The WPSR medical delegation in front of the wall near East Jerusalem.

By Gerri Haynes

(Gerri Haynes, a former president of Washington Physicians for Social Responsibility, has been sending back reports from inside blockaded Gaza. As she did three times before, Gerri organized a team of doctors and other health care providers to work in hospitals and clinics in Gaza in an effort to directly help the people there and to bring attention to the ongoing humanitarian crisis that the Israeli blockade has created. Eighth and last in the series.)

This morning, we met with a representative of the Israeli Committee Against Housing Demolitions. Driving through Jerusalem, we could see again the effects of the Separation Wall and the inequities of services provided on each side of the “Green Line.” Disputes over land and the right to build continue – it seems there is a long way to go to reach peace between the peoples of this land.

In the afternoon, members of our group toured the water facilities of Bethlehem, observing the ways provision of water to Palestinians is controlled or limited. And in the evening, we heard from a hydrologist in Bethlehem – learning more about the distribution of water resources between Israel and Palestine. Water use by settlers is four to five times that available for use by Palestinians.

We were treated to another delicious meal at Wi’am and listened to Rafiq and Lucas Zoughbi, joined by their cousin Larry, as they jammed in the Wi’am Garden – and so we head for security at Ben Gurion to fly back to the U.S.

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Rafiq and Lucas Zoughbi, joined by their cousin Larry, jam in the Wi’am Garden (Photo by Bob Haynes),

Gerri Haynes, right, and the other members of the WPSR medical team navigate the intricate security system on the Gaza border (Photo by Bob Haynes).

(Gerri Haynes, a former president of Washington Physicians for Social Responsibility, is sending back reports from inside blockaded Gaza. As she did three times before, Gerri organized a team of doctors and other health care providers to work in hospitals and clinics in Gaza in an effort to directly help the people there and to bring attention to the ongoing humanitarian crisis that the Israeli blockade has created. Seventh in the series.)

Early this morning, we boarded a van for the border between Gaza and Israel. Leaving Gaza is complex. We bid farewell to the great people who helped make our stay possible, then drove north and east to Erez, the only passage between Gaza and Israel for people.

Passing to Israel took about two hours. First, on the Gaza side, two stops are required for passport checks. Then, with baggage on a cart pushed by a Palestinian, there is a long walk (1/3 mile?) through a linear cage to the first step into the Israeli side. There, after a door denying return to the Gaza side closes, a camera surveys people and bags and a disembodied voice provides direction to move through two sets of doors or turnstiles to the next section of the crossing.

With many more bags than people, we gradually moved up a long, wide corridor to another set of doors and turnstiles. Slowly, we fed our baggage through a turnstile and encountered a human being. This gentleman directed us to place all of our electronic gear into one large flat plastic bin. Then we waited for about one hour as Palestinian patients and businessmen filtered around us and through the next set of doors.

When our turn came, our gear and opened suitcases were placed on a conveyor belt and moved up and out of site. We then passed through another set of doors, approached a full-body scanner, waited in line for each persons turn to be scanned, completed the scan, entered an area of small individual cubicle and waited while our scans were analyzed by personnel visible on the building’s second floor. When we were released from the cubicles, we entered a room where plastic bins were moving slowly around on an elevated a square of rollers. We retrieved our electronic gear and moved through another door to the luggage inspection stands. Here, gloved human beings were going through each piece of luggage – the contents scrambled and then returned to us to be re-packed.

Finally, we passed through passport control and moved away from the building, across roads, down a sidewalk, through another turnstile and down a set of stairs to a parking lot where the driver of a van waited to take us to Bethlehem.

I recount this long process to demonstrate that each person leaving Gaza does so with difficulty. Joining us in this passage were sick children and heart-broken adults. Palestinians leaving Gaza must go through an arduous vetting process before passage is even a possibility and a mother (young fathers are seldom allowed to pass) completing this arduous journey with a sick child faces daunting obstacles.

The land between Erez and up to Bethlehem is beautiful. The political landscape is visible in the development and population of the land, but the land itself is lovely. In the afternoon, we drove the long, dangerous road through the Valley of Fire to Ramallah. Without special permission, Palestinians are not allowed to drive the direct (shorter, faster, safer) route to Ramallah through Jerusalem.

