April
14
2014

From Gaza to Bethlehem by Gerri Haynes, photos by Bob Haynes

(Washington Physicians for Social Responsibility has been sponsoring delegations to Gaza since 1993. In 2009, the group began offering medical service work to the people of Gaza.)

Leaving Gaza is always difficult: difficult to leave our friends knowing that their imprisonment continues, difficult to contemplate how much strength it takes for them to maintain their courage and hope, and then the minor difficult of the transit through the checkpoints. Two friends came early to Marna House Hotel to say “Good-bye.”

Moving across the small segment of land through the Gaza and Israeli checkpoints can take many minutes to many hours. On the Israeli side, every item in our luggage was checked and scrambled. One day later, we are still finding objects in our suitcases that belong to one another! Yet, finally, yesterday, after about 2 ½ hours we emerged and were greeted by the driver sent to us from our friend Daniel of Bethlehem. The day was spectacularly beautiful and we drove the curving road up to Bethlehem – where we will spend nights until we return to the US.

In the afternoon, on our way to dinner with Mustafa Barghouti and his staff from the Palestinian Medical Relief Society in Ramallah, we stopped in Jerusalem to observe the thousands of pilgrims walking from the Mt. of Olives to the Old City, celebrating Palm Sunday.

Settlements dot so many hills in the West Bank – erected on occupied land against international law. Leaving Area C, moving into Area A, the Israeli Qalandia checkpoint was slow, but we arrived in good time in Ramallah. We had a wonderful dinner – planning the next two days of service in Ramallah, Tulkarem and Hebron. We are grateful to Wi’am in Bethlehem for helping us to organize our time in the West Bank and to the Palestinian Medical Relief Society for providing opportunities for us to serve in West Bank communities.

April
12
2014

Day nine in Gaza: Saying goodbye to friends by Gerri Haynes

(Washington Physicians for Social Responsibility has been sponsoring delegations to Gaza since 1993. In 2009, the group began offering medical service work to the people of Gaza.)

Saying “Farewell” to friends – friends we have returned to and friends we have just met – is unsettling. We are so very thankful for this time in Gaza and wish the imprisonment of nearly two million wonderful people would end.

All that remains of a bombed building. Photo by Bob Haynes.

All that remains of a bombed building. Photo by Bob Haynes.

Rich and Grant spent today at Al Shifa hospital consulting on medical exams, Chuck and Don and Laura saw patients. Bob and Laura and I visited the Palestinian Medical Relief Society clinics in the northern part of Gaza. We learned more about the service this organization is doing in primary care throughout Gaza and were impressed by the dedication of the staff of these clinics. From the Bedouin villages in the north and south through the refugee populations in Jabaliya and other camps, the PMRS physicians are providing primary health care to underserved populations.

We discussed the rate of

Children greet Bob Haynes. Photo by Bob Haynes.

Children greet Bob Haynes. Photo by Bob Haynes.

Caesarian births in Gaza and were surprised to learn that the choice for Caesarian birth seems to be increasing here as it has in the United States. Because health statistics are not fully recorded here, it was not possible to get rates for this or answers to many other health statics questions we raised: Number of patients with Thalassemia, number of children born with Down Syndrome, etc.

In a situation where computer equipment is difficult to obtain and maintain, it is hard to quantify the prevalence of any disease or condition. The single exception to this: The rate of vaccination for communicable childhood diseases is 100% – children are not allowed to attend school without a current

Gerri Haynes thanks Bob Haynes for teaching.

Gerri Haynes thanks Bob Haynes for teaching.

record of vaccination and families come routinely to the clinic on their vaccination anniversary for scheduled updates.

This afternoon, Bob and I returned to a northern Gaza area where a dear friend lives. She and her friends particularly like the homemade chocolates that our Kirkland neighbor, Susan, makes and sends with us each time we visit Gaza. I was so happy to be able to give my friend and her family some of this delicious treat again!

She is a nurse, will have a Caesarian birth later this month – her third child in four years. We hope this third Caesarian will go beautifully.

A local mosque at sunset. Photo by Bob Haynes.

A local mosque at sunset. Photo by Bob Haynes.

Tonight, we said “Good-bye” to many of the colleagues we have worked with during the past week-plus. Our host, the Gaza Community Mental Health Programme has facilitated our visits each day and we are deeply grateful to Abu Husam and the GCMHP staff.

