Tuesday’s Child Blog

Tuesday’s Child Returns to Gaza – Day 8

Monday 13th July 2009

I waken at 7 a.m. and have internet access this morning again. It is good to be back in touch with the outside world and catch up. I receive an email from Cochacamba in Bolivia confirming receipt of transfer of funds to support abandoned children in Solomon Klein home with milk, fruit, vegetables and kindergarden teaching fees. I am pleased with how the work of Tuesday’s Child is reaching children in different parts of the world, even though we are still only 2 yrs old and, as NGOs go, child-like in size comparison. I am also pleased that we still manage to donate 100 percent of everything received.

This morning, my plan is to go to the Ministry to request permission to visit the three paediatric hospitals in Gaza as well as the paediatric and neonatal units in the main acute Shifa hospital. My own early early background is in neonatal and paediatric pharmacy and I am also interested in seeing the quality of service provision in these areas. I thought it was only a matter of contacting each hospital Director directly, however, I learn that I require a letter of permission from the Ministry for Health for such visits to be possible. I ask Him for extra assistance this morning to help me.

Nazem kindly offers to introduce me to the people I need to speak to. Nazem owns a pharmaceutical company in Gaza city and has good contacts in the health industry here. He is a gentleman and one who holds the respect of all who know him, regardless of their affiliation. He assures me that permission should not be a problem and that the Ministry will only be too grateful for support from Ireland for sick children here.

The Ministry is a busy building with people coming and going in all directions. We knock on the door of Dr Al-Kashif, General Director for Hospitals, and he welcomes us. He asks a lot of questions about Tuesday’s Child, the nature of our work in Gaza and why we wish to visit children in the hospitals. I tell him we have been helping children in Gaza since November 2007, also of my own background in health-care and of the supplies of toys and sweets we have brought for children here. I give him samples of the toys and I note the first thing he does is check them thoroughly; security is paramount. He asks, how, with little Arabic, I can possibly communicate with children and people generally and assess the health needs here. I tell him, that 70 percent of communication is non-verbal and he laughs, acknowledging his awareness of this, after all he is an ophthalmologist, he explains. I think of the letter last night of the two little children needing eye surgery to correct their congenital disorder.

He introduces me to his Director of Pharmacy Services who shares her vision of clinical pharmacy services for Gaza. She is intelligent and informed and is gleaning much information from other areas. However, it is clear, that there is a fundamental error here, the same error that health administrations around the world have made, a focus on secondary care clinical services. Ultimately, the first focus should be on primary care, for if you can get this right, it will ultimately reduce the burden and financial load on limited secondary care services and resources. She mentions a clinical pharmacist in Ireland who has proved helpful to the work of the new ministry in Gaza and asks me if I know her. While I know many, the name does not ring a bell and I tell her I do not, as indeed it is some 3 yrs now since I was made redundant from my national post in the Irish Health Service Executive (HSE). I reflect on that time for a moment and the disappointment of it, on the quality, excellence and level of clinical governance in the service therein, on the shallow boardroom games and politics that went with the territory, the persistent bullying and the shabbiness of what is now on offer instead, a pity really. Nonetheless, I would not return to it, not for twice the salary. I am infinitely more fulfilled in my current unsalaried role. I also reflect on a statement from the fabulous Mary Robinson to former President and buck eejit George Bush, “I came to do a job, not keep a job” and it makes me smile. She made reference to it in a Q and A forum following her speech on the UN Declaration of Human Rights at Queen’s in Belfast. Nonetheless, I do not regret the years spent in shaping good practice in my remit of promoting public well-being and I hope that, even some, benefited as a result. Strange, that this clinically focused pharmacist in Gaza should bring me back to it, for I have not thought about my former role for quite some time. She leaves for a moment and returns with a copy of the essential drugs list for Gaza. I always prefer the word medicines, however, to drugs. She inquires again as to my pharmacy background and I tell her simply clinical pharmacy and risk management of prescribing. She explains that she will be recruiting fresh graduates from the university for rolling out clinical pharmacy services here. I consider the approach flawed, surely, for good clinical practice only comes with a foundation of experience gained from learning from many patients and different disciplines and a thorough orientation under the shadow of more experienced peers.

