JMAP 2024 - Pain, Nostalgia and Resilience
The Place: Gaza Refugee Camp, Jerash, Jordan
The Time: June 2024, 8 months into the ordeal of Gaza
She shuffled into the consultation room, gingerly, evidently riddled by the ravages of prior uncontrolled rheumatoid arthritis. She established and maintained eye contact with me, with a mischievous twinkle of curiosity and intrigue akin to my late grandmother. I stood up ready to help, but she insisted on manoeuvring her tired body forward, aiming for the chair opposite my desk, a few long feet away. Having lowered herself carefully into the chair, she looked up, uttered a sigh of relief and whispered her thanks to the Lord for what He has ordained for her. She thanked God for everything, for still being alive, unlike those who perished in the real Gaza. Suddenly she changed her tone: she wished she was back in Gaza where she would prefer to die and be buried. Gazan dust to Gazan dust, and Gazan ashes to Gazan ashes, that is what was going through her tormented but lively mind.
“How are you?” I hesitantly asked. Sharp as a button, she pursed her lips for a few seconds and said, “All we can do is keep going, here and there and everywhere! What else can we do?”. I had not met this woman before in my previous visits to the clinic over the last two years, yet it felt like I had known her my whole life. She exuded a steely stoicism combined with the poise of a Muhammad Ali who is ready to pounce. I enquired about her diagnosis of rheumatoid arthritis. She explained: “they discovered I had rheumatism back in 1965. It was in Al-Shifa Hospital”.
She slowly lowered her gaze. I followed suit. A moment of brief yet poignant reflection filled the consultation room. I glanced over to Sister Rahaf, likewise engaged in deep thought at hearing the name of a hospital that is no more. To think that this 81-year-old woman had outlasted the hospital in which she was first diagnosed and treated, a former beacon of hope and recovery from disease, as its Arabic name means, was unfathomable to us all. Having been diagnosed at a time when effective treatments were limited anywhere in the world, it was inevitable that Al-Shifa could never offer her what she needed to manage her illness.
Welcomed by the bright lights of Amman
I landed in Amman in early June for my third visit to the Jordan Medical Aid for Palestinians (JMAP) clinics, knowing that this visit would be different. The calamity that is Gaza is roughly, very roughly, an hour from Gaza Refugee Camp as the crow flies. Against this background, I tried to prepare myself to cope with the mental scars of old which were bound to erupt with every visit to my clinic. Mass death and wide-spread destruction of kith and kin were bound to inflame gaping wounds in a chain of inheritance in which the elderly pass the legacy of loss and dispossession to the young. Will there be dawn for the residents of Gaza Refugee Camp, I wondered? I would like to think so, but I doubt it.
I tried to offer my patients feeble words of comfort, before reorienting them to the task in hand. The gesture was always gracefully accepted, even though it was always understood as a form of words, no more. However, my patients and I understood that my first and most solemn duty was to provide them with the best care and advice I can muster, using the available resources as best I can. When hope is in short supply, professional care must do the heavy lifting. “This is a laudable position,” I hear you say. “Yes, focus on treatment and cure! Don’t be distracted by the pain and suffering swirling around you! You can’t inject hope into hopelessness! False optimism is no cure for misery! There is no cure for this amalgam of abandonment and despair! Hold Your Nerves And Carry On.” I did! With atrocious difficulty!
A glimpse of the camp’s graveyard from the clinic
The rolling hills providing a soothing backdrop to the harsh realities on the ground
The clinic room
A comforting familiarity for clinicians
A fleeting moment of sheer importance and hope for patients
I was certain this year, more than ever before, I could offer more to my patients and colleagues. Two years in post as a consultant in rheumatology and internal medicine at the Royal Free Hospital in London must be made to pay in a challenging environment. Two years of robust experience that helped me harness a broad array of skills in manging complex medical issues – in a role where the buck stops nowhere else, except with me – must be made to count. Two years of experience in voluntary work in these camps must be made to make a difference, no matter how little it is. How can I not try to do my best when some of the most wretched people I treat, living in tent shelters or under zinc roofs, consider themselves lucky when comparing themselves with others who are paying the ultimate price. If there is a definition of nobility, here it is, in front of my eyes. And yes, try taking a history from a patient whose mind is elsewhere, who believes their disease is a blessing because they enjoy barebone safety, despite their unbearable pain. I was not prepared for this, but I persevered.