Traffic in Gaza is amazing – hundreds of thousands of people moving rapidly through the streets (cars, trucks, donkey carts, pedestrians) and rarely a traffic light, street sign or patrol person. Without the guidance of GCMHP, we would have been lost!!

Tomorrow, we will pass again through the Erez checkpoint and go to Bethlehem. We’re planning to work with the Palestinian Medical Relief Service for several days in the West Bank before we fly home next week. We are grateful for this time in Gaza… When will we be here again?

April
11
2014

On a tour and a prayer: Day eight in Gaza, by Gerri Haynes

(Washington Physicians for Social Responsibility has been sponsoring delegations to Gaza since 1993. In 2009, the group began offering medical service work to the people of Gaza.)

The Call to Prayer awakens us each morning at about 4:30 – through our window, we hear calls from many different mosques – the sound is beautiful. Through the call comes the song of several roosters – morning in Gaza.

On the Gaza-Egypt border near Rafah.

On the Gaza-Egypt border near Rafah.

Today being Friday, the clinics are closed and we were treated to a van trip to the western, eastern, and southern borders of Gaza. We looked down at the sea to observe some of the 90 million liters of partially or fully untreated sewage that flows each day into the Mediterranean from Gaza. We stood on the edge of the 35% of arable land in the east that is called the “no go zone” – that part of Gaza forbidden to normal traffic or to the growing of historically tall crops. This land borders Israel and is considered by Israel to be a security buffer zone. Trees have been eliminated here and only on the furthest west part of the zone do farmers plant low-growing crops…crops that provide no shelter from Israeli observation.
The Gaza airport, like the rest of Gaza, is in dire straits.

The Gaza airport, like the rest of Gaza, is in dire straits.

Israeli border guards shoot farmers wandering “too far” into this area.

We visited the Gaza airport – once a hopeful sight whose opening was celebrated in person by President Bill Clinton, the airport is destroyed. No planes fly in or out of Gaza – the airspace is controlled by Israel and Israeli warplanes, drones and observation balloons fly regularly over Gaza. We stopped at the Rafah border with Egypt – since the change of government in Egypt, this border is now often closed. And then we visited the tunnel area. At their peak, hundreds of tunnels were used for the importation of goods from Egypt to Gaza. In the last six months, the tunnels have been

A makeshift “fluid warming device” in the operating room at al Shifa medical complex in Gaza City. Photo by Grant O'Keefe

A makeshift “fluid warming device” in the operating room at al Shifa medical complex in Gaza City. Photo by Grant O’Keefe

destroyed by Egypt and the effect of their loss has had a devastating effect on the economy of Gaza – jobs lost, the price of goods increased, fewer goods available, etc. Life in a prison.

And then, this afternoon, an inspiring young man who is a nurse in a local hospital came to visit us. He and his friends are working on two projects. The first involves continuing education for nurses and the second is a support project for children – providing the children with joyful activities in an effort to relief the suffering of life. We will learn more about these projects!

Grant O’Keefe wrote the following – we are deeply grateful to have Grant on our “team.”

Some 90 million liters of partially or fully untreated sewage flows each day into the Mediterranean from Gaza.

Some 90 million liters of partially or fully untreated sewage flows each day into the Mediterranean from Gaza.

“I tried hard to have no expectations for this trip to Gaza, but clearly that would be impossible. 
So, I decided to expect extremes and this has turned out to be accurate. It is fair to say that this trip has been overwhelming so far and it is going to take some time for me to process what I have seen, heard and experienced up to now and what I am sure to experience in the next few days. I have consulted on patients in crowded clinics, reviewed CT scans and MRIs and helped the surgeons plan operations. I have met with junior and senior surgeons, anesthesiologists and radiologists who have trained in Moscow, Jerusalem, Cairo & Hamburg, just to name a few places. I am working with surgery residents from the relatively new training program at al Shifa hospital and medical students from medical schools in Gaza have presented cases to me on rounds. I have helped with simple and complex operations (hernias,
We got a chance to visit the local camels during our tour.

We got a chance to visit the local camels during our tour.

laparoscopic cholecystectomies, excision of a choledochal cyst) and helped manage a patient with an open abdomen and enterocutaneous fistula after trauma. This is one of the most difficult problems that is faced by multi-disciplinary teams and challenges even those with the most experience. This one patient could easily exhaust important material and resources and make them unavailable to other patients.

