there is a new building, but the services have not improved. She sees patients, organizes community health campaigns, works as part of the health team, but is troubled by the lack of ultrasound and specialists. She sees a patient every seven to ten minutes, but complex visits can last thirty. Most patients get three to four ultrasounds per pregnancy and pay a private doctor 18-100 NIS per scan. 90% of women are seen in the first trimester, 25% come for pre-conceptual care. Women pay for their endocrine tests out of pocket. Like US clinicians, she finds the electronic medical record a blessing and curse, very time-consuming to input data (typing through the visit, loss of eye contact), but excellent for retrieving information and tracking data.

The woman who deals with psychosocial issues sees cases from bedwetting or aggressive behavior in children to women unable to accept a pregnancy to people struggling with chronic disease to domestic violence. Interestingly, because of the stigma about mental health and disease, her visits are framed as “routine,” she is part of the health team and carefully not defined as a therapist.

Other challenges include patients “shopping” for the care they want, (UNRWA, Ministry of Health, NGOs, private care), patients complaining about the quality of free care at UNRWA (they reportedly don’t complain about private care), the inability of patients to get permits to East Jerusalem for high level care, the increasing shortages of medication, the bureaucracy, (non-emergency cases like hernia repair are not covered by UNRWA), and inadequate choice of free medications. On the other hand, there is a more rational use of antibiotics (drug resistant infections are a growing problem in the OPT), UNRWA now offers eye exams for diabetic retinopathy, high risk pregnancies are referred quickly and efficiently.

Empty chairs in Amman as Gaza doctors are denied permits to medical conference on Palestine – May 30, 2019

first published in Mondoweiss

The 10th Annual Lancet Palestine Health Alliance conference in Amman, Jordan. (Photo: ICPH/LPHA)

In late March and early April 2019 I traveled to Jordan and the West Bank (Palestine) with two colleagues, Sonia Dettman and S. Komarovsky, first to attend the Lancet Palestine Health Alliance conference in Amman and then to explore and better understand the lives of refugees and the workings of UNRWA, with a focus on the status of refugee health.

The 10th Annual Lancet Palestine Health Alliance (LPHA) conference titled “Health of Palestinians inside and outside the occupied Palestinian territory” was part serious scientific meeting, part determined act of political and cultural resistance, and part joyous celebration. The meetings were organized by the Institute of Community and Public Health at Birzeit University in collaboration with the Faculty of Health Sciences at the American University of Beirut and hosted by the Jordan University of Science and Technology. Professor Rita Giacaman, Director of the Institute of Community and Public Health at Birzeit, is the visionary spark that brings scientists from all over the world to present, critique, debate, and stand in solidarity, particularly over rather large amounts of excellent food, this being a Palestinian event, and a presentation of the Palestinian History Tapestry project.

The conference was held (like scientific meetings all over the world) in the Grand Hyatt in Amman, Jordan (which I learned after multiple attempts to communicate with the Uber driver is called the Grand Hy-yett with an accent on the second syllable – see cultural confusion). After the formal opening speeches, the schedule included topics like “Appraising the methodological quality of the Clinical Practice Guideline for Diabetes Mellitus using the AGREE ll” (Mahmoud Radwan from Tehran University) and “Anti-D versus immunoglobulin for the treatment of Acute Immune Thrombocytopenia in children: A 10 year Palestinian experience” (Mohammed El-Habil from Al-Rantisi Pediatric Hospital, Gaza).

But there was much that I would not see at a medical conference anywhere else in the world: “Health attacks and protection strategies during Gaza’s Great March of Return: A mixed methods study utilizing data from WHOs Surveillance System for Attacks on Healthcare” (Walaa Shehada and Hyo Jeong Kim from WHO West Bank and Gaza Strip). Or “Executions and maiming of unarmed demonstrators during 30 weeks of the Great March of Return” (Khamis Elessi from Islamic University, Gaza). Or “Spatial Agency among children living in Dheisheh refugee camp: engendered space and place as risk and protection from political and military violence in a refugee camp in occupied Palestine” (Guido Veronese from University of Milan). The extensive poster sessions also reflected this broad look at health from a more traditional to a global/political/contextual lens. The researchers from Gaza were mostly not able to obtain permits and their absences were noted by empty chairs at the time of their presentations or blank walls at their poster sessions. Some were able to deliver their papers via the internet which was an act of resistance in itself, a symbolic breaking of the siege.

Professor Graham Watt of Glasgow University and chair of the steering committee for the LPHA, described the alliance as a loose network of Palestinian regional and international researchers engaged in advocacy-based science that meets once a year to share research, network and inspire. He summed up much of what has happened to Palestinians over the past decade with the quote: “Smile they said, life could be worse. So I did and it was.” He sees hope in new female leadership and I also found the number of young female presenters impressive. He noted that as Einstein is said to have commented, “Not everything that counts can be counted, not everything that can be counted counts,” suggesting that the job of the Alliance researchers is to develop scientific methods and research that is culturally sensitive and specific for Palestinians, and to increase the capacity of research and collaboration in this de-developed area of the world. He noted that the survival and growth of the Alliance is a major achievement and an important point of resistance.

The Lancet conference in Amman, Jordan(Photo: ICPH/LPHA)
The 10th Annual Lancet Palestine Health Alliance conference in Amman, Jordan. (Photo: ICPH/LPHA)

An obvious example of this kind of out-of-the-Western-box thinking lies in basic definitions. Can a Palestinian living in the West Bank or Gaza have post-traumatic stress disorder (PTSD) if the trauma is never really “post?” How do you name and treat the anxiety, hyper-vigilance, and bedwetting that is epidemic in Palestinian children? Is an anxious, angry, hyperactive child exposed to repeated tear gas, shootings, and death in a refugee camp mentally ill or responding appropriately to a sick environment? Does structural violence always lead to psychological disorders; how does that relate to agency and life satisfaction as protective factors in this setting? In the West there is much talk of “caring for the caregiver.” How do you do that for a health care provider in Gaza who is not only dealing with a massive amount of young men with multiple explosive, fragmented bullet wounds to their legs, not to mention a steady stream of dead children and pregnant women, but is also at risk for being shot and killed herself while doing this work? The intersection between disease, wellness, politics and war becomes painfully obvious.

I had the opportunity to interview Professor Watt after his talk. The starting point for the Alliance began with Richard Horton, the editor of The Lancet, after he visited Palestine over ten years ago and bravely decided he wanted to publish information about the injustices he saw in the journal. The pushback was and continues to be fierce and unrelenting. Working with Dr. Rita Giacaman and Professor Huda Zurayk, an internationally recognized scholar on reproductive health and health in the Arab world at the American University of Beirut, it took two years to produce five articles with 37 authors, of whom 19 were based in the Occupied Palestinian Territory. The Lancet has published about half of the LPHA abstracts after appropriate peer review and Professor Watt noted that there is a learning curve for researchers, both in the quality of research and analysis and in how to write for scientific publications (in English). Much of the work in the region is surveys and reviews: the Palestine Center for Bureau of Statistics and the United Nations Relief and Works Agency (UNRWA) tend to have good data. Iain Chalmers, one of the founders of the Cochrane collaboration, (a research tool that is one of the foundations of evidence-based medicine), worked in Gaza as a young doctor and continues to work with Gazan doctors, so the Strip is actually ahead of the West Bank in the use of evidence-based medicine and clinical audits.

The Lancet conference in Amman, Jordan. (Photo: ICPH/LPHA)
The 10th Annual Lancet Palestine Health Alliance conference in Amman, Jordan. (Photo: ICPH/LPHA)

Unfortunately, health care in the occupied Palestinian territory is fragmented with the Ministry of Health, UNRWA, NGOs, and private clinicians all providing care with duplications, gaps, and chaos complicated by the priorities of international aid groups and donor agendas. The conference developed in an attempt to address many of these issues. If this was not Palestine, people would have founded a national scientific organization, gotten funding, and become an official group, but that is not possible in this world. Professor Watt explained that there is little culture of collaboration between Palestinian institutions, partly because they have no experience and everyone is guarding their turf and funding, plus travel is hard and unpredictable and one never knows who will show up. Additionally, when studies find important research findings, it is often impossible to implement changes: the siege of Gaza continues, the IDF continues its aggressive military policies, people continue to die.

