About The Project

My diabetic grandmother died trying to get from Bethlehem to the hospital; there were no ambulances, and she had developed fatal complications due to poor diabetes education, restrictions on movement, and the stressful political situation.

Diabetes is one of the leading contributors to disability and death in Palestine. I am intent on doing something about this. During my recent visit to the West Bank, I identified the staggering dimensions of the problem and some key difficulties in treatment delivery and education. My purpose is to narrow the gap between the established clinics' effectiveness in providing care and information, and the community's need for health services. Consequently, I am proposing to establish "micro-clinics" composed of small groups of diabetic patients meeting in designated houses or businesses for the purpose of diabetes monitoring and education. The micro-clinics will be vehicles of empowerment that utilize community support and create public ownership, so that the affected population can move toward improving health care in their communities, despite unfavorable circumstances. To encourage participation, the micro-clinics will form a partnership between diabetic patients, university students, academics, medical practitioners and members of the community.

The Palestinian population is plagued by diabetes and uneducated as to its real causes, effects and proper treatment. The tense political situation only serves to exacerbate the problem. These observations are supported by the World Health Organization's assertion that the diabetes epidemic causes greater mortality in the world each year than the 3 million annual deaths caused by AIDS. According to the WHO, the per capita death toll from the disease is highest in the Middle East and parts of the Pacific, with "more than one in four deaths in the 35-64 age range attributed to diabetes." The World Diabetes Foundation reported that 7 to 10 percent of the population in Palestine is affected by the disease; another 40 percent of women and 20 percent of men are obese and at high risk. Furthermore, those who can afford health care have become dependent on medication rather than addressing the fundamental issues: a healthy diet, sufficient exercise and regular monitoring of blood sugar levels.

My desire to start this project is based upon my observation that many Palestinians do not have the resources or education to purchase personal glucose monitoring systems like those widely used in America and Europe. The importance of these machines cannot be overestimated; they are the diabetic's first line of defense against the noxious effects of elevated blood sugar levels on virtually every organ and bodily function. In addition to lectures and workshops, The Diabetes Micro-Clinic Project will provide shared access to these monitors - in essence, creating mini-labs in diabetics' homes and businesses. The intention of my project is to show that innovative community development projects like the establishment of micro-clinics in economically depressed Palestinian cities can help the affected population to transcend the barriers of poverty and facilitate the prevention and control of deadly diseases. The clinics will create a public domain whereby people can obtain education and treatment for a basic life and death issue. If successful, The Diabetes Micro-Clinic Project could become a model for future health care delivery systems in underdeveloped, conflict-ridden areas - vehicles for screening and disseminating health care information to the population and for monitoring blood pressure, cholesterol levels and other health indicators using new technologies.

Dispatch 1

BETHLEHEM – Today I traveled to Tel Aviv – a very different experience than flying to Chicago or Paris; everyone on the flight seemed edgy, cautiously analyzing each other. I sat next to an Israeli man who was very curious to know why I was traveling to the Middle East, and asked me a plethora of personal questions. Although his style of conversation – or questioning – was a bit uncomfortable, I found him to be interesting. He told me about his family, his job as a Microsoft employee in Israel, and his origins in Paris. Among other things, we discussed ethical questions pertaining to the Microsoft Corporation.

As we exited the plane, I saw an Arab man, who was holding an Egyptian passport, being greeted by three Israeli security personnel, but I did not see what the problem was about. I passed through customs with relative ease, took a taxi from the airport to Jerusalem, and then from Jerusalem to Bethlehem. Although in the past, I would have been required to walk across a checkpoint or two to get to Bethlehem, the taxi driver was able to drive through, albeit with a slight detour, without even being stopped by the soldiers when we crossed the checkpoint. The trip, which was only a few miles, took about an hour and 15 minutes because the driver punctured his tire on the poorly paved road, and then made matters worse by attempting to drive away with the car still on the jack!

On the way to Bethlehem, we drove along the West Bank Wall, a barrier comprised of massive concrete partitions in some places and wire fences and ditches in others, which has been erected by the Israeli government for security purposes. Most Palestinians and some Israelis, however, see it as ineffective and a source of severe hardship on the Palestinian population. On the Palestinian side where I passed, the Wall's smooth concrete surface is painted with various murals ranging from depictions of suffering Palestinians and protest slogans to tropical scenes with palm trees and sandy beaches.

When I arrived in Bethlehem that night, I was invited to eat dinner, but by the time the tire was fixed and we had dropped the other passengers off, it was 11:30. I ended up eating a very late but delicious dinner, and then went to bed. The next morning I woke up and ate a large breakfast consisting of homemade falafel and hummus, cucumbers, a tomato-garlic spread, bread, tea, olives, cheese and yogurt dip. Then, I had a rather large lunch: m'jeddera (rice and lentils) with yogurt, salata (tomatoes, parsley, and red and green peppers) and pickles.

But a family friend invited me over to eat just an hour later, and his mom insisted that I needed to gain weight. According to her, if I stayed with her for two months, I would gain a "healthy" 20 pounds. The food was delicious – tender baby goat's meat with rice, and yogurt soup. However, because of what she considered my "starving" appearance, the enormous servings were simply not enough. I was then asked to eat assorted fruits, vegetables, then chocolate, and then more fruit, then more chocolate, ice cream and, finally, fresh Arabic coffee. Needless to say, by the time coffee was served, I could barely move. And the worst part of it was that I insulted the cook by not eating all of my food!

Dispatch 2

	View of an outdoor market in Bethlehem
Location, location, location: Bethlehem's Manger Square a good place to spread the word about the diabetes micro-clinic project

BETHLEHEM – The weather in Bethlehem is very hot; however, most men here do not wear shorts, so it's hard to dress comfortably without looking like a foreigner.

Today, I went to the D'heisheh Refugee Camp to meet with the doctors and nurses I will be working with to implement the Diabetes Micro-Clinic Project. D'heisheh is a community of about 10,000 individuals living in high density housing with shops and other permanent fixtures – essentially a small city. I visited a cultural center, which is the base for a variety of community outreach programs, including a well-established health program.

In planning for my project, I have been running around the Bethlehem area, meeting with doctors, nurses and directors while trying to secure the location and supplies for the project. This has not been an easy task as things have not been going quite as I planned. First of all, the people I had contacted regarding the purchase of glucose monitoring systems changed the price, so I have had to negotiate a deal with another supplier. I am also concerned that the monitoring systems will not be delivered in time for the project, or only some of the supplies will arrive. Secondly, I was informed that some of the speakers I lined up will not be able to attend. This put me in a little bit of a bind because I had planned on those speakers to cover major topics, but thankfully, I have been able to secure other well-qualified people to fill in.

Another obstacle I am facing is how to publicize the project. On the one hand, I cannot invite the whole Bethlehem area because we have limited supplies, personnel and facilities. But, on the other hand, I do want a significant number of people to show up and benefit from the project. I have decided that to make the project more successful, I will have announcements printed, and the volunteers and I will personally distribute them in the local area. I have been advised that this is the best way to control the amount of participants who will attend while still ensuring a good showing. I have also been going to local medical organizations and NGOs to recruit volunteers to help with the project. I have received many "Yes, we will come," answers, but only time will tell if they really will come. Because I have never worked with most of the volunteers before, I have no way of knowing if they are dependable. I have no choice other than to trust that most of them will show up.

Despite all of these setbacks, I am very encouraged that I was able to secure an auditorium and meeting area at the Bethlehem Peace Center, a newly constructed white stone building with a 150-seat auditorium, art gallery, and conference rooms. The center is centrally located in Manger Square along with the historic Church of the Nativity, Bethlehem Municipality, post office and other important buildings. I especially wanted to use the center because of its prominent location, its professional atmosphere, and reputation in the community.

On a different note, as I travel around planning my project, I have been able to understand the severe economic deprivation of the Palestinians. As I was walking in Manger Square today, little boys who looked anemic and malnourished were begging for shekels from tourists, and still others were trying to sell gum, postcards and other small items. The problem is that if you buy from one, 15 other boys will insistently ask you to buy from them. It is really an awkward situation to be in. Also, whenever I go to take a cab for a short distance, the taxi drivers fight over my fare, which is approximately $3.

