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Behind the
Wall
'Medical Conditions caused by Political
Decisions'
By Rich Wiles
09/03/07 "ICH"
-- - On Christmas Eve in 1952, a Swiss priest
called Father Schnydrig was on his way to Mass at the Church
of the Nativity. He had come to Palestine to celebrate in
the birthplace of Jesus. He walked past a huge area filled
with tents and saw a man attempting to bury a child. This
was Dehaishah Refugee Camp. The man was digging in the mud
to create a makeshift grave for his own son. His son had
literally frozen to death. Father Schnydrig began to
question his own place in Bethlehem and wondered how he
could be in the city to celebrate the birthplace of Jesus
whilst children were suffering so much within a kilometer of
the church. Upon returning to Europe he began to fundraise
and soon opened Caritas Children's Hospital in Bethlehem.
In 1978, Caritas opened a new building: it now has excellent
facilities. Conditions at the hospital have improved greatly
from an initial fourteen beds in the mid 1950's to being
able to treat over 34,000 babies and children in 2006. Life
has also changed greatly in Bethlehem over this time.
Dehaishah's refugees now live in houses instead of tents.
Bethlehem itself is now an Occupied city.
Earlier this year a man walked into Caritas Hospital
carrying a small baby in his arms from a refugee camp. The
child's feet were blue, they were frozen: this time the
child's life was saved.
Palestine in 2007 is geographically hardly recognizable from
Palestine in 1952. Go back a further five years and
'historical Palestine' still existed. Now only around 12% of
'historical Palestine' is accessible to Palestinians.
Caritas cannot even cater to all of this 12%. Children from
Jenin, Nablus, and other cities in the northern section of
the West Bank cannot get to the hospital due to travel
restrictions, checkpoints, and the series of Bantustans
which the Occupation is dividing the country into. Because
of this Caritas can only treat children and babies from the
southern West bank, the areas around Bethlehem and Al Khalil
(Hebron). Despite this massive reduction in its catchment
area, last year saw the largest ever number of patients
treated at the hospital.
The effects of the Occupation are varied and widespread.
Children injured by the IOF are not brought to Caritas as it
has no emergency casualty unit, instead they are taken to
state hospitals in Bethlehem. But saying that, a very high
percentage of all children in the hospital have conditions
which in some way relate to the political situation.
Walking around the hospital it is hard not to be impressed
by the facilities and the standard of care, but another very
striking thing is the size of most of the children. Children
suffering from serious malnutrition are regularly brought
into the hospital, but as I am taken around the hospital by
some of the many dedicated staff they begin to explain to me
about F.T.T. - Failure To Thrive. The majority of the
children at Caritas are not from the cities of Bethlehem or
Al Khalil but from the refugee camps and villages in the
area. The environmental and social conditions in these areas
are much lower than inside the cities. Poverty levels are
higher, and subsequently diet suffers, heating is
insufficient through the winter, and access to clean
drinking water is also a major problem. One tiny child
catches my attention as her huge brown eyes gaze at me
inquisitively. After covering myself with a face mask, a
gown, and gloves to prevent spread of infection, a doctor
takes me over to meet her:
"Lama is from Al Khadr village. She is ten months old but
has the growth parameters of a baby less than four months
old. Her mother had no milk to feed her with so she simply
couldn't grow. Her parents haven’t been here in a month
now."
A lot of the children are suffering from gastro-intestinal
problems, which can manifest itself as sickness and
diarrhea. Such problems are common in children worldwide but
in Palestine, as in many parts of the unprivileged world,
children are dying from such conditions. Parents do not have
the money to pay for hospital care so are often delaying
going to hospital until it is almost too late. And as
another doctor explained in some cases it is too late by the
time children reach the hospital:
"A few months ago a man brought his son in. They had no
money at all and felt ashamed to beg for help so they put
off seeking treatment hoping the condition would improve
with time. Eventually the family got very desperate as their
child deteriorated and they took him to a Government
hospital. When they got there the hospital couldn't treat
him as all doctors were striking, and they were sent here.
The child died within a few hours of getting here, it was
just too late."
This child died from acute gastro-enteritis, he was just six
months old. Had he been taken to hospital earlier he could
have been treated successfully.
Since the international blockade on Palestine began last
year, imposed by the world's leaders of so-called ' freedom
and democracy', staff at Caritas have found the situation
has deteriorated greatly, and at an alarming rate. Doctors
at state hospitals had not been getting paid and eventually
took up strike action in protest so many more children were
getting passed on to Caritas. Parents have no money so their
diets and those of their children have suffered greatly. One
child was brought in suffering severe vitamin B-12
deficiency which is unusual in babies here according to the
doctors at Caritas:
"B-12 is found in meat and vegetables which very young
babies do not eat. Her father was a policeman so had not
been getting paid since the blockade began, he could not
provide food for his family, so his wife during pregnancy
had lived on not much more than bread and black tea. By the
time she gave birth she herself was suffering severe B-12
deficiency and as she began breastfeeding this was made more
acute in her new born baby as there was no B-12 in her milk.