Dr Al-Kashif asks me to send him a letter in and he will consider my request to visit the 4 hospitals. He reminds Nazem and me that we do not have an appointment with him this morning and that he is very busy. I take responsibility for this and explain that I am not au fait with protocol here and also that my time is limited and I would prefer to write the letter now, if at all possible. He says he does not have time as he has a meeting and asks if I can submit a letter to his department on our headed paper. I explain that I do not carry our official stationery with me on field visits, only business cards, however, I would be very happy to write a letter now and it will only take a few moments. And so, he permits me to write a letter in his office. My persistence does not go unmarked, although he attributes it to Irish charm. He is in a rush to a meeting with ”his excellency the Minister for Health” and approves my request with a signature before leaving, giving it to his staff to process. I wait in his office and once the letter in Arabic is ready, I leave, also leaving sample toys and a kiddie toothbrush on his desk. His staff are efficient and the required letter of introduction to the respective hospital managers is given to me within 5 minutes of his approval. I could like this man and warm to him, if it were not for the cruel regime he is part of for it is not just Israel who breach the human rights of civilians in Gaza.

I thank Nazem for the kind introduction to Dr Al-Kashif, bid farewell for now and make arrangements to schedule visits to all 4 hospitals into my busy timetable for the coming week. I hope to start with one of the hospitals today, but am told morning times are better, so I will have to wait until tomorrow.

I return and do a head count of the bears, dolls and many other toys. I note that I have already distributed many of the toys I brought during home visits to families and, randomly, to children I have met. I do a second toy headcount and have only about 150 left, not enough for children in 4 hospitals and so I enquire about toy shops in Gaza to replenish our supplies. We have some families to visit this afternoon and after that, I will go shopping, as shops here are open until about 7 p.m. I would also like to buy some quality footballs, basketballs and also basketball nets.

I have some unplanned time now and use it to interview some more young people, this time, those starting out in their careers and finishing their studies in their chosen fields. I am interested in their views and where they see Gaza going.

My first interview is with Shadi, also a pharmacist. I ask him in his own words, to tell me his story, his experience of the war and of his hopes for the future. His English is almost fluent. “I am 25 yrs old and qualified as a pharmacist. I am newly married as of last week and my wife is also a pharmacist; we met at university. Our marriage has brought great happiness after a time of great worry and heartache. I was born in Libya and have one brother and 4 sisters; I have lived in Gaza since I was a child. My family home was damaged in an attack by 2 F16s and my father was injured, his arm and hand both hurt, in the same attack. All of the windows and doors in our home were destroyed but otherwise the house is ok, unlike many of our neighbours whose homes were completely destroyed. I have travelled to Egypt and Jordan but the last time I left Gaza was 14 yrs ago in 1995. I tried to leave Gaza to go to university abroad but it was not possible. I would like to travel the world and also start a family. We always had a reasonable standard of living, as my father had a good job as director of education for child development and for children with disabilities programme. Gaza has huge needs at the moment. The infrastructure is in need of repair for some years – water services, roads, electricity services – all civil services really were in gross disrepair before the war and now are almost obliterated. Sanitation services are a particular problem currently and lack of these is a health risk to many. The strip also needs huge investment in terms of money and ongoing humanitarian relief. The spirit of the people is very low, many are broken and people have lost all sense of security and personal safety. Unemployment is high and there is a huge need for job creation and development of young people. I am hopeful that the blockade will end and this black spot will leave us. I am still shocked and heartbroken about this attack on our country. This was a civilian assault on the people of Palestine, it was not about a war against Hamas. What is most disappointing of all is the deepening divide between the two parties here and their supporters, for we will never have a future unless Palestinian factions of Hamas and Fatah unite. The leaders of each, need to shake hands and come around one table, a table of power-sharing. We need union not division if Gaza is to survive”.

Shadi, 25 yrs old, pharmacist

I thank Shadi for sharing his thoughts and experience and it is the same view I have come across when speaking to many this week. For Gaza has never been more polarised and in this, Israel has achieved its goal in, not only annihilating Gaza, but dividing the people here. My greatest fear for Palestine is, that unless Palestinian factions unite, there may be civil war and even more suffering and that would be a catastrophe. I had hoped after such a heinous war, Palestinians would have forgotten their differences and come together in the best interests of their future and of an independent Palestinian state.