I also have observed the clear spatial differences between the Palestinian areas and the neighboring Israeli settlements, which are built in highly-planned clusters and offer a much higher standard of living compared to the Palestinian homes just a short distance away. Many of the Palestinians I spoke with see these settlements as a further encroachment on their land because the settlements exist on or could expand to include land formerly belonging to Palestinians. However, many Palestinians work inside of these settlements, often illegally, because of the scarcity of jobs in the area.

Despite all of the hustle and bustle, I am having a great time and learning new things every day. For instance, today I learned that pedestrians do not have the right of way in Bethlehem. It is sufficient to say that when you walk down the narrow stone streets in Bethlehem and hear a car coming, you had better hug a wall or duck into a doorway. Cars do not stop for pedestrians, there are hardly any traffic signs, and the preferred mode of communication with pedestrians is a toot of the horn. I think that I will use a bit more caution in the future so that my next dispatch will not be from a hospital!

Dispatch 3

	The meeting that launches the Diabetes Micro-Clinic Project
Motivated by memories of a grandmother, organizing the first of a planned 30 diabetes micro-clinics

BETHLEHEM – After months of preparation, today is the big day, when I will officially start the Diabetes Micro-Clinic Project. I am thinking about what I would like to say to introduce the project; I want to come across as a person genuinely interested in improving the situation, not as a young college student with some wild idea. Most of the participants who will attend are living in the Bethlehem area and come from varying backgrounds; many but not all are suffering from diabetes.

I get up early and go with my friend Samir to pick up the supplies. Samir, a great help to me, is a recent graduate of Bethlehem University. Like many other educated Palestinian young people in search of a job now that he has finished his degree, his prospects do not look hopeful.

I am able to pick up the glucose machines, but I am still missing the needles. Without them, we cannot measure the blood sugar levels. The man I bought the machines from promised that he would have them for me today at 8 a.m., but he didn't show up on time. After finally obtaining the needles and expressing my disapproval about the delay, which was a breach of our agreement, I go to a few more shops to pick up some last-minute supplies and head off to the Peace Center. Most of the nurses, lecturers and volunteers are there early to rehearse the presentation. Knowing that people would arrive late, I had announced that it would start at 9:45 instead of 10 a.m. I soon realize that I should have scheduled the start time one half hour before, as people trickle in and slowly fill up the auditorium during the first 15 minutes of the program.

To publicize the project, I had distributed about 350 announcements through personal interactions along with the help of local NGOs, health organizations and youth volunteers. The project is organized as follows: Participants attend a series of lectures covering critical topics (i.e. diet, exercise, causes and prevention of diabetes), then participants form smaller groups of 20-30 and attend workshops, where they learn how to use a personal glucose monitoring system and have their blood sugar measured. Lastly, those who have elevated blood sugar levels and agree to form small groups of no more than six individuals will receive a machine to share. These groups will become the "micro-clinics" and meet in homes or business, allowing their members to gain shared access to monitoring and group support. I intend to establish 30 micro-clinics in the Bethlehem area.

Before starting the program, I speak to the audience and describe the project. First, I tell them about my personal motivation for the project – how my grandmother, a Palestinian woman, died from diabetic complications, restrictions on movement, and poor health care education, and also that I have noticed the ways in which many Palestinians continue to similarly suffer. I then describe the structure of the project and what we are trying to accomplish through its implementation. Above all, I emphasize the importance of using the information gained from today's lectures and workshops, coupled with support from each other, to help them control and prevent diabetes and other complications in the future.

During the lectures, which are delivered by three women – two nurses and one faculty member from Bethlehem University – I observe that the project participants do not simply want to sit and learn; they want to interact with the speakers and each other. As they listen to the lectures, some express their agreements or disagreements with what is being said while others pose important questions. One man, dressed in a traditional Palestinian headdress and wanting to be polite, gets out of his seat and walks up on stage to deliver a note to the lecturer, providing an explanation of another participant's dietary question.

OParticipants having their blood sugar levels tested

After the lectures, we have a short break and then separate the participants into smaller groups in two different halls. The lecturers and nurses help to measure the blood sugar levels of every participant using the machines; many people have dangerously high blood sugar levels – some even above 300. Since we had asked all participants to eat before coming (approximately two hours before being tested), anything above 140 is considered high. These elevated blood sugar levels can be lethal and often result in the loss of limbs or eyesight and lead to other permanent health problems. The other volunteers, mostly young women from the university, then document the blood sugar levels. They also ask participants to provide us with their contact information so that we can make home visits to the micro-clinics and distribute the machines according to the guidelines of the project. We are very careful not to promise the machines to anyone beforehand, but people still demand that they receive one – even if they openly acknowledge that they do not have a problem.

For me, this momentary chaos clearly reflects the desperate economic condition of the Palestinians that I have written about in previous dispatches.

All in all, I feel that the project is off to a good start and that we are meeting a great need; the test results only confirm my worst fears about the dire health situation of the population. Not only do official statistics from the World Health Organization confirm the severity of the issue, but local doctors and nurses have also described to me the problems which have contributed to the diabetes epidemic in Palestine. They told me that the problem stems from a lack of proper education, for both health care professionals and the general population, poor dietary habits and the stressful political situation.

It is now several days since starting the project. Based on data obtained from workshops held after the lectures at the Peace Center, I have now begun to distribute machines to a few home micro-clinics. During the home visits, I am noticing that many people's readings are still dangerously high. One man I visited attributes his high sugar levels to the arguilla, or waterpipe, which he smokes. I am aware that smoking can have other negative side-effects on diabetic individuals, but I wonder if the fruit-flavored tobacco in the arguilla can introduce sugar into the system.

*

When I am not working on the diabetes project, I have been socializing with different types of people and trying to visit new places. I have found that some of the most intriguing places to meet people are the small shops in Bethlehem. There are three shops that sell household items that are near where I am staying, down the street from Manger Square. The problem is that I was introduced to all three of the owners, and so if I go to one, I feel awkward about walking past the others who sit outside their stores and ask why I did not buy from them. Today, I visited the shop of Abu Mohammed, and he gave me a free falafel (I think as an incentive to return). He also sells water more cheaply than the others. Abu Ahmed is the most pensive of the three. He is an older man in his late sixties with short gray hair slightly visible behind a headdress. His tan, wrinkled face is highlighted by the bright white dress he wears daily. As someone who knows my family and wants my business, he always greets me with a kiss. But his sorrowful eyes reveal his pain over recently losing his 16-year-old son to a bullet as he was throwing stones at Israeli soldiers. Having recently been told the story of his death, I now know why there are pictures of a handsome young man posted all over the walls of the neighboring houses. When these children die, they are called martyrs, and their pictures are subsequently placed on a poster and plastered on buildings all over town. Sadly, the walls in Bethlehem and the neighboring cities are covered with these posters.

I hope a time will come when there are clean walls in Palestine.

Dispatch 4

	Palestinian day laborers being detained as they return to the West Bank from Israel
Gunshots in Bethlehem, body searches in Jerusalem, homeland security on steroids

BETHLEHEM – After staying up late working on e-mails, I was about to fall asleep when I heard gunshots and explosions at 1 a.m. I thought for a minute that they were just fireworks, as there have been many late night wedding parties nearby (this is wedding season), but I soon realized they were the sounds of the Israeli Defense Force (IDF) and Palestinians exchanging gunfire.

From the newspapers and conversations the next morning, I learned that the conflict took place down the street from where I am staying and was an IDF operation meant to apprehend some wanted men. Apparently, there were about 20-25 armed Jeeps which came and surrounded the house(s), and arrested about 15 men. I read in the Israeli newspapers today that Israel is cracking down on the Islamic Jihad because it claims the organization is not respecting the ceasefire. This is, of course, seen by many Palestinians as yet another heavy-handed provocation. The IDF has already arrested 50 members in the West Bank; these men were probably part of that number.

I have also observed tensions inside of Israel. As I was traveling to Jerusalem through one of the many bypass roads (only for the use of Israelis and foreigners), I saw about 30 men being detained. They were Palestinians who had sneaked into Israel to find work, and on their way back were detained at the checkpoint. This is quite a serious problem for them, as I was told that many Palestinians who have been caught in the past have been permanently blacklisted; their names were recorded and further restrictions were put on their movements. Many Palestinians depend on this illegal form of employment in order to put food on the table.

