I Shall Not Hate: A Gaza Doctor's Journey Read online

  Another key part of my Cairo experience that stays with me is our student celebrations of Ramadan. About fifteen of us would gather and share food at each other’s houses, then we’d go out into the Cairo night and join the festivities—the singing and storytelling in places like the Al-Azhar club—until the sun came up. Those were carefree, precious days unlike anything I had known before, or have enjoyed since.

  After one preparatory year, another five years of medical school and a year interning at Cairo University Hospital, I graduated with my MD in 1983 and received my licence to be a general practitioner. I was young, passionate and ready to work. But after what I’d been through as a kid growing up in Gaza, I also saw myself as a conduit that could bring news of life in the refugee camp to the outside world. Someone had to start paying attention to what was happening to the Palestinians. They didn’t have proper health care or education, not even enough food. There was no end to the needs of the Palestinian people, the needs of my family, and even the size of my own career goals. In my culture we don’t study just to improve ourselves; we study to raise the standard of living for our brothers and sisters. My family saw me as a role model. And goodness knows we were all in agreement about the need to improve the lives of Palestinians.

  That was also the year my brother Noor went missing; no one in my family has heard from him since 1983. The Israelis had put him in prison when he was eighteen years old because he was working for Fatah. Actually, my view is that he got caught up with a bad crowd of friends; he was discouraged, his self-esteem had faltered, and he’d started dealing in hashish, although none of that was what got him arrested. When he got out of prison, he said he wanted to go back to Gaza or start over in Lebanon. He came to Cairo and stayed with me for six months. I told him I’d help him find work in one of the Gulf States, but in the end he did not accept my offer and chose to go to Lebanon. The last time I saw him, he said, “I don’t want to make trouble for you, leave me.” I told him I couldn’t leave him, that he was my brother, I would always love him and be responsible for him. But he went anyway. We could presume that he was killed and that no one has found his body. But we don’t do that. If we don’t know what happened, there is still hope. I think he would have been in touch if he was alive, but I leave those thoughts alone. For me and my family, I maintain the hole that my eyes will see him again.

  My return home was bittersweet. I’d been offered a residency to become a specialist in obstetrics and gynecology in Cairo, but I had turned it down, not only because I couldn’t afford to stay on but because my parents wanted me to come home. My father was desperately ill with liver disease, and he’d been hanging on, waiting for the moment when he would again see his son who had become a doctor. But his health was deteriorating daily. He hadn’t been well enough to come to my graduation from medical school in Cairo. In fact the family stayed at home with him, so rather than have no one there to witness my graduation, I went home and missed it myself.

  I was in for a shock when I got back to Gaza. I couldn’t get a job in the place where I was born and raised, this place that was in so much need, the very place I’d vowed to help by becoming a doctor. The Israelis had been occupying Gaza since 1967; it was now 1985. You couldn’t travel anywhere in Gaza without seeing Israeli influence, and if you wanted to be employed, you had to be the son of an important person such as a government official or an influential person with connections to the Israelis, or a millionaire, or an Israeli collaborator.

  Eventually I was offered a position in the obstetrics and gynecology department at the Nasser hospital in Khan Yunis, nearly thirty-five kilometres away from Jabalia Camp; you couldn’t get much farther from my home and still remain in the Gaza Strip. The position paid pocket money, so although I accepted it, I knew I would soon have to find something else.

  Then, just eight months after I got home, my father died. Here was a man who had worked hard and suffered a lot. He didn’t get to enjoy what he planted in his life. He’d been a successful farmer, the son of a respected landowner, but then he was homeless, living in a refugee camp, raising his children there, working as a guard, never earning enough money. It was humiliating for him. I could feel his anxiety throughout my boyhood, and as my life began to improve at medical school in Cairo, I felt guilty that my father hadn’t been able to be the role model to his children that he believed he should be.

