Here's the updated piece I wrote on Nablus. I won't put up the edition the Kuwait Times published as they actually managed to edit in about one major grammatical error per paragraph, as well as several factual errors. C'est la vive. If you've already read the first draft of the Nablus piece you probably won't be terribly interested in reading the second draft. It just has several new additions.
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In the West Bank town of Nablus emergency medical technician (EMT) Mohamed Harshi had just dropped off his partner after a day of work. Driving down Nablus’ main road on his way to return the ambulance to the Palestinian Red Crescent Society (PRCS), Harshi spotted a small group of teenagers at the entrance to an unlit alley. They waved him down and led him to an unconscious teenage boy just inside the alley who’d just been shot in the head. It was unclear who shot him. Harshi loaded him into the ambulance, turned on the siren, and delivered the boy to the nearby emergency room.
Long considered one of the most turbulent cities in the West Bank many expect situations like Mohamed Harshi’s to be the biggest problem facing EMTs in Nablus. Although EMTs still contend with extreme situations, the principle challenge for PRCS’s emergency services in Nablus has arisen from non-emergency cases.
Five years after the Intifada started clashes between Israel and Palestine are decreasing, but the effects continue to shape the lives of Palestinians. In Nablus, checkpoints have increased the caseload for PRCS ambulances, frustrating EMTs and creating a funding shortage that threatens the future PRCS emergency medical services.
A day after finding the teenager, Mohamed Harshi and his partner Fadi Zagar deliver an older woman from the Bulata refugee camp to Nablus’ al-Watani hospital for hemodialysis, a routine medical procedure that rarely requires an ambulance under normal circumstances.
Non-emergency cases like these have become one of the most common and frustrating cases for EMTs in Nablus. Last October people traveling to and from the hospital for hemodialysis alone constituted for twenty-five percent of the people PRCS ambulances served.
PRCS began serving these non-emergency cases when Intifada started and the Israelis installed checkpoints that cut off Nablus from its surrounding villages and the rest of the West Bank. Home to the two largest hospitals in the north, Nablus’ medical facilities support locals, surrounding villages, and provide specialized medical services for Palestinians in northern cities like Tulkarem, Jenin and Qalqilila.
Sick people traveling to Nablus for routine medical procedures, like chemotherapy or hemodialysis, were too weak to cross checkpoints where they could wait for several hours often in extreme weather conditions. In response PRCS offered to transport non-emergency cases to and from the hospital, as Red Cross had an unofficial agreement with the Israelis that ambulances, whether Red Cross or PRCS, wouldn’t be delayed for more than fifteen minutes.
“This has put a burden on our shoulders,” sighs Dr. Awadeh. During the pre-Intifada years without the non-emergency cases PRCS in Nablus responded to about twelve calls a day. Now it responds to over thirty.
At the peak of the Intifada, Nablus dealt with nearly eighty cases a day. To cope with a caseload that large the staff size doubled to its current thirty-nine employees, EMTs slept at the center and worked twelve-hour shifts. While thirty a day is manageable some non-emergency patients can wait up to three hours for an ambulance to arrive. At least one ambulance is left on stand-by to ensure prompt responses to emergency cases.
“I talk to these people everyday, I know they’re not that sick,” says Mohamed Ramadan Saka, a PRCS EMT for the last eighteen years. While Saka is friendly with everyone he transports, he complains that driving someone from Nablus to Ramallah to visit an eye specialist makes him feel like a taxi driver.
Before the Intifada PRCS charged non-emergency cases to use the ambulance. A ride from Nablus to Ramallah cost 250 NIS ($50). When the second Intifada began PRCS removed the fee. Saka believes that half of the non-emergency cases would stop using ambulances if they cost more than a taxi. PRCS directors are discussing bringing back a fee, but they are still deciding how they will implement a fee.
Even if charging non-emergency patients reduces the number of cases, it still wouldn’t provide enough money to alleviate PRCS’s financial struggles. The larger staff size required to deal with the increased demand has taken a toll on EMT salaries.
