I Shall Not Hate: A Gaza Doctor's Journey

by Izzeldin Abuelaish

  Most of the world has heard of the Gaza Strip. But few know what it’s like to live here, blockaded and impoverished, year after year, decade after decade, watching while promises are broken and opportunities are lost. According to the United Nations, the Gaza Strip has the highest population density in the world. The majority of its approximately 1.5 million residents are Palestinian refugees, many of whom have been living in refugee camps for decades; 80 percent of us are estimated to be living in poverty. Our schools are overcrowded, and there isn’t enough money to pave the roads or supply the hospitals.

  The eight refugee camps and the cities—Gaza City and Jabalia City—which make up Gaza, are noisy, crowded, dirty. One refugee camp, the Beach camp in western Gaza City, houses more than 81,000 people in less than one square kilometre. But still, if you listen hard enough, even in the camps you can hear the heartbeat of the Palestinian nation. People should understand that Palestinians don’t live for themselves alone. They live for each other and support each other. What I do for myself and my children, I also do for my brothers and sisters and their children. My salary is for all of my family. We are a community.

  The spirit of Gaza is in the cafés where narghile-smoking patrons discuss the latest political news; it’s in the crowded alleyways where children play; in the markets where women shop then rush back to their families; in the words of the old men shuffling along the broken streets to meet their friends, fingering their worry beads and regretting the losses of the past.

  At first glance you might think everyone is in a hurry—heads down, no eye contact as people move from place to place—but these are the gestures of angry people who have been coerced, neglected, oppressed. Thick, unrelenting oppression touches every single aspect of life in Gaza, from the graffiti on the walls of the cities and towns to the unsmiling elderly, the unemployed young men crowding the streets and the children—that December day, my own—seeking relief in play at the beach.

  This is my Gaza: Israeli gunships on the horizon, helicopters overhead, the airless smugglers’ tunnels into Egypt, UN relief trucks on the roadways, smashed buildings and corroding infrastructure. There is never enough—not enough cooking oil, not enough fresh fruit or water. Never ever enough. So easily do allegiances switch inside Gaza that it’s sometimes hard to know who is in charge, whom to hold responsible: Israel, the international community, Fatah, Hamas, the gangs, the religious fundamentalists. Most blame the Israelis, the United States, history.

  Gaza is a human time bomb in the process of imploding. All through 2008 there were warning signs that the world ignored. The election of Hamas in January 2006 increased the tension between Israelis and Palestinians, as did the sporadic firing of Qassam rockets into Israel and the sanctions imposed on Palestinians as a result by the international community.

  The rockets—homemade, most often missing their targets—spoke the language of desperation. They invited overreaction by the Israeli army and retaliatory rocket attacks from helicopter gunships that rained down death and destruction on Palestinians, often defenceless children. That in turn set the stage for more Qassam rockets—and the cycle kept repeating itself.

  As a physician, I would describe this cycle of taunting and bullying as a form of self-destructive behaviour that arises when a situation is viewed as hopeless. Everything is denied to us in Gaza. The response to each of our desires and needs is, “No.” No gas, no electricity, no exit visa. No to your children, no to life. Even the well-educated can’t cope; there are more postgraduates and university graduates per capita here in Gaza than in most places on earth, but their socio-economic life doesn’t match their education level because of poverty, closed borders, unemployment and substandard housing. People cannot survive, cannot live a normal life, and as a result extremism has been on the rise. It is psychologically natural to seek revenge in the face of relentless suffering. You can’t expect an unhealthy person to think logically. Almost everyone here has psychiatric problems of one sort or another; everyone needs rehabilitation. But no help is available to ease the tension. This para-suicidal behaviour—the launching of rockets, the suicide bombings—invites counterattacks by the Israelis and then revenge from the Gazans, which leads to an even more disproportionate response from the Israelis. And on it goes.

