Home / Nablus / International Solidarity Movement Podcast episode 8: Building autonomous healthcare in Palestine

International Solidarity Movement Podcast episode 8: Building autonomous healthcare in Palestine

In this episode, Nicole and Tom interview Dr. Ghassan Hamdan of the Palestinian Medical Relief Society (PMRS). PMRS is a grassroots NGO that’s provided a much-needed response to the medical crises caused by the occupation. PMRS’ workers, like other Palestinian medical workers, are constantly targeted by the occupation forces. On top of providing medical care. PMRS has trained up thousands of people, building resilience to the occupation’s attacks on the Palestinian people.

Organisations like PMRS are a vital part of remaining steadfast against Israel’s colonisation policies. Building health autonomy is a key part of building resistance to the occupation.


Supported by

Shoal Collective

Introduction 00:01

Hey, welcome to international solidarity movement podcast. [Arabic]

Tom 00:18

Hey, and welcome to Episode Eight of the International Solidarity Movement Podcast. My name is Tom and in this episode we interview Dr. Ghassan Hamdan of Palestinian Medical Relief [Society]. PMRS is a grassroots NGO that’s provided a much needed response to the medical crises caused by the occupation. PMRS’s workers like other Palestinian medical workers, are constantly targeted by the occupation forces. On top of providing medical care, PMRS has trained up thousands of people, building resilience to the occupations attacks on the Palestinian people. Organisations like PMRS are a vital part of remaining steadfast against Israel’s colonisation policies. Building health autonomy is a key part of building resistance to the occupation. And now over to Ghassan and Nicole for our interview.

Nicole 01:17

Hello, thank you so much for making time for us today. Please, can you introduce yourself?

Ghassan Hamdan 01:23

Welcome, I’m happy to meet you to have you here in Nablus first. My name is Ghassan Hamdan. I’m a doctor, and I’m the Director of Medical Relief Society in Nablus region. Medical Relief Society, it’s one of the biggest non governmental organisations in West Bank and Gaza Strip. And it was established in 1979 by different medical personnel, doctors, nurses, social workers, lab technicians. And the association began as a doctor who was interested to provide medical services for the people in the rural and difficult areas, the area where we didn’t have medical services for the people. And you know, in that time, all the countries were fall[en] under Israeli occupation. And the also the medical services also was controlled by soldiers, where they are not interested to provide medical services for the people, especially in rural and remote areas. Thinking by that, that they can make pressure on the people to migrate from their houses, their villages, their places. And by that they can implement the policy of transfer policy – where they are trying to push the people by themselves to go out from their country to go out from other countries where they can find better situations. Especially for their children for their families, and medical things.

The doctors who think to establish medical archives and organisation medical services, it’s kind of building health infrastructure for Palestinians where we can make services for the people and relate it to their needs. And in health condition. After that, of course, the medical relief was growing and work in different areas, different regions in the West Bank and Gaza Strip. And now, we run as a medical relief more than 43 Medical Primary Health Care Centres. Big primary health care centres – and we provide more than 14 programmes. Like woman health programme, school health programme, first aid programme, emergency programme, chronic diseases programme – different programmes which [are] related to the needs of the people and the Palestinian community. Of course, during our work. What I want to explain that health is affected by occupation, health is affected by politics and the condition which [is] caused by Israeli occupation. So this is about medical relief, and we’re still working as health provider, but we based our work on primary health care.

Nicole 04:41

Amazing. And you said about health being affected by the occupation? How do you see this in your work?

Ghassan Hamdan 04:47

So what I want to explain by this, that we can’t here implement our strategy in healthcare. Why? Because under occupation, there is no sustainability. So if you want to implement your strategy on healthcare, you need sustainability. You need to have own conditions, conditions in which you can implement your strategy. For example, if you want to improve the health condition for the people in chronic diseases, which is very difficult in Palestine – it’s the highest percentage in the Middle East – because of the stress, the political situation, economic situation, social situation. So we face many people who are suffering of hyper tensions, heart diseases, heart attacks, and diabetes mellitus. You know, all the these diseases [are] affected by your style of life and your condition – especially economically and politically, socially.