Rasha, 21 yrs old, studying engineering and graphic design

My next interview is with 21 yr old Rasha, from Gaza city. “My name is Rasha and I am studying engineering. I have 5 sisters and 2 brothers. I lived in Saudi Arabia for 6 yr, between the age of 6 and 12 yrs. It was a lovely place to live – happy, safe and free and I am fortunate that I had that experience, even for a short time. I am very saddened and, well, heartbroken about the recent war here, and all of the incursions that preceded it also. Life is very difficult for people here, it is a miserable situation and there has been too much death. Thankfully, all of my family are safe. I was at university on 27^th December when the war started, it was a horrible day and one I will never forget. The sky was full of fighter planes and helicopters, looking out of the university, there must have been at least 20 in the sky above firing indiscriminately on the area below. It was terrifying. There were no phones or internet access or electricity, everything stopped and everyone was panicking and there was no guarantee of arriving home safely. The bombs continued to fall hard and there was also constant shelling from the sea. We had to leave our home as it was not safe and go and live in our Uncle’s house. There was no comfort there, very little food or water and it was impossible to sleep. Thankfully, all my family our safe but our home is badly damaged – all the windows and doors are broken and the internal walls are all damaged; also the roof. And this is how it still is, now 6 months on, as it is not possible to get materials to fix the damage. It is miserable and very depressing. I want to travel abroad and I would like to go to the United Arab Emirates to complete my studying and to live and work there. I do not want to remain in Gaza, there is no work here and no future. I hope that the blockade will end soon but this needs unity between the Palestinian people. I think there is much more unity between our generation than the older generation and it is essential in order to achieve peace. Here families who support Hamas and families who support Fatah, must come together. The reality is that many families don’t want to know about either, they are completely disillusioned with both. I think the young people of Palestine have more vision, they can see that unity is essential for us to move forward and have a future but the older generation here are set in their ways and will not permit that. They are destroying any chance of a future for their children and young people, for by refusing to settle their differences they are robbing us of our future”.

Asmaa, 22 yrs old, studying engineering and architecture

My last interview is with Asmaa, also from Gaza City. “My name is Asmaa, I am 22 yrs old and I am studying construction engineering. I have 6 brothers and 4 sisters. I live in Gaza with one of my brothers, the rest of my family is in the United Arab Emirates and we hope to join them soon. I was in university when the war started, it was crazy, we were being bombed from all directions. My brother and I left the university together and made it to our grandmother’s home and stayed with her for the duration of the war. There has been so much death and destruction and many students were killed. Many here are still confused. People cannot concentrate or make decisions, they are bewildered and are going around in circles. People go outside their homes and it is as if they don’t know what to do or where to go. They are still in shock and cannot think for themselves and many are exhausted, the stress and the trauma. Gaza, needs leadership and there is none here, politically the country has never been more divided. This is the saddest, the lack of unity here now. I do not want to stay in Gaza. There is no future here for me here. I am one of the lucky ones as I have a visa. I will hopefully live in the United Arab Emirates with the rest of my family. I would like to travel and see the world. I would like to visit Italy and Malaysia. Italy especially, as the architecture is so beautiful”.

I thank Rasha and Asmaa for their insights and wish them good luck with the rest of their studies and for the future. The over-riding theme from the three interviews is the need for unity between Palestinian factions. It is clear from many of the families we meet that they are sick of the politics here, many in Gaza don’t want to know about either Hamas or Fatah, they are fed up with the lack of hope that both options currently offer. Clearly, a new, all embracing, political solution is needed.

I return to the hotel to take a break from the heat and prepare for the home visits this afternoon. I cannot eat the hotel food, indeed I can eat very little. I bought some bread, cheese and nutella yesterday and more soft drinks as the water is definitely dodgy and so I have two pittas, one with cheese, one with nutella and a can of strange tasting 7UP, that clearly came through the tunnels . This has been my diet for the last few days and there is very little fresh fruit here to buy. Still, it is much more than many people have to eat here.