Mustafa Barghouthi (Photo by Bob Haynes).

Returning to Bethlehem, we enjoyed a wonderful dinner, prepared by the sister-in-law of our friend, Zoughbi Zoughbi. Zoughbi is the tireless director of Wi’am, the Palestinian Conflict Resolution Center. He and two of his sons, Lucas and Rafiq, accompanied us to Ramallah. It was late when we bid farewell to our hosts and their other guests. Zoughbi parted from us, saying that he was needed to facilitate the resolution of another conflict in Bethlehem. His days are always long.

Tomorrow, we will tour East Jerusalem, gather more data on water in preparation for a presentation by members of our group to the American Public Health Association meeting in Washington DC, and then return to Tel Aviv for our flights from this land.

This beautiful land (Photo by Bob Haynes).

(Gerri Haynes, a former president of Washington Physicians for Social Responsibility, is sending back reports from inside blockaded Gaza. As she did three times before, Gerri organized a team of doctors and other health care providers to work in hospitals and clinics in Gaza in an effort to directly help the people there and to bring attention to the ongoing humanitarian crisis that the Israeli blockade has created. Sixth in the series.)

This evening, our group was hosted in the lovely garden of Dr. Eyad Sarraj, president of the Gaza Community Mental Health Programme. Dr. Sarraj is respected throughout the world for his work on peace and reconciliation and for his study of refugees and the trauma of war and occupation. His giant spirit has inspired members of WPSR to return again and again to Gaza and to provide information about the situation in Gaza to our medical and nursing colleagues.

As we complete this brief journey, members of our team are preparing to give two presentations on Gaza at the American Public Health Association meeting in Washington DC next weekend. We have had hospital and clinic experiences and listened with open hearts. We hope to return next year with an expanded medical team, prepared to offer services not presently available here.

Kara Mochan (Photo by Bob Haynes).

“These days have been a whirlwind of activity:
• Meetings with the Palestinian Nursing Association to talk about the state of nursing in Gaza and the need for continued nursing education for the 7,000 nurses in Gaza
• Meetings with the only certified child psychiatrist in all of Gaza, my wonderful colleague Dr. Sami… One meeting with Dr. Sami included a tour of the child therapy room – fully equipped and ready for use.
• A tour and meeting with the director of the Qattan Center, a private organization, serving the children of Gaza City with a resource center and full library for children and parents”
• And many more…

Kara has been busy in Gaza. She has taught and learned and consulted with colleagues throughout Gaza. The list is long and full. In many meetings, she has been invited to return to teach, conduct research, and consult.

Kara writes, “I have slept little. Today, as the light starts to wake up Gaza, I look out to the sea to take in the calming waves and this time I only see one Israeli boat watching me as I write this………. maybe that is why I was sleepless in Gaza tonight.”

Dr. Laura Hart (Photo by Bob Haynes).

Laura Hart, M.D. writes: As the sun set tonight in Gaza, our last evening here, I thought of how privileged we are to travel to this remarkable place. I was struck again by the grace and courage of the people of Gaza. Whether it is a mother worried about her child, a doctor or nurse thirsting for the most current treatment protocols and techniques, or the hotel clerk who wants only to work in the field of his educational degree, I am humbled. I am so grateful for the hospitality of Dr. Eyad Sarraj, Gaza Community Mental Health Programme and the physicians and personnel of the hospitals and clinics who welcomed us.

A special note of thanks goes to Amani, Ashraf and Abu Husam of the Gaza Community Mental Health Programme for arranging meetings, teaching opportunities, transportation and hundreds of details to make this journey successful – we are blessed.

Amani (Photo by Bob Haynes).

Abu Husam (Photo by Bob Haynes).

(Gerri Haynes, a former president of Washington Physicians for Social Responsibility, is sending back reports from inside blockaded Gaza. As she did three times before, Gerri organized a team of doctors and other health care providers to work in hospitals and clinics in Gaza in an effort to directly help the people there and to bring attention to the ongoing humanitarian crisis that the Israeli blockade has created. Fifth in the series.)

A proud, young artist shows her work (Photo by Bob Haynes).

