Intifada 1-0-1:

Palestine Through the Eyes of a Local Medic

Brian Dominick

Almost since the beginning of the current intifada, I have been watching eagerly the brave men and women who answer emergency calls for help resulting from the vicious occupation imposed on the Palestinians by their Israeli neighbors. As an emergency medical technician and a veteran "street medic" (providing first aid at protests), I responded to nightly dreams/nightmares by pursuing them all the way to the Middle East.

On May 17, 2002, I traveled to the Middle East with a friend and fellow EMT/street medic, Brian Spina. We spent the next two months working on Palestine Red Crescent Society ambulances in the West Bank cities of Ramallah, Hebron and Jenin, responding to 1-0-1 (like our 9-1-1) calls for medical emergencies, ranging from the mundane and commonplace, to those which were anything but.

During my time in Palestine, I was witness to some of the worst the Israeli Occupation has to offer. I saw Israeli forces violate international law on countless occasions. I treated the victims of senseless violence _ disproportionately unarmed children. I saw the brutal treatment of Palestinians at the hands of soldiers and settlers. I was kidnapped by an Israeli army unit and used as a human shield against an imaginary enemy for 48 hours. And I had the great honor of working with some of the bravest, most dedicated colleagues I could have hoped to encounter.

The Palestine Red Crescent Society (PRCS) is part of the international Red Cross/Red Crescent movement, and adheres to that movement's principles of neutrality and universal humanitarianism. PRCS provides for medical needs _ emergency and otherwise _ of the Occupied Territories' more than 3 million Palestinian residents. With its limited resources in terms of supplies, equipment and personnel, the PRCS works feverishly to respond to the hundreds of emergency calls which flood the dispatch centers of its various stations each day. Most of these calls have little or nothing to do with the Occupation in origin; but for responders and patients alike, the Occupation plays a significant role in nearly all emergency cases in the Territories. A case that begins with typical heart attack symptoms can become an adventure in and of itself for all involved.

On occasion after frustrating occasion, ambulances on which I was working were stopped at various of the scores of military checkpoints peppered throughout the West Bank. The checkpoints are one of the Occupation's most sinister and widespread manifestations. Characterized by long lines and random acts of brutality against helpless civilians, the checkpoints strangle life in the Territories. They nearly paralyze traffic, stranding villagers in the villages, cutting off supply routes and medical aid.

These official checkpoints, typically guarded by a squad or more of Israel "Defense" Forces troops and Border Police, blockade the major roads. They are complemented by a system of makeshift roadblocks, taking the form of ditches and dirt piles, and sporadic armored jeep patrols. Rather than guard every single road in and out of every city, and in order to funnel traffic through the official roadblocks, this network of ad-hoc barricades is maintained with ruthless force.

This entire "security system" exists ostensibly to protect Jewish Israelis _ especially those who live on illegal settlements in every part of the West Bank and Gaza _ from the Palestinian Arabs. But as anyone who truly needs to get from Point A to Point B in the region knows, where there is a will, there is a route. The saddest victims of the checkpoints are those who lack the able body or the courage to make the harrowing journey of circumnavigating their stranglehold. For the likes of suicide bombers, these impediments are not so real. For an ambulance, ironically, they are sometimes a deadly nuisance.

Another sad reality which has come to characterize pre-hospital emergency care (and life more generally) in the Territories is that of curfew. Since mid-June (a month before I left the Middle East), most cities and many villages in the West Bank have been under nearly constant curfew. In some areas, water, food and medical care are in severely short supply, leading to malnutrition among children and a sharp rise in complications from treatable diseases. During curfew, the ominous drone of tank tracks and gunfire seems omnipresent in the distance.

It is against this backdrop that Palestinian rescue workers attempt to carry out their jobs in the middle of a conflict that is for one side a war, and for the other side a liberation struggle. Every day in Palestine patients suffer while ambulances are delayed. Due to the curfews and checkpoints, patients who would normally call a taxi to reach routine treatment such as dialysis or therapy, or for minor injuries and ordinary delivery cases, wind up relying on ambulances. Naturally, this ties up vital yet scarce emergency response resources.

According to Israeli officials, Palestinian ambulances are allowed relatively unfettered movement throughout the West Bank. In reality, even with foreign citizens aboard as escorts, ambulances are regularly delayed, rerouted and turned away at the hands of Israeli checkpoint guards and patrols. On some occasions, patients and medical personnel are detained, arrested, beaten, used as human shields, and even shot. Settlers and soldiers have attacked and damaged nearly every ambulance in the PRCS fleet.

PRCS has been accused by the Israel Defense Forces, on numerous occasions, of using Red Crescent ambulances to transport bombs, arms or even terrorists themselves. The IDF almost always quietly retracts its accusations, once the damage is done in the Israeli and American media. Hypocritically, Israeli ambulances carry arms on a regular basis. Some Red Star of David (Israel's "civilian" counterpart to the Red Cross/Red Crescent) ambulance crews are armed to the teeth with submachine guns and assault rifles. And, as another violation of the Geneva Accords (in addition to shooting at and impeding civilian ambulances), the IDF's own military ambulances are routinely used to transport non-medical personnel, heavily armed and uninjured. I witnessed these infractions with my own eyes.

It's no surprise chronic stress and severe burnout have taken their toll among Palestinian medics. The conditions under which they work on a daily basis are simply appalling. It's difficult to reconcile being a skilled medical professional, with the sense of helplessness that inevitably marks every encounter with Israeli soldiers in Palestine.

Certain images are forever chiseled into my mind. Among them was the instance where I was treating a boy with multiple gunshot wounds. We were stopped at two checkpoints. We had just finished bandaging our young patient when we arrived at the second checkpoint, where an Israeli soldier claiming to be a doctor boarded the vehicle, undid our bandaging, and began pressing on the child's injuries. His buddies filmed the whole ordeal while he delayed our patient from definitive care and tortured him for some ten minutes.

After everything I saw and experienced while living among the Palestinian people, I am unsure whether I learned more about the Intifada/Occupation, or about myself. All that is certain is that humanity and dignity have become ever harder to maintain in the face of an increasingly violent occupation. I even felt mine slipping here and there during my short visit.

Brian spent two months working on ambulances in the West Bank this year. Brian is available to address audiences about his experiences with and perspective on the Israel-Palestine conflict – dominick@action-medical.net. For more information about the PRCS, visit www.palestinercs.org.