  The last days of his life were painfully difficult. He had hepatic failure—his liver was shutting down. He was vomiting, he couldn’t eat, and he was barely aware of his loving family hovering over him. When he slipped into a coma, we took him home as there was nothing else the hospital could do. As a doctor, I felt so helpless. I am the one who is supposed to help the patient, but this patient, my own father, could not be saved. I had vowed that once I graduated my family would have a better home, we’d have enough to eat, and my father would know what he meant to me and he’d see that I was going to be all that he’d been denied. But just as I was beginning to fulfill that promise, he was gone. I still have the grief of his passing in my heart. So I will always do the three things that Muslims do for the dead: I share his knowledge and wisdom with others, I pray for him, and I give to charity in his good name.

  As for my career, I’d been transferred from Nasser hospital in Khan Younis to Al-Shifa hospital in Gaza City, but this hospital, too, wasn’t run by merit but by people with connections. A classmate from university was the son of the director general of the department of health for the Gaza Strip. His mother was chair of the obstetrics and gynecology department at Al-Shifa. He’d got a job with an excellent salary even though he’d been a playboy at university and hadn’t achieved good marks. The next thing I knew, he was acting as though he was my superior, a big boss, always giving me orders.

  So I quit and applied for a job with the ministry of health in Saudi Arabia. Actually, this was another of those cases where good came out of bad. I got the job, but it was four hundred kilometres away, in Jeddah. I was not at all familiar with the place, and when my uncle said, “All those good times you had at school in Cairo are about to be paid back,” I wondered if taking the job had been such a good idea. However, I had a close friend from medical school who was from Saudi Arabia and I called him to find out how hard the posting and life in Jeddah would be. He was an ambassador’s son, and so I too now had connections, and he got a perfect job for me, caring for Palestinians at Al-Aziziyah maternity ward. It wasn’t Gaza, but it was taking care of Palestinians, and it was an opportunity to test the waters of the medical specialty I’d been drawn to from the time I studied obstetrics and gynecology at medical school.

  That I liked the job goes without saying, but the other piece of this experience was that it gave me an opportunity to build a real social life and feel economic life for the first time. I also earned enough to help my mother pay for repairs to our house in Jabalia. I was also able to help my brother Atta go to the Philippines to study medicine (though he soon came back to Gaza and switched to pharmacy), and I helped another brother, Shehab, with money so he could get married. One of my half-brothers lived in Jeddah too, so we would get together at each other’s houses. I enjoyed this kind of social life—being welcome in another house, talking, eating, sharing stories, having time to do things other than work, which was all I knew when I was growing up in Jabalia Camp. Then, just two years after starting the job, I had saved enough money to go back to Gaza and marry.

  Nadia and I were married in Jabalia Camp in 1987. Only days after the celebration I had to return to Saudi Arabia by myself because she didn’t have a visa and I couldn’t get her one until after we were married. She joined me about a month later. We lived in a rented house, and although we were unhappy about being so far away from our families, I did have my half-brother in Jeddah. I was happy to have relatives nearby: our culture prizes being near to family very highly.

  Two months after our wedding, the first intifada began. Sadly, it started right in my neighbourhood in Jabalia and spre
ad pretty quickly throughout Gaza and into the West Bank and East Jerusalem. No one is really clear what triggered it. Some say it started because of an incident on December 8, 1987: an Israeli army tank ran into a group of Palestinians from Jabalia, killing four and injuring seven. A few days earlier, an Israeli salesman had been stabbed to death in Gaza, and many Palestinians felt the so-called accident was actually a revenge killing. Or is could have been retribution for an another incident: a week before the intifada began, Palestinians had been accused of infiltrating an Israeli Defense Forces (IDF) camp in Lebanon and killing six Israeli soldiers. Whatever the spark, people were outraged and took to the streets. There was so much tension created by the humiliation of the occupation, by Israeli soldiers doing stupid things like forcing a Palestinian to walk like a donkey just to make fun of him, that any small incident, real or imagined, could have set it off. But as far as I could determine, the unrest came mostly from the fact that nothing was being done to alleviate the situation for Palestinians. There was no sign of a Palestinian state; the leadership on the issue from the Arab states was faltering. Palestinians had been waiting for change, for relief from intimidation and harassment, for the twenty years since the Israelis took over in Gaza, and it was not surprising to see violence erupting in our streets.