This morning, I sat with a group of women whose family members have died. A dear friend in Washington state is interested in writing the stories of women in Gaza and I wondered if it would be possible to find women who might be willing to tell of their experience.

In brief, waiting for the fuller expression of their stories, these are the words I heard today:

Reem: My brother was killed in the Fakhoura massacre during the Cast Lead operation of 2008/2009. He had four children and after he was killed, his widow took the children to another part of Gaza and we no longer see them. We lost my brother and his whole family.

Amal: My child was five years old during Cast Lead. He was burned by white phosphorus and one year later, he died of cancer. There are many cases like this – children who were exposed to white phosphorus and who have now died of cancer. One day on the street, I heard other children calling a child by the name of my son – I began to cry, calling out his name again and again, “Hamza, Hamza, Hamza.”

Nahala: My husband and three of my children (two boys and one girl) were killed in the Fakhoura massacre. My daughter-in-law was also injured. Now I live with four sons and two daughters. One of my sons lost his legs – one above the knee and the other below the knee. Doctors have tried to help. He had artificial legs, but they didn’t fit and made him sore. Now he gets around in a wheel chair (note: there are very few handicapped-access places in Gaza) and needs more care. So much has happened. I find that I am very forgetful.

A young girl wanders in the rubble (Photo by Bob Haynes).

Asma: My husband died during the civil war in Gaza. We have one son who was one-year-old when my husband died. He is six now and has trouble with speech and he is hyperactive. I don’t know how to help him.

Khifa: My husband was 37 years old in 2006. He was standing in front of our house. Someone fired rockets into Israel and Israel fired back – my husband was killed. My two daughters are married and live with their husbands. My son is 16 and we live in a room in my father’s house. Soon, I will have to leave this house and I don’t know where we will go. I am physically and psychologically tired. My son is also very tired. We don’t know what will happen to us.

Eman: Two of my sons and my brother-in-law died in the massacre. At 3 AM, the Israelis called and told us to evacuate our home. When we were leaving the house the next day, we were attacked. Now my husband and I live with our four young children. One of my sons who was killed was older – he had been married for twenty days. I’m OK, but this is hard. My children have a hard time – they witnessed the killing. My husband doesn’t express his grief, but when he sees the children of my one son, he does cry. In one family I know, eleven people were killed.

Linda: My husband and fourteen-year-old son died in the massacre. I lost my home and now live in the home of my brother-in-law with my son and daughter – my brother-in-law lives abroad.

Nihad: Two of my sons died. I saw one of them die. I stay in my house with my family. My daughter-in-law lives with me.

The recent prisoner swap brought many feelings to these women. Together they told me that when they saw the released prisoners they were happy for the families, but wanted the same thing for those who died. As these women told their stories, a social worker from the agency where we met, listened and at the end of our time together, she spoke of having them meet together again to try to do some healing work.

Shipping containers re-used to make a school for Gaza students (Photo by Bob Haynes).

(Gerri Haynes, a former president of Washington Physicians for Social Responsibility, is sending back reports from inside blockaded Gaza. As she did three times before, Gerri organized a team of doctors and other health care providers to work in hospitals and clinics in Gaza in an effort to directly help the people there and to bring attention to the ongoing humanitarian crisis that the Israeli blockade has created. Fourth in the series.)

While medicines and medical equipment are not technically prohibited for importation to Gaza, the reality here is that medicines and equipment are difficult to obtain:
1. There is only one crossing between Israel and Gaza that allows passage of goods and this crossing is open for a limited number of hours/day.
2. Transport of materials is onerous – goods brought to the crossing must pass through a secure set of doors, one door closing before another opens, with all doors to Israel fully secured before Palestinians can open doors on the Gaza side. UN personnel refer to this as materials passing through “sterilized zones” – high security clearance is required for each person who touches the goods and only UN personnel may make contact with the goods.
3. No goods are transported between Israel and Gaza on trucks. Materials are off-loaded from Israel and then must be palletized prior to entering Gaza to be re-loaded on trucks. The result is a minimal amount of material can be received – the delivery time is short and the process is long.
4. Requests for materials must be cleared by Israel and this can take weeks/months
5. The economy of Gaza is markedly depressed. UNRWA announced today that the unemployment rate is 45%. Funds to purchase materials are extremely limited.

