Monday, November 8, 2010

Physicians for Human Rights, by November blogger of the month Elizabeth Nowak

Olive groves.
Like most of my classmates, I was drawn to MSIH because of its integration of global health curricula into the standard medical curriculum.  I think one of the most incredible and unexpected things about moving to Israel, however, is the classroom it has opened for me beyond the walls of the sixth floor of Soroka Teaching Hospital. 

I recently had the chance to shadow a doctor working with a Physicians for Human Rights mobile clinic in a small village in the West Bank.  I think there comes a time in most of our lives when we have to play the part of the outsider – the person who understands too little, sticks out too much, and will be gone almost as soon as they arrived.  I’ve come to look at these fleeting moments as one of the purest forums for self-change.  Thus it came as little surprise, as I sat in the back of a small Palestinian classroom observing patient visits, that my impetus for change - my teachers - were the men, women and children who came to the clinic seeking help.
Pediatric examination with Physicians for Human Rights.

I’m just a few months into my first year, and I have a better understanding of glucose metabolism than I do of patient diagnosis and treatment methods.  Dr. K graciously translated and explained the case history and plan for each of the patients we met, but even more importantly, he translated both the spoken and unspoken social and political contexts behind their visits.

The village where we worked lies in the bottom of a valley, and spans for miles layered in dense, stocky olive trees.  Most of the residents are olive farmers.  High above, on either side of the valley, are two Israeli settlements. The settlers frequently attack the village in the bottom of the valley, burning the olive trees, the livelihood of the people.  Dozens of patients had come into the clinic complaining of chronic illnesses – hypertension, headaches, gastroenteritis, and asthma.  At one point in a patient interview, Dr. K turned to me and asked, “Can you feel this tension within the patients?  They are sick because they are worried.”  He speculated these were somatic expressions of fear, and the high rate of pediatric asthma, a result of breathing in smoke from burning olive trees.

The issues that surfaced in these patient visits neither begin nor end with the olive trees.  For me, the trees are an interesting jumping off point for deconstructing what I observed that day because they represent a means of building or destroying human agency.  They have sparked a series of questions in my mind about the role that health plays in creating more peaceful societies, and the role of peace in creating more healthy people.  There is a part of me that questions whether it is possible to be healthy in circumstances plagued with violence and fear.  Likewise, I wonder if there is a way to address the symptoms expressed by a person in conflict without addressing the nature and cause of that conflict.  I was only a transient observer of what life is like in that village, but as I continue to reflect on the ways that health engenders peace, I will always remember the people I met there as the best kind of teachers.  - Elizabeth Nowak, MSIH first-year student