Professor Watt explained that the main success of the LPHA is existential, “We exist,” and the data adds to the Palestinian narrative in a new way. He noted that it is ironic that we are having this conversation while bombs are dropping on Gaza, a medic was shot in the Deheisheh Refugee Camp today, and a medic was killed in Gaza 12 hours earlier. “This is a long term game. Palestinians need to hang on. They need to be still standing when Israel falls or changes.” He felt that doctors on the frontline have responsibilities because they bear witness but, “Anger without discipline is mere cursing. We must have passion with rigor. As a scientist, all research is passionate but disciplined.” He noted “This is an academic effort with an implicit signing up to the use of the scientific method to gather data. Our voice is getting bigger and stronger and more connected. We need to move from the unsatisfactory present to the future. You do not negotiate for power, you fight for it.” I usually don’t hear such opinions from a very respectable older looking gentleman sitting elegantly in a tie and suit in an upscale hotel.

Mads Gilberg, at the Lancet Palestine Health Alliance.

Dr. Mads Gilbert, the Norwegian surgeon famous for his work in Gaza in 2008 and 2014 and for his painfully graphic books, “Eyes in Gaza” and “Night in Gaza”, has a different style. At the LPHA he sponsored a disturbing poster describing unexpected findings from war-related extremity amputations in Gaza. We sat down for an intense interview during a brief break in the afternoon. Dr. Gilbert talked about how he seeks to describe reality using scientific tools, what he calls “evidence-based solidarity,” to strengthen advocacy and justice. As opposed to humanitarian work, this “medical solidarity” involves, “going there, working under Palestinian leadership. They say ‘When you come we are not alone.’” His goal is to do medical care, gather data, and tell the world what he has seen in a systematic way. “As an activist, the tool is evidence; medicine and science may be more dangerous to the oppressor than slogans. We produce irrefutable evidence.” Collecting data and demonstrating how there are violations of international law serve a larger effort than just strict science.

He found the LPHA a perfect meeting place for sharing knowledge and it is now an important movement to reinforce Palestinian studies done by Palestinians, and to educate and inspire Palestinians who define research objects and tools to build the field of Palestinian research. He noted that Giacaman and Horton’s objective was, “to build a movement of the international community of key academics for solidarity in order to change the world.” Research is thus not only a way of obtaining clear answers to clear questions, it is also a basis for values- based advocacy and for pursuing social justice and peace, to “be intellectually calm in the midst of our outrage.”

He began his amputation studies (examples here and here) and drone studies in 2006, exploring the effects of the Israeli attacks on Gazans). He found that with so much need for medical care in Gaza it was difficult to do research, but the LPHA gave Palestinians an opening, “Oppressed people can define their medical reality in a scientific way.” Dr. Gilbert disliked the term “giving voice to the voiceless.”–“No, they were made voiceless, they were muted. Our job is to de-mute them.”

He said he works as an academic and an activist, “to transition despair and shouting, to document and describe atrocities. Health workers, in particular emergency staff like myself, have a particular responsibility because we are working in ‘the fog of blood’ and we would betray our ethics if we don’t ask, how can we stop this bloodshed, not just patch up the wounds and soak up the blood on the floor. And the simple answer is: stop the bombing, lift the siege, end the occupation of Palestine[…]This is – in fact – not a ‘difficult conflict’ – this a difficult and unbearable occupation! The relief industry never questions the root causes of the disaster; this is the colonial morphine of oppression.”

People are kept oppressed by “denying access to the root causes, i.e., Israeli apartheid.”

Dr. Akihiro Seita, at the Lancet Palestine Health Alliance.

I think about the American Public Health Association, (APHA), probably the most progressive medical society in the US, where it has been impossible to successfully organize a statement to the effect that the Israeli occupation is a public health problem. I think about the International Association for Relational Psychoanalysis and Psychotherapy (IARPP) which prides itself in focusing on the individual’s relationships in society, (“committed to doing away with privilege and discrimination in our field”), and has scheduled its next international conference in…. Tel Aviv. I think about the remarks by Dr. Akihiro Seita, head of health care for UNRWA, where he outlined the successes and challenges facing UNRWA, the political and social determinants of health, and the need for data. Then he said, “Life without LPHA: no network, no scientific papers, no advocacy, no moral support, no friends.”

Not your usual medical conference. Next year in Birzeit.

In Jerash refugee camp, 2-minute doctor’s appointments and rage at American visitors – May 27, 2019

first published in Mondoweiss

In late March and early April 2019 I traveled to Jordan and the West Bank (Palestine) with two colleagues, Sonia Dettman and S. Komarovsky, first to attend the Lancet Palestine Health Alliance conference in Amman and then to explore and better understand the lives of refugees and the workings of UNRWA, with a focus on the status of refugee health.

Even “ex-Gazans” have more trouble

We Uber over to the UN Headquarters again (Uber just bought Careem in the never ending cycle of capitalism). We are heading north to Jerash Camp (aka Gaza Camp), with Julia McCahey and several Japanese and German/Iraqi interns and analysts. In the van we learn that in Jordan, where 42% of Palestinians live, there are ten official and three unofficial camps which accommodate less than 18% of the total refugee population. The aspirational UNRWA microfinancing program was largely cut in the latest financial crisis. There is a Department of Palestinian Affairs in Jordan; the UNRWA camps are owned by UNRWA or rented for about 1 Jordanian Dinar per year, either from the state or leased by the state from local landowners. The EU and the Saudis are providing funding to upgrade buildings which are often dilapidated and desperately in need of renovation and repair.

It seems that financial allotments to each clinic depend on need, plus local field officers approach donors and funds get earmarked for special projects like education. The 2018 and 2019 budgets for UNRWA were $1.2 billion per year. With the budget cuts, UNRWA launched the #Dignityispriceless campaign in 2018 to raise money for health and education. The reasons for the extreme disparities of resources and structures in the different camps still feel murky to me. I suspect it’s complicated. Jerash may give us a clue.

The weather is cold, rainy, and grey as we pass City Mall and Mecca Mall which feature swimming pools, cinemas, bowling alleys, and a wealth of international brands. In front of us is a truck with tens of bunches of bananas tied to its back, like a giant Big Bird. We travel through green rocky hills and the sun starts shining as we edge north towards Irbid. There are piles of pottery for sale, rows of olive trees, irregular terraces, solar panels on large structures, nurseries with stacks of plants, eucalyptus trees, and an increasing amount of garbage on the streets, junkyards, and goats wandering along the road. Our ears start popping from the hills.

As we head north, the scenery turns gorgeous with rolling hills that remind me of the West Bank along with increasing signs of poverty, markets piled with scallions and watermelons, villages of narrow winding streets. We are witnessing the economic extremes that are characteristic of the Jordanian economy. FYI, we are some 37 miles from Amman’s new downtown central business project, a $5 billion residential, entertainment, shopping, and business space in Al Abdali neighborhood with glamorous boulevards, shopping smalls, and tall glass and steel high rises.

But that is another world. Away from the hype of Amman, we chat with Julia who explains some of the challenges UNRWA faces. For instance, for unmarried pregnant women, UNRWA must provide care: this is a very rare situation but is very sensitive. The women’s IDs state whether they are married or unmarried, so the clerk in the clinic can see when an unmarried woman is registering for prenatal care. There is little privacy in the camps and a pregnant unmarried woman brings shame and danger to her entire family. This is a legal issue for the UN as a whole, both in Jordan and internationally. New technical instructions are being developed that ask women their preferences for the ID, collaborate with protective services, connect to counseling, and financial aid.

