Sitting cross-legged on her bed in her white shawl and black dress, a faint smile showing across her weathered face, Hadba looked quite at home while recovering from uncontrolled hypertension at the Ahli Arab Hospital in Gaza.

It is rare, however, to find a patient who lives in her troubled part of the region at any hospital these days. Hadba's village near the Jewish settlement of Kfar Darom has no hospital of its own, and military checkpoints prevent villagers from receiving health care in nearby communities.

Yet the Mobile Outreach Clinic, a new service offered at Ahli Arab Hospital, a ministry of the Episcopal Diocese of Jerusalem, is helping villagers like Hadba receive desperately needed medical treatment for the first time in months.

"Every time I see them here, I think, 'God bless them,'" hospital director Suhaila Tarazi said as she watched clinic patients line up for the buses that would take them back to their home villages.

The monthly clinics, which started this fall, offer transportation for patients from their villages to Ahli Arab. Patients receive access to pediatric, dermatology, gynecology, urology, cardiology, surgical and medical care. All services are cost-free, including laboratory tests, radiology exams and medications. The clinic also provides patients with food supplies.

Each clinic attracts some 170 families or more than 500 people. The mobile outreach service aims to help people from the villages of Al Mawasi, Um Al Dohair and Mogharakia and surrounding areas, which suffer an estimated 95 percent unemployment rate.

Prisoners in their villages

Villages served by the clinic are virtual islands surrounded by Jewish settlements, military encampments, and Israeli military checkpoints. These checkpoints prevent most residents from travelling to nearby locales, such as Gaza City, for medical care. Those people who do happen to make it through the checkpoints are not allowed to take any metal objects with them.

Fatima, one of the patients at Wednesday's clinic, said soldiers would not even allow her to take hair clips, coins or clothes with zippers through the checkpoint. She said she was separated from her husband and two of her three children because soldiers would not allow her to return to her village during the past month.

"Why, in Al Mawasi, do we always have to suffer?" she asked in Arabic. "We are asking for human rights people to come and help us."

Despite the difficult situation facing these villagers, most are not refugees, so they do not have access to help from the United Nations Relief and Works Agency and other refugee assistance groups. As a result, they are virtual prisoners in their own towns, with no access to food, supplies or medical care.

Ahli Arab Hospital cannot obtain the permits from the Israeli military needed to bring doctors or medical supplies into these villages, so residents must walk past local checkpoints, where a bus waits for them. The majority of people who come are women because soldiers will not allow boys older than 8 or men younger than 45 through the checkpoints.

Medical care limited

Still, a handful of elderly men made the trek recently. One man, Adel, said that a French humanitarian agency (Doctors without Borders) tried to help his village, but Israeli soldiers would not let them inside. He said he was thankful to have the mobile clinic come to his village.

"We hope to see them more and more."

Patients sat in plastic chairs and conversed under an outside canopy while waiting for hospital staff to call their numbers. The mostly female crowd was dressed in varied attire, ranging from black shawls that covered almost every part of the body to mere dresses with head scarves. Meanwhile, children played near the canopy or contentedly munched on sandwiches.

Doctors say the majority of pediatric patients they see are malnourished. Al Mawasi, a village of 10,000 people, has no hospitals and only one government primary health care clinic with an extremely limited supply of medicine. Other villages offer no medical care at all. Many families in these villages are living on tomatoes if they happen to grow in the region. Others simply starve when military curfews are fully enforced.

Environmental problems

A doctor running the dermatology clinic said he has encountered many "environmental problems," including fungal infections, bacterial skin infections, eczema and scabies. Many people have had their hair fall out because of nutritional problems and stress reactions.

Meanwhile, a pediatrician said that many children have chest infections, such as asthma, croup and colds. Several children also have diarrhea linked with contaminated drinking water, pinworms and other parasites.

Dr Yousef, who ran the medical clinic Wednesday, said he mostly sees cases of diabetes, hypertension, stomach ulcers and various infections, such as tonsillitis. Many of these may be indirectly related to the stress of the regional violence, he said. Many patients go to bed at night to the sounds of bombs and bullets.

Hadba confirmed Dr. Yousef's account as she sat on her hospital bed.

"We ask that God would help us," she said in Arabic, pointing to the sky. "But we are suffering not only in the night, but also in the day.... Women and children are scared and stressed all the time. They can't sleep because of the tanks, helicopters and guns."

The situation is difficult for hospital employees, too. Ahli Arab social worker Mohammed Al Naqa looked weary after a sleepless night of listening to Israeli forces bomb the area surrounding his home. He also was hungry because Muslims like himself fast during the day during their holy month of Ramadan.

International support crucial

Still, Al Naqa maintains optimism when talking about the Mobile Outreach Clinic, which receives help from three volunteer doctors. The clinic appeared to operate seamlessly, but that was because of three prior days of preparation, he said.

The hospital must first send a women's committee into the villages to advertise the clinic, determine resident needs and find out how many people want to attend the clinic, Al Naqa said. A few days later, the hospital will send a bus during the wee hours of the morning to pick up patients, he said. The 25-kilometer bus ride to the hospital takes some three hours because of delays at various military checkpoints.

Occasionally, doctors will find patients who needs special hospital care, and they will schedule them for a follow-up hospital visit. Such patients receive free medical treatment. For example, the hospital offered to pay for surgery for Fatima on Wednesday after discovering she would need hernia repair, and Hadba received free treatment for her case of uncontrolled hypertension and diabetes.

Such free medical care has taken its financial toll on the hospital, which had a $400,000 deficit for the first six months of this year. However, support from local charities has kept Ahli Arab alive. Financial aid from groups such as the Australia-based AngliCORD, Episcopal Relief and Development (USA), the Church World Service, the United Church of Christ and others have made the Mobile Outreach Clinic a reality.

Financial and political constraints make work difficult for the hospital staff, but Tarazi said the work has its rewards, too. She noted a woman who waved and asked for God's blessing on the hospital as she left the clinic.

"After it's all done, and we have put a smile on the face of somebody, it makes it all worth it."

By Albert H. Lee
chtoday_editor@chtoday.com