  More than half the people in Gaza are under the age of eighteen; that’s a lot of angry, disenfranchised young people. Teachers report behaviour problems in the schools—conduct that’s related to war and violence. Violence against women has escalated in the last ten years, as it always does during conflict. Unemployment and the related feelings of frustration and helplessness create a breed of people who are ready to take action because they feel they have nothing to lose—and worse, nothing to save.

  They’re trying to get the attention of the people outside our closed borders. Their rallying cry is, “Look over here, the level of suffering in this place has to stop.” But how can Gazans attract the attention of the international community? Even humanitarian aid organizations depend on permission from Israel to enter and leave the Gaza Strip.

  The acts of violence committed by the Palestinians are expressions of the frustration and rage of a people who feel impotent and hopeless. The primitive and cheap Qassam is actually the most expensive rocket in the world when you consider the consequences it creates on both sides of the divide.

  I’ve lived with this tension in various degrees for my whole life, and have always done my utmost to succeed despite the limits our circumstances imposed on us. I was born in the Jabalia refugee camp in Gaza in 1955, the oldest of six brothers and three sisters, and our lives were never easy. But even as a child I always had hope for a better tomorrow. Through hard work and constant striving, and the rewards that come to a believer, I became a doctor. I went to medical school in Cairo then did a diploma in obstetrics and gynecology with the Ministry of Health in Saudi Arabia in collaboration with the Institute of Obstetrics and Gynecology at the University of London. Later, beginning in June 1997, I undertook a residency in obstetrics and gynecology at Soroka hospital in Israel. Then I studied fetal medicine and genetics at the V. Buzzi hospital in Milan, Italy, and the Erasme Hospital in Brussels, Belgium, and became an infertility specialist. After that I realized that if I was going to make a larger difference for the Palestinian people, I needed management and policy-making skills, so I enrolled in a masters program in Public Health (Health Policy and Management) at Harvard University. Now I am working as a senior researcher at the Gertner Institute in the Sheba hospital in Israel. All of my adult life I have had one leg in Palestine and the other in Israel, an unusual path in this region. Whether delivering babies, helping a couple overcome infertility or researching the effect of health care on poor populations versus rich ones, or the impact on populations with access to medical help versus populations without access, I have long felt that medicine can bridge the divide between people and that doctors can be messengers of peace.

  I didn’t arrive at this conclusion lightly. I was born in a refugee camp, grew up as a refugee and have submitted myself on a weekly basis to the humiliation of checkpoints and the frustrations and endless delays that come with crossing into and out of Gaza. But I maintain that revenge and counter-revenge is suicidal, that mutual respect, equality and coexistence is the only reasonable way forward, and I firmly believe that the vast majority of people who live in this region agree with me. Even though I could feel immense trouble coming our way—an even broader threat to our sense of security than Nadia’s death—these ideas were playing on my mind as I watched my children romping in the waves.

  I chose this date—December 12—to bring them here because it followed hajj, one of the holiest days in the Islamic calendar; it was a time to reflect, to pray, to gather the family together. Hajj is the pilgrimage to Mecca that takes place between the seventh and twelfth days of the month of Dhu al-Hijjah in the Islamic calendar. This is the largest annual pilgrimage in the world; every able-bodied Muslim is required to make the trip at
least once in his or her lifetime. Whether you go to Mecca or not, Waqfat Arafat is the Islamic observance day during hajj in which pilgrims pray for forgiveness and mercy. It’s the first of the three days of Eid al-Adha that mark the end of hajj. In Mecca, pilgrims stay awake all night to pray on the hill of Arafat, the site where Muhammad delivered his last sermon. For the millions of Muslims, my family included, who do not go to Mecca each year, bowing to the Alkebla in the east, falling to your knees and praying the prayers of the believer is sufficient. On the second day we mark the Feast of Sacrifice: the most important feast of Islam. It recalls Abraham’s willingness to sacrifice his son in obedience to God, and commemorates God’s forgiveness. Everyone observes the day by wearing their finest clothing and going to the mosque for Eid prayers. Those who can afford to do so sacrifice their best domestic animals, such as a sheep or a cow, as a symbol of Abraham’s sacrifice. We observed the prayer day in Jabalia Camp with our relatives and went to the cemetery at the camp to pray for Nadia. I’d bought a sheep and had it sacrificed, donated two-thirds of the animal to the poor and needy, as is the observance, and had some of the rest of the animal made into kebabs for a barbecue at the beach to mark the final day of Eid.