  At first it took the form of a lot of tire burning and stone throwing at Israeli troops. The response from the Israelis was disproportionate—kids throwing stones were met with soldiers attacking with M16 assault rifles. My brother Rezek was detained for no apparent reason. My sister had a miscarriage likely caused by the stress of the intifada. The daily news we were reading in Saudi Arabia was full of reports about attacks on the people, the deaths and injuries they suffered. The hostility was building every day: there were boycotts of Israeli goods, barricades were thrown up, there were strikes, and then Molotov cocktails and hand grenades were being thrown.

  It was not a good time to be away from home, as Nadia and I were always worried about what might happen next to our families and friends. On the other hand, soon enough Nadia was expecting, and our personal joy and excitement battled for precedence in our hearts with the constant political tensions back home. Our daughter Bessan was born in 1988.

  In the personal realm, life was at last satisfying, even wonderful. I was gaining the medical experience I wanted. My family was growing and prospering, and despite my mother’s desire to see me back home as the patriarch of the extended family, especially in these troubling times, I decided we’d stay in Saudi Arabia for a while. A huge factor in this decision was that the opportunity to specialize in obstetrics and gynecology was presenting itself to me again, and this time I wanted to follow my dream. In early March 1988, I received a scholarship from the ministry of health in Saudi Arabia to specialize in obstetrics and gynecology, getting my diploma at the Institute of Obstetrics and Gynecology at the University of London. I’d become extremely interested in infertility. In Jabalia Camp there was a lot of infertility, which seems at odds with the high birth rates everyone assumes are the norm in Palestinian families. The paradox is that places with high fertility also turn out to have the opposite as well, high infertility rates. I decided to do my thesis on this issue. Most of the classes were in Riyadh, the capital of Saudi Arabia, with only a few months of coursework in London.

  I had a valid visa for travel to the UK, and my Palestinian passport caused me no travel problems: I boarded the plane for my first flight brimming with excitement. I already spoke English, so I did not face much of a language barrier, and London was a larger-than-life experience for me. So different from Gaza—cold, rainy, dark—but alive, fascinating, cosmopolitan. It was a place where people from all over the world—all races, all religions—lived together, though of course I was aware of the conflict between the British and the IRA. And the one thing that truly bothered me was the way native-born British sometimes looked down at people who weren’t British. I noticed that superior attitude on the street, in stores and in community centres. Happily it didn’t exist in the classroom, so it didn’t affect my studies in London.

  My research gave me a tempting taste of the work I could do in this field, and I was thoroughly smitten. I’d seen so much suffering in women who were having difficulty conceiving. In a male-dominated culture such as my own, the woman is blamed for infertility problems even though not being able to produce a child can be the man’s problem just as much as the woman’s. She’s even blamed for the sex of the baby, although the Y chromosome that creates sons is an exclusively male factor in the conception process. I wanted men to know the facts and stop blaming the women, and I wanted those women to be relieved of the shame of being condemned as “barren.” In my culture, ominous expressions such as “the unproductive tree should be cut” are common. I wanted to educate people so that they never say such things about any woman again.

  Working with couples who are trying to conceive, you learn how hard it is for them, how disappointed they are every single month that conception doesn’t occur. But it’s particularly painful for women, and I wanted to focus my efforts on how to alter that reality. As my research into infertility progressed and my clinical work in London and Jeddah with couples dealing with fertility problems started to produce excellent results, I decided to commit my career to this subspecialty.

  After I completed the course in 1989, I returned to Saudi Arabia and my job at Al-Aziziyah maternity ward. I was so glad to be reunited with my family. By then Nadia, who’d stayed in Jeddah to take care of Bessan and our second daughter, Dalal, who was born while I was in London, wanted to go home to Gaza. Saudi Arabia was much more conservative than Gaza; as Palestinians, we felt like foreigners there even though the Saudis were supposed to be our Arab brothers. I wasn’t free to move where I wanted to move and I worried that, as an outsider, I wouldn’t advance much further than I’d already come in my career. The social norms were different; we found the restrictions too onerous. So we decided that we would leave. But it wasn’t as easy as packing up the car and driving home. In order to repay the educational opportunities given to me by Saudi Arabia, I had to agree to provide three years of medical service. Only after that obligation was fulfilled, could we go home.