Rich Grady (Photo by Bob Haynes).

Bob Haynes, cardiologist, is consulting and providing direct care for cardiology patients in several clinics. He is doing most of his work in the evenings and is seeing patients of all ages, including one 10-month-old child! The expertise of cardiologists in Gaza is high, but association with international colleagues is rare and one physician commented to Bob today, “It’s just nice to know that we haven’t been forgotten.”

Maxine Fookson (Photo by Bob Haynes).

“Since this is my first trip to Gaza, I find my eyes and heart wide open. I could use many more days or weeks here to see all that I want to see. I am shocked at the abject poverty and suffering from the siege on all of Gaza’s borders (air, land and water). And yet, I am so totally impressed with the talent, ingenuity, warmth, humor and total determination of the Gaza people. At an amazing technology fair we visited today showcasing students’ projects and designs at the Islamic University, as we were in awe at an optical invention that a student invented to correct childhood amblyopia (poor vision), the Dean of Nursing exclaimed, ‘See, that’s Gaza under siege!’ He is so right! What would Gaza be if it were free?

“I have visited a few health care sites providing maternal child health care. The first was a hospital and clinic called Al Awdah, which is funded by NGOs. The first impression is that the actual environment, including their instruments, looks to be about 30-40 years behind that which we have in the U.S. However, the environment was spotless. The pediatrician who showed me around explained that due to the difficulties in global economics, their funds are greatly reduced. As a result their intensive care units are closed completely. They have had to cut staff by about 30% and their pharmacy is almost bare of many essential drugs.

“I also visited the UNRWA Clinic in Nuserat, in the Central Gaza Strip. I was greeted with such warmth and hospitality. Again, I heard about the incredible manpower shortage. Nurses working in pairs see 60 to 70 well child visits in a day. The doctors average over 120 patients per day. Despite the shortages, they have a specialized clinic for children having school difficulties consisting of a pediatrician, a mental health provider and a nurse. It has been so rewarding to talk to these medical practitioners as colleagues. I am so totally impressed with the quality of the care they deliver under such incredible stress and conditions of scarcity.

“Other highlights for us have included visiting the fabulous programs of Qattan Centre and an UNRWA school located in converted shipping containers. It is estimated that UNRWA needs to build 100 schools to provide education for all the refugee children at this time, but they have funds to complete only 7 of the schools. Again, the structure of the school was so depressing, but the passion and dedication of the principal and teachers is amazing.”

The UNRWA container school is a facility of 15 boxes without air conditioning. We met representatives of a dedicated parent committee and were impressed with the passion of faculty and parents in assuring that the high priority on Palestinian education is respected. Set in a bare sandy lot, this facility will be replaced by a new school as soon as Israeli authorities allow the necessary building materials to enter Gaza.

(Gerri Haynes, a former president of Washington Physicians for Social Responsibility, is sending back reports from inside blockaded Gaza. As she did three times before, Gerri organized a team of doctors and other health care providers to work in hospitals and clinics in Gaza in an effort to directly help the people there and to bring attention to the ongoing humanitarian crisis that the Israeli blockade has created. Third in the series.)

Reem Abu Jaber (Photo by Bob Haynes).

The huge garbage dump across the street and the dumpster dump next to the primary Qattan seem to disappear when the lights and books and activities of the Center open to children and families. The energy and hope of Reem buoy up all who encounter her.

A re-use worker gives us a friendly greeting (Photo by Bob Haynes).

Yesterday afternoon, we visited a young man from Bethlehem who was released from prison in the recent prisoner exchange. He is not allowed to return to his home, but speaks frequently on the phone to his Bethlehem friends. For now, he must stay in Gaza. There was a gathering of family members whose loved ones remain in Israeli prisons. Several women spoke to us of their loved ones who have not come to trial and yet remain incarcerated. One woman told us with great sorrow that her son has been in prison for many years – he was jailed at age 11. http://www.parliament.uk/edm/2010-12/2274?mid=50

Gazans gather chunks of concrete from bombed buildings to re-use in construction (Photo by Bob Haynes).