  We got up early the next morning, made sandwiches and packed a picnic, and at seven a.m. we all climbed into my car—a 1986 Subaru—and set out.

  Before we got to the beach, I had another treat for my children. In early December I’d bought a small olive grove, maybe a thousand square metres in size and half a kilometre from the beach. It was like a little piece of Shangri-La, separated from the hurly-burly by a three-metre fence, a place where we could be together, a place where maybe we could build a little house one day. I’d kept it a secret until I could show them. As they tumbled out of the car, the kids were surprised and delighted with this unlikely piece of utopia on the outskirts of Gaza, with its olive trees, grapevines, fig and apricot trees. They explored every corner, marvelled at the tidy rows of trees, and happily chased each other through the undergrowth until I reminded them that there was work to be done. We all dug into the task of tidying up the place, which was a little neglected and needed weeding. Even though they had known nothing but life in the crowded confines of the Gaza Strip for most of their lives, my children—the descendants of generations of farmers—seemed at home here.

  After we had done enough work, we retreated to a small area of the grove bordered by a line of cinder blocks and shaded by an arbour of grapevines. We spread mats and made a small fire from the twigs and brush we’d cleared from the olive trees, and sat in the shade of the vines eating our falafel sandwiches and talking about the events of our family life—the loss of my wife, their mother, a change so enormous we were still, four months later, trying to come to terms with it.

  I also needed to talk to them about another significant surprise. Recently I’d been offered a chance to work at a hospital in Canada. Except for a brief stay in Saudi Arabia, where Bessan and Dalal were born, the family had never lived anywhere but Gaza. Moving to Toronto would be a monumental change, maybe even too overwhelming so soon after their mother died.

  When I told them about the opportunity, Aya said, “I want to fly, Daddy.” So I knew at least one of them was willing to leave everything behind—our home, the uncles, the aunts and cousins, the friends—and start over in a new country. Soon the others had also agreed: together we would go to Canada, not forever, but for a while. The older girls, 21-year-old Bessan, Dalal, 20, and Shatha, 17, would attend the University of Toronto; the younger ones, Mayar, 15, Aya, 14, Mohammed, 13, Raffah, 10, and Abdullah, 6, would go to public school in Canada. There would be many challenges: attending classes in English, experiencing a Canadian winter, learning about a different culture. But we would also be out of the constant tension of Gaza; they’d be safe. These eight children had seemed to be adrift, even in our home, without their mother. This change would be good for them. Together, we’d manage. I could see the excitement on their faces and my old optimism returned for the first time in months.

  After the family discussion ended and we had cleared away our meal, the kids were anxious to get to the beach. Fifteen of us—if you counted the cousins and uncles—followed the rutted path up a small hill and through a meadow that led from the olive grove to the water. We walked all together, our group changing shape every few metres as one child ran ahead and two others stopped to examine an object on the path and three girls walking together became five, arms linked. But eventually we made it to the sand.

  Despite the cool day, the children ran straight for the water, where they swam and splashed each other for hours, taking breaks to play in the sand. These children of mine—my offspring, my progeny—were the joy of my life. And they’d meant the world to Nadia.

  I’d known Nadia’s family before we were married in 1987, when she was twenty-four and I was thirty-two. It was an arranged marriage, as is the custom in our culture, but of the young women my family arranged for me to meet, Nadia seemed the most suitable. She was a quiet, intelligent woman who had studied to become a dental technician in Ramallah, on the West Bank. Our families rejoiced at our union but were not as happy when we left Gaza almost immediately after our marriage for Saudi Arabia, where I had been working as a general practitioner. Nadia, too, felt the anxiety of dislocation. Though Bessan and Dalal were born there, Nadia never adjusted to living in Saudi Arabia, never felt that she belonged. The customs were different to the ones we were used to, and she keenly felt the separation from our extended family and wanted to return home, which we eventually did in 1991.

