make sure they don't register you

I know its a bit old now, but I recently came across this video documenting the recent cuts in Canada to the health coverage for refugee claimants. In one of the segments, a Toronto doctor advises one of her patients not to register at the clinic reception because the authorities would find out the clinic was treating under-insured people and revoke clinic privileges. The idea that a government is to be feared, that service providers need to warn clients to avoid and not formally receive care is simply unbelievable to me.


This summer, while I was away, the Conservative government passed legislation to dramatically cut back the services available for newcomers to Canada.

I have lived and worked with people fleeing Rwanda, Slovakia, Colombia and Mexico. I have seen them at their worst, their most worn out, their lowest points. But I have also seen their immense strength, the life and courage that courses through their veins and the joys they bring to those around them about life and what it means to put in days in wait and uncertainty.

People are resilient, and even in the hardest circumstances find ways to survive. As a country as wealthy, materially and socially, as Canada, we can help enhance and build that resilience and recovery for people who have arrived in our country as refugees. The real number of people applying for refugee status in Canada is less than 30,000. According to the UNHCR, more than 900,000 people officially filed for refugee status, which if you simply consider Syria or Congo right now, is obviously a gross under-estimate.

Some principled doctors here in Toronto spoke out against cutbacks to services we provide to the 30,000 people who come to our country. (Incidentally, that number comes out to .08% of people living within our borders at any given time.) Here is the link to illustrate what I'm talking about:
Doctors against cuts
And for a quick change of pace, a satirical look at the cuts:
 http://youtu.be/FC9EUhuiWfA

I am writing this today, being the International Day of the Girl. Yesterday was Global Mental Health Day. Women's health and mental health are issues dear to my heart, and both are intertwined in the outrageous policy choices the Harper government has taken regarding the Interim Federal Health program. Having fled from their homeland, refugee claimants experience significant mental trauma and psychosocial isolation coming to a new country. Being a woman, we know, compacts that. More often than not, the women who come to Canada as refugees come alone, or with their young children, having fled abusive situations in their home countries. In the denial of primary health care, psychosocial counseling and community supports, Canada is letting these women down, and by extension weakening all of our national well-being.

If you've read all this, and are rightfully out-raged, there are things you can do.
You can counter the overt racism in many conversations being had in this country about refugee claimants.
You can write to your political representatives.
You can read more.
You can write more.

And reflect on what has made this country great, and what needs to be done to ensure the gains for the health of all in our country over the past 50 years are not irreversibly lost. 

My work in Palestine

too many airports

Is there a point when you see too much to make anything really stand out?

In the past month, I have been to 15 countries and stayed and met people from all walks of life.

It has been exceptionally interesting, yet also schizoprehenic.

I signed up for, much like I have signed up for a job and lifestyle that involves foreign travel and residence for the long-term.

I sat in my room this morning, in a bed and breakfast in Reykajvik, and I looked out the window (it was pouring rain exceptionally hard) and I cried.

I don’t really know why.

Something just didn’t feel right.

I was alone. But that was nothing new.

Was this what a modern woman does?

Is it healthy for someone to travel into peoples’ lives, across the world from her own, and meet them and make them like her, and learn about their lives and worlds, and then leave?

With no real control or agency to promise any material assistance or support.

Is that normal?

I ask myself, what am I waiting for?

This summer I went to a photo exhibit on Srebrenica in Sarajevo, a Holocaust museum in the old Jewish quarter in Krakow and little gallery in Bethlehem. In all three, Edmund Burke was quoted;

“The only thing necessary for the triumph of evil is for good men to do nothing”

any place, any time, any language, this is confrontationally true.

This is to say, I suppose you leave any place where conflict and discrimination are daily practice feeling inadequate and potentially harmful.

While I’ve spent most of the past four months in the West Bank, I recently had a chance to go to the Gaza Strip. I wanted to go because I thought it would be more ‘black and white’. Life and death. Not as much political posturing bullshit.

You hear, if you follow media from the U.S. or Canada, that Gaza is a hot-bed of terrorism, and the poor civilians who find themselves locked there live in misery, poverty and destitution.

But it wasn’t like that.

It was actually awesome.

I should I guess preface that with letting you know that I like mid-sized, semi-rural cities, where people use donkeys and fruit stands outnumber ATMs.

Gaza is a complex place. Life is not easy. Living there requires defiance, hope and perseverance. We can’t say life is unequivocally better in one place or another. Obviously there are standards, limits and markers. Basic rights we all need to live full lives and realize our potential.

But I could not help but feel that in this discourse of indicators (economic, medical or otherwise) we lose the ability to talk about certain intangible things that make life in Gaza what it is.