We can’t take care of these people while we have emergency situation. Explaining that, for example, one month ago Nablus area – one and a half months agoNablus area was completely under siege. So during the siege, Israel had closed all exits to the city. Totally. So the people, they can’t go out, and they can’t come into the city. And the main medical and health services here, especially hospitals it’s in the city only. We don’t have in the rural and remote areas, the hospitals, full good and full primary health care centres where you can get good and every, all medical services.

So other things that the medical personnel, doctors, nurses, lab technicians, different people are going out from the city to the rural areas, or sometimes coming from the rural areas to the city. It’s not everyone working in the city, and not everyone working in the village. So this restricted the movement of the medical team and medical people. And we faced that we couldn’t, for example, many doctors, they couldn’t go to the primary healthcare centres where they are working; because of the closure, because of the checkpoints, because of the soldiers, where they prevent the people to go out from the city to the villages and from the villages to the city. Other things; the people who need to be hospitalised – they can’t come to the hospitals. And we face some conditions like some pregnant ladies from Beit Furiq town – it’s near Nablus not far from here, just seven / eight kilometres. Normally it takes the way from Bet F’riq to Nablus. Normally, it takes 10 minutes. But when we had the closure, the way, it takes six, seven hours because of the checkpoints. And this lady she gave birth at the checkpoint, where she [was] prevent[ed from] cross the checkpoints because of the closure. And because of the soldiers. Like this case, we have it all the time. So you can see that we can’t improve our health situation and our health system when we have emergency, because everything is going to the emergency.

During that we have for example clashes with the soldiers at the checkpoints, at the roads – not only with the soldiers, with the settlers also who are attacking the people. Especially in Nablus area. Many places were attacked by settlers. Stores, cars, people. And if you heard about the two guys, [who were] killed just three, four days ago, near Nablus by car, it was accident by car, the settler went to where they stopped their cars in the way of the road. And [the settler] attacked them with his car and he killed [the] two people. So like this case, also we have all the time.

So our work is going on emergency as doctors and as health workers. We don’t take care of other things where we have to care. For example, to children, women, chronic diseased people. We have a big problem with the kidney dialysis people. For example, in Nablus city area, we have more than 470 people who need dialysis every day. And these people are now [including] 190 people living outside of the city. So they need to come to the hospital because we have only one center to make dialysis. When we had the checkpoint and closure they can’t come. So this causes different kinds of complications. And they face a very hard health condition.

So like, that, this is what I mean that we can’t have sustainability in healthcare and we can’t improve our healthcare system. For that what we are trying to do is to create different activities related to this condition. To [the] condition of closure, condition of the political situation, which is very hard and very difficult. and very difficult.

Nicole 10:44

And in terms of resources going to the emergency situation. I read on your website, and I know – you know – websites can sometimes be a bit out of date and things. But that you trained 180,000 people in first aid skills. Can you say a bit about why this was necessary and how you made it happen?

Ghassan Hamdan 11:01

Yes. So I remember in 1996 when we had attacks on the mosque in al-Aqsa Mosque in Jerusalem by Shimon [Peres], if you remember… He was the Prime Minister of Israel, he [has] died now. He go there to the mosque. And you know, this is a sensitive issue and it’s very sensitive issue for the Muslims, for the people, the Palestinian people. So he go there, he went there with settlers – hundreds of settlers – and there was a kind of Intifada, yani, people they refused these things. And we had a lot of – it’s not happening only in Jerusalem, but it happens also everywhere, in all regions. Also in Nablus area. We had hundreds of injured people. These injured people, they didn’t find good help from the local medical people, because we don’t have enough resources for that. We don’t have enough medical people. We don’t have ambulances enough.

So there was a lot of complications. And the handicapped people increased from two percentage among the community, to four, five percent. Because the people who are related to these injured people was doing bad things for them. When they evacuated them, they evacuated them from the field in the wrong way. And this cause different complications. So we think that we should have people who are trained on first aid, especially young girls and boys. And we have, we created this program in Nablus area, we began this in Nablus area – where we began training different groups of young people, boys and girls, from the schools, from the youth centers, different with working with different associations. We trained hundreds of people, in that time, on first aid.

So we prepared ourself, and we increased this our way where we expand this work everywhere in the West Bank and Gaza Strip, not only in Nablus area, but the work began in Nablus – here, in this place.