“Every person I have spoken with has a different story, of course, but there are a few things that are remarkably similar. First is the importance and love of family and children. Everyone is so gentle and patient with children; this in an environment that would otherwise not seem to foster either. Second is that everyone here feels abandoned by the rest of the world; they are living in the world’s largest prison. Among all their needs, almost everyone asks that we tell the rest of the world about the terrible situation in Gaza and also that “we are not all terrorists”. I have heard this exact phrase more often than I could count.

“You might assume that medical care isn’t terrible given that the patients I have seen come with CT scans and MRIs, both of which are available in the hospitals in Gaza. This assumption is wrong. The surgeons here are operating with instruments that are almost unusable, in gowns that are torn and wearing thin, and have little access to supplies and medicines that are inexpensive, should be easily available and are necessary to practice surgery safely.

“The pace of work here is not tiring for me nor is it excessive, yet, today, I am exhausted. I need to be alone to recharge and to try to sort out all of this. Introverts will empathize, but this time it is more extreme.”

April
10
2014

The medical work continues: Day seven in Gaza, by Gerri Haynes

(Washington Physicians for Social Responsibility has been sponsoring delegations to Gaza since 1993. In 2009, the group began offering medical service work to the people of Gaza.)

Kindergarten students dancing.

Kindergarten students dancing.

What a delightful start to the day! This picture of kindergarten children performing a traditional dance only partially captures the fun they were having. We delivered donated school supplies to this kindergarten and loved seeing the staff there again. Each year, I am impressed by the creativity and dedication of the director and teachers!

Our various medical work continues: operating, consulting, teaching. We have traveled the length of Gaza (about the length of Lake Washington’s 27 miles) and visited with people along the way. The strong sense of family here helps us to understand how this population can endure and grow even while living under the constant threat of armed attack. The sound of fighter planes overhead reminds us that the threat is real.

This evening, Grant O’Keefe and Rich Grady each gave a talk at a Surgical Society Meeting. We were told how much it means to have colleagues from “the outside” join them here in Gaza as “we can’t get out to see you.”

Dr. Don Mellman wrote this today:

People are like tea bags; you never know how strong they are until they are in hot water. Source forgotten.

In this my fourth, or is it my fifth, trip to Gaza? I have been able to put the various issues that are raised into a perspective that is both historical and philosophical. The time spent in the sun and heat while waiting to just “enter” the wall erected by Israel to physically complete and represent its siege and occupation of Gaza, and the approximately three-quarters of a mile metal-enclosed trek that the Gazan authorities now willingly accept as the “cost of entry.” And, while I am at it, Israel’s Alice in Wonderland denial of the words “siege” and “occupation” to describe its treatment of Gaza brings the unsustainability of its actions into a stark “black comedy” reality.

Since my first trip into this surreal absurdity of “man’s-inhumanity-to-man,” I have thought much of Gaza and created formal presentations to several different audiences, which has forced me to articulate my ideas into a coherency that otherwise I would not have.

During this trip I have, as before, evaluated clinic patients with neurosurgical issues, assisted in the operating room, met with medical and human rights functionaries as they discuss their frustrations, and given talks on relationships (a concept Gaza has helped me to understand as the most important issue in life). But more importantly, the connections (read “relationships”) I have made with Basil Bakr, a neurosurgeon at al Shifa Hospital, and Husam al Nounou, from Gaza Community Mental Health Programme, have led to invitations into their homes, where I have been allowed into their personal lives and to share their families and food.

Thus, I have been able to witness their inner strengths and resilience as they cope with the severe political and economic restraints imposed by the self-aggrandizing leaders of the internal Fatah-Hamas disputes, the external Israel-Palestinian conflict, and the not-so-peripheral world community.

April
9
2014

Day Six in Gaza: Health care expensive and supplies short, by Gerri Haynes

(Washington Physicians for Social Responsibility has been sponsoring delegations to Gaza since 1993. In 2009, the group began offering medical service work to the people of Gaza.)

Al Amal Center for Children with Cochlear Implants.

Al Amal Center for Children with Cochlear Implants.

