Project Description

Reaching Far

The director of the Emergency and Mobile Clinic program is Dr. Mohammed Iskafi. He was trained in Russia as a General Practitioner, and joined PMRS in 1988—first as a volunteer, and then he became part of the staff.

The Emergency Response Program was largely born out of a need to take action to serve unarmed Palestinians who were victims of the violent actions by Israeli military and police though community based training in first aid. This training program resulted in 180,000 citizens trained in first aid just four years later, in 2000.

The Second Intifada

During the Al Aqsa Intifada [uprising] for Independence in 2000, the Emergency Response Program quickly expanded to provide services to the victims of the increasingly violent and repressive response of the Israeli government and its army and police.

The ensuing reoccupation, which included more and more permanent checkpoints, closures and curfews, resulted in an increase in the isolation of Palestinians from one another and from medical services. These also resulted in the separation of medical personnel from their places of work.

Naturally, these results of occupation further aggravated the health status of Palestinians, particularly in terms of diseases and conditions (such as diabetes, hypertension, pregnancy, and early childhood healthcare-including vaccinations) that require and benefit from primary care. In response, PMRS’ work expanded to include emergency medical centers inside of towns.

Mobile Clinics In 2001, its services also grew to include mobile medical teams. The goals of this project were to: ”Facilitate access of patients to health services in view of restricted mobility, alleviate the economic burdens by providing free-of-charge curative services, as well as prevent and minimize the development of medical complications.” Mobile Clinics were an essential contribution to Palestinian health and health care provision, especially in light of data that indicates that by 2002, 260 governmental and non-governmental clinics had ceased working, leaving 73% of rural Palestinians without medical care.

Since 2001, the mobile clinics have grown. In 2003-2004, PMRS ran sixteen mobile clinics. PMRS’ mobile clinics are an example of how the grassroots sector of the Palestinian medical/health care system has adapted and grown to meet the needs of the people through the ever-increasing barriers to health and health care delivery.

Impacts of Occupation and the Role of PMRS’ Mobile Clinics

When asked about the impacts of the occupation on the health status of Palestinians, Dr. Iskafi emphasizes that the mobile clinics are indispensable because they serve people in remote areas.

For the increasingly isolated people of Palestine who suffer from chronic diseases, access to primary care through the Mobile Clinics is crucial in order to keep their situation from deteriorating into conditions that are more acute.

While the Mobile Clinics aid Palestinians through provision of crucial primary care, they are not sufficient in intervening with the detrimental impacts of the ongoing Israeli occupation. For example, Dr. Iskafi notes that the ability of the mobile clinics is limited in terms of solving the ongoing challenges due to continued isolation of villages.

For example, lack of sufficient follow up or medication (either because the medication is not available or because patients cannot afford to obtain it due to increasing unemployment and poverty) exacerbate the conditions of patients with chronic diseases like diabetes or hypertension. Dr. Iskafi also notes that the rates of late diagnosis of cancer are a direct result from the lack of access to primary care services due to the impacts of occupation.

Mental Health and Children

Finally, and of particular interest to those concerned with mental health, Dr. Iskafi notes the psychosocial problems of the occupation, especially among children. One major problem is that symptoms of psychosocial problems, such as nightmares or bed-wetting, go largely unrecognized as such by parents—who tend to think of these things as normal.

Unfortunately, the occurrence of PTSD among children is actually “normal”, numerically speaking, in Palestine. For example, one study conducted in East Jerusalem and the West Bank found that 54.7% of children studied had experienced at least one lifetime trauma and PTSD was diagnosed in 34.1% of the children (N=1000).

A study of the impacts of the Apartheid Wall found that 40.8% of children studied had noctiphobia (fear of the night) on a permanent basis. It also found that children between age 6 to 12 have become increasingly aggressive, per parent reports.

Regarding mental health, Dr. Iskafi says that a major task is to educate parents that these symptoms are not, in fact, “normal” within the trajectory of development. The growing mental health program of PMRS has in fact begun working to this end.

Impacts of Occupation and the Role of PMRS’ Mobile Clinics

When asked about the impacts of the occupation on the health status of Palestinians, Dr. Iskafi emphasizes that the mobile clinics are indispensable because they serve people in remote areas.