Our first stop this afternoon is to one of the older cemetaries in Gaza city to meet the Fahtma El Mokabry family of 20 people, refugees who have been living here for 20 yrs. In Gaza, unlike in neighbouring Egypt, people are not permitted to live in cemetaries. This family is the exception. The Palestinian Authority has tried to move them on many times, but they remain, stating that this is their home and they have nowhere else to go.

Fahtma El Moukraby family living in cemetery

Home in cemetary

Some of the El Moukabry children who live in the cemetery

The extended family live here with the wives and children of Fathma’s sons. He husband is mentally ill and also disabled. Inside, she shows me around her home and the damage sustained during the war. Their refugee status permits the children to attend UNRWA schools and access food allocations there. In the kitchen, her eldest daughter is making pastry and I notice a sewing machine in the main entrance area, clearly in use. We give her cash assistance towards the needs of the large extended family. It is a grim environment for children to grow up in and I wonder what it must be like for a child to have a cemetery as their garden and playground. The children are delighted with the sweets and, as with all children I have met here, they are very polite.

We say good-bye to the graveyard children and drive to a very different area, the middle class area of Tall El Haw in South West Gaza. Initially, as we drive, it looks as if it has escaped the obliteration of other areas until we turn into a main area where homes and high rises are completely decimated. We pass a large park where over 200 tanks parked during the war before causing mass destruction and then onto a large apartment building, hit by 19 rockets.

Apartment block in Tall El Haw destroyed by 19 rockets where many people died

Another bombed apartment block in Tall El Haw

Remains of large apartment block

More bombed apartments

Again, the direct bombing of so many apartment blocks in this large residential area confirms that Operation Cast Lead was directed towards civilians.

Many people in this area repeatedly called the Red Cross and the other hospitals for assistance but no help could get through for over 24 hrs and many bled to death on the streets. It is estimated that 500 people lost their lives in this part of Gaza, the loss of life greatly exacerbated by the inability of emergency services to access the dying.

In this area, the famous Arafat Al-Quds hospital, also under siege. The hospital was bombed and shelled and went up in flames. Physicians evacuated patients from the hospital and lay them on mattresses in the road outside while Israeli forces made them move people back into the burning building. They said that anyone leaving the hospital would be shot. One man, in defiance, of their treatment walked straight out onto the street and they shot him through the head. Here, healthcare workers and ambulance drivers were killed and tanks rammed ambulances and crushed them. And again, they say this was not a civilian attack.

Al Quds Hospital

A physician here shows me a video he made of the hospital under attack with flames pouring from the roof and the main wing, the people killed and the sheer devastation caused. It is hard to believe. I am shocked. Outside the hospital the remnants of ambulances chewed up by tanks are still evident. How could they possibly not have seen they were ambulances? What was the excuse this time? That Hamas militia were driving ambulances? It is nauseating. To attack a hospital full of sick people, healthworkers and emergency vehicles – it doesn’t get much lower than this.

Al Quads Hospital

Main foyer of former hospital 6 months on

View from entrance to hospital 6 months on

Children’s playground in grounds of hospital

Ambulance crushed by an Israeli tank

Another ambulance also rammed by an Israeli tank

Front view of ambulance above

I have worked in 5 hospitals in my time, 2 in London, 1 in Edinburgh and 2 in Ireland. I simply cannot envisage any of these coming under similar attack even in a war situation. Yes, Belfast, had it's moments, but not an onslaught like this.

We drive on to meet our next family, new to the feeding programme since the war. We pass the area where another body was found on Monday under the rubble.

Area where a body found under the rubble a few days ago

We stop to pick up a lady who is coming with us on our next family visit, a friend of the family, and as, wherever we stop, even for a few moments, children gather. We give sweets and they are delighted. One of these children however is carrying a make believe gun that, from a distance, looks quite realistic. I ask him what he is doing and he says that he and his friends are defending their area. A tragic game of make believe and the reality for children living with violence. I think back to my own childhood, where the kids in our house, joined forces with the local Methodist minister’s 4 children, who lived in our avenue in Lisburn. We called our group the Parkmount Defence Regiment (PDR), a harmless gathering, but nonetheless children absorb their environment. I offer to swap his gun for a football and a colouring book and crayons, but he would rather keep his gun. As we drive along. I notice, another child, even younger, pointing a toy gun out of a car window.