This posting comes at the end of an amazing and confounding journey. I don’t want my reflections and writings to end once I return to Toronto.

My learning certainly will not.

I suppose the implications of this for those of us working in the global health field are that we are in great need of being grounded, whether that is in our spiritual faith, personal relationships, or physical retreat. Places like Gaza can easily become buzzwords for all things dangerous and exciting, if we are only able to see them from afar and scurry away to write about them for our colleagues.

how do we accommodate?

I've been doing a lot of thinking recently. Maybe more thinking than actually 'doing'
I finished my official business here, and I've been waiting for more projects, cues, and calls to action.
and I have waited for what seemed like forever.

Most of this thinking and waiting happened in an apartment, in Ramallah, overlooking a valley littered with minarets and cacti. A lot of the thinking was provoked by turkish coffee, and very little wine.
I didn't want to go out during certain times of the day - I was tired of being harassed on the streets by hoards of men and even the thought of it was enough to send me either to the gym or Jerusalem.
Which in some ways I think speaks a lot about life here for lots of Palestinians.

They are trapped. They are waiting. We don't really know for what. We have an idea of what they/we want, but who knows how its delivered or achieved.

So I got a bit depressed and began going to Jerusalem and Tel Aviv more often (ie. every 2nd day).
I just couldn't stand being alone in my apartment, knowing the loud throngs of people were outside and likely to yell and stare at me as soon as I stepped foot on the main street. I donned my headphones and walked hastily to the bus station, eyes on the prize.
I crossed the checkpoints many times, as if I was holding my breath, almost gasping for fresh air.
And I got it.
and it was great.
and then I had to go back.

I hate saying that Ramallah is an unlivable place.
It is not.
It is a perfectly fine place if you have a car, close family and friends, and meaningful work.
I don't have all of those things.
which makes it less than ideal to live here sometimes.

That said- I heard some interesting things today.
I had the pleasure of conducting a focus group about my research today in a camp near my house where I have been working a lot during my stay.
15 women showed up and we talked about what it was like to live in a camp and the challenges of building community.
Most of the women (especially the younger ones) were born in the camp.
To me, and it seemed to them, the camp was like any other village.
Except for basic things, like sanitation services, public schools, employment opportunities or access to agricultural land.
As our conversations became more candid, I just asked them "how can I explain to people back home how you live under occupation? what would you say to them?"
"Its our everyday. Its normal. If you are strong, and you have a purpose, you can live through anything."


Later on at a bbq with co-workers, I heard similar thoughts to the same question.
"We are used to it. I've gone to Jordan and Turkey, but after a week, I want to come back here. Even if there are many many problems, we know it and we love it. We have accommodated ourselves to it."
And it was true. Sitting out in this beautiful valley, smoking shisha and watching the stars, life was good.

I suppose in the end its not really where you live, but with whom and how you live.
I have realized a lot of things about myself in these past 3 months. And I've seen a lot of things I probably would have rather not seen. But that's life.

and who am I to say someone else is unhappy under circumstances that I couldn't handle?
Occupation is horrible, petty, dehumanizing and inhumane.
I am not for a minute saying that it is simple or understandable how people can be 'happy' under such conditions.
but its not impossible.
and people are pretty dynamic, resilient creatures.

Rilke wrote that "the world is still full of roles which we play as long as we make sure, that, like it or not, Death plays, too, although he does not please us."
There are many roles and many lives we live, and I think we all do "play Life rapturously, not thinking of any applause" from time to time, in our own special ways.

Health and Peace Promotion

Hello dear friends,

I am in Egypt.
It is a lovely place.
Some similarities to the West Bank (similar language, crazy driving, desert vistas) but also lots of differences (no checkpoints, freedom of mobility, somewhat certainty that you will arrive where you said you would arrive, trees, no fear of IDF).

I am here on vacation for a week. As soon as I left Ramallah, and started the journey towards Amman, and then Cairo, I was struck by an odd sensation.
I felt free. like I had taken off a heavy wool jacket or removed uncomfortable shoes.
It seemed I could run forever and not have to look left and right, worry about encountering a wall, or worse.
It hit me again that truly the West Bank has become a prison.
a large psychological, and physical holding cell.
and for most people living there, a permanent daily reality.

I have the luxury of leaving.
But I don't want to dampen the mood so much right now.

In the fall, I will find myself again in Toronto, working (and completing!) my Masters in Public Health at the University of Toronto.
One of the best parts of my first year was my introduction to Interchange, which is an international organization of peacebuilders, based at OISE, University of Toronto.