I feel sort of uncomfortable about traveling freely as an American, usually without any problems, while some of the people I have worked with in Bethlehem have not been able to leave the Bethlehem area for years, even to travel to other Palestinian cities. One lady from Bethlehem named Rima asked me which is better— America or Palestine; I responded that both are nice places and have their own benefits and problems. Rima is a stay-at-home mom in her 30s with a good sense of humor. I usually get asked this a lot, so this time I returned the question and asked her what she thinks of Palestine; she responded that it is like a big prison. Rima explained that she has not been in Ramallah, a nearby Palestinian city, in eight years, nor in Jerusalem for five years. One young man named George explained to me how his family had visited a church in Jerusalem every Easter, but now he and his wife and baby must sneak over the borders to celebrate with their friends and family. Needless to say, if they were caught, they would be in big trouble. I got to thinking how I get sick of Berkeley if I do not leave for a month, and Bethlehem is not nearly as exciting as Berkeley. What would I do if I could not leave for eight years? In Bethlehem, there are hardly any unpolluted open spaces to walk; many people do not have adequate homes and live in poverty; there are often violent crimes, and the automobile congestion is atrocious. Wait! Maybe Bethlehem is like Berkeley!

Whenever I visit Jerusalem (some five miles from Bethlehem), I am awed by the beauty of the city. Unlike Bethlehem, a city continuously existing under conditions of instability and occupation, Jerusalem is maintained by a functioning Israeli government that keeps it sparkling clean. The sun scintillates off of the Jerusalem limestone, and the walls of the Old City are a sight to behold. In other sections of Jerusalem, there are shopping malls and every other modern amenity available in the United States.

But … you cannot go anywhere without being searched. It's like homeland security on steroids! Just the same, from my point of view, these security measures are not really effective. For instance, before entering an underground parking lot in the Canyon Shopping Mall (one like you might find in America), the security guards check your car inside and out. In reality, if someone really had bad intentions, they would just drive right through the mini-checkpoint, and the security guards could do very little to stop them. I observed another example of a useless checkpoint in Jerusalem; many Palestinians bypass the checkpoint and IDF soldiers by walking up a parallel street without being stopped or questioned. I suspect that the IDF is not that careless, which leads me to believe that the checkpoints are often more of a symbolic gesture than a practical one. I am convinced that if someone wants to come into Israel to do damage, they will do so regardless of checkpoints and walls. When you enter movie theaters, restaurants and other public spaces, even hospitals, you must go through a metal detector. Jokingly, I told my cab driver, Khalid, that pretty soon searches will be required before entering the restrooms. He looked at me very seriously and said, "That's no joke!" I wonder if we are getting to the point where we will live like this even in the United States. I hope we can understand, before it's too late, that peace, justice and security go hand in hand.

Khalid, a tall, Arab-Israeli taxi-driver wearing an Andre Agassi-type haircut, told me that he is studying to be an electrical engineer and is trying to save enough money to pay for his final year at the university. When I asked him about the conflict, he replied, after releasing a plume of L&M brand cigarette smoke, that he hopes it will get better but that, like many, he remains skeptical. He then changed the subject and laughed as he told me how he and many other Arab-Israelis are fluent in Hebrew, and because of similar physical appearances, they pretend that they are Arab when they have Arab patrons, and Jewish when they have Jewish patrons. He even has a Jewish name that he uses for his Jewish patrons, or if he wants to go to a party. For me, Khalid is a perfect example of how the differences between Jews and Arabs are not very clear – the "irresolvable" differences are manufactured within people's minds, and it is this imagination that is translated into a horrible reality.

Panoramic view of Jerusalem from the Mt. of Olives

Dispatch 5

	At the D'heisheh Refugee Camp, Palestians attend a diabetes micro-clinic meeting
The D'heisheh Refugee Camp, high blood sugar levels, cigarettes and police

BETHLEHEM – I head over to the D'heisheh Refugee Camp late in the evening to meet with some doctors and nurses in the Ib'da Cultural Center to discuss the project. As I come near the entrance, we pass some dumpsters with U.N. markings that are absolutely the worst things I've ever smelled in my life. Some stray cats are scrounging around in them for food. To make matters worse, I have my window open in the car, and there is sewage water on the street. As we're driving, some of the water splashes through the window and hits my face. As soon as we arrive at the center, I hurry to the bathroom and wash my face with soap and water, thinking about the poor people who actually have to live in such conditions.

The center is a four-story, recently constructed building with dormitories, meeting rooms, an auditorium and a restaurant on the fourth floor. After entering, you are immediately in the stairwell, which is completely painted with murals all the way up to the fourth floor. The murals depict images of a young Palestinian fighter slinging a Molotov cocktail, a group of tents with important dates on them to symbolize the creation of the Palestinian refugees, and Palestinians engaged in traditional dances.

When I enter the restaurant, I am greeted by some of the nurses and doctors that will be helping tomorrow. We talk about the project and make some last-minute adjustments to the program, and then socialize for about half an hour. One of things we discuss is whether or not to change the program from the earlier Bethelehem project session, and ask people to come fasting, not having eaten breakfast. We ultimately decide to invite the people fasting, but we move the start time of the project to 8 a.m., so that they can go home and eat after the program.

As I am getting ready to leave, a college-aged boy named Abdullah starts to talk with me. Apparently, he has taken a liking to me, as every time I see him, he always comes and greets me. He is about 5'10," with a dark complexion, wearing his long black hair in a barrette and bearing a real similarity to the picture of Marxist Revolutionary Che Guevara that he wears around his neck. I get asked the question about which is better – America or Palestine – maybe for the fiftieth time. Again, I try to answer diplomatically by saying that both are nice places in different ways. I explain that in Palestine, there may not be the most modern buildings and large attractions that the mega-cities of the U.S. have to offer, and that living under occupation is certainly not the most favorable of circumstances. However, I point out that the most attractive aspect about living in Palestine is the warm hospitality of Palestinians towards each other and strangers, and the close family structure, which is an integral part of Palestinian society. I explain that in the United States, it is very common for both parents to work full-time, and for relatives to live clear across the country and not see each other for years on end. In contrast, the Palestinian family lives in the same town, sometimes even in the same building, and a close family structure is valued not only for support in raising children, but also for creating a strong family presence in the community.

After chatting for a few minutes more, I leave the center in the dark. My driver and I take a ride through the camp at night, coincidentally behind one of the new Palestinian police cars. They are brand new Volkswagen Jettas, painted baby blue with flashing blue lights on top. They always drive around with their lights on, whether there is an emergency or not, to establish their presence (I think). Most Palestinians do not pay much attention to the police because they have been living without a strong police force and government presence for many years, some Palestinians see them as untrained and unskilled, and still others see them as corrupt.

The houses in the D'heisheh Refugee Camp are made from hurriedly-constructed concrete and stone walls and are far enough from each other to allow only space for one car to pass. The streets are dirty from cars and discarded food from street vendors' carts. People are still meandering along the streets and make way for us as we drive. It's really like a maze. We have to ask a few people how to get out of the camp, and they tell us to keep going straight until we finally exit.

THE NEXT MORNING:

I wake up at 7 a.m., get dressed, put the supplies in the car and head back over to D'heisheh. We had arranged for the health committee members at the cultural center to use their list of already diagnosed diabetics or at-risk patients in inviting people to attend. I thought it would be interesting to compare the Bethlehem project, where we announced that both diabetics and non-diabetics could attend, and this project, which targets at-risk and previously diagnosed diabetics.

Unlike the Bethlehem participants, most people arrive on time and sit in the waiting area. We call them into rooms where we have our testing stations, and they are each tested by the volunteer nurses. Although I have done a few demonstrations of the machines the day before, some of the volunteers still have some trouble, but are quickly helped by their colleagues. Using the monitors, the nurses show each participant how to use them and take everyone's blood sugar levels. After each person's reading is recorded, they are asked to go upstairs and wait in the auditorium. Having scanned the list of names, it is very clear that these diabetics, like many others I've encountered, are not managing their diabetes properly. They have very high readings.

The nurses, knowing each patient's type of diabetes and conditions, give them some insulin obtained from UNRWA (United Nations Relief and Works Agency for Palestine Refugees). The nurses then serve the participants some wheat bread and tea with no sugar. Most of the participants are women in traditional Palestinian embroidered dress, wearing white headscarves or hijabs. There are a few men and three children.

After the food break, I again speak to the audience, telling them about my motivation for starting the Micro-Clinic Project and its main purpose. I then yield the floor to the five speakers; they cover diabetes-related topics, like causes and effects, management and treatment, care and complications, and diet and exercise. Again, as in the Bethlehem project, people are not satisfied to listen; they have many questions and enjoy interacting with the speakers.