Rebar is straightened to be used again (Photo by Bob Haynes).

The mental health of Gaza suffers from constant threat and continuous deprivation caused by recurrent military attacks and the siege. Mental health providers we talked with today spoke of “learned helplessness” – and the ways that providers can continue to provide care: group meetings, close supervision, continuing education and family time. The spirit of the people of Gaza is tremendous.

(Gerri Haynes, a former president of Washington Physicians for Social Responsibility, is sending back reports from inside blockaded Gaza. As she did three times before, Gerri organized a team of doctors and other health care providers to work in hospitals and clinics in Gaza in an effort to directly help the people there and to bring attention to the ongoing humanitarian crisis that the Israeli blockade has created. Second in the series.)

The three physicians in our group spent today in clinics and operating rooms – teaching and consulting. We are busy working on the schedule prepared for us by Amani at the Gaza Community Mental Health Programme. Maxine Fookson, nurse practitioner from Portland, gave a lengthy training and facilitated a discussion for nurses on postpartum depression. In Gaza, where the threat of attack by Israel is constant, women report that giving birth is accompanied by the additional stress of insecurity – will life continue or will it be suddenly ended by another attack from the air?

Bob Haynes making friends with his photography.

But the trauma of living in the world’s largest open-air prison continues. In a meeting tonight with a child and adolescent psychiatrist and a clinical psychologist from the Gaza Community Mental Health Programme, we heard the term, “Learned helplessness” – the reality that people living under siege learn that even if they are educated and eager to work, the lack of jobs and lack of ability to change the external control on their lives gives them a deep sense of helplessness. Hope lies in the possibility that Gaza will be opened to the world – that politicians will realize the absolute need to free Gaza and allow Gaza’s people to heal. For now, the lack of access to clean water (the water of Gaza is 95% polluted), clean air, safe soil, adequate classrooms for education (children are double and triple-shifted in schools), jobs, adequate housing – the list is long – makes living difficult for these courageous people.

Israel restricts fishing to shallow, non-productive areas along the coast of Gaza (Photo by Bob Haynes).

From the director of the nursing association, we learned that there are many more nurses in Gaza than there are available jobs. More hospital beds are needed (unable to be built because building materials are forbidden). These beds could mean increased placement for nurses and more access to care for the population. Kara Mochan, nurse practitioner, is working on plans to assist with specialist education for nurses here. There are answers to the public health needs of Gaza, but until the power of freedom is granted, the awakening of our conscience regarding their plight compels us to continue asking for help for this land.

(Gerri Haynes, a former president of Washington Physicians for Social Responsibility, will be sending back reports from inside blockaded Gaza. As she did three times before, Gerri organized a team of doctors and other health care providers to work in hospitals and clinics in Gaza in an effort to directly help the people there and to bring attention to the ongoing humanitarian crisis that the Israeli blockade has created. First in the series.)

Five members of Washington Physicians for Social Responsibility and one intrepid member of Oregon Physicians for Social Responsibility arrived in Gaza yesterday – hoping to provide medical care and consultation to this besieged population. This is the fourth WPSR delegation to travel to Gaza in the last two years.

The 1.6 (or more) million people of this small strip of land are captives of a situation that offers them no free access to the rest of the world. Once, they were able to move relatively freely through Palestinian and Israeli lands. Many Gazans worked daily in Israel. Many visited their families in the West Bank. For nearly five years, the only “free” movement has been through the dangerous tunnels that connect southern Gaza with Egypt. More on that below!

We made our way to Gaza through Israel, Jerusalem and Bethlehem, meeting interesting people along the way.

Amos Givertz, an Israeli working to help the Bedouin population of the Negev Desert (Photo by Bob Haynes).

Laura Wharton is a member of the left-wing Meretz Party in Israel and was elected to serve (without pay) on the Jerusalem City Council. She met with our group at the Notre Dame Hotel to talk about actions to increase services to Palestinians living in East Jerusalem. She says Arabs are rapidly immigrating to East Jerusalem and the cost of housing is sky-rocketing. Issues of water and infrastructure such as schools in East Jerusalem remain challenging for the City Council. One complicating factor for management of City finances is the presence of a large number of ultra-orthodox Jews in West Jerusalem. The ultra-orthodox do not have to work, serve in the military or pay taxes, yet receive social services and stipends for studying in the Yeshiva.