  Life was further complicated by the ever-present monsters in the Middle East: politics and war. The lead-up to the first Gulf War was creating problems for Palestinians in the Gulf States. In August 1990, Yasser Arafat made statements that sounded as though he approved of Saddam Hussein’s invasion of Kuwait, and suddenly Palestinians were personae non gratae. I could see the writing on the wall: lots of Palestinians were being laid off in Saudi Arabia. Happily, by November 1990, my employers determined that I had fulfilled my obligations to the hospital in Jeddah, and Nadia and I were able to pack up our daughters and our belongings and return home on a bus. By the time the Gulf War started on January 16, 1991, my family and I were back in Gaza.

  We arrived home in the midst of the continuing intifada. There were Israeli guns and tanks at every corner. And then, in the face of all this madness, it turned into a fratricidal bloodbath as well. An estimated one thousand Palestinians who were accused of collaborating with Israelis were executed by our own people even though there was no proof of collusion in most cases. By the time the first intifada ended, on August 20, 1993, with the signing of the Oslo Accord, more than 2,100 Palestinians were dead—a thousand at the hands of their own brothers and 1,100 killed by Israeli soldiers. One hundred and sixty Israelis had been killed by Palestinians.

  What came out of the intifada is hard to measure. Certainly the world began to pay attention to Palestinians as a result. And Israel got a black eye for its treatment of the Palestinians and for Palestinian living conditions. That the United States officially recognized the Palestine Liberation Organization as the legitimate representative of the Palestinian people was seen as a victory for us. But a new and disastrous weapon of terror was born during the intifada: suicide bombings. On April 16, 1993, in a parking lot at Mehola Junction,
a rest area on the Jordanian Valley Highway, a Palestinian man who had loaded his car with explosives drove it between two buses and detonated the bomb. The blast went upward instead of radiating out sideways, so most people were spared. A Palestinian who worked at the junction was killed and so was the bomber. Twenty Israeli soldiers and civilians were injured. That horrible event began a string of equally terrible suicide bombings, which led to the bloody destruction of our youth, the deaths of many innocents and paralyzed many regions of the Middle East with fear. Certainly the people of Gaza, the West Bank and Israel are not better off as a result of the birth of this inhumane tactic. Like the cost of most wars and uprisings, the cost in human treasure of the intifada and the suicide bombings was too high for everyone.

  I had opened a private evening clinic in Gaza with money I’d saved from Saudi Arabia so I could treat poor people in my own place. I was committed to providing care for people who could not afford it. I also accepted a post with the United Nations Relief and Works Agency as a field obstetrician and gynecologist.

  While studying at the University of London, I had noticed that most of the references I depended on for my thesis on infertility were by Israeli professors, so I decided to make a bold move and get in touch with the Israeli medical community to see what they were doing about infertility and to exchange ideas. Although the intifada continued apace, it didn’t stop me from communicating with and eventually meeting my colleagues in Israel. I’d come across a important textbook on infertility by two professors from Ben-Gurion University in Beersheba, Israel: Dr. Bruno Lunenfeld and Dr. Vaclav Insler. I called them, described who I was and what I wanted, and was surprised when they were so willing to meet with me and assist with advice on the care of my patients. In time I started taking Palestinian patients to Dr. Lunenfeld’s clinic. Some of them needed laparoscopic surgery, and he referred them to Marek Glezerman, who was at that time the chairman of the department of obstetrics and gynecology at the Soroka hospital, also in Beersheba. Because of the depth and importance of my subsequent relationship with Dr. Glezerman, I take the liberty of referring to him by his first name. Meeting Marek was a turning point in my career and my life. He immediately saw the value in bringing me onto his team and tried to figure out a way to make that happen. As I had no formal association with the doctors of Soroka hospital, he suggested I become a volunteer at the hospital to introduce myself to the Israeli medical system and to find out how its doctors were dealing with issues around obstetrics and gynecology, and especially infertility.