“I used to play in this park. It was the only place where I could have fun outside. But I can’t go there now because the settlers destroyed it. I even got attacked when I went there to take these photos. It will remain in my memory forever.” Raed“This story is one of a hundred stories: Israeli settlers attacked our property and destroyed everything - our houses, cars and land. They came one night to my house, burned the car and hit my father. I was so scared, and felt very sad for my father.” Dana“This house belongs to my neighbor. When I see it, I think about my house and I am afraid it will happen to me too. So I pray that it will never happen to my house.” Ahmad“The olive tree connects Palestinians with their land. We have deep roots in Palestine, just as the olive tree has deep roots in the land.” Ameera“The olive tree is not only a tree – it’s our livelihood. It gives us olives and oil.” Nour“I belong to a farming family. My parents raise animals, and we count on these animals to help us during harvesting and to give us what we need to live.” Jamal “This is who we are. This is where we belong.” Ezzat“Nothing is more delicious than my grandmother’s cooking. I like the basket that my grandfather made.” Raghd“These are the animals in my village. Playing with animals is part of my life and it makes me feel happy. ” Du’a“These are my favorite Palestinian dishes. They are cooked with a traditional pressure-cooker.” Mohammad“I am proud of the wonderful handcrafts that my grandmother, mother and sisters make.” Yanal “I love my village. This is the view from my window. I would like to live up on the mountain, but there is a settlement there, so I cannot live there.” Doa’“I like the sky and the landscape of the spring in my village. It is full of trees and it has a beautiful sunset.” Hadeel“In Palestine there are many kinds of flowers and beautiful nature all around us.” Abdullah“Wheat is like gold.” Ahmad“I go here to swim with my friends. I know it’s not a good place to go swimming because we get infections from the water, but it’s the only place we can go.” Mohammad“These are the traditional clothes and tools that the people used to wear and use. My relatives maintain this museum in their house so they can preserve our Palestinian heritage. I go there because I love to be connected to my family’s history.” Shatha' My relatives got married when they were very young, but I don’t want to do the same as they did, because I want to go to university and study.” Ameera“I live next to the stone pit and everything is full of dust. My cousin had to leave her house because of the stone pit as she had breathing problems. I miss her.” Ruba“Our roots, our palaces, and our fun places.” Abdullah“Our past, our present, and our future.” Ayah“The fruits of our land are the most delicious in the world.” Hadeel“In the past the cactus plants were our natural borders. Unfortunately, the borders now are very different.” Abdullah“This is the inside of a typical Palestinian house.” Ruba“I dream of seeing my land without barbed wire because it hurts me to see borders; because I want to feel free to go to Jerusalem with my friends and family.” Motlaq“This is taboon. It is our special way of baking bread. Before I go to school, I wake up to find delicious taboon bread made by my mother early in the morning.” Noor“My father is a farmer and I hope to work on his land one day, if it will still be his land.” Salsabeel“We are Palestinians.” Muhammad'We find happiness in our lives, even when there are many things that could make us sad.” Mustapha During 2013-2014, MdM implemented an emergency preparedness project in Deir El Balah Governate, Gaza.The project aimed to increase the quality of the emergency response at the level of communities, medical staff at the primary healthcare clinics and ambulances.During the project, 810 community members were trained on basic life support.The whole training involved 49 primary healthcare staff.In one year, 25 ambulances were trained on emergency management and triage.On 11th of March 2014, MdM organized a simulation to test Gaza health actors' response to emergencies.During the simulation, all parties of the training had to coordinate and manage the situation in the most efficient way.In the simulation, MdM provided first aid kits, essential drugs and disposables for emergency room, medical equipment and communication devices.During the exercice, two emergency events were organized within an hour. In the naval exercice, 800 Palestinian in Deir El Balah governate were trained. It included the training of 100 fishermen.The second event of the simulation was a building explosion in Deir El Balah beach.The training included the management of urgent cases , the triage and evacuation of the cases to the emergency room at the primary health clinics with the objective of decreasing the work load on the hospital. Airstrikes on hospitals, violence against healthcare professionals, hijacking medical facilities, and lack of supplies and equipment has brought Syria's health system to its knees. The following powerful words and images show the struggles and acute dangers that both Syrian medical staff and civilians face in the extreme conditions of war.