We arrive at the camp, five kilometers from the phenomenal Roman ruins of Jerash. Also another world, trust me, I explored them both. The camp was set up in 1968 to provide food aid, sanitation, health services, and education for 11,500 Gazans fleeing from the 1967 War (some displaced for a second time). It covers 0.75 square kilometers and is currently home for 30,000 “ex-Gazans.” There are a total of 158,000 Gazans living in Jordan, and the government has taken measures to limit the numbers. Jerash is the poorest of the Jordanian refugee camps for Palestinians, with over half of the population living below the national poverty line, 88% without any health insurance, and 97% without a social security number. The camp looks pretty bleak, densely crowded, mostly one-to-three story concrete structures, pot-holed streets, broken tarmac, crisscrossed with sagging electric wires, small markets with piles of strawberries and bananas, a rare straggly tree. The place is haunted by extreme poverty.

We are warmly welcomed by Dr. Maher Badr and Jumana Khader, the head nurse, and sit around a long wooden table with flowery curtains rippling in the breeze. Much of the conversation confirms what we learned yesterday. Once again I struggle with the concept of “ex-Gazans” who arrived in 1967 during the war and are not recognized as refugees by the Jordanian government, are granted temporary two-year Jordanian passports, but do not hold a national ID number. Because of the cost (200 JD), the refugees often cannot afford to renew and if the passport has expired for more than two years, it cannot be renewed without approval from the Ministry of Interior. These folks are often officially stateless and unable to access governmental services. Fortunately they have UNRWA. Fifty percent of the clinic’s employees are ex-Gazans.

Dr. Maher reviews UNRWA’s impressive achievements, the institution of an electronic medical record, the family health team approach to care, the preventive services, care for women (IUD inserts on Saturdays) and children, curative care, with a focus on noninfectious chronic diseases (NCDs). There is a pharmacy in the clinic as well as a laboratory, dental hygienist and two dentists, a pediatric clinic and a breast feeding room.

There are particular challenges with this population: Vitamin A is given as prevention for eye disease and measles complications every six months per WHO recommendations for refugee children. Mental health and psychosocial care will be embedded within primary health care, but this is rolling out soon; the needs are enormous. Health education is critical regarding marriage between close relatives and the increased risk of congenital problems. The incidence here is high. Some men have up to four wives, there are 1,200 women receiving family planning care, 700 receiving prenatal care, and 3,500 children ages newborn to five.

The sweet tea arrives perfumed with sage as Dr. Maher notes that the work loads are high, there are four doctors and two teams; each doctor sees 100 patients per day in six hours, two minutes per consultation, 25,000 patients in each doctor’s caseload. If one doctor is on leave, then his load is divided amongst the others. One midwife follows 700 pregnancies and sees 25 women per day. And today the electricity will be off from 9:30 am to 2 pm for repairs, although there are generators for the computers and the refrigerators.

Dr. Maher has worked at UNRWA for eleven years, the nurse for 20. He says he knows all his patients, he types into the electronic record, listens and examines the patient (in two minutes total remember). There are seven nurses who have five to seven minutes for taking a history, vital signs, labs, and education. The nurse says, “When you know that you deal for people who have no choice you will give everything, you will give the best,” and Dr. Maher adds, “I know all the family so it is very easy for me to see if this family has congenital malformation or noncommunicable disease so I will screen another from this family.”

With mental health issues, he can refer to a psychiatrist who has at least ten to fifteen minutes for consultation. Suddenly, a young man in a leather jacket, smoking a cigarette, calls at the open window. The doctor responds and closes the window. “Fuck you Israel,” the man yells in English. The doctor says the young man wants another psych drug, his current prescription is not enough. He appears at another window yelling, “Fuck you Americans,” and the doctor explains, “We have too many mental patients.” The electricity switches off. He says the patient wants psychosocial support. “Many of our patients are very poor, there are limitations with staff, drugs, many shortages. We do the best we can, for such cases we can speak with the patients, but we have a problem with the budget and the shortage with the drugs.” We sit in the dim room feeling the tension, the level of desperation and need.

Dr. Maher explains that IUDs and injectable contraception are popular and can be given without the husband’s approval, but persuading women to accept birth control can be a big challenge. If the woman wants contraception, the staff talk with the husband, but ultimately, they observe the woman’s privacy. “But the mother-in-law may monitor the door [of the family planning clinic] and rush in demanding to know.” Privacy in a refugee camp and the desire for large families is a tough dynamic.

Diabetes is common but people don’t want to use insulin. “It’s difficult to work with limitations, always an issue of shortage of drugs and staff members. Despite all, we work with love with every patient, what can we do?” The unemployment rate is high (he quotes 70% – but accurate numbers are hard to get and complicated by numerous variables. UNRWA cites lower numbers, but a wide range depending on many factors including gender, educational level, age, etc.). A 2014 UN report states most men work in agriculture, harvesting olives, on local farms. Girls are married between 15 and 18, and many have two babies by the time they turn 18. If they are not pregnant in a year, then they are diagnosed with infertility. UNRWA can offer lab analysis, a gynecological appointment, but the facilities are limited. Many go to a private doctor or the husbands take a second wife. “In our culture, always the problem is with the female, and the male may refuse any analysis.” UNRWA does not pay for infertility treatments.

The Caesarean section rate is 50%, in the private hospitals physicians are paid 300 JD for a normal vaginal delivery, 700 JD for a C-section. UNRWA covers 75%, up to 100 JD, the patient pays the difference (like 600 JD for the C-section). “This is a big problem.” He claims the women do not want C-Sections, but they are clearly preferred by the doctors. And then we are off for a tour of the clinic, symbolically done in the dark.

There are many educational posters about pregnancy, sexual exploitation and abuse, chronic disease, and a really creepy image of a heart with smoke pouring out of all its major vessels. The pharmacy is neat and orderly with piles of boxes of medications lining the shelves. We learn that a central UN pharmacy places the orders, each health center submits their quota, and the medications come from the World Health Organization’s list of essential medications, the Ministry of Health, and local and international donors. When they run out of anti-hypertensives, insulin, and antibiotics (yes this happens), then the patient has to buy it from private pharmacies, no prescription required except for narcotics, or go without. This is obviously a recipe for chaos. The laboratory has basic equipment for blood and urine tests.

We watch patients register and get a number and a time, (a big improvement from the past when everyone arrived and just sat much of the day waiting for a turn). The patient population is much darker-skinned by and large than at Nuzha Camp (a reflection of the Gazan Afro-Palestinian population). A brief bit of a long history: Folks from Senegal, Niger, Sudan and Chad arrived in the Holy Land as far back as the seventh century, often after making pilgrimages to Mecca. There are pockets of Afro-Palestinians in Jerusalem, Jericho, the Negev, and Gaza. And now the “ex-Gazans” in Jerash.

Many of the women are totally covered with niqabs and sometimes a full burka (with veil covering their eyes), often attending to a collection of young children.

We peek into the pediatric clinic with four scales, one in each side of the room, and lots of kids. A child squirms as he gets a vaccine. We greet a tired looking internist sitting at his desk, with a computer screen, a sphygmomanometer (for measuring blood pressure), a small pile of papers, and an exam table, scale, and the smoking heart poster behind him. There are lots of mostly women and children sitting in the darkened waiting areas, just waiting. We really don’t want to bother the clinicians who are busy doing the two minute visits, so we leave, thanking the staff and apologizing for the interruption.

If You Want To Fly With Eagles, Don’t Swim With Ducks

We walk over to the UNRWA school just as the morning and afternoon shifts change. The grey-white building with blue on the metal trim crisscrossing the windows is old and the concrete wall along the perimeter is peeling with white paint and graffiti. There are waves of children, all the girls wearing white hijabs. Suddenly a group of boys starts throwing stones at us and hitting our legs with sticks, yelling, “Fuck you! Fuck you!” After the initial shock, all I can imagine is, what they see is another parade of white people dropping in, clutching notebooks and cameras, for what? They have a right to be enraged.