  I travelled a lot after we settled again in Gaza—to Africa and Afghanistan for work and to Belgium and the United States for more medical training—but Nadia stayed at home with the children. We were a very traditional family, surrounded by my brothers and their families as well as my mother, who lived next door, and Nadia’s mother and father, who lived nearby. Since I had to be away quite often, both Nadia and I felt the need to be close to other family members. She never complained about my frequent absences during the twenty-two years we were married. I could never have studied at Harvard or worked for the World Health Organization in Kabul, Afghanistan, or even done my obstetrics and gynecology residency in Israel, without the support she gave me.

  It seemed surreal that she was gone. I watched my children and wondered what would become of them without their beloved mother. How does anyone come to terms with this sort of pain?

  In the weeks since Nadia died, Bessan, our first-born, my oldest daughter, had assumed the role of mother as well as older sister. It was a particular relief this day to see her dashing into the sea, the surf soaking her jeans, her laughter carried away on the wind. She was a remarkable girl, my Bessan. She was on track to graduate from the Islamic University in Gaza at the end of the academic year with a business degree. She seemed to be able to handle anything: mothering the children, taking care of the house, getting high marks at school. Since her mother died, though, she’d begun to see that exams are the easiest part, that there were other, harsher realities. It was a lot for a twenty-one-year-old to bear.

  Dalal, my second-oldest daughter, was named after my mother. She was a second-year student at the same university as Bessan, where she was studying architectural engineering. She was a quiet, studious girl, shy like most of my daughters. Her architectural drawings were remarkable to me—a sign of the precision she demanded of herself.

  Shatha was in her last year of high school and hoping to score the top marks in the class when they wrote their exams in June so she could fulfill her dream to become an engineer. The three girls were best friends and slept in the same room of our house in Jabalia City, a five-storey building that my brothers and I had built. Each of us had a floor for his family; my children and I lived on the third floor. One brother lived apart from us in a separate house. He’d had his own house in Jabalia Camp, and when we constructed the apartment building, he said he wanted to be near but in his own place. So we built an
other house for him. (My sixth brother, Noor, had become caught up in the conflict of the region, and has been missing for decades.)

  Mayar and Aya, who were in grades nine and eight, were almost painfully shy. Sometimes they even asked one of their older sisters to speak to the others for them. But they were clever girls. Mayar looked the most like her mother, and she was the top math student in her school. She entered school competitions here in Gaza and usually won. She wanted to be a doctor like me. She was the quietest of my six daughters, but she was not shy about describing the impact the strife in Gaza had on the people who live here. She once said, “When I grow up and become a mother, I want my kids to live in a reality where the word rocket is just another name for a space shuttle.”

  Aya was never far from Mayar. She was a very active, beautiful child who smiled easily and laughed a lot when she was with her sisters. She wanted to be a journalist and was very determined in her own quiet way. If she couldn’t get what she wanted from me—permission to go to visit a relative or to buy a new dress—she’d go to her mother and say, “We are the daughters of the doctor; you must give this to us.” Aya loved language, excelled in Arabic literature. She was the poet in the family.

  Raffah, my daughter with eyes as bright as stars, was an outgoing child, inquisitive, rambunctious and gleeful. She was in grade four this year.

  Mohammed was a young man of thirteen. He needed the guidance of a father, and I was worried about that because I was away four days a week, working at the Sheba hospital in Tel Aviv. He was to write the grade seven exams in June. His little brother Abdullah, in grade one, was the baby of the family. Watching him running to his sisters on the beach, kicking up the sand as he bounded over the dunes, I felt a special pain for this motherless boy: how much would he remember her?