During the lectures, some of the men in the audience start smoking – a habit which is not good for anyone, especially diabetics. Despite my mentioning the problem to some of the volunteers, it is impossible for us to do anything about it. When I visit people's homes, I feel asphyxiated from the constant smoking of the men; sadly, many are holding their babies as well. But everyone here sees it as absolutely normal, and they think I'm crazy when I tell them that, in California, we cannot even smoke within 15 feet of some buildings. Perhaps the next Micro-Clinic Project will be about smoking!

After the lectures finish, we thank the participants for coming and tell them that we will be in contact with some of them later in the week. We do not promise machines, because the center will become swamped with requests. The nurses and I meet upstairs in the restaurant to look at the results from the testing. From this data, we will make our decisions about how to form the groups and distribute the machines in the micro-clinics later in the week. We decide that Type 1 diabetics and children will have priority. We have also obtained some information as to who already has access to machines.

I then take a walking tour of the camp with the doctor and nurses and visit some of the center's facilities, including an unfinished building that will house a new health care center. According to the volunteers, this facility is critical to the well-being of the community. It will provide preventative measures, as opposed to the medicine distribution practice of the UNRWA. Furthermore, one doctor explained that an average doctor in the UNRWA sees about 170 patients a day, and therefore cannot do much other than hand out medicine.

As we end the tour, the volunteers thank me for the project, and I thank them for all of their hard work and effort which made the day a huge success. They tell me this was the first time they had ever done an educational outreach program for a large group of people. I anticipate that in the coming days we will be able to start distributing the machines and establish many new micro-clinics in the camp.

Dispatch 6

	Bethlehem.
Diabetes as stigma, grades as humiliation, and security as a slippery slope

BETHLEHEM – I am keeping busy distributing machines to each micro-clinic, which consists of a small group of diabetics meeting in a home or business. For many of the participants in Bethlehem, I distribute the machines by actually visiting the groups of diabetic patients in their meeting places.

In one micro-clinic, a volunteer helper and I are greeted by a very nice older woman in her sixties who is very grateful to receive the machine and will be sharing it with her neighbors. She lives in an old stone house with an arched ceiling and well-worn furniture, and in her living room her husband lies in a bed that he has not left for 15 years. His body has completely atrophied so that his neck hangs off the pillow. But despite his condition, he still asks what we are doing inside his home. His wife was diagnosed with diabetes two years ago and has been complaining about a loss of vision and problems with her legs – both are symptoms of diabetes complications. After a test shows her sugar at 221 (it was this high even though she had previously taken some medicine), I explain that the sugar in her body is acting like a poison and is destroying her bodily functions. I tell her that by keeping her blood sugar levels under control, she will save her vision and her legs, and avoid the tremendous cost and grief associated with such complications.

As the conversation strays away from diabetes, again I get asked the question as to whether Palestine or America is better. Again, I give the prepared answer about the advantages and disadvantages of each, having answered the question so many times before. I am also instructed to marry a girl from Bethlehem. This mother is pretty low key; some others have told me about how their nieces or daughters are doing great in school and are wonderful girls. I find that the best way to deal with such comments is with the words inshalla, or "God willing." This way, I do not insult people by saying no, but it leaves the possibility open that maybe God is not willing. This expression also works if someone invites you to his house and you know you don't really have time to go, or for hopeful statements about the future such as "inshalla I will finish high school next year."

Having visited another micro-clinic, I am thanked profusely by the participants, who insist that I finish my hand-squeezed lemonade and who are not insulted when I tell them it is too sweet for them – a possible indication that the message is getting through. After a few more comments, I get up to leave and see the hostess's son testing his crippled father's blood sugar – a very encouraging sign. Then, his mother brings out a hand-carved piece of olive wood, which her relatives and many other Bethlehemites sell. I immediately refuse the gift and explain that this is a project for school, and that I really would not feel right about accepting a gift. But with her and her neighbors surrounding me and insistently pushing it toward me, I looked helplessly at my friend, and finally relent. She says she wants me to know that she is generous. But as I say goodbye for the third time now, she says to her friends that I look skinny. It's funny that I still get this a lot here, and I'm starting to wonder if I have been starving myself for years. She tells me to wait and disappears into the kitchen. Knowing what she is doing, I try to excuse myself, but the other ladies will not let me go. She returns with 20 fresh eggs in a plastic bag. Again, this time trying not to laugh, I refuse the eggs, but then figure that it is no use. And besides, if I stay any longer, resisting, who knows what will be next? She and her son then insist on walking with us down the dirt path and steps that lead to the main road. Although I know her leg must be hurting, I'm glad she gets a chance to walk as it will help to lower her sugar before she sleeps. I leave her home humbled by her generous spirit yet saddened at seeing another group of Palestinians suffering from diabetes and the terrible economic situation.

I have been observing that some of the people I visit have "nurses" in their families – nurses in the sense that they work as health care professionals or that they are simply caregivers who have learned how to do simple tasks related to health care. I find these nurses to be a very interesting development in the micro-clinic model, as now not only will homes and businesses become health-care facilities, but a family member or friend can help "staff" the micro-clinics as a volunteer. In other cases, I have sought the help of youth volunteers, most often a granddaughter, son or other relatives of the micro-clinic participants, to watch as I test the blood sugar. I see the low volume of requests for further assistance as an indication of the success of the model in training these volunteer staff members. So far, I have received only one repeat call to help a micro-clinic learn again how to use the machine. However, I recall that a blind woman's grandson was present when I visited and delivered that machine, so I will find out whether he can remember how to test. This group participation and staff support is essential, as often the diabetics I have been dealing with find it hard to work the machines themselves.

Dispatch 7

	The vibrant and relatively modern city of Ramallah
The 'Israeli' shirt incident, the good life in Ramallah, a neighborhood in the path of the 'Wall', and a moody soldier

BETHLEHEM – I have been working closely with the nurses that helped with the D'heisheh Project. We have finished compiling from our data gathered at the Micro-Clinic Project in D'heisheh a list of the people who will form another 20 micro-clinics in the refugee camp, bringing the total number of clinics in Palestine up to 50.

I have also decided to try something new. I would like to invite the 20 groups from D'heisheh to come to the Ib'da Community Center, and there we will show them how to use the machines, and then give them out. Though I prefer visiting the homes or businesses where the micro-clinics will be located, I want to try a new method of distribution, partly because making house visits has been quite demanding, and I am not as familiar with the refugee camp as I am with the Bethlehem area. Unlike the Bethlehem Project, the D'heisheh Project also has the advantage of easy access to health committee volunteers at the center. In Bethlehem, we refer the diabetics to the Ministry of Health and other similar health organizations, but I feel the D'heisheh center is more accessible.

When I do distribute the machines to the people, I am surprised at how calm and collected people are compared to the momentary chaos we had in the Bethlehem Project. When groups come in, some with representatives, we talk with them and provide each micro-clinic with a machine, and show them how to use it. Many of these people are Type-I, meaning that their diabetes can only be controlled through insulin injections, not simply by eating right and exercising. We also give priority to two young girls and one boy who have diabetes. The problem, I was told, is that these young people and their families do not want to admit that they have diabetes, as there is a stigma put on such diseases. They believe, and in some cases rightfully so, that if the community knows that they have a "genetic problem" that no one will agree to marry them. As a result they hide it.

I give a machine to one girl who comes alone and is clearly very shy about receiving a machine. She is about 16, dressed in a white, slightly sparkly headscarf, a pink and white shirt, white pants and stylish sunglasses. She asks me for a bag to carry the machine in, and after I tell her I do not have one, I can sense her anxiety. She says that she has to walk home and does not want to carry it in the street. I then suggest that we try to fit most of the pieces in her purse. We do so successfully and, after few joking words, she leaves with a smile and a bulging purse.

After doing some more work, I go to eat lunch in an ordinary restaurant near the camp. You can buy some meat cooked on the side of the street in a mini-oven for a lot less, but I have tried to stick to home-cooked meals or food that looks appetizing from shops. I notice that my complete meal is about $6.50 with a drink. I could get a cheaper meal on Telegraph Avenue in Berkeley! I am told that the relatively high prices of food and other basic items make it very difficult to survive on the low wages in Palestine. Some have told me that the high prices are due to many things being imported from Israel, which has similar prices to the United States. Also, Palestinians are not usually permitted to work in Israel, and local production of certain goods is sometimes prohibited or the goods have been destroyed.