And what about the industrious JMAP volunteers I worked with this year? Those who’ve dedicated their lives to serve in the cruellest of conditions. Take Samar, for example, one of the highly accomplished nurses at the JMAP Gaza Camp outside Gaza, 25 miles north of Amman. I was working alongside her for the first time. Her approach with patients, a gentle empathy blended with robust knowledge, was a humbling experience. Her presence was well felt by both doctors and staff. She exuded positivity and exhibited forward thinking in spades. However, lurking underneath all of this was a tragedy she endured in silence, never allowing it to impact her work. Her brother had passed away from a heart attack, aged 42, just 20 days earlier, leaving behind a grieving wife and a bereft young family who will have to go through life without him. Samar was a professional to her fingertips. And I salute her from afar.
Generous donations
Enabling the clinic and its dedicated specialists to conduct their work to the highest standards
Ophthalmic disease commonly presents in a variety of rheumatic conditions
Early detection and treatment reduces the chances of lasting complications
However, not everything was doom and gloom. JMAP have continued to think ahead. They have purchased a plot of land next to the Jerash clinic where I volunteered with plans in hand to expand their medical facilities. Relying on local goodwill, their fund-raising activities have paid off, with some help from people of goodwill outside who, I hope, will be able to offer their expertise directly to patients. A similar expansion is planned for the clinic at Hiteen-Schneller Camp on the outskirts of Amman. Yaseen, the clinic manager, showed me around the expansion under way which, I am glad to say, is earmarked for lifestyle provision, covering education on exercise and diet as well as some physiotherapy provision. I am full of hope that next year will not just usher better facilities for the residents of Gaza Refugee Camp – and those of Hiteen-Schneller – but that Gaza itself, where most of the Gaza Camp refugees hail from, will enjoy the peace Gazans everywhere miss, but deserve.
My visits to Amman are not always about work, although volunteering is the main goal. I look forward to those visits every year because they allow me to reconnect with members of my extended family on my father’s and mother’s side. Social visits are never free from medical consultations about this or that ailment, but this is a miniscule price to pay in return for all the love they shower on me, the excellent food they lovingly prepare for a relative visiting from afar, and the noticeable improvements I discern in my Arabic.
This year was, however, special in two ways. Sitting under a cherry tree in my cousin’s garden, I enjoyed one of the best cheesecakes I have ever tasted, a signature offering to special visitors, I was told. Thank you, Randa! And thanks for your great work on behalf of Save the Children in these turbulent times.
Ripe and ready
Time to savour some sumptuous apricots
And visiting my aunt on my mother’s side, I availed myself of the delicious apricots their garden yielded in abundance this year. Being taller than my aunt, her husband, my cousins and my mother I was able to reach to the high-hanging fruit, leaving the less juicy and less aromatic low-hanging fruit for those less able to reach! Thank you, aunt Dalal! And please do keep up the good work: I will be on my way next year!
And, as in the past two years, my mother was there to support and, from time to time, to help translate, assuage and socially navigate. She does all of that in her exquisitely understated manner which she displays in abundance wherever she goes.
JMAP HQ
Never ceasing to expand their remit and to develop medical and community-based services
Incredible work by all involved since the charity’s inception 34 years ago
Despite all the allure of my job in London, which I thoroughly enjoy, I am already looking forward to volunteering next year. Going back to the camps, seeing my patients and working with trusted and highly motivated colleagues in a well-run medical charity is a true privilege, not a duty. This is what kept me going this year despite all the traumas I had witnessed.
Thank you, Jordan Medical Aid for Palestinians. Your work has never been more needed than now!
The end of a long day in the Gaza camp
The beginning of a long journey back home!
