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Diabetes micro-clinics in conflict-ridden West Bank

Micro-clinic participants Bethlehem.  (Photo by Daniel Zoughbie)
Diabetes as stigma, grades as humiliation, and security as a slippery slope

BETHLEHEM – I have been working closely with the nurses that helped with the D'heisheh Project. We have finished compiling from our data gathered at the Micro-Clinic Project in D'heisheh a list of the people who will form another 20 micro-clinics in the refugee camp, bringing the total number of clinics in Palestine up to 50.

I have also decided to try something new. I would like to invite the 20 groups from D'heisheh to come to the Ib'da Community Center, and there we will show them how to use the machines, and then give them out. Though I prefer visiting the homes or businesses where the micro-clinics will be located, I want to try a new method of distribution, partly because making house visits has been quite demanding, and I am not as familiar with the refugee camp as I am with the Bethlehem area. Unlike the Bethlehem Project, the D'heisheh Project also has the advantage of easy access to health committee volunteers at the center. In Bethlehem, we refer the diabetics to the Ministry of Health and other similar health organizations, but I feel the D'heisheh center is more accessible.

When I do distribute the machines to the people, I am surprised at how calm and collected people are compared to the momentary chaos we had in the Bethlehem Project. When groups come in, some with representatives, we talk with them and provide each micro-clinic with a machine, and show them how to use it. Many of these people are Type-I, meaning that their diabetes can only be controlled through insulin injections, not simply by eating right and exercising. We also give priority to two young girls and one boy who have diabetes. The problem, I was told, is that these young people and their families do not want to admit that they have diabetes, as there is a stigma put on such diseases. They believe, and in some cases rightfully so, that if the community knows that they have a "genetic problem" that no one will agree to marry them. As a result they hide it.

I give a machine to one girl who comes alone and is clearly very shy about receiving a machine. She is about 16, dressed in a white, slightly sparkly headscarf, a pink and white shirt, white pants and stylish sunglasses. She asks me for a bag to carry the machine in, and after I tell her I do not have one, I can sense her anxiety. She says that she has to walk home and does not want to carry it in the street. I then suggest that we try to fit most of the pieces in her purse. We do so successfully and, after few joking words, she leaves with a smile and a bulging purse.

After doing some more work, I go to eat lunch in an ordinary restaurant near the camp. You can buy some meat cooked on the side of the street in a mini-oven for a lot less, but I have tried to stick to home-cooked meals or food that looks appetizing from shops. I notice that my complete meal is about $6.50 with a drink. I could get a cheaper meal on Telegraph Avenue in Berkeley! I am told that the relatively high prices of food and other basic items make it very difficult to survive on the low wages in Palestine. Some have told me that the high prices are due to many things being imported from Israel, which has similar prices to the United States. Also, Palestinians are not usually permitted to work in Israel, and local production of certain goods is sometimes prohibited or the goods have been destroyed.

* * *

It's now the day that all high school seniors find out what they got on their exit exams, or towjihi. This day for Palestinians is like the Fourth of July for us. People will go crazy celebrating, and others who do not do well will cry. If students flunk this exam, they will not be able to enter college.

I go to my friend's house at 8 a.m., and we gather around the TV. After numerous delays, the Minister of Education announces the top 10 scores in Gaza and Palestine. My friend's sister, Nameh, is extremely nervous, as she had been studying very hard for this test. First, he announces Gaza. When he announces the top 10 in the West Bank, Nameh shrieks with joy as he mentions that she received the 5th highest score. After congratulating her, we go to her girls' school, where her classmates and teachers are also waiting to congratulate her. After driving around Bethlehem and Beit Sahour, I see the streets beginning to fill with honking cars and young graduates hanging outside the windows shouting, "Towjihi! Towjihi!"

After we return to the house, local television stations start calling, in addition to friends, families and neighbors congratulating Nameh. But as I watch the TV, I notice that it continuously displays the score of all the people who took the test. I could not help but wonder if it was the best idea to publicly broadcast students' scores, given that some were not especially good. Some of the girls at Nameh's school are pretty upset with their scores, and if getting a bad score is not punishment enough, having it displayed on public television must be, quite simply, humiliating.

We spend the whole day running around, and during the night throw a party for her. All over Bethlehem, fireworks are going off and people are celebrating the achievements of the next generation of Palestinian scholars.

* * *

A few days later, I begin to hear that the Israeli Defense Forces have been making more surprise visits here in Bethlehem. In a previous dispatch, I wrote about how the IDF had visited Bethlehem at 1 a.m. This time they came at about 6 a.m., and then on another day at about 10 a.m. All the raids were in pretty close proximity to where I live, near Manger Square, and there was some light gunfire. Little boys subsequently started throwing stones at the jeeps as they exited the square, and others saw this as a sign to come out of their not-so-concealed locations. I am starting to think twice before I go and make the micro-clinic visits and am erring on the side of caution. Because of these increased tensions, it is becoming a little bit more difficult to visit people's homes regularly - though no significant curfews or restrictions have been implemented.

The IDF was looking to arrest some men, though I do not really know the exact reason why, if there was one. I was watching the news coverage on the day of the 10 a.m. raid, and the IDF had arrested a man associated with Hamas. His teenage son was interviewed; he was free only because his mother said she had begged the soldiers not to take her son. I continued to watch the coverage as it replayed pictures of masked IDF soldiers in army fatigues searching an unfinished concrete building. With guns poised, they climbed a ladder and cautiously climbed onto the flat roof. One soldier in a crouching position walked across the roof and knocked on the water tanks, perhaps to see if there was anything hidden in them. They then showed the prisoners under a tree, waiting to be taken to an Israeli prison.

Some Palestinians with whom I have spoken say that the men being apprehended are low-level, insignificant individuals in organizations like Hamas and the Islamic Jihad. Others have said that some of these raids are just meant to provoke and incite fear, not to apprehend any specific individuals. Some Palestinians would argue that the bombings in Israel are a result of these provocative incursions, in which many Palestinians have in the past died or been arrested and subjected to torture. Israeli newspapers have stated that the IDF has been conducting raids in the West Bank to apprehend the militants who continue to facilitate such bombings.

With all the bombings, military exercises, searches, checkpoints and metal detectors in mind, I have been following the tragic bombings in London with some interest. First, I was in London riding the trains that were blown up not long ago; second, I will be returning home with a layover in Heathrow Airport, and lastly, I have met a guy here from London who is Palestinian. I was interested to see his concern for his family's safety when he heard about the bombings and his comment that "it just might be safer staying in Palestine than London nowadays." I thought about how, in my previous dispatches, I described the hyper-security situation in Israel and then said that I hope that we can realize that peace, justice and security goes hand in hand before it is too late.

Well, now that the second bombing in London has hit, New York subway passengers are going to be searched. But, as I observed in Israel, these security precautions will only lead to more clever operations, which will in turn lead to more stringent laws and suspensions of freedom and so on and so forth, until we are living in an Orwellian society. Let us instead invest in building bridges, creating mutual trust and respect, and improving the lives of people who live in places of deprivation like Palestine. That is, of course, unless we would like to be searched before using the restroom.

The choice is ours.

—Daniel