* * *

It's now the day that all high school seniors find out what they got on their exit exams, or towjihi. This day for Palestinians is like the Fourth of July for us. People will go crazy celebrating, and others who do not do well will cry. If students flunk this exam, they will not be able to enter college.

I go to my friend's house at 8 a.m., and we gather around the TV. After numerous delays, the Minister of Education announces the top 10 scores in Gaza and Palestine. My friend's sister, Nameh, is extremely nervous, as she had been studying very hard for this test. First, he announces Gaza. When he announces the top 10 in the West Bank, Nameh shrieks with joy as he mentions that she received the 5th highest score. After congratulating her, we go to her girls' school, where her classmates and teachers are also waiting to congratulate her. After driving around Bethlehem and Beit Sahour, I see the streets beginning to fill with honking cars and young graduates hanging outside the windows shouting, "Towjihi! Towjihi!"

After we return to the house, local television stations start calling, in addition to friends, families and neighbors congratulating Nameh. But as I watch the TV, I notice that it continuously displays the score of all the people who took the test. I could not help but wonder if it was the best idea to publicly broadcast students' scores, given that some were not especially good. Some of the girls at Nameh's school are pretty upset with their scores, and if getting a bad score is not punishment enough, having it displayed on public television must be, quite simply, humiliating.

We spend the whole day running around, and during the night throw a party for her. All over Bethlehem, fireworks are going off and people are celebrating the achievements of the next generation of Palestinian scholars.

* * *

A few days later, I begin to hear that the Israeli Defense Forces have been making more surprise visits here in Bethlehem. In a previous dispatch, I wrote about how the IDF had visited Bethlehem at 1 a.m. This time they came at about 6 a.m., and then on another day at about 10 a.m. All the raids were in pretty close proximity to where I live, near Manger Square, and there was some light gunfire. Little boys subsequently started throwing stones at the jeeps as they exited the square, and others saw this as a sign to come out of their not-so-concealed locations. I am starting to think twice before I go and make the micro-clinic visits and am erring on the side of caution. Because of these increased tensions, it is becoming a little bit more difficult to visit people's homes regularly - though no significant curfews or restrictions have been implemented.

The IDF was looking to arrest some men, though I do not really know the exact reason why, if there was one. I was watching the news coverage on the day of the 10 a.m. raid, and the IDF had arrested a man associated with Hamas. His teenage son was interviewed; he was free only because his mother said she had begged the soldiers not to take her son. I continued to watch the coverage as it replayed pictures of masked IDF soldiers in army fatigues searching an unfinished concrete building. With guns poised, they climbed a ladder and cautiously climbed onto the flat roof. One soldier in a crouching position walked across the roof and knocked on the water tanks, perhaps to see if there was anything hidden in them. They then showed the prisoners under a tree, waiting to be taken to an Israeli prison.

Some Palestinians with whom I have spoken say that the men being apprehended are low-level, insignificant individuals in organizations like Hamas and the Islamic Jihad. Others have said that some of these raids are just meant to provoke and incite fear, not to apprehend any specific individuals. Some Palestinians would argue that the bombings in Israel are a result of these provocative incursions, in which many Palestinians have in the past died or been arrested and subjected to torture. Israeli newspapers have stated that the IDF has been conducting raids in the West Bank to apprehend the militants who continue to facilitate such bombings.

With all the bombings, military exercises, searches, checkpoints and metal detectors in mind, I have been following the tragic bombings in London with some interest. First, I was in London riding the trains that were blown up not long ago; second, I will be returning home with a layover in Heathrow Airport, and lastly, I have met a guy here from London who is Palestinian. I was interested to see his concern for his family's safety when he heard about the bombings and his comment that "it just might be safer staying in Palestine than London nowadays." I thought about how, in my previous dispatches, I described the hyper-security situation in Israel and then said that I hope that we can realize that peace, justice and security goes hand in hand before it is too late.

Well, now that the second bombing in London has hit, New York subway passengers are going to be searched. But, as I observed in Israel, these security precautions will only lead to more clever operations, which will in turn lead to more stringent laws and suspensions of freedom and so on and so forth, until we are living in an Orwellian society. Let us instead invest in building bridges, creating mutual trust and respect, and improving the lives of people who live in places of deprivation like Palestine. That is, of course, unless we would like to be searched before using the restroom.

The choice is ours.

Dispatch 8

BETHLEHEM – Today, I traveled to Jerusalem proper and then to East Jerusalem, where I will be staying for a couple of days while traveling back and forth to Ramallah. I started out by taking a taxi from Bethlehem to Beit Jala, where I waited on the side of the road for a white bus to pass by. These white buses are used primarily by Arabs that have papers or permission to enter Israel and are an important means of transportation for Palestinians. I usually don't pay much attention to what "colors" I am wearing when I get up in the morning, especially since this is not East L.A., but this morning I happened to wear a baby blue and white shirt – the colors of the Israeli flag. How much more "patriotic" could I get in a Palestinian area?! I would not have noticed my shirt if it was not for a Palestinian teenager with cuts on his face who started speaking Hebrew with me on the bus, and though I do not know Hebrew, I could tell that his words were not favorable. Because most people usually assume that I am Palestinian, I am guessing that my flagrantly "Israeli" shirt did not sit well with him. Later that day, I went to Ramallah and did not have any further problems with "the shirt."

To get to Ramallah, I had to go first to East Jerusalem, a primarily Arab and highly disputed section of the city, and from East Jerusalem travel to the Qalendia checkpoint to get to Ramallah. The checkpoint is utterly chaotic. Taxis are honking their horns, people are trying to sell things, cars are pointed in every direction, and it was dreadfully hot. I walked through and got in a taxi/van with eight other people. The man I sat next to was a Palestinian from one of the neighboring villages. I would guess that he was in his sixties, and he wore a thinly-shaved grey moustache and had dark wrinkled skin. He asked me where I was from, and I said San Francisco. He replied, "Oh, you are American?" and I confirmed his statement. He then said, "Americans are unjust and Bush has murderous policies," before commenting on Iraq. I cleared my throat nervously as I thought of an appropriate response before reminding him that although there are many bad things happening in the world, not all Americans are in support of these actions. Assuming that I was American and Palestinian, he asked me if I had family in Palestine, and I said that I did. He seemed pleased and then offered me his cell phone so that I could call the people I was meeting. I thanked him and left the van in Ramallah.

Ramallah is a very vibrant, seemingly more "modern" city (whatever that means) with many high-rises and a more organized physical appearance than Bethlehem. Ramallah reflects the spatial organization of power, as most headquarters for government agencies are based there, and many prominent officials live comfortable lives in pleasant "suburban" neighborhoods characterized by large houses and surprisingly peaceful surroundings. In Ramallah, the streets are clean; there is little graffiti on the walls, and many of the buildings are much more complex than those in neighboring cities. The people walking in the streets appear to be more inclined to American and European styles and, overall, there is more freedom with regard to open relationships among young people. Couples do not usually walk down the street holding hands, but they sit in cafés and socialize instead. One girl described the huge difference between the social life out on the streets and the life inside the shops, where some may change into more fashionable clothes just to sit inside a restaurant.

In Ramallah, I tried to arrange a meeting with some health care professionals, but did not have success this time. I will try again in the coming days. Afterwards, I met some friends in the city and basically sat in several different places. The first was a small café where I had some sour lemonade before exchanging it for another overly sweet smoothie-type drink. Most of the people in the café were young and seemed to be attracted to the private atmosphere and air conditioning. Then, I sat in an informal restaurant and talked with some other friends and had a hamburger. It was interesting to note that most of the people I met during my time in Ramallah were transnational citizens. They are Palestinians from Ramallah, but carry American passports and currently or in the past have studied in America. The others who did not carry an American passport had either traveled extensively in the United States or had studied there on a student visa. In Bethlehem, on the other hand, many of the students have traveled to Italy, Greece, Russia or other European countries to study. But I think that everyone reading this should be very happy and proud to know that UC Berkeley has a very good reputation here in Ramallah and is the "dream school" of many students I have spoken with. So, keep up the good work!