The need for services for the hearing impaired is addressed through two more services I visited today – the Atfaluna Center and The Al Amal Center for Cochlear Implants. The Atfaluna Center has many services for deaf or hearing-impaired people – including a wonderful kindergarten and a busy workshop for the creation of Palestinian crafts. The Al Amal Center has many classes for children who have had cochlear implants. Speech therapists work with small groups of children – many who attend regular school for part of the day – to help the children who now can hear learn to speak. Many of these children are hearing impaired due to war injuries. Cochlear implants are hugely expensive and equipment and funding are often not available. This center has 400 children waiting for care.

Today also, I learned more about the need for a children’s library in the central part of Gaza – an area that has had no library in the last thirty years. The wonderful woman who hopes to organize this library told me of generations of children growing up with no access to books – she hopes to remedy this!

Rich Grady operating.

Rich Grady operating.

Attention to mental health is a major concern for caregivers here. The continuous threat of attack and the loss of many relatives during recent wars on Gaza have rendered a population at risk for depression and other psychological troubles. I met with university staff who are creating mental health treatment clinics, hoping to alter the cultural sensitivity to mental illness.

Bob Haynes spent today seeing patients at Al Shifa Hospital. He writes: Heroism is not seen only on a battlefield, unless you count Gaza as a battlefield. The air, water, streets, and sea are polluted. Supplies coming into Gaza are tightly restricted by Israel, with no goods flowing through the bombed tunnels from Egypt. The export of goods and agriculture from Gaza is severely limited. The economy is contracting from poor to worse, resulting in decreasing wages, rising unemployment and inability to purchase goods and services. And yet, the people of Gaza go on living life with good spirit and even good humor.

In my work at the hospital today, I witnessed a patient’s son as he fluffed the bed pillows and tenderly removed her shoes and socks and straightened her legs on the bed. He continued to tend to her throughout my visit. Her angina pattern has become unstable, accelerating to several times per day. Last week, she had one clogged heart artery opened at this hospital and a stent was placed. Another artery was left untreated, as the correct size stent was not available.

Doctors in multiple clinics on the same floor share one very old computer. When the computer reports that the hospital still does not have the correct sized stent to treat this patient, the doctor informs the patient and family that the stent will not be available for several weeks. After serious conversation in Arabic evolves to light-hearted tones then laughter, I ask what was said. The patient’s family and then the doctor shrug, “What can one do?” The doctor says, “Her son has just become engaged and the family is happy.” I am again amazed and inspired by the spirit of these people in the midst of the Gaza prison.

This evening, we gathered for the staff of Al Awda Hospital to say “Thank you”, particularly to Ismael Zamilpa who will leave Gaza tomorrow. In our conversation, one hospital physician summed up his feelings: “We are exhausted from suffering.”

April
8
2014

Busy days for WPSR medical team in Gaza, by Gerri Haynes

Student nurses at Islamic University

Student nurses at Islamic University

Quickly these days in Gaza pass – full of stories and lessons. With his expertise in autism, Chuck Cowan is in high demand. With his great ability to teach many subjects, Don Mellman is consulting and lecturing. Bob Haynes, Laura Hart and I spent the day at the Islamic University with nursing students. Bob lectured on advanced cardiac life support, Laura on urinary incontinence, and I talked about medical decision-making at the end of life. We were enthusiastically received and the students (who all speak English) eagerly engaged us in a clinical question and response session.

Mama and Baba Al Bashir

Mama and Baba Al Bashir

We also toured the University’s special section for the education of blind students. With a staff devoted to this unique program, students are assisted in learning through Braille and computer-associated voice programs. We watched one student manipulate the keyboard of his computer and then move to a sound device that the instructor told us was proving to be very helpful in the student’s studies. More such devices are needed – access is, again, limited due to the siege.

This afternoon, we met with staff members of the Gaza Community Mental Health Programme to review our schedules for the remainder of our visit. Each encounter with these friends brings stories of the extreme difficulties of life in Gaza. While they live with courage, the prospect of the siege continuing into an increasingly future is hard to contemplate. A few examples of the public health burden: education is suffering – the lack of schools is profound; presently, 38 – 41% of the male population is unemployed; unless rapid reparations are accomplished (and nothing significant appears to be happening now), the Gaza aquifer will be damaged beyond repair by 2016 and there will be no drop of potable water in all of Gaza.