The school principal is apologetic and appalled. She explains this behavior is highly unusual. We try to explain, no harm done, they are understandably angry. In Jerash there are four double shift schools and one single shift school for grades one to ten (which means the number of hours of classroom time has been reduced). There are girls’ and boys’ schools in the camp and one boys’ school outside the camp. After tenth grade, students go to government schools. The approximately 5,000 students in Jerash Camp are very well prepared for governmental schools and score higher on the Tawjihi, the General Secondary Education Certificate Examination, than the general population. That is something to be proud of. To put that in perspective, however, according to UNICEF, educational outcomes in Jordan are low in both basic and secondary education and students do poorly on international standardized tests, including mathematics and science. So this is both good and bad news for the ex-Gazan students.

Each school shift has its own hierarchy of principals, administrators, teachers, etc. Most students are “ex-Gazans,” and the principal explains, they can get a temporary national passport but no ID and no health insurance. They are not considered refugees but are called displaced persons per Jordanian law. Sometimes they can get a visa to travel. She says the main challenges are poverty, unemployment, and lack of resources. There are eight UN branches for microfinance, three in Irbid, mostly used for things like personal loans, minimarkets, and crafts.

The principle explains that 1,462 girls are attending this shift and there is a big focus on education among their families. At university they are charged as foreigners and sometimes can get scholarships from the Palestinian embassy and businesses. After graduation, unfortunately it is very hard to get employment because the majority don’t have a national ID. They can’t even get a driver’s license, or own a taxi. While men mostly work in agriculture and raising animals, there is still a strong societal motivation to get advanced degrees. Most of the teachers at the school are ex-Gazans.

We visit classes, still in the dark, and smile at rows of girls in a variety of styles of white hijabs. The girls are very engaged, sparkly, eager to ask questions. We see classes studying financial education and the renaissance. The school reminds me of a big, loud urban school in a poor neighborhood somewhere in the US. The level of disrepair, we are told, is a reflection of the lack of upkeep for two years due to budget cuts.

The walls are decorated with colorful displays done by the children, packed with lots of thoughtful advice.

When people throw you stones, it’s because you are a good tree full of fruits. They see a lot of harvest in you. Don’t go down to their level by throwing stones, but throw them your fruits so the seeds of yourself may inspire them to change their ways.

If you want to fly with eagles, don’t swim with ducks.

Keep your thoughts positive because your thoughts become your words. Keep your words positive because your words become your behavior. Keep your behavior positive because your behavior becomes your habits. Keep your habits positive because your habits become your values. Keep your values positive because your values become your destiny.

We walk through the crumbling streets, back to the van. There is no green space and piles of litter gather along the walls of buildings. Thanks to Trump’s budget cuts, the 43 workers collecting garbage have now been reduced to ten. I ponder Trump’s comment that Palestinians are not grateful and respectful enough. We see crowds of lively children lugging backpacks, with no place to play, living in a place where 52.7 percent of the people live below the poverty line, surviving on a dollar a day. At 6:15 pm I discover that Israeli forces are bombing Gaza and it is snowing in Petra. The world feels upside down.

We end up at a lovely restaurant in Amman, sipping white wine and the local beer. In the bathroom over the toilet is a sign: “Do not flush toilet paper, phone bills, goldfish, or your hopes and dreams down the toilet.” Strangely, that feels like solid advice.

UNRWA: A critical but impossible mission – May 21, 2019

first published in Mondoweiss

Sunday March 24, 2019

In late March and early April 2019 I traveled to Jordan and the West Bank (Palestine) with two colleagues, Sonia Dettman and S. Komarovsky, first to attend the Lancet Palestine Health Alliance conference in Amman and then to explore and better understand the lives of refugees and the workings of UNRWA, with a focus on the status of refugee health.

Today begins with a ride through Amman (I have not remotely figured out the “circles” and hills and the travel brain fog seems denser today). Perhaps because I was awakened by the muezzin at 4:30 am, not the melodious kind, but more like a blaring announcement at a mall. In turns out the minaret is located right next to the Caravan Hotel, perhaps directly aimed at my eardrum. Pity I do not pray, I certainly would have leaped out of bed. The Turkish coffee arrives with cardamon as we wait for our ride and I am moderately revived.

The sky is cloudy with the threat of cool rain when Careem, (Amman’s answer to Uber), pulls up and we are off to Nuzha Camp in North Amman. The car has that familiar smell of cigarette smoke and perfume. We fly past tall cream colored office buildings, six story apartment buildings, glitzy hotels, palms, and pointy Cypress trees. There is some construction and the usual assortment of Popeyes, Burger Kings, and the local Jo Petrol. The street garbage and litter is minimal and the traffic can only be described as positively civilized.

The neighborhoods tend towards poorer as we reach the United Nations Relief and Works Agency (UNRWA) facility, a sprawling white building with light blue trim, cheerful graffiti on the outside walls, and kids everywhere. But no guns/barbed wire/ bullet holes. (My previous experience with refugee camps has been in the West Bank and Gaza, FYI). This really makes a difference, needless to say. We meet with Julia McCahey, a cheerful Australian who works in the Health Department at UNRWA headquarters, other staff, and Dr. Akihiro Seita, the health director. He speaks softly, quickly, but with tremendous authority and knowledge, punctuated by a quick, self-deprecating laugh that I suspect is the key to his equanimity.

We talk about the recent UNRWA Trumpian budget cuts of $500 million out of a total budget of $1.2 billion per year, the subsequent need to cut expenditures while protecting both the core supports and the Emergency Appeal (EA) for the West Bank and Gaza (especially food support for Gaza). Among EA-supported activities, the highest priority was given to the food support to one million Palestine refugees in Gaza. In order to preserve such life-saving support to Palestinian refugees, UNRWA had to make a very difficult choice, downgrading other EA-supported activities like community mental health and mobile clinics even though they were important activities. UNRWA was able to save $80-90 million and the Gulf States coughed up $200 million. Ultimately UNRWA came out even and no health center closed. This time.

But challenges obviously remain. Of note, the infrastructure in the refugee camps is primarily the responsibility of the Jordanian government; however, UNRWA is responsible for improving roads, pathways, drainage, as well as the garbage collection services which are all vulnerable to budget cuts.

Dr. Seita explains that it is hard to recruit doctors and hard to retain them, medicine is expensive. UNRWA usually orders medication 15 months in advance but last year could only afford a 12 month supply and there are now “stock outs”. So there has been more sympathy for the UN. “There was no Plan B,” they had to make it work.

In Jordan, 2.2 million Palestinian refugees are registered with UNRWA, most have Jordanian nationality and are included in the social and economic life of the country. The refugees are the center of the work of UNRWA. But even the definition of refugee is complicated here. There are Palestinian refugees from 1948, refugees from 1967 (who are treated differently from ’48 as they theoretically fled from the Jordanian controlled West Bank to the country of Jordan and are thus internally displaced persons).

There are Palestinians who were made refugees (for a second time) from Syria (17,000), Iraq, (numbers are hard to find). Of note, the Palestinians arrived in Iraq in 1948, 1967, (from Palestine) and 1991 (from Kuwait). With the 2003 Gulf War, several hundred fled to Jordan. I am told that those with money were welcomed but the reception was mostly hostile and the population desperate. In 2011, the government estimated that 450,000 – 500,000 Iraqis live in Jordan, although only 31,000 of these Iraqis are registered with the United Nations High Commissioner for Refugees (UNHCR). Many were stranded in the no-man’s land between Iraq and Jordan or detained in the Al-Ruwaished Refugee Camp, administered by UNHCR along with Iranian Kurds, Somalis, and Sudanese. Under the Baathist regime, Palestinians were not registered with UNRWA, but had governmental services, health, education, and the right to work. In Jordan they appear to have nothing but their own determination, connections, and the kindness of churches and NGOs.