So, in 2000, when we have the Second Intifada we had thousands of people who are trained in first aid. Young boys and girls. While the Intifada began, they were working with us as volunteers in the field. So with these volunteers, we could do quality health work, dealing with the injured people in the field. By that we were, this way, we help ourselves first, as the medical relief and medical people. And we help the peoples who are facing the soldiers, the attacks from the settlers. Who are the people who are injured, who are evacuated from the field in good way, and the right way, without complications. And by that, we believe that we’re only with volunteers, we can do a good work. So for that we have 1000s of people who are trained now and we continue this work until this moment, of course. And we’ll continue it in the future. Not only because we are under occupation, but because we think that this is important for how we can educate the community and we can have a good community which is educated, on first aid and health things.

In 2000 and 2008. Especially Nablus area, if you heard, it was full[y] under siege, and the condition, political condition was very difficult and hard. When in 2002 Israel decided to reoccupy the cities, you know, Oslo agreement made [zones] ABC, and the A is under control of Palestinians, B also mixed, C is fully under Israeli control. But in 2002, everywhere is under Israeli control.

So that time for example, in Nablus area, Nablus city was divided for eight parts by tanks. They use the Merkava tanks, which is very huge and very powerful. And they separated this part at the other part inside the city of Nablus. And they made trenches, and road blockade by [blocks and] stones. So how we could help the people? The people – they need food, they need water, they need medicine, they need – the children need milk. Sometimes electricity was cut because they destroy[ed] the infrastructure everywhere. So we have shortage of water, we have shortage of electricity, everything.

So by these volunteers who are working well with us, and we had in that time Nablus area, I remember in Nablus city, more than 600 volunteers. Who are with uniform and vest. And they are young people, and they have good energy, we divide them in, in the city. And we receive calls, this family needs milk for their children, this family, they need medicine for chronic[ally] disease[d] people, that family, they need water – drinking water. So we had centers, and where we can distribute all these things, by using these volunteers. They go there, they face very difficult conditions, some of them there was arrested, many of them there was beaten by soldiers. Some of them, they [were] prevent[ed to] cross the, from this part to another part, by of course, the soldiers.

So with this difficult time. But we could, because we have the energy, we need this work, to do it. By that so we could help many people, we could help the families who are under occupation and war. And that time, I want to tell you that the buildings was occupied by soldiers also. So it’s not only in the street, they are inside the buildings. In big buildings, they put all these people’s family in one flat, and the soldiers they occupied the other roofs and flats. So this is why when I talk about it, it’s easy to talk about it now. But in that time, when you do the work, it was very hard and difficult under high, very, very high risk. But we got it and we do a very good work. And this [has] give[n] us an experience: how to deal with the emergency situation and the difficult situation.

So by training the medical people and the first aid people, we have big army from, by, volunteers who are helping us in the difficult time[s]. And we are prepared to do this by our own resources. We don’t have enough money, of course, but we have army of volunteers who [are] first aid [trained] people who are helping us with doing our services.

Nicole 18:54

Amazing, like how do you think you are different from – I’m sure you work with all different groups, but how do you think you are different other like NGOs, you know, maybe other international ones like Red Cross or something like this. Like do you have a different approach?

Ghassan Hamdan 19:09

So, yes, medical relief is a created model and design by – in this work. So we create the model of primary, for example, first aid program, which I talked about it. We create the mobile clinics. With mobile clinic, in the time of closure is going to the people to provide medical services. We are not waiting the people to come to the primary health care centers. We go there. Because sometimes the Israelis are imposing curfews, on the people. So the people, they can’t go out from their houses, they can’t go out from their towns or villages. So we go there with the mobile clinic. [In the] mobile clinic, we have physician, we have lab technician, we have women’s health doctor, and nurses and pharmacy – portable pharmacy – medicines. We go there by our cars. And we declare about it by the most – we declare about the medical day and the people can come to small buildings or municipalities or local communities, where we have contacts with them. And we take these buildings, and we provide medical services for the people.

So we create some models, which will be related to our situation and condition. There are some other medical associations, they go there with other models, and they do it – which is very important for us. Because we can’t cover everywhere. So we need to be, yani, cooperating with other organizations and communities. Red Cross and Red Crescent. We have a problem with them. Because they are following some kind of international law. For example, when you have clashes – risk place, risk area – it’s not allowed [for] you to go there. So you have to wait where, when the condition will be good, and you can go there to take and to evacuate the people from here.

