An MSF worker puts a young Palestinian girl at ease during an initial visit to her family's house in a precarious spot near an Israeli army checkpoint in Gaza. After the first visit, the family was given psychological follow-up and social assistance.
Violence has sprung from extremists on both sides, with Palestinian and Israeli civilians often the main victims, killed or wounded by bullets, deliberate and stray, or in suicide bombing attacks.
A campaign of intimidation has been carried out against Palestinian civilians. The Israeli army has reacted to stone-throwing with bullets, bulldozing houses and olive groves, barring off access roads to homes and villages and multiplying the number of checkpoints.
The effects on the health of Palestinians have been twofold: the economic and logistical consequences complicate access to health care, and the violence provokes stress-related problems evidenced by symptoms ranging from nightmares in children to post-traumatic stress disorder.
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MSF shifts into emergency gear
Present in the region since 1994, MSF was concluding a mother-child mental health program based in Hebron and a psychological care program for ex-detainees in the West Bank when the Al'Aqsa intifada began. The second phase of a primary health care support program in Hebron was also ending, but a project aimed at improving health services for the Bedouin people in the Yatta region was continuing.
In September 2000, all this gave way to the new emergency. MSF provided support, including emergency surgery kits, to hospitals receiving the wounded. Mobile clinics and a home-visiting program were also set up focusing on the most vulnerable groups.
Doctors and psychologists: a joint practice
Because exposure to daily violence provokes both physiological and psychological problems, MSF decided on a dual approach. Medical examinations enable detection and treatment of the former, while psychologists, working in parallel, encourage the expression of fear and treat the trauma, leading to a reduction of stress. With so many obstacles to free circulation and many afraid to leave their houses, teams focus on visiting families in their homes in both Hebron and Gaza.
Also in Gaza, an MSF psychologist provides individual consultations and group therapy for children under twelve and women attending a locally run social center.
A small MSF convoy makes the rounds near Hebron. Teams offer medical and psychological aid to people living in Hebron and Gaza.
An essential presence
Trauma is usually treated at a remove from the circumstances that originally caused it. In Palestinian territory this is not possible. But the MSF presence in proximity to this vulnerable population is proving to be a source of support and encouragement in itself, sometimes the only sign that they are not abandoned.
MSF has also encouraged individuals to document their experiences and in January 2001 published a short report entitled "Palestinian Chronicles," detailing the deterioration of conditions in Hebron and Gaza (accessible at www.paris.msf.org).
In a step toward helping raise awareness in Israel, MSF organized a conference at the psychological department of Hebrew University, explaining MSF work and presenting testimonies about the unbearable life of two Palestinian families in Gaza and Hebron.
International staff: 11
National staff: 20