If you are not confused enough at this point, there are some 158,000+ registered refugees from Gaza who are officially called “ex-Gazans,” who fled from Gaza to Jordan in 1967. “According to UNRWA ‘ex-Gazans lack legal status in Jordan and are denied many of the basic services and rights afforded to pre-67 refugees, including access to state schools, government employment, and healthcare.’” Much like Lebanon, without a national ID they are unable to get work licenses in professions including law, engineering, medicine, nursing, pharmaceuticals and journalism. They face further legal and bureaucratic obstacles and cannot become taxi or bus drivers, cannot purchase land or buildings, and cannot set up businesses outside the camp. They are temporary residents with a passport which must be renewed every other year and is often prohibitively expensive. They cannot work in the public sector and can only work in the private sector with security approval which is hard to get. Essentially they are treated like foreign workers. Most work in agriculture, crafts, or vocational jobs like carpentry and black smithing, without social security or health and safety requirements. I would like to note that these restrictive policies violate Jordan’s international and regional obligations as well as international law pertaining to human, economic, social, cultural civil and political rights. Without security approval for a passport, they cannot even legally get married.

Whatever their designation, all these Palestinian refugee groups have a right to UNRWA services. In contrast to other countries, ’48 Palestinians in Jordan can get citizenship and medical and health care benefits. If an ex-Gazan tries to get health care beyond what UNRWA can provide, the cost often triples.

UNRWA is tasked with providing basic primary care and has contacts with Jordanian hospitals for tertiary care and specialty care and provides some reimbursement for that care. Primary care is defined as maternal and child care, dentistry, gynecology, HIV, and internal medicine. Most of the services are for women and children. The centers are open six days per week, eight hours per day and each doctor sees 100-150 patients per day. (Do the math.) The average visits lasts four minutes. UNRWA is working on decreasing “over use” around hypertension, diabetes, and cigarette use through better prevention and screening.

Since 2011, mental health and psycho-social services have been incorporated into primary care. As we question further, this seems to involve brief screenings and referrals to psychiatrists but the numbers of mental health workers in Jordan is relatively quite low (big problem). In 2011, for instance, there were 16 psychiatrists in the Ministry of Health and a total of 61 in all of Jordan

Impressively, each Palestinian presents a refugee card for an appointment, there is a comprehensive computerized medical record, and then care is provided. Of the 2.2 million Palestinian refugees, only the 30,000 most vulnerable live in the camps, the rest live nearby. UNRWA tries to employ Palestinian refugees and 90% of their staff is from Jordan. The care is organized around family health teams, where an entire family consistently sees an entire team of providers who presumably get to know the family closely.

We meet with Dr. Rashad who is responsible for north and south Amman and later we meet with the head educational officer. We are told that of the 2.2 million Palestinians in 2018, UNRWA serves 800,000 clients. There are 26 health centers located in Irbid, north and south Amman, and Zarqa. Since 1949 UNRWA health centers have provided preventative and curative care with three major projects:

Mother: This includes preconceptual care, a minimum of four prenatal visits per pregnancy, postpartum care, and family planning. In Jordan this service cannot legally be provided to an unmarried woman. Depending on risk level, the pregnant woman is followed by a midwife, a family doctor, or an obstetrician. Over the past ten years birth rates have dropped significantly. Contraception is free.
Child: From birth to five years, children have routine screening, vaccinations, monitoring of milestones, vitamins, and dental care. At five, the child enters school where the school health team provides follow up through 10th They check hearing, vision, vaccinations, and provide dental care. After 10th grade, the teenager is referred to the general clinic
Noninfectious chronic disease (NCD): Patients receive diagnoses and treatment per guidelines, mostly for hypertension and diabetes, plus dental care. UNRWA serves 80,000 hypertension and diabetes patients in Jordan.

Dr. Rashad informs us that there have been reforms since 2010 including an electronic medical record, an appointment and cueing system, and the family health team approach. The team consists of two doctors, then nurses, and other professionals. Pharmacy, labs, dentistry are not on teams. Since 2017 they have started integrating mental health into the primary care with training from the World Health Organization (WHO) and the Ministry of Health. There is a two week training for screening, and tools, and medications for anxiety and depression. The provider then can refer to the Ministry of Health. There are some psychosocial support groups with trained nurses. It is not clear to me if there is any long term “talk therapy” or if this is all mostly drug oriented.

Each mother and child has a comprehensive health handbook that includes all relevant health information that will soon be available on their smart phones, including appointment reminders.

UNRWA official shows brochures of service. Photo by S. Komarovsky

UNRWA provides educational programs for patients 40 and above, screening for diabetes and hypertension, (endemic in the region), and younger if there are risk factors like a positive family history or obesity.

Before e-health was rolled out, doctors saw 100-150 patients in 6 hours. That number has dropped to (the still way to high) 72-75, but with austerity it is up to 87. (Thank you Mr. Trump.) Nurses do some of the work, but the care is still very doctor oriented. Patients’ electronic files are not shared with the Ministry of Health as they use different data systems.

We learn that mental health and mental illness are very culturally stigmatized, but bringing it into the realm of primary care is providing an opportunity to approach this significant issue. There is no screening for sexually transmitted infections or HIV, but if the provider has suspicions, they may screen for gender-based violence. Addiction care comes under psychosocial care and is referred for treatment.

UNRWA buys drugs from the WHO essential medications list, but last year the pharmacies started having stock outs, for reasons related to international donors, testing standards, etc.

Next we meet the head officer from the Educational Department. He is in charge of the North Amman area. UNRWA runs grades one to ten with the belief that all children have a right to a quality education There are 120,000 studying in Jordan, with 32,300 students in North Amman, 1,000 teachers, 39 schools with double shifts of teachers and students (7 am-12, 12pm – 4:30). Recently grades one to three have become coeducational, overcoming some cultural barriers.

UNRWA follows the curriculum of the Ministry of Education. Some schools are small rented spaces, others large buildings built to be schools with playgrounds. There are 50 students per class and one teacher. Special needs students are included, but not all schools are fully equipped to manage their needs. There is continued teacher training and quality assurance. The teachers do not receive year-long contracts but are paid a day rate. The students generally outperform students in the Ministry of Health schools which is impressive, but probably a low bar.

Post-graduation, depending on students’ scores, they go to vocational schools, secondary governmental schools, or (expensive) private schools. Good scores lead to university training which is highly competitive and expensive, but doesn’t always lead to employment. Rates of unemployment are high in Jordan.

We then tour the clinic and I am pleased with the orderly, clean appearance, the respect for privacy (we are not allowed to take pictures of patients). We see exam rooms, the pharmacy, a dental clinic, a lab. There are a lot of engaging educational posters on the walls. The C-Section rate is reported around 66%, partly doctor preference, partly patient demand. There is not that feeling of chaos and depression I often feel in UNRWA clinics in the Occupied Palestinian Territories.

UNRWA family services, Amman. Photo by S. Komarovsky

We then tour the Nuzha School compound and I am so impressed with Nadia Musa, the energetic creative principle, hobbling around on a broken foot in a cast. The school is for grades one to six with 700 students and 25 teachers, built in 1969. There are 49 to 51 kids per class, all of the teachers are from the camp. The teachers do a great deal of group work, focus on different learning styles, and do a lot with very little. The classrooms are lively, decorated, the halls are filled with inspirational displays. “It’s not our differences that divide us. It’s our inability to recognize and accept the differences.” “Together we can reach the stars.” “Work to bee proud of…” then a swarm of bees, “homeland, identity, gender, family…” Nadia helped build a community garden out of recycled materials; there are music classes – kids share instruments, two traffic cops (military men in black) appear to talk to the students about road safety. We see a learning center for children with disabilities and a theater with rows of chairs for student performances and community celebrations. One room has a puppet theater.

The Nuzha School, administered by UNRWA, in Amman. Photo by Alice Rothchild

Nuzha school, Amman. Photo by S. Komarovsky

When we peek into a few classrooms, children are sitting at high desks that are placed on steps, amphitheater style. There are no bullet holes in the windows, and the atmosphere is generally one of infectious enthusiasm. One girl asks: “Is America beautiful?”

