Wednesday, May 23, 2012

Did you come to Israel through Sinai? by April blogger of the month R. Mayuri Garikepati

“Did you come to Israel through Sinai?”First-time patients at the Tel Aviv Bus Station Refugee Clinic usually answered, “Yes”. Prior to living in Israel, I did not know the implications of this route; terrible violence and human rights abuses are rampant in countries like Eritrea and Sudan compelled these people to make a very treacherous journey into Israel.

Levinksy Park, Tel Aviv
Thousands of African political asylum seekers, refugees or illegal immigrants—their official status is ambiguous—cross the border from Egypt through the Sinai on foot smuggled in by Bedouin guides. The risks are rape, torture, and enslavement, even organ theft.  In Israel the newcomers are not welcomed, but are held for some time at a detention facility in the Negev then given a one-way ticket to Tel Aviv where many take up residence at Levinsky Park outside of the bus station. Social services are limited and they must look for health care in places like the Refugee Clinic that is funded by the Israeli Medical Association where I recently began to volunteer.

Patient room at refugee clinic.
During the times I sat with the physician, her frustration at the language/cultural barrier was obvious, and she admitted that her ability to help was limited when she couldn’t truly understand what patient—even if they could speak some Hebrew or English. Also individuals also came in with various aches and pains with no other apparent signs of illness; interestingly the physician felt these symptoms were psychosomatic in nature—something she could not effectively address during the brief consultations.

I was surprised to find that I was by myself at the reception registering patients my second time at the clinic. Thankfully the multi-lingual patients in the waiting room would help translate for the Tigrinya and Arabic speakers; other times I’d manage with English, broken Hebrew and hand gestures. The entrance was crowded with patients without appointments hoping to be seen by the one doctor and nurse working—some cases could wait and others were urgent. A distressed pregnant woman in severe pain arrived with her anxious husband. They waited for over an hour before she was allowed to see the doctor who ordered a urine test. She was very weak so her husband and I helped walk her to the bus station bathroom to so she could provide a urine sample. The sample tested high for ketones and the doctor insisted that they go to the emergency room right away. As I watched them leave I hoped, but was not sure that everything would be okay.

The Haaretz newspaper quoted Benjamin Netanyahu’s statement regarding the African refugees: “If we don’t stop their entry, the problem that currently stands at 60,000 could grow to 600,000, and that threatens our existence as a Jewish and democratic state.” The hardships faced by the refugees have no easy solutions and it is difficult for countries to deal with the costs and cultural misunderstandings that come with such an influx of immigrants. Each visit to a clinic reminds me of the complexity of global health and that medicine is but a small part of the cure. - R. Mayuri Garikepati