Children of the Tall El Haw area

With sweets and a make believe gun that he refuses to trade for a football

Another child points a make believe gun

The next family we visit this afternoon is the Niveen family. Unlike, many we have visited so far, they have a nice home, yet the suffering here is as raw. They are new to the feeding programme, since the war. Mrs Niveen is now a widow, her husband was killed while evacuating families from their building, on 15^th January, when it came under attack. He was hit by a rocket and decapitated, she witnessed his death and it plays over and over in her mind. She has received no psychological support or counselling, her own family live a distance away in Rafah and her mother is sick. The only support she has is from the lady we picked up en route, her friend. Her husband had already evacuated all his own children to a UNRWA school and returned to help others trapped in the building. Up until that, the family had no food, as it was impossible to get out and there was very little drinking water. A photo of their father hangs in the centre of the living room wall. “I miss my husband so much”, she says, “he was a good man, a loving husband and father, my life is empty without him and we have no source of income now. The children miss him so much, they cry for him even the little ones, and they cannot understand why he had to die, especially when he was helping others. There is no way they could not have seen him evacuating the people here, they were quite close when they fired the direct hit”. I ask the children about school and what subjects they like. Nadim, who is 13 yrs old, says her favourite subject is art and she would like to study design later. Mahmoud, the eldest, at 15 yrs, likes most things and would like to be a doctor, Fatima, 11 yrs enjoys arabic and science most and would like to be an engineer. Namie, 7 yrs old, likes science also and wants to be a doctor and 10 yr old Mohammed wants to be a teacher. The youngest children are 3 yr old Reda and the baby Ahmed, 19 months. I ask how long the food lasts and she says about 12-14 days, other neighbours help for the remainder. The poor lady is grief-stricken. I tell her I think she is coping very well, under the circumstances, her home is lovely and the children are all looking well and she is pleased. We give the children a football and will return with other things for them.

The Niveen family who lost their father on 15^th January 2009

Family man Mohammed Niveen, killed while evacuating other families from his building

Time now for more toy shopping to replenish our supplies and we visit three different shops this evening. There are a few toy shops in Gaza and also that things like colouring books and crayons are available to purchase. Recent reports say that crayons and books for children have been refused access to the strip, however, we find there is no shortage here; perhaps they came through the tunnels.

Selection of toys purchased from one shop

The third shop we visit has an excellent range of colouring books and crayons and we take much of their stock, for we still have to visit the children in the tents as well.

Colouring books and crayons

I get back to the hotel about 10 p.m...I will get up early and sort the toys in the morning! The Niveen family are still on my mind. I cannot begin to imagine this woman’s trauma and grief. To see her husband’s head blown off while he is helping others, and to be left to bring up 7 children on her own with no money or family support, and only the kindness of a solitary friend to help her through. The things we worry about. Every family here seems to have some trauma and a story to tell. No one has escaped this war unscathed. I ask God to watch over her and her family and look after them. I also pray that the vision of the young people I met today, one of unity and peace between all Palestinian people, may be fully realised. I also give thanks for her family sponsor, Mary Ryan.

I lift volume 3 of Direction for Our Times, God speaks to his children and I open at “It is I, the Father of All, who speaks to this small soul. I wish to give My children both notice and direction. If you are following Me, continue to follow me, but in a more dedicated fashion. Ask yourself on this day, what can I do for my Father in heaven? I will put an answer into your heart, little souls, and you will have My request....for those souls who are not following Me, but who understand they must change, begin by prayer....souls who are working against Me, I speak to you now with the greatest of gravity. You know who you are and you understand that you have pitted yourself against all that is Light. You must cease now.....I see all. I will judge every action. I will reward every decision made by one soul for the benefit of the other. In the same way, I will challenge every decision made to the detriment of another. Children, all is being recorded. You will account for your life”.

I pray that all those working in the Middle East to promote darkness and injustice have a change of heart and cease their persecution of others. Their activities make the world a very unsafe place for every child and we will never have world peace without peace in God’s beloved Middle East.

If you are in a position to help any of the families we met during our time in Gaza, please contact us at info@tuesdayschild.co.uk or donate online here »

Continue to read Day 9 »