A day with Palestine's emergency medical teams

Published: 27 March 2002 0:00 CET

Sébastien Carliez in Bethlehem

At the Palestine Red Crescent (PRCS) branch of Bethlehem, West Bank, ambulances and their crews are on alert. At ten o'clock in the morning, five sorties have already been recorded on the log book. "These days, even benign cases have to be taken care of," notes Mohamad Samhan, head of the PRCS emergency medical team (EMT) for the Bethlehem governorate (pop 230,000). "We bring pregnant mothers to 'maternity houses', children to clinics for x-rays, and elderly persons to hospital for renal dialysis. No one else can help patients go through the checkpoints held by the army," he explains.

The Israeli defence forces had sealed off the city for a week. Only vehicles of the United Nations, the International Committee of the Red Cross (ICRC), and Palestine Red Crescent ambulances are allowed to leave the area and access the many and more sophisticated medical facilities of neighbouring Jerusalem.

Mohamad Samhan, 39, is the father of a 9-year-old child. He has been working for nine years with the Red Crescent, first in Jericho and then in Ramallah, before he joined the Bethlehem branch to coordinate rescue services. "A big challenge," he acknowledges. His team is made up of twelve permanent staff - paramedics and drivers - backed up by around ten volunteers. They are 25 years old on average.

Three weeks ago, two of their colleagues were killed while on duty in the West Bank cities of Jenin and Tulkarem, and several more were injured (see previous story at: http://www.ifrc.org/docs/news/02/031301/). In all cases, the ambulances had received previous clearance by the Israeli army, via the ICRC. Even the bullet-proof vests provided by the ICRC to all EMTs could not help.

Now, medical teams are scared to go out, Mohamad admits. "They come to save people's lives and get shot at. It's hard to accept when you think you're protected by the emblem," he explains. Half of them say they have faced death at least once over the past seventeen months, as they came under fire while assisting others.

At 11:00, it's the coffee break, to get some energy. Fifteen staff and volunteers spent last night in the office. The four luckiest slept on beds, the others on mattresses laid on the floor. "After work, it's like family life: we sleep in the same room, we cook together, do some washing, watch TV," they say. None joined the PRCS for money. Mohamad makes 1,600 shekels a month (340 US dollars). Beginners earn 700 shekels (150 US dollars). Mo'tadi, 21, already the father of a girl, gets paid by the day - 60 shekels. He receives neither medical insurance nor transportation fees. A native of Hebron, in the south of the West Bank, he goes home only for weekends.

Mo'tadi has hardly slept over the past 72 hours, as he had to stand in for his boss, Mohamad Samhan, who lives in a village twelve kilometres north of Ramallah at the other edge of Jerusalem. Mohamad could not reach Bethlehem for three days in a row, because the city was sealed off by the Israeli forces. He finally arrived, after a six-hour journey. He walked for four hours and rode four different taxis going from one neighbourhood to the other, through a number of checkpoints he hardly remembers. "I really can't tell when I will be able to go back home next," he says.

"They are doing a wonderful job," insists Dr. Elia Awwad, head of the PRCS mental health department. "Yet we have to respond to their personal and emotional needs", he adds, explaining why and how he has extended psychological support activities to emergency medical personnel, exposed to the threat of multiple traumas. "Rescue teams have for too long been confronted daily with violence, blood, and death; now, they fear for their own lives; and they feel guilty about this."

For a few months now, a team of eleven PRCS psychologists and social workers are travelling around to all PRCS branches in the West Bank and Gaza to talk, and more importantly to listen to, the EMT staff and volunteers - "to ventilate their feelings," as Dr. Awwad puts it. When they cannot travel, a simple conversation over the phone is all they can offer - yet it helps a lot.

Noon in Bethlehem. Younis Al-Khatib, the PRCS president, has just arrived from Ramallah-based headquarters for a short visit. It's the second of this kind after a particularly tragic week for the Society. He sits with the team for an hour, listening to their stories, suggestions and requests. He answers in simple words, candidly, and pays tribute to those who "dedicate their lives to saving others, a job that is not only risky but sometimes deadly."

Meanwhile, phone calls for assistance keep coming. "No sorties without the green light from ICRC," Mohamad repeats to his shebab (young men), although this often delays access to people in need. Earlier today, it took two hours and a half to get the army's approval for a single case. Plus another thirty minutes as the ambulance was searched at the checkpoint on the road to Jerusalem. The patient was going to one of the main hospitals in town for tests.

At 15:00 hours, Mo'tadi leafs through his log book. Over the four deadly days when the Israeli army conducted incursions into Bethlehem's three refugee camps, the PRCS teams evacuated five Palestinians killed in clashes. One of those was a 14-year-old girl. On one single day, they took care of 24 wounded people, of which half were taken to hospital. A tough experience when you are only 21.