UNRWA’s Nuzha School, Amman. Photo by S. Komarovsky

We return to talk with Dr. Seita before he dashes off to Istanbul. When comparing UNRWA schools, he says Nuzha was upgraded recently, is less busy and smaller than the Gaza Camp. He stresses that we tell the world that UNRWA does critical work in health care and education in particular. Food is no longer distributed in favor of cash. UNRWA is also responsible for water and sewer infrastructure. But the funding has not kept up with the population growth. Patient expectations are higher, they do not understand why there are not specialists and sophisticated equipment, why ultrasound is only used in high risk pregnancies. In addition, host countries’ health sectors have been getting better as well. UNRWA’s task is basic primary care and the provision of medications on the WHO essential medication list.

In terms of mental health, he states that according to WHO, primary care can manage 70% of the issues when mental health, (ie. the WHO Mental Health GAP Action Program mhGAP), is appropriately and extensively introduced. (I wonder how this happens in the four minute visit). High risk for mental illness includes the Great March of Return, postpartum state, and out of control diabetes. These factors result in more screening, diagnosis and medications such as fluoxetine (Prosac). More serious problems go to the psychiatrists and group sessions.

Violence prevention is still very passive, though domestic violence is common. Plans involve de-escalation training methods in schools for body and mind, (such as deep breathing), and gender based violence teams. For rape victims, there are no emergency services; there is a tremendous amount of family shame, no privacy, and fear of retaliation. Victims sometimes go to governmental hospitals. If a woman is pregnant outside of marriage, she is reported to the Ministry of Health for her own protection and for the protection of the medical staff taking care of her. (Staff have been attacked and there are fears of honor killings). A baby cannot be registered without an identified father.

‘Refugees are a tool of war’ — the view from the Syrian border – May 17, 2019

first published in Mondoweiss

March 26, 2019

Aerial view of Za’atari refugee camp.

In late March and early April 2019 I traveled to Jordan and the West Bank (Palestine) with two colleagues, Sonia Dettman and S. Komarovsky, first to attend the Lancet Palestine Health Alliance conference in Amman and then to explore and better understand the lives of refugees and the workings of UNRWA, with a focus on the status of refugee health.

We leave the Collaborative Repair Project and drive north to Mafraq, near the Syrian border. A highway sign catches my attention as it points in the various directions we might go: Iraq, Syria, Saudi Arabia. We are definitely not in Kansas anymore.

We zoom through rolling, barren desert hills, a palette of mottled yellow and brown, pass universities, a stretch of buildings once used for military housing, concrete factories. Lights twinkle on the horizon. Over an hour later, as the sun sets we reach Mafraq, a sprawling, bustling city with many poor neighborhoods and we are told, a cross roads for drugs from Jordan’s neighbors.

We have come to meet Reverend Nour Sahawneh at his Mafraq Christian and Missionary Alliance Church. As we settle into his office, he tells us we are 15 kilometers from Syria. There are 80,000 Syrian refugees living nearby in the Zata’ari camp, now one of the largest “cities” in Jordan, just east of Mafraq. He says there are 100,000 more Syrian refugees in Mafraq and 40-50,000 in nearby villages. The city tripled in size due to the influx with the onset of the Syrian civil war. The United Nations High Commissioner for Refugees (UNHCR) approximates that 670,000 registered Syrian refugees live in Jordan, as of March 2019. While most reside in cities and towns, around 17 percent live in three refugee camps—Azraq, Zaatari, and the Emirati. A further 41,000 live in ramshackle unofficial camps splayed across the isolated desert in northeastern Jordan near the borders with Iraq and Syria, known as the Rukban.

To keep this in perspective, according to UNHCR, Jordan has the “second highest share of refugees compared to its population in the world, 89 refugees per 1,000 inhabitants.” Lebanon tops that list with 209 refugees per 1,000 inhabitants and the US sinks towards the bottom with 0.84 reported in 2015. With a population of 327,000,000, the US (in all its racist and xenophobic wisdom) has set a refugee limit for 2019 of 30,000. Do the math.

In the three square miles of Zata’ari camp, 20% of the families are headed by women, more than half of the population is under 24, and 20% of the population is under five. UNHCR estimates that 6,500 refugees work for cash inside the camp and 9,000 refugees have work permits and are able to work outside the camp. There are 21,400 children enrolled in 29 schools. In 2017 there was a dramatic improvement in the camp when 40,000 photovoltaic panels were installed, providing electricity 12-14 hours per day. The Jordanian government partners with a host of governmental organizations and NGOs including international, church, and UN based, to provide services to the camp residents.

We sit in Rev. Nour’s crowded office with shelves loaded with jumbles of papers, panels of security cameras, awards, and posters. He was born in Jericho in 1965, and fled with his family in 1967. He tells us that he has a son who is a freshman in university, a daughter studying pharmacy, one studying civil engineering, and one daughter in the ninth grade. His wife was a lab tech and manager and is now retired.

In Mafraq the church has focused on refugee aid in the city and in two villages. Their efforts started in 2011 with 300 people, but then the numbers exploded; many Syrians are stuck here and afraid to go back. All the refugees are Muslims. Relief includes:

Food packages to 400-500 families per month, costing $35 each, consisting of rice, lentils, oil, etc.
A welcoming kit with items for eating, cooking, sleeping, like cooking stoves and mattresses. The church has supplied 9,000 families, goes to door-to-door assessing what each family needs. The cost is $300 per family and the church uses warehouses storing relief supplies.
In winter they supply 4-5,000 families with a gas heater, gas coupons, etc. at a cost of $200 per family.
Supplies of milk, diapers, eyeglasses.
Connections for patients with hospitals.

Rev. Nour tells us that Syrians are no longer coming to Jordan and those who have returned home are full of regret. The Jordanian border was closed due to the threat of ISIS, but now the border is open again, though few Syrians are able to get in due to security issues. Some leave the camps to find work in the city. Many work, including children, under-the-table, paid below minimum wage, in the agricultural sector, as Al Jazeera reported.

Funding for this relief work comes from the Christian and Missionary Alliance Church, which was started in the US in 1881. Their suppliers are mostly local, some sent by church organizations. They receive money and in-kind donations as well. Initially the US church sent missionaries to Jerusalem, the West Bank, and Jordan. Then in 1948 Mafraq started a Bible study group that grew into the church which is now also a multipurpose building, currently under renovation.

The community center sponsors English programs, sewing and handicraft training, and trauma meetings for women. Rev. Nour explains that there is no counselor; the women do not talk much about their own trauma but “mostly work on forgiveness.”

Rev. Nour Sawahneh

He explains that in the refugee camp we would see an expanse of cream-colored caravans stretching in every direction, crisscrossed by rocky, dry dirt streets, a hospital, schools, and markets, run by groups such as the United Nations High Commission on Refugees (UNHCR) with the Jordanian government. There is a collaborative effort between Jordan and “the donor community, UN agencies, international and national NGOs, community based organizations, refugees and host communities.” This includes local Islamic organizations and mosques.

The big challenges for refugees, who have experienced a huge amount of personal trauma, are daily living and healthcare. UNHCR is no longer paying for health care. For a detailed Amnesty International analysis of Syrian refugees and their struggle for health care (as an example of the challenge and complexities facing the refugees and their host country), read here.

Refugees are able to obtain IDs but not citizenship, and they are able to work. Rev. Nour believes that Jesus heals but clearly there are major unmet challenges in this physical world. The Syrians in Mafraq are mostly from villages, they are Bedouins and, “Hide when asking for help.” When the Muslims enter the church building, their kids play in the playground, the parents register for services, and drink tea. They are treated with respect. That is the beginning of building a relationship.

Many of the households are headed by single mothers. The husbands have disappeared, have died, or are fighting. The husband may also have taken a second wife. There is an average of five children per family, no birth control, and a general lack of education. In the family, men are in control.

Rev. Nour notes that the refugees are victims of war and displacement and are “victims of themselves.” Many marry at less than 18 years old, with girls sometimes as young as 13 or 14. Many do not have legal papers in Jordan. “Their lives are a disaster. They are a tool of war. They became a subject in a war, not a people to help.”