This is with… is not, yani, is not related to our condition. Because we have clashes, we have emergency and we have risky areas. The people there need your help. So we go there in risky area and we got this risk. And we do our duty and our work with the people who needs us. So we are not waiting that the Israelis will allow us to go there. Because if we will wait [for] them and this happens different times… We can’t help the people. And we have many hundreds of young people who were killed and died because Israel didn’t allow the medical people and ambulances to evacuate them from the field where they were injured. They wait with them until the bleeding is finished and the person was fully dead. You can’t help them you can’t do anything.

And personally I got many times injured, injury, because I go there in those areas. And this is not only myself, also our volunteers, our medical people, the ambulances which we run is doing this duty all the time. We have many people who still working with us. And they’ve got injured during their work, during their duty. And soldiers – they are not following the international conventions. For example, Geneva Convention, which says that if you have – if you are a medical person, you have uniform and you have the sign. They have to let you pass and they have to make your work easy to help the people. Because your work is humanitarian. It’s medical work. But the Israelis are not following this. They shoot on us! And I can show you pictures where we have medical people who were injured. Our ambulance several time, got bullets, live ammunition bullets from the soldiers they shoot on the ambulance. And we have our driver – ambulance driver – he was injured at Balata refugee camp. Myself I were injured in the old city of Nablus in Balata refugee camp and Beita town. It’s not far from Nablus. The last one was four months ago, where I got a rubber bullet. It’s very, very difficult one, five or six months ago, and I can show you the picture from my mobile, where it shows that. So we have many examples on this.

Nicole 24:21

How was it during the pandemic? Like I know it’s still happening, but yeah, how was your experiences here with Covid-19?

Ghassan Hamdan 24:28

We have a good experience, and we have a good experience with epidemics in general. Because in 2002, I remember 2003. When we had the closure and the Israelis they destroyed the infrastructure, especially the pipes, the water network, or the pipes. The water, drinking water, clean water mixed with the sewage water. And we had a big problem in three or four villages around Nablu [inaudible] it’s not far from here. Where the people, they have Hepatitis A – all of them. So, we help them by stopping the using their dirty water, which was mixed with sewage water, and we got the clean water for them, and we do our medical services for them. Treating these people from the epidemics.

Now in Covid epidemics. Of course, the resources what we have is very limited. And the vaccine we got it too late. Israel, they got [it as] the first country in the world, Israelis and when they want well, they had pressure from the international community. They decided to give the Palestinian Authority some of this vaccine and they give them the vaccine which was expired. This is – this was declared in the media, and different. So we didn’t use it. But when we got the vaccine – before getting the vaccine. So all measures to make prevention, and to isolate the people who were infected, and we create some hospitals for Covid – which was not created because our hospitals is not prepared for these epidemics. So, we have some buildings especially for Covid epidemics.

And personnel we trained them on dealing with the people who are infected. And by that, we [encountered] this epidemic, and, of course, many people died. We have, I don’t know that number, but we have we have more than hundreds of the people who have died because of Covid-19. But we dealt [with] it and we provide the health lectures, educations for the schools, for the women in different associations, in the rural areas, in the city – everywhere. So we do our best to educate the people how to deal with Covid-19.

Nicole 27:25

Amazing. And just s last question, like, yeah, I saw on your website, again, that you have the like a kind of psychosocial and like counseling program. Obviously, like, I’ve read, like some critiques of things like PTSD – Post Traumatic Stress Disorder – because in a lot of contexts, like, there isn’t a “post”, like things haven’t finished. People are still living in very like kind of ongoing traumatic situations from say, violence and from living under occupation. I just wondered like, what your approach is to this kind of, like, emotional health of the people.

Ghassan Hamdan 27:59

You know, I remember from also to 2002 until 2008, what we do, according to these things. The people in the old city of Nablus, this, the old city of Nablus totally was under attacks and siege by Israeli soldiers. So all the families who are living there, of course, everywhere, but especially in this area. Families, woman’s children, old people, sick people, young people, all of them were under siege and curfews. They can’t go out from houses, they are attack[ed] by bombs. And we had a full family which was killed, the Shubi family. When they bombed the buildings by F-16 plane with rockets. And eight people from these – children and father, mother were killed. And we got them from the, from the houses which was destroyed on them.