©Zein Al RifaiiShortly after sunrise, the first airstrikes start. The ambulances and medical teams sent to rescue the victims regularly find themselves under the fire of a second strike. ‘We asked the ambulance drivers to stop rushing to the scene of an attack immediately after it has happened, but they don’t follow our recommendations. They cannot stay calm and wait while people are screaming for help’, explains Dr. F. who works in one of the hospitals supported by MdM in Aleppo.
©Zein Al RifaiiTo avoid the hospital’s windows being shattered during an explosion, sand bags have been installed to protect them. Airstrikes have directly damaged several hospitals as well as their surrounding areas. In February, a missile damaged part of a hospital run by one of Doctors of the World’s medical partners, killing two patients and wounding several staff members.
©Zein Al RifaiiMost medical staff have fled the city of Aleppo, particularly in the last three months during which extreme violence created massive population movements. The resulting lack of human resources led to many trainee nurses having to learn on-the-job. Many of them didn’t finish their studies but after six months of supervised work at the hospital, they are able to work independently.
©Mohammed WesamProviding the hospital with drugs and supplies remains a challenge. While international organisations such as Doctors of the World manage to support the hospital, deliveries are often delayed or blocked by fighting around the city of Aleppo. The hospital has huge difficulties getting some specific drugs, such as anaesthetics, although they are essential.
©Mohammed WesamMuhammad, 13 years old, was admitted to the hospital in the afternoon. ‘The airplane attacked us while I was playing marbles with my neighborhood friends and my cousin. I was thrown from one side to the other and an electricity pole fell on me. I felt tired, I was speaking meaningless words and I hallucinated. What did I do to deserve this? I am a child, I had no dynamite, only marbles to play with’.
©Mohammed WesamSyrian doctors and nurses who each receive around 17 patients per day for emergency care suffer from high levels of tiredness and stress. The medical staff live in isolation at the hospital, eating and sleeping all together. They only go out a few days per month to visit their families.
©Zein Al RifaiiDoctors and nurses live in fear that they will see wounded or dead relatives arriving at the emergency room. ‘I didn’t recognise my cousin when he arrived at the hospital. We managed to identify him only by his T-shirt’, explain Dr. Zakaria, who works at the hospital.
©Zein Al RifaiiDuring the day, patients also come for the treatment of common or chronic diseases. If there are too many people in the emergency room, these patients have to come back the next day. Coming to the hospital is often risky. ‘At the height of the TNT barrel attacks, many patients died silently at home: for example, patients suffering from renal failure who couldn’t attend their dialysis sessions, patients suffering from cancer or with diabetes’, explains Dr. F.
©Zein Al RifaiiDue to the lack of specialist doctors, some of them work via internet ‘tele-consultations’. Doctor Zakaria, an anaesthetist, is in charge of caring for nine patients in several intensive care units throughout the city of Aleppo, while not being able to go there. 'This is a very difficult job, but we cannot gather all the patients in a single intensive care unit because it might be the target of an attack.'
©Zein Al RifaiiThe hospital has two childbirth units. In addition to caring for patients, the medical staff must ensure all the hospital’s maintenance. They need to purchase the fuel to run the generators which supply the hospital’s electricity and must ensure the proper functioning of all medical devices.
©Zein Al RifaiiIn the evening, all the hospital’s beds are usually occupied by patients. At dusk, airstrikes and shooting stop and the hospital does not receive any more emergency intakes. At this time, doctors meet to discuss what they will do with their different cases. 'We cannot keep a patient for more than three days. Our policy is to perform the operations that will keep him or her alive. As soon as the patient is stable and his/her life is not in danger anymore, we look for another medical facility that can accommodate him/her, often in Turkey’ says Dr. Zakaria.