As I was walking around later that night, I ran into a girl who had volunteered to help with the Micro-Clinic Project. She is currently acting as a youth volunteer for her micro-clinic, along with her mother, who is a nurse. I was delighted as she explained how she and her mother had started testing those participating in their micro-clinic and that she had even taught her brother how to use the machine. She went on to say that, recently, she had been testing other family members and neighbors and had found that her brother-in-law in his 30s had a very high reading, indicating that he may be a diabetic. I encouraged her to have him visit a doctor to go through the necessary tests and reminded her to share with him the dietary recommendations made during the project. This incident got me thinking about how these micro-clinics not only serve their participants, but because of the culture in which friends and families socialize regularly, they have also become neighborhood outreach centers. Many of the micro-clinic participants have told their neighbors about their new machines, and their neighbors have then asked to be tested or to watch how they work.

In the late afternoon, I saw a group of Palestinian policemen being trained in the streets. They were wearing blue camouflage uniforms and were being led by a drill sergeant. There were about 30 of them walking through the streets of Ramallah, and they really looked quite professional compared to some police in other areas, who wear worn-out uniforms. Clearly, looking at the police, the built environment and the social life, Ramallah is a wealthier city than Bethlehem, and some of the people carry a slightly elitist pride in being from a more "sophisticated" society than some of the neighboring cities.

Later that evening, I went back to Qalendia checkpoint and crossed it. On the Ramallah side, a huge line of cars was waiting to cross and impatiently inching along, as each car was searched and the passengers questioned. On the other side, I made a mistake by telling the taxi driver that I wanted to go to Shaherizad, a place to buy sweets, not knowing that there are a thousand places named Shaherizad. I ended up traveling back into Jerusalem before a kind man with two young boys finally directed me to the correct place.

I stayed in East Jerusalem for a few days, where I visited with some friends. Down the street from where I was staying, the Wall was being constructed in a way that would greatly affect real estate values in the area. Its continued construction and the maintained ambiguity of its path has created great anxiety in the area. Most of the people in this neighborhood are Palestinians who carry an Israeli ID and are therefore permitted to live in Israel and buy homes in certain areas. Thus, many of the residents bought small apartments in this neighborhood before the construction of the Wall – when the area in which they were living would fall inside Israeli control. If the Wall cuts through this neighborhood, the residents' homes could fall from $180,000 to $80,000 overnight with a single court decision directing the Wall a few blocks in either direction. If their homes were suddenly to become West Bank homes, they would lose a significant investment in their homes, as well as Israeli ID cards, health care and the ability to go to work, to name a few serious problems. Some Palestinians that I have spoken with tell me that by moving Palestinians outside of the Wall, they are reducing the Palestinian population in East Jerusalem and perhaps undermining any future Palestinian aspirations for control of East Jerusalem.

When I first heard the story, it took me awhile to understand what was going on. Were these Palestinians fighting to have the Wall include their land as a part of Israel as it separates the West Bank from Israeli-controlled territories? Yes, I had heard correctly. They explained how the lack of stability in terms of land occupation/annexation has made it difficult for them as working families to invest in any sort of future – financially or socially – and because they had made the investment to buy apartments in an area that was supposed to be included inside East Jerusalem, they paid a much higher price than if they had bought homes in the West Bank.

I then went to Jerusalem to pick up some friends of the family I was staying with, but getting there was a bit tricky. I went with the family and, because of their Palestinian status, they walked across the checkpoint, and I drove their car into the "express lane," open exclusively to foreigners. If I went through the Palestinian line with the car, I would have to wait 1.5 hours. When I got to the checkpoint, I smiled at the soldier and handed him my American passport. He was a serious guy in his 20s, wearing mirrored sunglasses, a gun and a "mug" that he must have practiced in the mirror for hours. He first spoke to me in Hebrew, and I responded that I do not speak Hebrew. He then asked me in a Hebrew-Arabic accent, "Inta Arabi?" (Are you Arab?) I did not want to respond in Arabic, otherwise I would be sent to the back of the Palestinian line, despite the fact that my whole life I have only held an American passport. I replied, "I am an American," and I pointed to the passport and asked him to speak in English. He went on to ask me again if I was Arab, and I kept telling him I am American and speak English. Then he started calling me a liar in Arabic, telling me that I am an Arab and ordering me to go to the back of the Palestinian line.

At this point I was pretty upset, and the United Nations car behind me was honking impatiently. I was not going to move until he spoke with me in English, and I know that he spoke English because he unconsciously responded to what I said in English by answering in Arabic! Finally, the soldier, unwilling to speak with me in English, with me unwilling to move, told the Arab UN worker behind me to translate. After exchanging some sharp words with the soldier and explaining the negative effects of such behavior on the Israeli tourist industry via the UN worker, I turned the car around, picked up my passport, picked up my friends who had successfully crossed, and went through another checkpoint about 15 minutes away with no trouble.

Later that day, I wanted to go shopping inside Israel, so I tried to pass through the same "express lane" that I was stopped at in the morning, this time determined not to get turned down. They change the soldiers frequently, and at this time of the day, there was a new group. I drove up to the checkpoint and handed my passport to the soldier, greeting him with "shalom." This soldier wore a very unintimidating expression; he did not look like he was enjoying his job and would much rather be doing something else. Before he asked me any questions, I asked him in English how to get to the mall in Israel, and he responded that he did not know but would ask someone. I told him that I would manage, and he said "be'sader" (go ahead). I guess in situations such as these, the difference between an hour and a minute all depends on the mood of a soldier.

Dispatch 9

BETHLEHEM - A few weeks ago, I had a tasty meal consisting of rabbits stuffed with rice, salata, humos, baba ghanoush (mashed eggplants with tahini), and other small dishes. Today, I found out that the rabbits that I ate were infected, and three others living with the ones I ate had just died. I did not feel so good after hearing the news, but I guess it's too late to do anything about it.

This goat was one of many animals encountered in West Bank homes.

I have concluded that if the SPCA were located in Palestine, it would be horrified by the way people keep and feed their pets. In one house I visited, I saw a small boy petting a porcupine and subsequently start bleeding. In another location, I saw some sheep and chickens being kept in a vacant unfinished apartment. But I guess it is sort of silly to criticize people for not caring for and feeding their animals properly when they often cannot even afford to feed their sons and daughters.

There are plenty of stray cats and dogs roaming around the neighborhood and, during the night, they scavenge in the dumpsters for meat. Last night, I heard a cat and dog fighting with each other. Coincidentally, I read in an Israeli newspaper the other day that a professor at Tel Aviv University has done research showing that cats and dogs can indeed get along. I got to thinking that if cats and dogs can overcome their age old rivalry, then perhaps there is hope for the Israelis and Palestinians.

The Hamas table welcoming new students to Bethlehem University conjured up memories of student organizations tabling at Sproul Plaza.

Today, I also visited Bethlehem University, a Jesuit institution founded in the 1970s that is considered one of the best universities in Palestine and is attended by both Christian and Muslim students. Most of the male students at the university dress in European-style clothes with gelled hair and cell phones glued to their ears. The female students vary much more in their attire — some are in jeans and t-shirts, and others dress in hijabs with long cloaks covering their clothes. The campus is completely walled off, and its gardens offer a serene retreat from the busy city. When I visited, there were tables set up to welcome new students, just like in Sproul Plaza, though on a much smaller scale. Their were four booths: one for Fatah, one for Hamas, one for the Popular Front for the Liberation of Palestine (PFLP), and one for the Democratic Front for the Liberation of Palestine (DFLP). These student organizations, though probably on the U.S. list of terrorist organizations, are looked upon by most Palestinian students the same way we look at the Berkeley Urban Studies Student Association, for instance. The students that are involved in the clubs (not all students join) do not necessarily involve themselves in violence, at least to the best of my knowledge, but are nonetheless dedicated to ending the Occupation. All the same, a young man from another Palestinian university told me that 20 or so students from his school were involved with operations against Israel. As a result, Israel closed the university for a period of time. Out of curiosity, I asked if they were normal students, and he replied that he had not seen any unusual behavior in them beforehand. So when I pressed him as to the reason why educated college students would act in such a way, he replied casually that most likely their brothers or mothers were killed by the IDF, their land was stolen, or something similarly devastating had happened to them. The most popular of the student clubs in many Palestinian colleges seems to be Hamas, clearly reflecting Hamas's strong representation in the universities, in the local municipal elections, and perhaps in the future of the Palestinian Authority.