For a long time, I have seen the similarities between health promotion and peace promotion.
I have always believed health is a vehicle to peace. My experiences in Palestine so far have both re-affirmed and further confused my feelings on this, but nonetheless I think it is important to make these linkages and build better programs and policies that recognize the interconnectedness of people's health to their community participation and functioning.

So, I've been writing for the Interchange blog and interviewing organizations around the West Bank that I feel exemplify how we can bridge the two sectors.
Here is the link to the blog: http://interchange4peace.org/?page_id=2185
I hope to be putting up my interview with Physicians for Human Rights, an Israeli medical organization that works for non-status and Palestinian refugees, within and outside the 1967 borders.

Let me know what you think!

how can it possibly not...

cause significant anxiety, depression, and other psychological disorders.
"It" being the environment of occupation.

I set out to do an interview in Jaffa (next door to Tel Aviv) on Monday, for a peacebuilding organization I am involved with called Interchange.

In a series of blog posts and invitations to other practitioners to share their stories, I am trying to make a forum that describes the overlapping work of peacebuilding and health promotion. As someone who has experience in international development and community peacebuilding, and is currently working towards a Masters of Public Health, the topic interests me greatly and allows me to give more shape and  weight to how I view good public health work. ie. raising health literacy, improving access to resources, encouraging involvement in community groups and bringing people from different sectors and walks of life together to see the social determinants of health, and how they can best provide them.

so. without going into further detail (that is what the other blog is all about!), I am interviewing organizations that I feel embody this marriage between health and peace promotion.

Yesterday, I had the privilege of meeting with Physicians for Human Rights, which is an Israeli NGO that works toward making the right to health a reality for all people living in this region. They have an open clinic in Jaffa which serves about 40 people a day, as well as mobile clinics that go into the West Bank on a weekly basis and provide health services to refugees, stateless people, and anyone else who lacks access to primary health services.

The reason I tell you this is because of my mental state once I finally arrived at their office.

I left my house in Ramallah at 1pm, to begin the journey which I knew could last 3 hours typically, even through Tel Aviv is less than 50 km away.

I got on the first bus, got out at the Kalandia check-point, waited... waited... waited for probably 30 minutes, walked through and got on another bus to Damascus Gate (or the "Arab bus station" in Jerusalem). For this portion of the journey, everyone around me is speaking Arabic, people look like they may be going to university or coming home from work. Its calm, but its sweltering. I can't imagine doing this everyday, just to attend class or go to work.

If you are foreign, or have a Jerusalem ID, you can then get on the public transit system that goes through West Jerusalem, and will take you to the Central Bus Station, where again, you must take another bus to Tel Aviv.
The duration for all of this (up to the Central Bus station) is about 2 hours. and remember one can see Ramallah from Jerusalem easily. they are close neighbors, that have become very far apart because of the apartheid wall.

I digress.

So now its 3:45. I've got my ticket to Tel Aviv. I think "no worries, shouldn't take more than an hour max" My appointment was at 5pm in Jaffa. Tons of time.
No. it was not tons of time. We took a different route, some national holiday, major traffic. I arrive in Jaffa, after another two buses, at 7pm.
I felt so helpless and inept. I couldn't call the organization I was going to meet because Palestinian phone companies have no coverage in Israel, even though cities are minutes apart. I couldn't really complain either, because I don't speak Hebrew, and few people I met in the Israeli transit system spoke English.

So in short, I came away feeling incredibly anxious, irritated and worn down. Why did that need to take sooo long?
This brings me back to my opening remark. How can this system - one of perpetual checkpoints, segregated transportation companies, and monopoly of force - not lead to depression, anxiety, chronic fatigue and a whole host of other psychological problems.

After that experience yesterday, this morning I visited Palestine's only psychiatric hospital.
It has been around since 1922, and currently serves 150 patients, 90 of which are chronic in-patients.
The building was beautiful. Old early 20th century architecture, typical of the British presence here at the turn of the century. I asked about the most common illnesses they treat. "Schizophrenia, bi-polar disorder... in some cases heavy depression."

What is the incidence of schizophrenia here in the population? "about 1%, normal, global average"

What about depression? "Way more. probably 3 or 4 times more. Its different now too. During the 1st Intifada, Israel didn't close all the borders. there was fighting, but you were still to walk around. That changed in the 2nd Intifada. They closed all the borders. Now we live in a cage. At the hospital, and mostly at our community clinics, we see so much more anxiety and depression and PTSD now, because of the Wall.

There is was again.
The physical embodiment of people's daily struggles and small tortures in this environment. The occupation penetrates one's psyche. Even if you have freedom within a jail, you are still in a jail.