Tonight, the family of a Seattle couple joined our group for a visit at our hotel. We had a good time telling of our adventures and there was much laughter. Over and over, the strength of family is apparent here. We hear of young people leaving Gaza only to return to the tribal warmth of their family.

April
7
2014

WPSR delivering medicine to Gaza Community Mental Health Programme, by Gerri Haynes

Many people in the US contributed money for the purchase of medicines badly needed for patients of the Gaza Community Mental Health Programme. This morning we delivered those medicines to GCMHP’s pharmacy – such a joy to be able to fill some of the pharmacy’s empty shelves. Thank you to all who made this possible!!

woman of courage baking breadLaura Hart and I had wonderful opportunities to learn about Gaza from families served by GCMHP and by a great women’s group, AISHA. In central Gaza, we visited three families who are experiencing severe mental health challenges – depression, fear, anger – much of it closely related to the siege and to the constant threat of being attacked by Israel. In one humble home, we were treated to hot bread, pulled directly from the Tabool oven. The mother of the family (pictured here) arises at 3 AM each day to prepare food for her family, clean the home, and get her children ready for school.

This afternoon, in visits to war-affected families, we heard tragic stories of the death or injury of family members. One very worried mother asked for the prayers of anyone we speak to – her son lost his eyes in a recent Israeli attack and is now in Egypt awaiting surgery. She is desperately worried about him.

Late this afternoon, we met with Scott Anderson of the United Nations Relief and Works Agency (UNRWA). Scott has served for six years in Gaza and acknowledged that lack of funding to the UN has resulted in the suspension of school feedings and the elimination of financial aid to families. (A woman told me last year that their monthly allotment of $100 from UNRWA was the family’s only income.) UNRWA provides food assistance to 860,000 people in Gaza. This agency works on many projects to aid Gazans – they provide schools for a majority of Gaza’s children, medical clinics and micro financing for encouraging entrepreneurs and the empowerment of women.

Earlier today, I asked Ismael Zamilpa, pediatric urologist, to write about his experience so far. He wrote:

“This is my third trip to Gaza. We have had the opportunity to continue our relationship with local surgeons and to see complex cases. We are trying to share our experience and opinions with them.

“The hospitality of the Palestinian people continues to be evident. They make us feel so welcome and are appreciative of our services. I hope the American public will get the chance to witness this instead of the frequent negativity reported on the news.”

April
6
2014

WPSR returns to Gaza: Day three by Gerri Haynes

In every meeting and nearly every encounter we are hearing about the life-threatening effects of the siege and the closure of the tunnels in Rafah. Shortages of medicine and hospital equipment routinely compromise medical care. We talked with women’s health leaders today. There is only one mammogram machine for all of the people served in Gaza through the public service. This is not a new machine and frequently needs repairs that are often not available. Still, the ingenuity of the dedicated medical care providers continues to be inspiring.

To more fully involve patients in their care, cards have been developed that show the patient the list of questions being asked by his/her physician during an interview. As the interview proceeds, the patient has the opportunity to continue to review the questions and responses. This process is proving to more fully inform and involve patients in their care. My editorial comment: we might consider this process for US health care!

Rich Grady and Ismail Zamilpa, pediatric urologists and Grant O’Keefe, general and trauma surgeon, are fully employed in surgical endeavors.

The director of the Cerebral Palsy Center greets one of the children.

The director of the Cerebral Palsy Center greets one of the children.

A visit to the cerebral palsy center – founded by Suhar Arafat and newly constructed was inspirational. The director, touring us through the building greeted children with great joy. The children, seeing him, obviously responded in a familiar and loving way to his attention. When I asked him if he loved his work, he said, “No.” He paused, then he said, “I adore it.” This photo of him cradling the face of a little boy does not adequately demonstrate the delight they both reflected when they first encountered each other today.

Bob Haynes teaches advanced cardiac life support to medical students.

Bob Haynes teaches advanced cardiac life support to medical students.

Bob Haynes spent the day teaching advanced cardiac life support to medical students. He witnessed the dean of the medical school talking and joking with a group of students in a familiar and loving way – showing great interest and pride in them. Medicine here is a family-centered process.

Each day we see friends from previous visits and are blessed to meet courageous citizens of Gaza who are working to make life more fulsome here. This evening, we talked with a young man who is staffing a project to have children employ donated cameras to document life in Gaza. They will show the world what the world is presently not seeing.

