HOPE FOR PALESTINE?

By Lesley Morrison
Contact the author by e-mail at christopher.johnstone@ntlworld.com

The situation in Palestine is dire, and it will probably get worse. Yet Dr Runa Mackay, the Scottish paediatrician who, in 1955, went out to work in Palestine for six months and stayed thirty years, says there is hope. “There is always hope”.

Spending time with Runa feels like a great privilege. Quietly spoken, very astute and very determined, yet also twinkly, it is easy to understand how she developed such rapport and trust with the Palestinians whom she has spent so many years of her life helping. Born in 1921, she trained at Edinburgh and gained an MD in 1955 on “Infantile Gastroenteritis”, a subject which was going to be a focus of her clinical work in the Middle East later. She worked as a GP for two years, was a paediatric registrar then made the move which set the course for the rest of her life. She joined the staff of the Edinburgh Medical Missionary Society Hospital in Nazareth as a paediatrician and obstetrician and worked there for twenty years until 1975. Between 1975 and 1985 she worked as a medical officer in mother and child care clinics in Galilee and was a founder member of the Galilee Society for Health, Research and Service. In the next few years she spent time working with Medical Aid for Palestinians in the Lebanon, graduated MA Honours in Arabic from Edinburgh University, was made a member of the Iona community and held a paediatric consultancy for MAP at the Children’s Hospital in Hebron where she initiated a hospital based outreach programme to villages.

In 1995, she published her book, “Exile in Israel; a personal journey with the Palestinians” and currently she is a trustee of MAP and chairperson of Scottish Medical Aid for Palestinians which involves her in visits to projects in the Middle East at least once a year. MAP is an independent British-registered charity established in 1984 after the Sabra and Shatila massacres “for the relief of poverty and sickness and the advancement of education among refugees….displaced from the former British mandate of Palestine.” Its priority is the provision of training programmes for Palestinian health personnel working in hospitals, clinics and the community. There is only one medical school, in El Quds (Jerusalem) set up after the first intifada and there is a problem for the students getting clinical experience. At Beir Zeit (well of the olives) University there is a department of health science and the Royal College of Paediatricians is currently working hard to set up training for an overseas Diploma in Child Health between the two institutions. The hope is that nurses as well as doctors would be accepted for the training.

The Royal College of General Practitioners has been involved in training programmes and one of the challenges, working with Palestinian doctors, is to encourage them to see general practice as a worthy specialty in its own right. The tendency is for them to want to train for a hospital specialty while the need for effective primary care is acute. UNRAW, the United Nations Relief and Work Organisation are responsible for the health and schooling of registered Palestinian refugees and are their main health care providers but there are many Palestinians who do not fit into this official category and who desperately need good primary care. The Palestinian Red Cross, the medical arm of the PLO, and Hamas, better known for their terrorist activities, play important parts in addressing this need. Many doctors working in Palestine have trained in distant countries and do not have enough appropriate postgraduate experience. As Runa Mackay says, “There are too many doctors without proper clinical skills”. Another practical issue she emphasizes is the need to improve and make more use of working relationships with nurses and to encourage health education with mothers.

So how can we, in our relatively well-provided surgeries immersed in NHS changes and GP politics, respond to the medical situation in Palestine?

Perhaps we could usefully, for our own wellbeing apart from that of anyone else anywhere else, recognize how relatively fortunate we are. We are generally able to prescribe drugs at will, we have endless opportunities for postgraduate training, we do not, at least to the same extent, have to contend with a local culture which believes that there is a medicine and a cure for everything. Runa Mackay vividly describes the difficulty of getting villages to accept the value of rehydration salts as a treatment for gastroenteritis because they were not perceived as a medicine.

We could make colleagues, and perhaps especially registrars, aware of educational opportunities. For instance, Queen Margaret’s College runs a one-year course in international health and the Department of General Practice in Glasgow runs a series of seminars on international health. Perhaps there is the potential for twinning arrangements between practices and Palestinian primary care projects, and for practices or departments to accept visiting Palestinian doctors. Plans are afoot to establish a link between Edinburgh and Ramallah. We could learn useful lessons about lifelong learning being put to good international use.

Dr Runa Mackay has “retired” several times from clinical practice yet it is very clear that, while there is work to be done to bring the plight of the Palestinians to people’s attention, actual retirement is not on her agenda.

Exile in Palestine; a personal journey with the Palestinians.
Dr Runa Mackay,
Wild Goose Publications, ISBN 0 947988 75 0
MAP, 33A, Islington Park St., London N1 1QB.

Other hoolet online articles by Lesley Morrison can be found at:
hoolet edition 49 - Review: Reflective Practice Writing and
Reflective Development
hoolet edition 49 - Enjoyable Journeys
hoolet edition 45 - Read All About It
hoolet edition 43 - Whistle-Blowing
hoolet edition 38 - Hope For Palestine?
hoolet edition 36 - Letter To The Editor
hoolet edition 32 - Letters To The Editor
hoolet edition 27 - The Bag Lady
hoolet webextra - Edinburgh Restival Review

Other hoolet reviews by Lesley Morrison:
Reflective Practice Writing and Reflective Development

hoolet is the magazine of RCGP Scotland. It is supported intellectually, financially and emotionally by RCGP Scotland.

This issue maintained by Robert Hallam.