EMT Radwan Abu Hamdan complains that the job pays, “little money and psychologically damaging (seeing so much violence).” Over the last five years PRCS has been unable to increase EMT salaries.
While Red Cross provides medical supplies for PRCS, the majority of its funding comes from private donors. However, in the midst of an ailing Palestinian economy contributions have nearly vanished. Every year during Ramadan PRCS in Nablus conducts a tele-athon. Before the Intifada tele-athons raised nearly 500,000 JD; tele-athons in recent years have raised only 15,000-30,000 JD. Additionally, new restrictions on wire transfers drastically decreased the amount of donations from locals living in the Gulf and other countries.
On Wednesday small groups of EMTs across the West Bank went on strike. EMTs felt that a new contract would reduce their income, while Jad Tawil, Communications Coordinator for PRCS says that EMTs will be “surprised” by how much they make with new contracts. An average EMT salary on these contracts would pay 2,500 NIS a month, roughly equivalent to the salary of a bank teller.
Even when the dispute is resolved, many within PRCS worry about how much longer funds will last. Not including fuel, operating an ambulance for one day costs about $180 a day. To meet the present demands PRCS in Nablus runs four ambulances everyday. With minimal donations, EMTs demanding larger salaries, increased caseloads and a large staff Dr. Awadeh wonders if PRCS will have enough money to offer emergency services. “We can’t ask people to work for free,” he says.
Dr. Awadeh sighs, “If the checkpoints were not there everything would go back to normal.” Almost everyone at the PRCS station in Nablus agrees.
The Israelis have indicated that within a month they will remove a dirt berm blocking the road between Nablus and Ayseera, one of Nablus’ villages. The barrier forces those in Ayseera to drive forty kilometers and pass through the Huwera checkpoint to enter Nablus. If the direct road reopens, Nablus would be only a ten-kilometer drive from Ayseera without any checkpoints. This would most likely create a substantial reduction in the number of people using PRCS ambulances.
While Dr. Awadeh is optimistic, he still has his doubts. “We’ll see what happens in a month,” he says.
_____
In the West Bank town of Nablus emergency medical technician (EMT) Mohamed Harshi had just dropped off his partner after a day of work. Driving down Nablus’ main road on his way to return the ambulance to the Palestinian Red Crescent Society (PRCS), Harshi spotted a small group of teenagers at the entrance to an unlit alley. They waved him down and led him to an unconscious teenage boy just inside the alley who’d just been shot in the head. It was unclear who shot him. Harshi loaded him into the ambulance, turned on the siren, and delivered the boy to the nearby emergency room.
Long considered one of the most turbulent cities in the West Bank many expect situations like Mohamed Harshi’s to be the biggest problem facing EMTs in Nablus. Although EMTs still contend with extreme situations, the principle challenge for PRCS’s emergency services in Nablus has arisen from non-emergency cases.
Five years after the Intifada started clashes between Israel and Palestine are decreasing, but the effects continue to shape the lives of Palestinians. In Nablus, checkpoints have increased the caseload for PRCS ambulances, frustrating EMTs and creating a funding shortage that threatens the future PRCS emergency medical services.
A day after finding the teenager, Mohamed Harshi and his partner Fadi Zagar deliver an older woman from the Bulata refugee camp to Nablus’ al-Watani hospital for hemodialysis, a routine medical procedure that rarely requires an ambulance under normal circumstances.
Non-emergency cases like these have become one of the most common and frustrating cases for EMTs in Nablus. Last October people traveling to and from the hospital for hemodialysis alone constituted for twenty-five percent of the people PRCS ambulances served.
PRCS began serving these non-emergency cases when Intifada started and the Israelis installed checkpoints that cut off Nablus from its surrounding villages and the rest of the West Bank. Home to the two largest hospitals in the north, Nablus’ medical facilities support locals, surrounding villages, and provide specialized medical services for Palestinians in northern cities like Tulkarem, Jenin and Qalqilila.