©Zein Al Rifaii 3,200 children in fifteen different schools of the Nablus governorate benefitted from MdM psychosocial activities during the first semester of the school year 2013-2014. Living in poor and isolated villages and frequently exposed to violence from settlers and Israeli Security Forces, these children need an open, safe and confidential space to express their feelings. “Through drawing, role playing, music and traditional games, we work with the children on social interaction, communication skills, conflict resolution and self-esteem. Our aim is for them to reach psychological balance”, explained Shaheera, MdM social worker conducting sessions with the children.During the sessions, children are encouraged by MdM social workers to express their thoughts and feelings. For this drawing, children were asked to represent themselves in two situations: one where they are happy and one where they are sad. “A person can be happy at his/her birthday party and sad when he/she goes to prison” said the author of this drawing. During sessions focusing on the improvement of communication skills, children were requested to draw whatever they want with another classmate. They have to talk to agree on what to draw and share the materials. In this drawing, two children chose to represent “the army attacked the village and started to shoot on people and killed them all”. Asked to draw a happy and a sad situation, this child drew only a sad situation, using black color only. Imprisonment or soldiers’ attacks are recurring themes in children’s drawings. They reflect the environment of violence and fear in which children of the Nablus governorate live. Nablus governorate is the governorate most affected by settler’s related violence in the West Bank: in 2013, fifty-nine Palestinians, including seventeen children, have been injured due to settlers’ violence. In this drawing, two children chose to draw together “people of the village defending a house that will be demolished by soldiers”.Following the activities, changes have been noticed in children’s behavior. “Interaction and children’s participation in my classes have increased”, said a teacher at Duma Mix School. During the second semester of the school year 2013-2014, MdM continues to organize psychosocial activities in the schools of As-Sawya, Duma and Al-Luban villages, in partnership with the Ministry of Education and Higher Education – Directorate of Education of South Nablus. Since July 2012, MdM has been supporting a post-operative and rehabilitation centre at the Syrian-Turkish border which ensures the follow-up of patients operated elsewhere for trauma injuries. © Agnes Varraine-Leca Ghada (all names have been changed) is one of the in-patients at the centre. She’s been here for three months. She lost an arm and one of her legs was wounded: 'I was watering the trees in my garden when a bomb fell straight to the left of me. I saw my hand burn right there beside me. What did I do wrong? I was not carrying no weapon and was no threat to anyone. I was just an old lady looking after her plants.” © Agnes Varraine-LecaPatients followed at the centre were previously operated in field hospitals, often in very poor conditions. “A bomb fell two meters away from me and I received shrapnel in my leg. I was taken to the closest field hospital but the conditions there very poor. It was a small field hospital, with only two doctors and one nurse. There was not enough space. And the hospital was not secured from bombings and shellings,” says Mahmoud, a young Syrian man who has been in the centre for more than a month. © Agnes Varraine-LecaReaching the centre to receive proper care is a real challenge for many patients. “At the field hospital, doctors were able to operate my hand and my leg but they lacked medicines. One of my wounds got infected and I could not go anywhere else to receive care: I am a widow, I had no money to travel. So for four months, I collected money and finally I came here”, says Ghada. © Agnes Varraine-LecaSince July 2012, the post-operative and rehabilitation centre has provided care to 750 in-patients, some of whom stayed for a week or less, some for several months. “Everything is going well at the centre. It's clean. Nurses are very caring with patients. For seven months, I could not walk at all. With the help of a doctor here, I can walk a little bit now... But I get tired very quickly”, says Ghada. © Agnes Varraine-LecaMdM aims to improve the centre’s physiotherapy and post-operative care through staff capacity-building, the supply of drugs, equipment and consumables and the development of new services (laboratory, rehabilitation tools and so forth). © Agnes Varraine-LecaMaïssa has been working as a nurse at the centre since the start. She saw the positive effects of MdM’s support to the centre: “We want to thank you, thank your organisation. Many turned their back on us, many abandoned the Syrian people. When we opened the centre two years ago, working there was difficult but it has improved, in particular, thanks to the collaboration with MdM. MdM teams have been by our side on a daily basis, supporting us with human resources, supplying us with equipment”. © Agnes Varraine-LecaNews from Syria, through television or through relatives, has a strong impact on the evolution of the condition of many patients. 'I am very worried for the children. I am an old lady, it’s not so important for me... but our children!', says Ghada, the 50-year-old widow. The chemical attacks on the Ghouta region where many children died dismayed her, thus deteriorating her condition. © Agnes Varraine-LecaAs a nurse, Maïssa analyses the situation as follows: “The biggest problem is the psychological pressure created by the situation in Syria. Bad news coming from Syria has an impact on the medical staff as well as on the patients. It’s difficult to apply our medical references to treat the cases we have at the centre. A patient can feel much better and, suddenly, his condition deteriorates, his wounds hurt again and we need to take care of him. We discharged some patients who then came back and needed to be admitted again. This phenomenon is difficult to explain but, for me, all this is linked to what’s going on inside the country”. © Agnes Varraine-Leca In July 2013, one year after its opening, Zaatari camp is hosting around 120 000 Syrian refugees. It is the second biggest refugee camp in the world. © Clément MahoudeauMdM provides camp’s inhabitants with primary health care services through its two health centres. MdM teams also bear witness to refugees’ stories and living conditions. © Clément MahoudeauReem, 19 years-old, is living in Zaatari refugee camp with her family. She told MdM: “Now that we are in the camp, we are no longer afraid for our lives; we found peace of mind to a certain extent. However, the living conditions inside the camp are very hard, we realise now how difficult it is to live in a camp and we are praying for the best especially as summer is approaching”.