We see this a lot - mothers who cannot produce good milk
because of their own dietary suffering which is in turn
passed onto their children."
Many of the children here suffer from some form of anaemia,
another condition directly related to poor nutrition. One
child I saw had 80% iron deficiency anaemia. Iron is vital
in the first few months of life for amongst other things
development of IQ and this child has been found to be
suffering from incorrect psychological development as well
as physical problems. So these are some of effects of the
policy which Bush and Blair promoted last year because they
didn't like the democratic choice of the Palestinian people:
"We found things got a lot worse after the Intifada began
and again since last years blockade things have deteriorated
greatly. Nutritional care has suffered a lot. Mothers cannot
produce milk so are using powdered milk but it is being
diluted so heavily because of the families poverty levels
that it has virtually no nutritional value. It is also being
made with dirty water."
Another very evident factor at Caritas is a disturbing lack
of parents in the hospital with their children:
"We find this to be another major problem, particularly from
the camps and villages around Al Khalil. This baby here for
example is from Yatta (a town south of Al Khalil). She has
Short Bowel Syndrome, a twisted intestine. She also suffers
from various nutritional deficiencies, anaemia, and FTT. She
has been with us since just after birth and her parents have
not been to see her in over two months now. Yatta is a very
poor town and her parents simply cannot afford the transport
to get here, they have other children to feed at home..."
Walking around the hospital I see rooms and rooms full of
tiny babies suffering from conditions in some way related to
social conditions and poverty, children whose eyes light up
when I walk in at seeing a new face. Some smile up at me
with the beauty of new life, others cry almost constantly.
One baby is so tiny I am sure she must have been born very
prematurely but as we look through her notes we find that in
fact she was born after a full term of pregnancy. She is now
four months old but seems no bigger than a bag of sugar. The
doctors go on to tell me of other children brought in,
carried in their fathers arms, carried in like babies, but
in fact these children are not babies but three, four, or
five years old. They simply cannot grow - this is FTT at its
most severe.
In the winter, children such as the child described earlier
with frozen feet, are being brought in with temperatures as
low as 32 degrees, particularly from the camps and villages,
because their houses have insufficient heating, or in some
cases no heating at all. Not all children brought into
Caritas can be treated at the hospital. The hospital has
built strong links with hospitals inside Israel and some
children are sent to hospitals there if they cannot be
treated at Caritas. This is particularly the case with major
operations. But this procedure also faces many problems.
Endless paperwork must be completed and then the child will
be put into an ambulance: but this ambulance is permitted to
travel only a few hundred metres up to Bethlehem checkpoint.
It can go no further. It can go no further because it is
Palestinian. Even ambulances are not allowed passage through
the checkpoints to hospitals in Israel irrespective of
paperwork. So at the checkpoint a child will be unloaded
from the ambulance and an Israeli ambulance will wait to
collect the child to continue the journey. And once the
child is safely in the hospital inside Israel where are his
or her parents? They are invariably stuck behind the other
side of the Apartheid Wall to their child, unable to get
permission from the Occupation to themselves visit and care
for their sick children during their hospital treatment. In
one recent case from Caritas a baby in an incubator was held
up at Bethlehem Checkpoint for a couple of hours before the
soldiers finally allowed him to be transferred to the
waiting Israeli ambulance.
The doctors at Caritas have also, since the start of the
Intifada, found incredibly high numbers of very young
children suffering from a rare strain of cancer behind the
eye. They have been unable to pinpoint exactly what is
causing this and it is not being found in neighbouring
countries which leads the doctors to believe it is possibly
a chemical toxin being used by the Occupation. They have
been researching the possibility that it could be caused by
tear-gas but have so far been unable to categorically prove
this theory. Premature birth and miscarriage as a result of
shock caused during IOF attacks is also widely seen.
The work of all the staff at Caritas Children's Hospital is
admirable. The faces and tiny, weak bodies of the patients
are heartbreaking, wanting eyes looking out of shallow faces
pleading for help. Palestine diminishes day by day. It gets
smaller and smaller. It cannot thrive and its children
suffer from a Failure to Thrive. It cannot develop, and its
children illustrate that fact through their continued
development of poverty related illnesses. These are medical
conditions caused by political decisions.
Richard Wiles, is a British photographer who regularly
visits the occupied West Bank. He writes reports on the
situation and memories of Palestinians in the camps and
takes photographs of the life these refugees are living now
for future exhibitions. He has been writing regularly under
the title “Behind the Wall”.
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