Medical Program Brings Care to Isolated Palestinian Seniors
Three Palestinian nurses from Dar al-Kalima Wellness Center hefted a brand new mattress into the trunk of a taxi and
headed over the back roads to Shwaware, a windblown hamlet east of Bethlehem, the West Bank, where goats graze the
barren slopes between the houses.
Fatima, an octogenarian afflicted with Alzheimer's disease, lay in her room on a dirty foam rubber mat, staring at the
ceiling. She clearly was not expecting a visit from this roving Palestinian medical team. Her purple dress was soiled
and her ankles scraped from where she had stumbled barefoot on the rocks two days earlier. A walking cane was tossed
beneath her bare bed, out of reach.
But when the three nurses bustled in, Fatima sat upright and nodded at them with recognition. "Marhaba," she mumbled.
"Welcome."
The nurses donned latex gloves and got down to business -- scrubbing the walls with antiseptic and hosing out Fatima's
modest quarters. Even though folded bedding was piled high atop a cupboard, the frail widow had not hauled it down. Nor
had she touched any of the food packets left the week before. One nurse monitored Fatima's blood pressure while another
cleansed her scratches.
"I'm hungry," Fatima complained. "I can't remember when I last ate." Dehydrated, she took gulps from a bottle of water
that a nurse uncapped for her.
Two nurses placed the plastic-wrapped mattress on Fatima's newly washed bed frame, while the third helped her walk
outside to sit in the autumn sunshine.
Fatima's son and daughter-in-law, who also care for their own 10 children and a growing brood of grandchildren, arrived
in the midst of the cleaning. The son grabbed a broom and set out to help.
"You need to clean your mother's living quarters at least twice a week," the head nurse admonished.
Operating with a USAID grant, medics from Dar al-Kalima visit Fatima on a weekly basis. (Photo by Grace Bradley)The son
turned to Fatima: "Mama, maybe it's time we put you into the care of strangers," he said, but Fatima began to sob. Few
facilities for institutional care are available outside the West, and private care here is as expensive as it is rare.
The predicament of this great-grandmother is becoming increasingly common in the West Bank, where no social security
safety net exists. Dar al-Kalima clinic alone handles 17 different villages, where some 500 elderly women live by
themselves. Residential care for 25 inpatients is limited to the disabled, mostly younger patients who need urgent
physical therapy.
Long-term care for senile or infirm in-laws usually falls to Palestinian housewives. Married daughters are expected to
care for their husbands' mothers, not their own. In the strained economy of the West Bank, extended families frequently
are dispersed and curfews and travel restrictions hinder visits that could help ease the growing eldercare crisis.
George Sahhar, a documentation specialist for CARE International, which administers this rural outreach program in
Bethlehem district with a grant from the U.S. Agency for International Development (USAID), was shaken by his encounter
with Fatima.
"This is not our way. By tradition, Palestinians respect our elders," he said. "This terrible situation demonstrates the
breakdown of the family, which has been the sole social support in the absence of [a state] government. Incomes drop and
family savings are quickly depleted. The family gets stretched beyond its capacity."
Demographically, the Palestinians are overwhelmingly young; current statistics show a median age of just 18.5 years,
with 42 percent of the population under the age of 15. Yet rural home visits to the elderly have become a crucial
component of the humanitarian assistance program. In the West Bank, only about 3 percent of the population is older than
65, but many of these estimated 86,000 senior citizens are left to fend for themselves. These include patients
recovering from stroke, or coping with diabetes, fading vision or impaired hearing.
A $30 million USAID grant funds the Emergency Medical Assistance Program, a three-year project aimed at alleviating
shortages in the Palestinian health care sector. To help people who have been affected by violence and the economic and
social dislocation resulting from the Israeli-Palestinian conflict, the program, implemented by CARE International,
assists approximately 60 clinics and 12 hospitals, as well as facilities run by the Ministry of Health.
In remote areas, medics like the ones who call on Fatima make home visits to the elderly and to people with special
needs, providing them with physiotherapy and occupational therapy. They also distribute medicines, technical aid and
supplies for geriatrics.
Just as essential are the educational talks and booklets aimed at families caring for elderly relatives. "With improved
hygiene, a balanced diet and exercise, the vulnerable can live with dignity," said Ghada Zahran, public health
coordinator for Dar Al-Kalima. "Eventually we all will get older."
ENDS