We were to cross (by permit) into Gaza on Thursday but the border was closed for a holiday. Friday morning, we crossed through to the Gaza side with no difficulties and were joyfully greeted by our hosts from the Gaza Community Mental Health Programme. Gaza has experienced many attacks by the Israeli military since our last visit here and we witnessed some of the building destruction as we traveled.

Our group is comprised of three physicians and three nurses and following a brief tour, Rich Grady and Laura Hart began their work by screening more than 30 urology patients.

During our tour, we witnessed several community celebrations – people gathering in the streets – welcoming home prisoners who were released this week by Israel in the prisoner exchange for the Israeli soldier, Gilad Shalit.

The young creator of this artwork was recently slain in an Israeli raid.

Traveling south, we stopped at the Rafah border to witness the preparation of another tunnel from Gaza to Egypt. These tunnels carry goods into Gaza and provide a lifeline around the ongoing siege while the people of Gaza continue to hope for a peaceful resolution to the conflict between Palestine and Israel.

Members of the Washington Physicians for Social Responsibility delegation to Gaza

Our last day of this visit in Palestine/Israel moved us from Bethlehem to the Old City of Jerusalem and on to Tel Aviv to meet with members of Gisha and then Physicians for Human Rights, Israel. Before leaving for the airport, a young reservist lieutenant from the Israeli military joined us briefly. While on active duty, this thoughtful young woman had helped to expedite our permission to enter Gaza in October, 2009 and May, 2010. She is now enrolled in college. We thanked her for her help and wished her well with her studies.

Also, we visited with a young woman who has greeted us several times during our trips to the region – a woman we talk with in general terms about the views of moderate Israelis. Her views contrast with the views of Gisha and PHR, Israel. From representatives of these agencies, we heard strong Israeli concern about the situation in Gaza – recognizing that medical care is deeply compromised and that access to rebuilding the economy to afford better medical care is not now possible.

Dome of the Rock, Jerusalem. (Bob Haynes photo)

Tania, of Gisha, tells us that they are “working to give people the option to do what is right.” Neither Gisha nor PHR Israel holds political positions. Both agencies work on accessing assistance for the people of Gaza – with Gisha concentrating on movement of people and goods and PHR, Israel focusing on better access to medical care – for the people of Gaza and for immigrants to Israel.

Tania relates that Gisha provides legal and public advocacy i.e. provision of individual legal assistance with travel out of Gaza and public advocacy in the right/need to bring goods into Gaza. They are seeking to expand Israel’s criteria for movement.

In the past few years, Gisha has been successful in helping to bring some students out of Gaza to study – their publication of the ban on Gaza’s Fulbright scholars being unable to leave Gaza created awareness in the Israeli public and the ban was lifted.

Staff from Physicians for Human Rights Israel discuss the problems with getting increased medical care for Palestinians. (Bob Haynes photo)

After the Flotilla in May, 2010 disaster, Israel announced a loosening of the ban on the entry of construction materials. Since June, 2010, a high of 137 construction-material trucks/month are entering Gaza – but all of this material is designated for use by international agencies such as the UN. Cement, steel and gravel are still not available through the crossings between Israel and Gaza for public use. This affects housing, schools, business, and employment – life in general for the people of Gaza. On the export side, there is an agreement for 400 trucks/day to leave Gaza i.e. with produce. The average before the siege was 70 trucks/day. This had dwindled to zero. Since June, with Israel’s announced loosening of the siege, 4.5 trucks/day have been allowed to leave. Again, the context of the numbers is important to consider.

There is an announced increase in permits for business people to move back and forth between Gaza and Israel. In context, each time one individual moves in or out of Gaza, this movement is counted as a permit. So, for example, if one official from the UN goes back and forth to Jerusalem every day for one week, this is counted as five permits – giving the impression that the number of permits has increased well beyond the actual number of people receiving permits.

Most students still go through the arduous (and frequently failed) process of transit through Rafah to Egypt. Most movement through Erez to Israel is for patients with critical medical needs and their companion i.e. a baby and mother. General travel between Gaza and the West Bank is almost completely banned.

