The Deir Ammar Medical Mobile Unit

Dr. Ibrahim arrives at the UNRWA Health Point in Beit Ur, some 17 kilometers south-west of Ramallah, at 1030 hours. He and his team of two nurses and a pharmacist are three hours late. But at least they got here and they are grateful for that.  (Dr. Shaker, the doctor in charge of the Deir Ammar Medical Mobile Unit, was on medical leave during the time of the interviews.  Dr. Ibrahim was replacing him during his absence.)

Last week their mini van, UN 772, was shot at in Ramallah by an IDF undercover unit aiming at a Palestinian vehicle traveling on the same road. The Palestinian got away, but the mini-van received at least two bullets shattering the rear window and injuring three staff members, including the driver who continued driving the team to Ramallah hospital. Dr. Ibrahim remembers, "When the bullets hit the car everybody was screaming and fell to the floor. I was the only one who didn’t scream. I was paralyzed with fear."

Today their delay had a relatively benign reason. They lost time waiting at IDF checkpoints – for over two hours.

Waiting patiently for the Mobile Medical Unit in the courtyard of the small clinic are about eighty elderly men, women and children. They know the team will arrive, sooner or later, and take care of them and their ailments. They also know that Dr. Ibrahim will have little time to see them. By the time the day is finished at 1330 hours, the doctor will have seen 110 patients in 180 minutes. But, as UNRWA registered refugees in this isolated village they have no other choice and they don’t complain.

Nurse Hayam, an UNRWA-trained pharmacist who started with UNRWA in 1982, is well-prepared for the expected onslaught of patients: an array of medicines is pre-packaged in small paper bags and neatly lined up in boxes in front of her. "The requirements are always the same," she says. "Diabetes, stress-related hypertension, kidney failure. We come, we see the patients, prescribe their medications and leave, hoping we will reach home safely." When asked what she considers to be the greatest challenge of her job she states, very matter-of-factly, "Getting there".

Nurse Hayam and Dr. Ibrahim are part of an UNRWA Medical Mobile Unit which is based in the Deir Ammar refugee camp, north of Ramallah, and comes to Beit Ur every Tuesday. On Fridays they go to Ein Arik, a village south of Ramallah. The team explains that the road closures and checkpoints on roads used by Palestinians present a daily challenge to the simplest tasks, "Getting there is the greatest accomplishment of the day. Work starts after you get there, and then you are already concerned about getting home."

Mustafa Nakhleh, a vital and trusted member of the team, is the driver of UN van 772. He explains: "The road between Ramallah and Beit Ur (Route 443) is actually 17 kilometers, but when Kalandia (checkpoint) is closed we have to drive about 40 kilometers to reach there." The roundabout road goes from Ramallah to Deir Ibzieh, Kufr Na’ameh, Na’alin and Saffa up to Beit Ur. Since the start of the intifada the Medical Unit has rarely been able to keep the hours of 0730 to 1330 hours, often arriving late if they arrive at all.

Mustafa outlines some of the main problems encountered on a daily basis: the checkpoints, the UNRWA ID and the permits issued by the IDF granting passage into Israel or on the so-called ‘settler roads’ inside the West Bank. He says that with regard to the checkpoints, the fact that he is driving a clearly marked UN vehicle is of little consequence at crossing checkpoints. He maintains that if he ever tried to jump the inordinate queues at checkpoints to exercise his rights under the privileges and immunities accorded to UN staff members, the IDF would detain him.

He complains that the UN IDs don’t help either. "UNRWA issues a number of different IDs and many times the IDF maintain that my ID is fake," he says. "It causes a lot of delay before they check our IDs and let us pass."

The permits issued by the IDF to enter Israel or use ‘settler roads’ inside the West Bank are often of little use. He says, "The IDF don’t recognize their own documents and it makes no difference if we do or do not carry these permits. If the soldier at the checkpoint doesn’t want to let us pass, we just don’t pass."

"But," says Mustafa, "the delays are not our main concern. Traveling in the West Bank in a UN marked car is dangerous." He explains that while driving on ‘settler roads’ the mini-van carrying the mobile team is frequently stoned by Israeli settlers. Prior to the shooting last week in Ramallah there were two other incidents involving IDF firing shots at or in the direction of the UNRWA mini-van. "The problem is," says Mustafa, "that there is little official appreciation for the trouble UNRWA staff have to go through on a daily basis just to go to work."

During a visit with the Ramallah Area Office the week following this interview were were told that a UN mini-van was stopped at the Ein Arik checkpoint. The IDF had dug a trench at the checkpoint, filled it will oil and set it on fire. The UN staff in the mini-van had to get out and continue the journey on foot. It was the Mobile Medical Unit from Deir Ammar in UN mini-van 772.

The problems faced by the Deir Ammar Medical Mobile Unit are not unique. Throughout the West Bank, every day somewhere some UNRWA staff member, both local and international, is returned or delayed for hours at checkpoints or due to road blocks.

The time lost to UNRWA operations (including schools and clinics) due to delays or refusals at checkpoints is almost incalculable. Since the start of the intifada in September of 2000, UNRWA Operations has counted close to 31,000 man hours lost, or 4,100 working days.

Unfortunately, but perhaps inevitably, in some cases the encounters with the IDF turn more violent and even deadly, resulting in a much heavier toll than time lost waiting at checkpoints or circumventing road blocks. In the last two and a half years, four UNRWA staff members lost their lives in the conflict while carrying out their duty.

Certainly, knowledge of these ‘incidents’ are ever present on the minds of those staff members who continue working in the field day-after-day. Under these circumstances getting there absurdly becomes more important than being there.