© Clément Mahoudeau© Clément MahoudeauHussam, a teacher from Dera’a, told MdM about his dramatic experience in the camp: “Ten members of my family and I were living in a tent between two caravans. One night, fire broke out. I don’t know where it came from: maybe someone threw a lit cigarette near the tent, maybe a child hit the gas stove or it was an act of arson... My niece died in the fire. After that, they accused me of having set fire to the tent myself! Why would I do that? To put my family in danger and cause the death of one of my parents? At first, authorities refused to give us new accommodation then they installed us in one of the caravans provided by Qatar”. © Clément Mahoudeau
© Clément MahoudeauMohammad, a young Syrian refugee, told MdM:
“In the camp, life is difficult. Security is an ongoing concern, in particular theft. There must always be at least one person in the tent, if not, you can be sure that everything will have disappeared when you come back.” © Clément MahoudeauAhmad, 50 years-old, a researcher coming from Homs, stated: “The area where we were living [in Syria] was bombed so I decided to go to Jordan. But this camp is like a prison for me and I can’t go away from it. I asked all the authorities to let me go but they refused. I was living a good life in Syria and now I feel like I’m in prison.” © Clément MahoudeauRasha, a 15 years-old Syrian girl explained to MdM while bringing her little brother to MdM healthcare centre:
“It’s normal to see a lot of sick people in here, people with cold, people with fever. It’s because of the cold. In my tent, we are five and we only received five sheets, not even proper blankets and we don’t have heaters either.” © Clément Mahoudeau© Clément MahoudeauIbrahim and Hanadi, a couple of Syrian refugees, said: “We arrived in Jordan eight months ago but it feels like eight years. We don’t know what the future will bring. We could die here or we could go back to Syria.” © Clément Mahoudeau In Lebanon, more than 400 000 Syrians are registered as refugees by the UNHCR but there would be one million Syrians currently living on the Lebanese territory. ©Richard DelaumeOne third of the refugees registered in Lebanon are installed in the Bekaa Valley where they live in very precarious conditions. ©Richard Delaume ‘<em> We don’t feel ashamed. Come and see the conditions we live in! </em>’ said Noor, a 25 year-old Syrian woman living with her three young kids in an encampment in the North Bekaa. ©Richard Delaume‘<em>I live off four food coupons. I sell two of them to buy milk for my newborn twins. There is a pharmacy which sometimes gives me milk or lets me pay later. This winter, we didn’t have enough blankets for everyone, so we gave the only ones we had to the children. We bake our own bread as it is cheaper than buying it. We can only afford to buy some flour and then use a small oven we built to cook the bread</em>’ said Noor, a Syrian woman. ©Richard Delaume Access to health care is particularly difficult for Syrians living in the Bekaa Valley: ‘<em>My daughter got sick. The medicine costs 70 000 LL (35 euros). I don’t have this amount of money</em>’ said Ali, a 50 year-old Syrian-Lebanese living in an encampment in the North Bekaa. ©Richard DelaumeSince March 2012, MdM is working with local partners, such as the Lebanese association Amel, and supports primary health care centres in the Bekaa Valley by offering free consultations and medicines. ©Richard DelaumeThe profiles of the people who fled from Syria to Lebanon vary a lot: Syrians from Homs or Aleppo, Kurds, Palestinians, Lebanese who have been living in Syria for decades, seasonal workers and Bedouins who were used to move between the two countries but stayed in Lebanon due to the violence and the lack of economic opportunities on the other side of the borders. ©Richard DelaumeSome people coming from Syria do not have Syrian identification papers and cannot registered. Some are afraid to register. Therefore, they experience major difficulties in accessing humanitarian aid. ©Richard DelaumeMdM and its partners chose to receive and to provide health care to any vulnerable person, whatever his or her origin and without any prerequisite. ©Richard DelaumeBetween 150 and 200 patients are treated daily in the three health care centres supported by MdM in the Bekaa Valley. ©Richard Delaume
Press Kit – December 2012 – Giving care in Syria and at its borders, bearing witness to suffering
Report – April 2012 – Improving Access to Health Care for Children in Street Situation in Greater Cairo
Leaflet – March 2012 – MdM in the occupied Palestinian territories
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