We meet the international volunteers who staff the church programs; Rev. Nour says he is “fully pastoring the mission and the church.” There is a Friday church service for people from India, Nepal, and Sri Lanka who are working in nearby factories. He notes that 30% of factory workers are non-Jordanians who are paid less than Jordanian citizens, live in compounds, and are recruited by manufacturers, much like Mexican migrant workers in the US. Construction workers are also Egyptians who make money and then return home. He explains that garbage collectors are Egyptian and Syrian; Jordanians won’t do this type of work. Palestinian Jordanians are often businessmen. He describes this as a “tribal effect…who will marry me if I collect the garbage?” There is also a big focus on getting an education and going to university.

When we ask, “How will this all end?” Rev. Nour explains that there are one million Syrian refugees (documented and undocumented) waiting for a resolution. He says that Syrians are hard-working, there is a big market in the camp ironically called the Champs Elysees, where in 3,000 shops and businesses refugees sell gold, mobile phones, refrigerators, vegetables, falafel, everything, as well as run restaurants. He describes this as a tribute to Syrian entrepreneurship and determination. At the same time, the camp is a haven for drug and weapon smuggling. “War is business.” He adds that Syria is a lab for Russian weapons. He nods and explains, as the Bible says, “Love of money is the root of all problems.” In all the Arab countries, he sees a battle for control and revenge, proxy wars and shattered societies, rich countries reduced to extreme poverty, and civilians caught in the catastrophe.

For Iraqi refugees in Amman, kindness, support and an application to Australia – May 9, 2019

first published in Mondoweiss

In late March and early April 2019 I traveled to Jordan and the West Bank (Palestine) with two colleagues, Sonia Dettman and S. Komarovsky, first to attend the Lancet Palestine Health Alliance conference in Amman and then to explore and better understand the lives of refugees and the workings of UNRWA, with a focus on the status of refugee health. This is my fourth report from the trip.

Tuesday March 26, 2019

We wait 45 minutes for an Uber to arrive and drive us to the Collateral Repair Project which is located across town in the poor neighborhood of Hashemi. There we meet with Jessica Miller, a dedicated, fast talking woman who tells us that the Collateral Repair Project was started in 2006 by two American women for Iraqi refugees. At that time, many Iraqi refugees were fleeing to Jordan. Some of the Iraqi families that came to Jordan with savings may have settled on the West side of Amman, where housing and the cost of living tended to be more expensive. However, many of those who came without such financial backing or quickly ran out of savings, unable to legally work, moved into neighborhoods in East Amman like Hashemi Shamali. CRP is located in this neighborhood which is home to many low income Jordanians and refugees from Iraq and Syria.

Clearly I need to get a quick education on the topic of Iraqi refugees and with a bit of googling, I find that by 2008 more than 4.2 million Iraqis (one in seven) had been displaced from their country, with an estimated 800,000 in Jordan (which has a total population of six million, just for perspective). (JAMA. 2008;299(14):1713-1715. doi:10.1001/jama.299.14.1713) These numbers are consistent with the UN High Commissioner for Refugees (UNHCR) which has estimates of 750,000 to one million Iraqi refugees in Jordan. This is all complicated by the fact that the Jordanian government insists that Iraqis are “guests” rather than refugees, (therefore the state has no responsibility for their welfare), and that many of the refugees were middle class urbanites who fled to Jordan’s cities and may have gotten lost in the counting. Those who did register with UNHCR received asylum-seeking cards and were thus able to receive (an inadequate amount of) humanitarian assistance from the UN and NGOs. A large percentage, (possibly a majority), of Iraqi refugees have no legal status at all.

Because of the concentration of Iraqi residents in Amman, many citizens blame them for rising prices for real estate, food, rent, and overcrowded schools and health care institutions, shortages of electricity and water. While there are other important contributors and the refugees are not a net drain on the country’s resources, they have seriously stretched some resources and services. Additionally, there has been an inadequate response from the international community. By 2007 the Jordanian government closed its borders to further refugees.

To put this into context, in 2007, a study by the NGO Coordinating Committee and Oxfam International of the population in Iraq found that 40% of refugees were living in absolute poverty, half were unemployed, and significant numbers lacked water, sanitation, electricity, education and health care. The middle class was broken and many of the professionals and technocrats either left or joined the ranks of the disadvantaged or those intimidated by political violence.

When people did leave, they quickly found out that employment can lead to longer term residency permits, but a job does not change their legal status as guests or tourists with temporary permits. This is compounded by the fact that children maintain the citizenship of their parents’ country of origin. A November 2006 Human Rights Watch report stated that Iraqis throughout the Middle East remain unregistered, uncounted, unassisted and unprotected.

From CRP’s Facebook page.

Those Iraqis who do not have the financial means to invest in Jordan must demonstrate that they are able to support themselves if they are to obtain and renew residency permits. They are required to deposit close to $150,000 in a Jordanian bank and must maintain a significant balance. Needless to say, many families that began with those kinds of resources are now impoverished.

The Jordanian government has affirmed its commitment to non-refoulement, ie., not forcing refugees to return to their place of origin if they will be in danger of persecution (they signed a Memorandum of Understanding with UNHCR in 1998). The actual practice, however, has been a mixture of generosity and flexibility (understanding that Iraqis are politically endangered in their home country) along with frequent abuses and egregious restrictions. For instance, unregistered children were not allowed to attend public school until 2007. UNHCR has been the primary source of support along with the Jordanian government Ministry of Planning and International Cooperation, the Jordanian Red Crescent, the Jordan Women’s Union, Mizan, the Jordanian Alliance against Hunger and a host of (mostly international) NGOs.

In the world of health care there are also painful contradictions. Iraqi refugees have high medical and psychological needs and theoretically regardless of their legal status, they can use public services. In reality, many are fearful of publicly identifying themselves and the facilities are already stretched and often unresponsive.

Which brings us back to Jessica and the Collateral Repair Project. In 2006 the two founding women started feeding 15 families and this attracted more low income refugees to the neighborhood and soon the project was growing by 50% annually. Quickly they became an international NGO.

From CRP’s Facebook page.

Jessica says that the population has become increasingly diverse and there is a huge pressure to focus on social cohesion. CRP’s international volunteers are very self-aware and make sure that beneficiaries know program registration and emergency assistance are monitored in an unbiased manner. The goal is to maintain as diverse a group as possible, with different nationalities well-represented among CRP volunteers, beneficiaries, and trainers. As CRP is a non-political and non-sectarian organization, divisive conversations are discouraged within the community center.

This can be challenging because last names often give away a particular sect. The project works with minority refugees like Sabaeans, a small, reclusive, ancient community that was destroyed by Saddam Hussein and radical Muslim groups, as well as ethnic Assyrian Christian groups from Iraq who were targeted in the 2003 Iraq war. Their expulsion and mass flight culminated in 2008 when then were brutally attacked by ISIS and fled from Mosul, an historic center of Christian antiquity.

From CRP’s Facebook page.

The emergency department focuses on food vouchers where money is used to purchase food in local grocery stores, food and cleaning supplies and hygiene products. CRP has recently started supplementing their food voucher distributions with a course on nutrition, fitness, and cooking. By using guidelines developed around low income SNAP food assistance in the US, CRP has developed a culturally sensitive nutrition program to educate beneficiaries on dietary diversity and healthy living. The children in the youth programming also receive healthy snacks which reinforce the curriculum taught to adults in nutrition courses.

The vouchers are paid monthly, bimonthly, and or as extras depending on the need. The emergency assistance group makes home visits monthly to assess what is in the refrigerator, what are people sleeping on, how many per bed, ie., is the need assessment accurate and has it changed.

Because refugees have difficulties accessing and affording health care, every few months, CRP partners with The IMANA Medical Relief (IMR) and United Muslim Relief (UMR) to provide free medical services to the community.

The Family Resource and Community Center runs coed childcare and youth programs, livelihood training, (craft, beauty, and barber), and psychosocial programs like mind-body medicine. They run groups for women’s empowerment and for men, gender based violence. They teach Capoeira, music, and English, and run a summer camp. CRP has 300 to 400 beneficiaries per day; 10,000 families per year get assistance from two different centers. The teen program is important because if children are out of school for more than three years, they cannot enroll in public school until they attend a catch up curriculum. At CRP this is called the Teen All Stars program.