April
5
2014

WPSR back in Gaza, day two by Gerri Haynes, photos by Bob Haynes

Our team has eight members: Rich Grady and Ismael Zamilpa (pediatric urologists), Laura Hart (adult urologist), Don Mellman (neurosurgeon), Chuck Cowan (pediatric autism specialist), Grant O’Keefe (general and trauma surgeon), Bob Haynes (cardiologist) and me. We parted in the morning with the surgeons and cardiologist in meetings and screening and consulting on patients and Chuck Cowan teaching.

Children playing with their gifts.

Children playing with their gifts.

I met with friends of several years – women who are experiencing the trauma of living in Gaza under siege. Again this year, I asked the women what they would like the people of the United States to know. Here are some of their responses:

• We want the people of the world to know what is happening here – we think people would do something if they knew how bad things are. We are living in a prison.

• We need the siege to be ended.

• People in Gaza are angry and frustrated. We are without electricity much of the time. Even though we have a new technology – a rechargeable battery – it provides very little light and is expensive to charge.

• There is very little fuel and it is very expensive. With the tunnels closed, all of our fuel comes from
Israel and it is four times more expensive now than when we were able to get fuel through the tunnels from Egypt.

• My brother needs a liver transplant. This is not available in Gaza – he got permission to go to Egypt, but when he got to the crossing at Rafah, only two buses were allowed through and he was turned away – the crossing was closed again as it often is.

• There is no material for building – we would like to move, but there is no material for building. Fifty-eight people live in our house – which has seven tiny apartments.

• Most adults in the family have jobs, but the pay is very low

• The UN has cut the monetary support given to 70 – 80% of Gaza it serves and has stopped the distribution of food staples such as rice, sugar, and oil to many families.

• Cancer is increasing – we need specialty services – people have to be referred to Egypt or Israel, but this may not be granted.

• Hospital staff needs continuing education – if they leave for more education they may not be allowed to return.

• UN says school children need computers but the UN does not have the money to supply them and we cannot definitely afford to buy computers for our children.

Again, I was impressed by the courage and dedication of these women. The husband of one of the women had died recently and she and their four children had been taken into this crowded home. Somehow, they continue.

A man awaiting surgery with his son.

A man awaiting surgery with his son.

Bob Haynes consulted on the care of many cardiology patients at Al Awda Hospital today. One of the patients, whose four older brothers have had cardiac bypass surgery, now also needs to have this surgery. He has family in Jordan and would like to have this procedure done there, but the Rafah crossing has been closed each time he has attempted to leave Gaza for a flight from Egypt. So, he waits. He will try again. Patience and resilience. And the danger of running out of time.

April
4
2014

Returning to Gaza by Gerri Haynes

A group of young women give a warm welcome to the delegation.

A group of young women give a warm welcome to the delegation.

Washington Physicians for Social Responsibility has been sponsoring delegations to Gaza since 1993. In 2009, we began offering medical service work to the people of Gaza and today we returned to Gaza with our sixth delegation. We are honored to again visit these loving, resilient and courageous people!

After one short night at Neve Shalom Hotel (Place of Peace) we made the long crossing from Israel to Gaza and were greeted by beloved friends. Gaza remains under siege by Israel. Most of the supply tunnels from Egypt are closed and we heard from our friends that the economy here is suffering. Goods coming from Israel are expensive and often such items as fuel are not available. Electricity is rationed to eight hours on and off. More on this…

This afternoon, prior to our orientation meeting with representatives from our host, Gaza Community Mental Health Programme, the Ministry of Health and the two hospitals where we will do most of our work, we had a short tour of central Gaza. We stopped at the harbor and were spontaneously greeted by a wonderful group of young women who insisted that we accompany them on a fast boat ride. One told me with delight that though her English is excellent, she had never spoken to someone whose primary language is English. The ride was exhilarating and the laughter of the young women was beautiful.

Gaza boat 4-5Traveling down the Gaza Coast, we witnessed again the lovely Mediterranean and the ugly pollution of the streams carrying untreated sewage into the sea. As we returned to Gaza City, the incomplete construction begun prior to the closure to the tunnels is evident everywhere.

Our meeting with our hosts in the evening was joyful and most worked out a schedule for the work we will do in the week ahead. Work begins soon!!