Physicians for Human Rights, Israel worked in and out of Gaza until prevented by the siege. Their partners in Gaza provide PHR with information about medical needs and they work to assist with movement of patients. They also focus on the need to improve the environment of Gaza – the impact of polluted water, air and soil on the health of Gaza is of continuing concern.

The ultimate solution to the critical problems facing Gaza, they maintain, will be freedom of movement, access to needed goods and services and the ability of the people of Gaza to heal and care freely for their own population.

Members of this delegation are available to give presentations about this work. Please contact Washington Physicians for Social Responsibility at 206-547-2630.

This center provides free access to books, art classes, music, dance, computers and study spaces for local children. (Bob Haynes photo)

As I pause to reflect on this visit, I know that the surgeons and cardiologist have seen scores of patients. The urologists have helped many children with complex surgical needs. Steve Gilbert has taught and discussed with hundreds of scientists – water, air and soil as polluted elements of the environment being their focus. The situation is grim.

I have talked with and counseled many women this visit – women whose desire it is to raise healthy, happy, secure children. Education is a primary value here. Schools are desperately overcrowded and children who are double-shifted go home to do their homework for three hours, then spend four or five hours with one or both parents – extending their learning.

Still, as the threat of attack is constant and the reality of extreme pollution is inescapable, the women I have talked with despair over the future for their children. The high unemployment rate means frustration and humiliation for men who cannot provide economic security for their families.

An example of Gaza's wall art. (Bob Haynes photo)

Young, bright Gazans express hope that the conflicts will end in a positive way when new leadership comes to power – the mothers I talked with only shake their heads and say, “God willing.”

One spectacularly bright light in Gaza is the Qattan Center for the Child. Funded by Mr. Qattan, a wealthy gentleman from the Gulf, the Center provides free access to books, art classes, music, dance, computers, study spaces and community for local children. Reem Abu Jaber, director of the Center, says she was born for this joyful work in an oasis of hope.

We have bid farewell to many friends in Gaza. The hardworking team of Amani, Marwan and Ashraf from Gaza Community Mental Health Programme has once again organized our days and made certain we were able to work as efficiently as possible.

It is late at night in Gaza. Dr. Ismail Zamilpa and Johanna Longacre, operating room nurse, are still in surgery.

More wall art. (Bob Haynes photo)

Monday evening, Bethlehem

It took only two and one half hours to pass our delegation through the Erez Crossing from this morning.

There were some questions, but we were greeted by an official of the crossing who told us they want to make the crossing more open. He would like to see more commerce and workers passing through the checkpoint and says that they have opened the crossing at all hours to assist people coming from Gaza who have medical needs, even on Fridays.

We asked him about the reason more patients aren’t allowed to pass to the West Bank for care and he told us that government of Gaza denies people permits to pass from Gaza, often until they are near death. The differences in reasons for delays vary with each person who speaks of them, but everyone agrees that the borders create enormous difficulties for the Palestinians who live in Gaza.

We stopped for lunch with an old friend in Jerusalem, Hillel Schenker, co-editor of the Palestine/Israel Journal. Hillel spoke of continuing hope for peace and told of several peace initiatives and groups that are working to resolve the impediments to peace.

Heavily armed guard towers dot the separation wall. (Bob Haynes photo)

The hospital’s medical director and told of expanded services and excellent care. We stood on the roof of the hospital and viewed the Separation Wall as it is being constructed close to the hospital, bisecting the Beit Jala area near Bethlehem from the open lands once included in this area – lands containing Palestinian olive groves and agricultural areas that will be inaccessible to the owners of the land.

We spent this evening in the offices of Wi’am, the Palestinian Conflict Resolution Center. We were treated to a homemade Palestinian dinner and listened to Yahav, a representative of the Israeli Center Against Housing Demolitions as he briefed us on the history of conflict here and spoke of possible resolutions. This is the organization headed by our friend, Zoughbi Zoughbi, and we heard of some of the excellent work the staff of Wi’am is doing in conflict resolution, women empowerment, child support and community negotiations.

The hopes for peace are strong.