Other things this situation is cause trauma for the children, especially for the children. So what we do with volunteers, again. We go there, and we try to take, to get them out from their houses, especially the children in the squares near their buildings. Trying to make some games, some painting on their faces for the children. Trying to get them out from the trauma. So – and we succeed to do that in different places in the old city of Nablus. Other things we do is direct talks with, with the children – face to face, one to one, and we got them out from this kind of trauma. This experience, yani, we got it from also our situation and our condition. But we try to do everything which is related to the condition again, training also the volunteers to do that. We have good volunteers who can do good work with the children, now. They can play with them, they can make games, they can get them out from the bad situation and bad condition. And by that, we do this work, we try to treat the trauma of the people. Yani, and do some different activities.

Nicole 30:31

In Calais, where I work, it’s like the border with France and England. There’s like 2000 refugees in camps and like loads of police violence, but there’s this organization called Project Play, and like they’re always next to our clinic and they’re always playing with the kids and it’s like – so nice.

Ghassan Hamdan 30:46

Yeah, this is what we can do also. We also can give them some gifts. We collect gifts from the people here, the local people. They are – they are very helpful. Yeah. And if you ask them for something, they will give you the things because first they trust us. Second they know that this is one of their responsibility to help the people. So give you gifts for the children. And we collect[ed], I remember, thousands of gifts for the children in the old city of Nablus, from the local people.

Nicole 31:22

Is there anything else you’d like to share about your work or that we haven’t covered?

Ghassan Hamdan 31:27

I want to tell you, during the normal time, also, we are trying to improve our health system. And we do different activities. Like for example, screening for the children, screening for the young and old people, especially people who are suffering from chronic diseases. So we do some analysis, we do activities for them, health education, trying to improve also our health system, where we can, yani, help the people who are suffering from diabetes or hypertension, to deal with these diseases. And improving that, we have now our primary health care design, is one of the most successful designs in the Middle East. And we got the World Health Organization award in 2000 for building models, primary health care models.

So in normal time, we can do many things, we don’t need yani. We have enough resources, we have good medical people, but we need good condition for that.

Nicole 32:42

And are there any ways that international people or other people can support you? I know you have huge support from, like, the communities here but is there anything we can do-

Ghassan Hamdan 32:50

No! The help from the community is not enough, because you know, the poverty is very high here. So unfortunately, the help from international community is going down and less than before. So it’s less than 60% [of what it was in] 2000, for example, [to] now. So this cause us difficult work and some of our services – we lost it. Like for example, in Nablus area, we don’t have the mobile clinic now, because we don’t have enough resources for the mobile clinic. European income communities, they stopped supporting some programs and we stop some of our activities, one of them in Nablus area is the mobile clinic. We have now a big problem with the ambulances.

In the law here, you can use the car as an ambulance for 10 years. After 10 years, you – it’s not allowed for you to have it as an ambulance. So we need to renew the car, the ambulance . One of the ambulances now was supported by French people by Toulouse city region. We asked them to renew the ambulance, they said ‘we don’t have now fund for that’. So we have a big problem with changing the ambulance in Nablus area, which is very highly needed for the people. Because our ambulances is working all the time with the clashes areas. Where we have clashes, our ambulances are there. We need to evacuate the injured people, we need to help the people to go out from buildings, which was for example, attacked by soldiers. The families who was under tear gas needs our help. So ambulances are very high[ly] needed and with volunteers who are evacuating the people who were injured in the ambulance to get them to the hospital. So this is one of our problems and big bad things what we have now.

Nicole 35:03

Just as a personal interest question for me, but you know, being here, it’s been really interesting, like seeing the women selling herbs on the street, and obviously everyone puts mint into tea. I just wondered like, what your experiences with health are with people using plants that they grow, or from their garden? Or does this play a role in preventative medicine or self care?

Ghassan Hamdan 35:24

Medical tradition or yani popular medicine, it’s is very good here in Palestine. And the people, the families, they plant these plants in their houses, like mint, meramiya [sage], zaatar [thyme], different things, which is very good for health. And they use it. They use it and not only in tea, they use it their food, which is very important and very good. And I think this kind of medicine is growing good in Palestine.

Nicole, Ghassan 36:02

Oh, that’s great. Yes, it’s good to know.

Thank you so much for your time.

Yeah thank you for your visit.

Thank you. So inspiring.