I see lots of UNRWA and other NGO agencies working in psychosocial counselling and trauma therapy, but today I learned that the Palestinian Authority Mental Health Community Centres rarely have group therapists, rehabilitation services, or family therapists.
"It simply doesn't exist here. Its not taught in schools. Even if you want to become a group therapist, you cannot in Palestine right now"

I do not understand how the World Health Organization, or numerous other health monitoring bodies has not been more incriminatory against the wall. Against all that is stands for, and all that it will effect in the future health of Palestinians. They recently published an atlas on the availability, governance, financing and structure of mental heath services internationally. Palestine, or the West Bank and Gaza Strip, were not included in this Atlas. I find this hard to take.

If you have thoughts on why, please let me know.

Two stories

This Friday I went to Cremizan and Welji, two small villages outside of Bethlehem.

I took part in a hike with 30 other Palestinians and internationals.

The group organizing takes people to hike on land that is under threat of occupation by the Israeli Defense Forces (IDF). Residents regularly receive demolition orders and threats. Most of the land we were walking through is in Area C, which falls under direct Israeli control within the West Bank.

I still get confused about the Areas A, B, and C. Area A is supposedly full Palestinian Control, B mixed ownership, and C under the supervision of Israel. “Your house can be in Area A, and your front step in Area C. Its soo arbitrary” says my friend. I don’t feel so bad about my inability to get them straight.

So we walked and walked, throughout an 19^th century winery owned by the Vatican, and by the world’s oldest olive tree (estimates range from 2000-5000yrs). It was dry, thorny, penetrating and punishing heat. The group was boisterous and would regularly break out into song. Songs from the 1^st intifada, songs from Egypt.

We went to see a house that has been the subject of years of threats and negotiation.

The owner has received multiple offers from the Israeli government for his land: compensation with money, other land inside the West Bank, anything he wanted essentially in return for leaving his house.

I saw his house.

We heard his story outside it, for 30 minutes in the 40 degree heat.

I thought to myself ‘why all the fuss?’ It was a small place, pretty, but hardly qualification for high level Israeli government officials to hem and haw over. But then he told us about the entire annexation plan the Israelis have for the winery, his house, and the village on the mountain.

They want it all.

They have already destroyed an entire mountain with explosives, to make way for more settlements and services for their residents.

The Israeli government wants the mountain because it wants the view.

It wants the mountain because it wants to control the entire area.

I should mention that all of this is taking place approximately 10 min by car from the centre of Bethlehem. The Nativity church, the Shepherd’s field, the entire Christian historical pilgrimage.

The land is under threat

Which one can think about and sort of make sense of. It’s a geopolitical and tourist tactic. I get it.

But what I didn’t get was what happened next.

We were walking down the other side of the mountain towards a field to have a bbq, and all of a sudden 7 IDF come up and wave us away.

Why?

Because right down below, in a public spring (in Area B), there were a group of Israeli settlers enjoying the water.

No problem I thought. We aren’t going anywhere near them.

It apparently was a huge problem. Our group, was told to walk further into the bush, and forbade from getting within 100 yards of the settler group.

Hmm. Alright

So we went and waited. We bbq’d. We talked. We waited.

For 3 hours.

While the Israelis enjoyed the spring and we sat in the blaring sun.

At about 6pm, we started to walk back down. Thinking it was Shabbat (it was Friday, and most observant Jewish families mark the Sabbath with a meal at sundown). It should have been time for them to go.

One Swiss woman in our group walked toward a smaller spring to get some water. No problem. IDF did nothing. One Palestinian man followed just behind her to do the same, and he was greeted with angry shouts and shoving.

I couldn’t really believe my eyes.

Such overt and blatant racism.

Is getting water on your own land a crime, especially after you have been made to endure 4 hours of needless waiting in the mid-day sun?

I guess so.

I again am plagued and confused by this apartheid state. But more than anything, the settlers, or colonists as some call them, confuse me.

Who can stand back and watch police forces actively segregate and restrict the movement of people who are simply having a picnic?

I am blessed to have grown up in a time and place where racial segregation was not tolerated officially, and while there may have been minority ghettoes in Vancouver in the 1990s, there were never cases of the RCMP actively telling one group of people to leave the premises while another group preferentially enjoyed the services.

I added some photos of two things I’ve seen here in the past two days.

The second is described above.

The first is the Festival of Lights in the Old City in Jerusalem. A beautiful night of performance art and light exhibitions throughout the ancient streets. Jews, Arabs, Christians and seemingly everyone else in the city was there walking around and admiring the quiet beauty.

It was such a perfect example of what can happen here. There can be cooperation and mutual understanding. It does happen. I hope to tell you about more of it soon.