In Bethlehem, for instance, a city which was historically dominated by Christian Palestinians, there is a proportional system put in place by Yasir Arafat, supposedly to protect the Christians who are now a slight minority in Bethlehem, and, because of mass emigration, make up about 2 percent of the population in Palestine. Under this system, eight members of the city council must be Christian and seven Muslim, with a Christian mayor. Of the seven Muslim seats, five went to Hamas. In predominantly Muslim cities, its representation is even stronger. Palestinian newspapers and pollsters have estimated that if Hamas were to enter the Palestinian Legislative elections, it would take one-third of the seats.

Because of my work here with Palestinian diabetics, I decided to talk with the Ministry of Health and other medical organizations. But I was told that groups like Hamas also provide health care, in addition to education, religious, financial, and other public services. So, I decided to interview two senior Hamas officials in the Bethlehem area and ask them about these services. I was a little bit nervous going into such an interview because not long ago, a journalist was interviewing an Islamic Jihad leader when the leader was shot dead by the IDF during the interview.

During our conversation, the leaders explained to me how Hamas's health care services include providing clinics, hospitals, and mobile clinics in the cities and villages and providing critical services to the Palestinians. But I then got to asking them about the political situation. In short, they stressed the fact that Hamas was starting to emphasize a political rather than a militaristic approach as its main focus — a statement that I view as a real positive step. Both men spoke about how they had been imprisoned many times in Israeli jails and had been apprehended by the IDF. During the interview, one of the official's sons came in with two bottles of cold juice for us — ironically, they were Israeli brand juices. All in all, the men were very warm and hospitable, and from the discussion, they did not seem unwilling to consider options for peace. Their main complaints were the biases continually maintained by the United States towards Israel, the attacks and imprisonment of Palestinians, and that Palestinians are deprived of their land and livelihood.

As one of the officials stated, "Jihad, for me, is struggling to put food on the table for my family."

Dispatch 10

BETHLEHEM - A few days ago, I visited a family with five members — a very overweight father, a physically fit mother, two young boys and one young girl. They told me that the father was recently diagnosed with diabetes, and the mother and children also had very high readings. I asked them about any advice given to them by their doctor regarding further care, medication and dietary adjustments. Their doctor did not really tell them very much, and they did not know what types of diabetes they had and what to do next. I explained to them how it is critical that they find out specifically if their children have juvenile diabetes, as it seemed that they might from their high readings and the presence of diabetes in their family. I spent quite a bit of time trying to convince them to eliminate harmful foods from their diet, and to care for their bodies. I noticed that the father's feet were discolored and had cuts that did not seem to be healing. I also explained the importance of the glucose monitoring systems.

Daniel picks cactus fruits in Beit Jala near Jerusalem, reaping a harvest of delicious yellow fruit (right, after peeling) and a handful of painful thorns, despite his best efforts.

Yesterday, I went with my friends to pick cactus fruits. They are usually green or red fruits growing on cactus plants. The delicious fruit is found inside a tough thorny skin and is well worth the hassle necessary to pick them — well, almost. It was a sweltering day when we came to Beit Jala, a town near Bethlehem. I walked carefully up to the cactus plants with my friend, who showed me how to avoid the thorns from the plants and grab the fruit with a piece of cardboard. This was all well and good, and I picked some fruit, but he failed to tell me that sometimes the wind blows thorns on you. The thorns are not large, but are very tiny slivers that can be dangerous if they get in your eye. On the way home, my hands started to hurt and itch, and after closer examination, I realized that I had thorns all over them. I tried to pull them out by my fingernails, but this only irritated my hands and broke off the slivers in my skin. When I came home, I found out that there is a method of removing the slivers. I wet my hands and then dumped salt in them before rubbing them together vigorously. It did the trick. After that, my friends wanted help peeling the cactus, asking with grins on their faces, and I graciously passed up the opportunity to get more thorns in my hands.

I was finishing up some work for the Micro-Clinic Project today and was going to take a taxi home but instead decided to walk — about 30 minutes back to my house. I stopped on the way to buy some shawerma and humos, and hurried home to eat it while it was still hot. I arrived home, put the food on the counter and started to turn on the computer when some friends called me to come and sit with them and drink tea on the veranda facing the street. All of a sudden, I started to hear loud explosions, followed by young boys proclaiming that soldiers were coming, followed by a parade of armored IDF (Israeli Defense Force) jeeps passing by the house. I had my camera with me, but those I was with advised me not to take it out in front of the soldiers, as they do not like photos. One jeep stopped in front of us while the others continued around the corner, where little boys followed throwing stones. By this time, everyone in Bethlehem was on their roofs or at their windows watching the action unfold. It was particularly sad for me to see people so desensitized, especially the young boys, so that when soldiers come, they run into the streets while their parents scream at them to stay inside. It would appear that this routine has become a form of excitement and almost like a morbid cat and mouse game between the boys and the soldiers. I watched this in greater detail later that night on the local news, as the little boys threw stones and then ran as tear gas was thrown at them.

Two American friends came to the house a little shaken up. One of them was on the road when they met the IDF soldiers head on and subsequently backed up and came another way. The other was a Texan woman who was coming back walking from Beit Sahour and was almost caught in the middle of the stone throwing. I was happy that I had decided to come home a little bit earlier than expected — especially since I was walking home. When the soldiers passed by the house, the Palestinian friends I was sitting with did not move, even as deafening explosions, caused by rockets and percussion bombs, were shaking the ground. The past incursions in Bethlehem were mild in comparison to this one, but they did not seem concerned. I wanted to capture a picture and tried to do so as a jeep went back up the street, but all of a sudden the back doors of the jeep opened as I was trying to shoot the picture. I froze before realizing that they had only forgotten to lock the doors; I did not get the picture, however. I stayed outside with my friends until I looked above my head and saw a tear gas canister flying through the air. Smelling something terrible, I hurried inside their house with their son, but they stayed outside, and later I heard from them that they could not breathe from the gas. I watched from an enclosed roof as the jeeps continued to pass by beneath the house while others surrounded a house not far from where I live. As explosions continued in various degrees of magnitude and rapid gunfire resonated, I watched as ambulances rushed to the scene, and a crowd of spectators continued to run to and from the action. The gunfire and explosions continued heavily for about three hours and, until 11 p.m., occasional explosions or gunfire continued. Then, perhaps to offset the shootings and explosions, prayers started to be continuously proclaimed over the loudspeakers of the local mosque, and there were two outside weddings in another part of the city that had their own music. So, the whole evening I heard prayers, wedding parties, shootings and explosions!

I started to watch the news coverage of the incursion. It described the types of rockets and weapons used, and the houses and names of people inside the selected houses; in this case the IDF was looking for members of Islamic Jihad. For me, this experience was a bit exciting, yet very frightening for a number of reasons. First, it is taking a little bit of time for me to get accustomed to heavily armed jeeps waiting in front of my house, rockets exploding and tear gas flying over my head. Just a few months ago, I bought an iced tea at Café Strada in Berkeley, walked across the street and sat on the bench in the peaceful surroundings of a fountain, grass and trees. It is sometimes hard for me to grasp the fact that people have to live like this in the West Bank on a continual basis and have come to accept these conditions, while I am sipping my iced tea in Berkeley. Secondly, this experience was frightening because I knew some people, not just my American friends, who were caught in traffic where the shootings were happening. Thankfully, they arrived safely, but it is a very scary feeling to know that people you care about are in danger. And thirdly, this experience was frightening because everyone I spoke with told me that this is nothing compared to what they have had to deal with in the past. I listened as a 13- year-old boy excitedly pointed to a neighbor's house telling me, "Wow! They sent rockets to the house!" … and "Wow! Me and my cousins, we hid in the bathroom, and it was Woooow! So loud!" Then, his mom interrupted and told me how they had lived like this, with tanks in the streets below, under curfew for 40 days! During one of these curfews, her niece needed to be rushed to the hospital to deliver a baby. Her husband and brother-in-law took her, despite the curfew, and thankfully were not hurt.

Today was a sad reminder of my first trip to Palestine — during the First Intifada — where I remember, among many similar things, the little boys throwing stones. On the one hand, I have seen a great change in the civil society here in Palestine, including the recent elections, but I sincerely hope that these positive steps will not be compromised by the negative ones I saw today. I believe that there is a window of opportunity at this point that has opened for the first time in the Israeli-Palestinian conflict, and to let that opportunity close would be a terrible mistake.

