|
Johns Hopkins University’s School of Public Health surveyed nutritional levels, availability of food in the markets, and household consumption on the West Bank and the Gaza Strip back in 2002, funded by USAID. The results said that chronic malnutrition in kids under five reached emergency levels then. That was two years ago.
As Peter Hansen – commissioner-general of the United Nations Relief and Works Agency – put it: “The stark fact is that 22 percent of the Palestinian children are suffering from acute or chronic malnutrition for purely man-made reasons. No drought has hit Gaza and the West Bank, no crops have failed and the shops are often full of food. But the failure of the peace process and the destruction of the economy by Israel’s closure policy have had the effect of a terrible natural disaster.
“Nursing and pregnant mothers too are suffering. On an average, they consume 15-20 percent fewer calories per day than they did before the outbreak of strife in 2000. The consequent anemia, low folic acid intake and lack of proteins threaten both their health and the normal development of their children.”
The report credited the Israeli-imposed road closures, checkpoints and curfews for trapping Palestinians in a dismal economic situation. Men can’t get to work, inside Israel or in Palestine. Women can’t get to markets. There is a shortage of fresh meat and dairy products – which most people can’t afford anyway.
In Gaza, 41.3 percent of families said they were selling assets in order to have money for food. Again, in 2002, the Palestinian Central Bureau of Statistics reported that more than two-thirds of Palestinian families were living on less than $1.90 a day.
That was then; this is now.
Which is why Sabah is looking for protein-rich meat alternatives; lack of protein causes malnutrition and anemia.
She tries to reduce starches, first. When families can’t afford meat, they stock up on rice, bread, potatoes. It’s filling. But Sabah pushes lentils. They are cheap and full of protein. Lentils can be turned into soup or served as a main dish. She wants new mothers eating vegetables and taking clinic-provided vitamins. “When the mother eats well,” she says, “the baby will be healthy.”
As Sabah is talking, 26-year-old Itaf Scafi walks into the clinic, bundled up in an ankle-length tan overcoat, a scarf about her neck and head. She is the mother of several children; her youngest child is two. She was already pregnant with her last child when the Intifada broke out. She never imagined anything like this. Her mother, Hitam Abu-Sacra, 45, with her.
The mother speaks first. “Yes, it’s been a difficult six months. Sometimes her husband can get bottled milk. Sometimes not,” she says, her voice escalating. “If I have money, I give it to her. We all have this same condition.
“Or, I go and try to get money from a friend or a neighbor … Whatever we can do, we do it.”
Scafi speaks up. It’s been awful, really. She lives close to the settlements that ring Gaza. There’s shelling every night. The kids scream. There is no way to hide the family’s predicament when the bombs start falling. Her entire family sleeps now in one room. Friends don’t bother to visit; it is too risky. And yes, when she gets tense, she has trouble breast-feeding. As does a friend.
Trying to talk women into taking food supplements and cooking with lentils is the easy part.
Daily catastrophes in Gaza City are harder to control.
“This is our situation,” says Abu-Hussain, who lives here, too. “We suffer from anxiety, fear. Every one of us. We don’t know what will happen next, where they will bomb. Maybe it will be us. Maybe our relatives, our neighbors …
“If you don’t feel safe yourself, how do you give safety to your child? How can you give what you’ve lost? This is a hard situation for us,” she says, adding that she talks with most of her patients as friends, listening to their sorrows, recognizing in them her own.
Then she starts the litany of what life is like.
Since the job market bottomed out, there’s no money. So men move their young families back home with older parents. Sometimes several sons and their wives and their children do the same. All in one tiny house. It is crowded. There are too many children. Other people’s kids get on your nerves. There is no privacy. Few breaks. Only a few people work – or still have savings left – and they have to help all of their brothers and sisters. A husband is humiliated by taking a handout from his brother. But he doesn’t have a choice. The mother-in-law is nagging. There isn’t enough food, ever.
 Esma Abu-Hussain on life in Gaza
(Requires Windows Media Player 7.0)
And, of course, there is the shelling. It is virtually non-stop at night. Heavily armed soldiers break into houses, pulling men and boys out in the street yelling questions, poking them with assault rifles, or, hauling them away in jeeps, without bothering to leave a forwarding address or explain why they’ve been taken. They can be held without charges for up to six months, and that sentence can be renewed if a senior officer testifies that they are suspicious.
She stops talking. “So, she’s nervous,” she says, meaning her patients. And herself.
Abu-Hussain thinks a moment and then goes on: “Every little girl wants to grow up, get married and have babies. Care for them. Nurse them. Give them love …
“If she loses that ability – her job in life – how does she feel?”
Anemia isn’t new in nursing mothers. Not in Gaza. Women here marry young. And they have lots of babies. When they start young and have little time between births, anemia is hardly rare. Top that off with poverty and a lack of education, and you have Gaza of the last few decades.
Losing the ability to nurse takes more than that.
When her patients come into the tiny clinic – from 7 a.m. to 11:30 a.m. weekdays – Abu-Hussain listens, soothes – and pushes. She talks nutrition. She tells mothers who are able to buy formula to be sure to boil the water before mixing it. Gaza’s water supply isn’t the safest; in fact, it is full of salt. She encourages formula only as a last resort.
If a woman is upset because her milk won’t flow – and using a formula substitute isn’t financially possible -- Abu-Hussain tries another tactic. She tells her to sit quietly, cradling her baby, to make eye contact, to try to relax.
She keeps her voice soft. But her instructions are direct.
“You must try to do it,” she says. “There is no choice. We must live in this situation … so you must try.”
|