As we start the tour, we see that several buildings have been converted from apartments, so there is a hodgepodge of rooms, a hall with books (the library), and an office with friendly folks working at computers. I detect a certain level of organized chaos as well as 21st century sophistication. In the midst of this jumble is a videographer waiting to interview a family…who is late.

We peek into the youth center, the English and livelihood programs. There is an empty room with a huge decorative elephant painted on the wall. This is where Super Girls meet in two different groups, six- to eight-year-olds and nine to thirteen. This youth program runs afterschool programs, reading, and educational games. The girls talk about their shared Arab heritage and their future development. They are asked to build small mud houses that represent their dream houses, to make murals that “draw your future.” We see rooms for yoga and rumba classes.

Jessica tells us that CRP is facing huge funding cuts and grants are running out. At the same time the numbers of people in need is not decreasing. Donors come from the US, EU, and Japan, with a budget of over $800,000, less than half from foundations and grants.

Problematically, there are no mental health counselors, although all staff and programs are “trauma sensitive.” These Iraqi refugees have had a host of horrific experiences including torture, witnessing killings and death, kidnappings, bombings, and rape. Many families have been ripped apart and relationships damaged. Countless people have lost everything including their hope. Refugees in need of support and counseling are referred to the Center for Victims of Torture in Amman.

CRP’s philosophy of care is reminiscent of Abraham Maslow’s Hierarchy of need. Emergency Assistance programs aim to address beneficiaries’ basic needs so that they can focus on engaging in community and acceptance. Eventually, CRP fosters leadership positions and volunteering opportunities for beneficiaries, allowing them to play an active role in leading the organization and giving back. This provides empowerment to beneficiaries who are unable to legally work and may lack a way to meaningfully engage with the community in which they live. Though the majority of CRP’s beneficiaries hope to be resettled, the organization strives to create a sense of community and meaningful engagement that makes refugees fulfilled with their lives in Jordan.

UNHCR re-evaluates refugees regularly, but this can be quite re-traumatizing. Following a referral, UNHCR staff confirms the family’s refugee status and then begins several long resettlement interviews with each member. The family is then registered for resettlement, a suitable country is chosen, (Trump pulled the US out of the mix), then there are more interviews and a lot of waiting. A family cannot apply for a second country until they are rejected from the first. This means that many people are living in limbo which only increases psychological stress. Once they are accepted, they are paired with an in-country organization and the flight is usually covered by the donor agency. The first choice these days is Australia.

Australia? I try to imagine living in, let’s say, Mosul, in a diverse, multicultural society, living through Saddam’s military efforts in the 1990s, the US invasion and bombings in 2003, the murderous growth of ISIS, maybe fleeing in 2008, then years of stress, poverty, and trauma in Jordan. What would it be like to arrive in Australia?

A pipeline protest in Amman – May 3, 2019

first published in Mondoweiss

In late March and early April 2019 I traveled to Jordan and the West Bank (Palestine) with two colleagues, Sonia Dettman and S. Komarovsky, first to attend the Lancet Palestine Health Alliance conference in Amman and then to explore and better understand the lives of refugees and the workings of UNRWA, with a focus on the status of refugee health. This is the third in a series of reports.

I find traveling in a foreign country is a strange mix of exhilaration and confusion, a humbling struggle to understand and decode what I am seeing, along with a regular dose of bewildering frustration. Like the nightly ritual of searching for an adequate number of electrical outlets to recharge our assortment of computers, phones, and cameras. We managed to break two adapters in the sockets last night, leaving an exposed arm of the adapter sticking out ready to electrocute me when I get up in the middle of the night, disoriented, and try to remember, where am I now and where did they put the bathroom?

Today we learn that for the past few weeks, once a week people from distant municipalities have been marching to Amman’s city hall to demand better employment opportunities, increased wages, and better working conditions in the field of education. We come upon a demonstration outside of the Ministry of Education. We see a crowd of men, chanting, holding signs and flags, flanked by rows of police who appear armed with billy clubs. When a van of riot police pulls up and starts emptying into the street we decide it is time to leave.

As we head towards another demonstration against the gas pipeline, we pass by the Department of Justice where rows of mostly older men sit at folding tables under umbrellas with old fashioned manual typewriters, pecking with one finger. It seems that they write official letters of complaint and official documents. One elderly gentleman offers us tea and another insists we take a brochure about mosquito control. (You get the part about decoding and confusion.)

We walk around the block, past the ornately decorated blue domed King Abdullah I Mosque to the parliament, an imposing cream/white building with a green clay tile roof. A crowd of about 50 mostly men of a variety of ages walks to the entry gate, chanting, demanding to be let into the session where the pipe line is being discussed and protesting the gas deal in general. Two lawmakers speak in support of the protesters, another suggests that lawmakers were not given the opportunity to read the deal and it is unconstitutional and part of a highly problematic relationship with Israel. “‘We are calling for the Wadi Araba agreement to be dropped [the 1994 agreement that normalized relations between Israel and Jordan]. What is peace when they’re attacking Gaza?’ [MP Saddah] al-Habashneh said. ‘And with yesterday’s recognition of the Golan Heights, what’s left? We want dignity.’”

Police move in at protest at Jordanian parliament. Photo by S. Komarovsky.

We watch more than 25 police in blue (men and women) and riot police in camouflage, with billy clubs and bullet proof vests. The police women wear their police caps perched on top of their hijabs. One guy at the gate has an automatic weapon. It looks like the security forces are armed with tear gas and pepper spray, with big black helmets clipped to their shoulders. Press mill about with cameras and the protesters hold a large poster: “Jordan is not for sale.” There is one poster of a boy and a teenager. We are told that this boy went to visit the West Bank and was arrested at 16, convicted of throwing stones, and sentenced to 15 years in an Israeli jail. His father is often seen at protests with his son’s photos. There is a lot of coming and going, parliamentarians in long robes over their clothes. Protesters chant, holding red signs and wearing large red buttons, saying the pipeline deal is “shameful.”

We hear that aggressive police tactics are common so we watch the police and the crowd carefully. The riot police stand in a row about the gate; some mingle into the crowd, and gradually nudge the demonstrators away from the gate onto the sidewalk. The demonstrators comply and are soon surrounded by a phalanx of police on two sides, and the wall surrounding the parliament on the third. The only escape is down the sidewalk, away from the entry. I see one press guy greet and kiss a soldier and I am told that the security mostly doesn’t disagree with the protesters, but each has to defend a different position politically.

Demonstrators hold red signs translated as: “The gas of our enemy [Israel] is occupation.” Or: “Importing enemy gas is occupation.” Apparently ten of 130 parliamentarians agree with this sentiment. The actual debate is being live-streamed, although no protesters are allowed in the chamber. While the deal has already passed and the pipe line is under construction, parliament has to discuss and reaffirm it. Apparently it would be a huge embarrassment if the pipeline is not rubber stamped as it is supported by the king. The crowd chants, “This is not just a pipeline.” “We want everything – end the pipeline.” “We are supporting war in Gaza.” Jordan’s national electricity company NEPCO has signed an agreement worth $15 billion to buy natural gas from Israel over the next 15 years. The amount represents one quarter of Jordan’s debt. The environmental impact is not discussed much, mostly the cost and lack of need. Jordan is well suited for developing solar energy.

An agitated elderly man with a thick white beard and hoarse voice, wearing a traditional keffiyeh, yells poetry from a grassy knoll. One protester says, “We are here to make noise.” Decoding and confusion.

As the crowd thins out, we head back to the first demonstration where the protesters are still chanting, surrounded by riot police in camouflage and regular police. I am told that wasta (favoritism or nepotism), bribery, and graft are prevalent in Jordan. You get places, it seems, often because of who you know. For me, that lends an element of skepticism and outright cynicism to the efforts of the protesters earnestly fighting an obvious injustice.