Sick people traveling to Nablus for routine medical procedures, like chemotherapy or hemodialysis, were too weak to cross checkpoints where they could wait for several hours often in extreme weather conditions. In response PRCS offered to transport non-emergency cases to and from the hospital, as Red Cross had an unofficial agreement with the Israelis that ambulances, whether Red Cross or PRCS, wouldn’t be delayed for more than fifteen minutes.
“This has put a burden on our shoulders,” sighs Dr. Awadeh. During the pre-Intifada years without the non-emergency cases PRCS in Nablus responded to about twelve calls a day. Now it responds to over thirty.
At the peak of the Intifada, Nablus dealt with nearly eighty cases a day. To cope with a caseload that large the staff size doubled to its current thirty-nine employees, EMTs slept at the center and worked twelve-hour shifts. While thirty a day is manageable some non-emergency patients can wait up to three hours for an ambulance to arrive. At least one ambulance is left on stand-by to ensure prompt responses to emergency cases.
“I talk to these people everyday, I know they’re not that sick,” says Mohamed Ramadan Saka, a PRCS EMT for the last eighteen years. While Saka is friendly with everyone he transports, he complains that driving someone from Nablus to Ramallah to visit an eye specialist makes him feel like a taxi driver.
Before the Intifada PRCS charged non-emergency cases to use the ambulance. A ride from Nablus to Ramallah cost 250 NIS ($50). When the second Intifada began PRCS removed the fee. Saka believes that half of the non-emergency cases would stop using ambulances if they cost more than a taxi. PRCS directors are discussing bringing back a fee, but they are still deciding how they will implement a fee.
Even if charging non-emergency patients reduces the number of cases, it still wouldn’t provide enough money to alleviate PRCS’s financial struggles. The larger staff size required to deal with the increased demand has taken a toll on EMT salaries.
EMT Radwan Abu Hamdan complains that the job pays, “little money and psychologically damaging (seeing so much violence).” Over the last five years PRCS has been unable to increase EMT salaries.
While Red Cross provides medical supplies for PRCS, the majority of its funding comes from private donors. However, in the midst of an ailing Palestinian economy contributions have nearly vanished. Every year during Ramadan PRCS in Nablus conducts a tele-athon. Before the Intifada tele-athons raised nearly 500,000 JD; tele-athons in recent years have raised only 15,000-30,000 JD. Additionally, new restrictions on wire transfers drastically decreased the amount of donations from locals living in the Gulf and other countries.
On Wednesday small groups of EMTs across the West Bank went on strike. EMTs felt that a new contract would reduce their income, while Jad Tawil, Communications Coordinator for PRCS says that EMTs will be “surprised” by how much they make with new contracts. An average EMT salary on these contracts would pay 2,500 NIS a month, roughly equivalent to the salary of a bank teller.
Even when the dispute is resolved, many within PRCS worry about how much longer funds will last. Not including fuel, operating an ambulance for one day costs about $180 a day. To meet the present demands PRCS in Nablus runs four ambulances everyday. With minimal donations, EMTs demanding larger salaries, increased caseloads and a large staff Dr. Awadeh wonders if PRCS will have enough money to offer emergency services. “We can’t ask people to work for free,” he says.
Dr. Awadeh sighs, “If the checkpoints were not there everything would go back to normal.” Almost everyone at the PRCS station in Nablus agrees.
The Israelis have indicated that within a month they will remove a dirt berm blocking the road between Nablus and Ayseera, one of Nablus’ villages. The barrier forces those in Ayseera to drive forty kilometers and pass through the Huwera checkpoint to enter Nablus. If the direct road reopens, Nablus would be only a ten-kilometer drive from Ayseera without any checkpoints. This would most likely create a substantial reduction in the number of people using PRCS ambulances.
While Dr. Awadeh is optimistic, he still has his doubts. “We’ll see what happens in a month,” he says.
posted by Tom | 5:43 AM
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