Dispatch 11

	Airports still look like clean, well-lighted places, but for Daniel Zoughbie, they were an ordeal
Security marathon, the long flight home, and dreams of peace

BETHLEHEM - I will be leaving to go back to America in a few hours and am sitting in a comfortable couch in Ben Gurion International Airport; I am having mixed feelings about leaving. On the one hand, I will miss all the old and new friends here, but on the other hand, I miss my family and friends back in the Bay Area, and am anxious to see them. I came to the airport at 4 a.m. after coming back from Tel Aviv late last night with some family friends. Tel Aviv is a very built-up city along the Mediterranean Sea and, in a way, reminded me of the waterfront of San Francisco. We walked along the beach, and the pleasant but humid night air was a nice change. I always like to hear the relaxing noise that the waves make as they crash onto the beach. People were fishing along a barrier wall — both Jews and Arabs — and did not seem to be having much success. People were walking along the beach and enjoying the night air. We passed a hotel where an Arab wedding celebration was taking place along with a fireworks display, and then we bought shawerma sandwiches and ice cream. My passion fruit ice cream was particularly delicious; all the ice cream I have eaten so far inside Israel has been completely natural and fresh. You can pick the fruit and watch as they make it into ice cream.

We left Tel Aviv at midnight but did not make it home till 1:30 a.m., because there was an accident on the road. As we have driven around inside of Israel, I've noticed many cars with bright orange ribbons on them. Those who display these ribbons are expressing their opposition to the Gaza withdrawal, and solidarity with the settlers who will be removed from the affected settlements. In Israel, people are bitterly divided over the Gaza withdrawal — some believing that it is a first step toward peace with the Palestinians and others that it is a symbol of defeat and will compromise Israel's security. There was a huge demonstration in Israel the other day protesting the withdrawal. In fact, Minister of Finance Benjamin Netanyahu recently resigned his position citing his disagreement with the withdrawal, though others have insinuated that his resignation was really due to the shabby economic situation in Israel, where about 25 percent of the population lives below the poverty line. Palestinians also have mixed feelings about the withdrawal. Like many Israelis, some Palestinians see it as a positive step, but others see it as not nearly enough, and also a move made out of necessity, not choice. These people would argue that Israel simply cannot continue to maintain the settlements and that they are not losing much. Additionally, many Palestinians suspect that the withdrawal is only meant to draw attention away from the West Bank, where the Wall continues to snake around Palestinian towns, and settlements continue to expand.

We inched along slowly until we passed the scene of the accident; the cars were completely totaled, and I would be surprised if anyone had survived such a horrible accident. I came home and lay down for about two hours before waking up and going in a taxi to Ben Gurion Airport.

My taxi driver was an older Arab man who lives in Jerusalem, and on the way to the airport he told me that he would one day like to visit the U.S. He then stopped in the middle of nowhere to talk to some men who had started a small fire in the middle of the street. I thought this was a bit strange, but then he asked them if they had any coffee. They replied that they did not have any yet. I did not know if the fire was to make coffee or for them to keep warm as they were huddled around it.

At the airport, I was going to get in the enormous line to get checked by security, but for some reason decided to check with the information desk first. The young lady that helped me told me that my flight was canceled due to a strike at Heathrow Airport and apologized because she could see that I was pretty disappointed. Not only was it a hassle to take a taxi here at 4 in the morning, but now I might have to get a hotel room and go through all sorts of hassle, not to mention miss important appointments that I had already made.

So, I decided to try and bypass the security and speak directly with the ticket counter. There were only a few people, as I came a bit early, but one man in particular was quite irate. He was an older man with stylish grey hair who was dressed in a Prada jacket and shiny pinstriped pants. His partner was a much younger woman who kept very quiet as he let everyone in the airport know that he was a premier card holder and that this was simply unacceptable. He spoke with a British accent and continued telling the British Airways agent that this was an outrage and that he was due in India, until they finally took care of him. I was next in line, and the lady took my passport and told me that I was flying on El Al four hours after I was originally scheduled to leave. With thankfulness that I was leaving the same day, I agreed and took my ticket to the security line.

I do not know if El Al has stricter security precautions than other airlines, but it was ridiculous. I got in line, and a young woman came up to me and spoke with me in English, which was strange because I had not said anything to her before, and my American passport was in my pocket. She looked like she was in her early- to mid-20s, as do most of the security personnel at the airport. She greeted me and asked for my passport. She asked me where I was going and how I pronounce my last name. She then asked what type of name it was. She then asked where I had stayed, what was I doing in Israel, and if I had family here. I told her that I was here to start a public health project, and as soon as I mentioned that I was working in Bethlehem, she did not stop asking questions. What was I studying? Do I have a university identity card? Why diabetes when I am majoring in urban studies? What is urban studies? Why do the project in Bethlehem? Then she started throwing in some questions she had already asked, I guess to see if I was lying. It was a real interrogation — I mean, before I could finish answering one question, another off the wall question was asked. She then took red stickers and put them on all my bags and passport and ticket. I knew what these stickers meant from the last time — more inspections.

The last time they put red stickers on my stuff, they took my suitcases for further inspections. When they opened my suitcase last time, the first thing they saw was a hata (a traditional Palestinian headress like the one Yasir Arafat used to wear) that I had brought as a souvenir left over from Abu Mazen's campaign; everyone in the airport looked at it, and their expressions froze. That's probably why they subsequently took my suitcase to test it for explosives and who knows what else.

This time I was not so careless as to pack a hata, but they still took everything out, checked every square inch of my laptop, suitcases and bags with every device under the sun. While I was impatiently waiting for them to x-ray everything and do their jobs, I decided to try to talk with the security person. They had asked me a million questions, so now it was my turn. I asked him why I was privileged enough to receive this special treatment, and he said everyone goes through it. I looked around and did not see anyone else, except another man who was fumbling for answers as to why his laptop was modified. The security agent then answered that when he came to America, he had to go through the same thing.

Then another guy came and told me that I had to go to a private room and get screened. I followed him to a room that looked like a changing room, where he made sure that I had nothing on me. While he was searching me, I asked him where he was studying, and he said he would like to study at Hebrew University. I then asked him if he liked America, and he said, "Yes," after which I asked him which he liked better — Israel or America — to which he replied, "Israel." I can ask a few questions after everything they asked me, and plus, I like talking to people. He then saw that I was carrying a money belt under my shirt, so I took it off, and it to had to go through explosive tests and the x-ray machine.

Afterwards, he informed me that he would accompany me personally as I checked in and did all the necessary things before my flight. I have to say I really felt special. Never before did I have a private "bodyguard." I felt like a diplomat. But, seriously, it worked for my benefit because the security man did not wait in the lines, so we zoomed right through some of them, though people were looking at me — a suspicious young male being escorted by security personnel.

After we had gone through everything, I thanked him for all of his kind attention and shook his hand. He shook mine reluctantly and said with a smile, "Enjoy the duty free!" (He knew that I had five hours to kill.)

During these five hours, I dozed off for a while, typed part of this dispatch until my battery died, and went shopping. It's kind of creepy— even some of the store clerks in the airport are security agents. I bought some items from one store with no problem, but when I went into a baby store to buy a present for my nephew, the lady at the counter asked to see my boarding pass and passport.

It was finally time to board El Al, and I was completely exhausted. I walked up to the entrance as everyone was eyeing each other suspiciously, and the same woman who had checked me in six hours earlier was taking my ticket. As she took it, she whispered something to the woman next to her and entered something in the computer. I anxiously asked her if everything was okay, and she replied that it was.

As I entered the plane, I thought that sleep deprivation was really getting to me, because I was greeted by a clown! I really thought that I was seeing things, but then she made a fist and wanted to do a special handshake with me; I was so tired, however, that I did not know what she was doing. She responded in a Hebrew-English accent, "Don't you shake hands like this in America?" I just laughed and realized that she was coming with us on the flight, as El Al hires clowns to entertain the children. El Al is the primary airline in Israel and is known for its excellent security record, armed guards present on the plane, and now, I guess, a world class circus!

On the flight, I was seated next to two men — one was a 21- year-old former IDF soldier and the other a sales representative for a defense company in Dayton, Ohio. I started to talk with the former IDF soldier named Moshe during the flight, and he asked me if I was in the university. I told Moshe that I would be entering my last year this coming fall, and he responded that he had just finished his three years of mandatory military service and was coming to America for a year. I congratulated him on finishing his service and told him that I thought he would have a good time in the U.S. He did not speak English very well and was reading a Hebrew-English dictionary, and from time to time would ask me what a word meant. I could not help but ask his opinion on the current state of affairs in Israel, and the situation in general. Assuming that I was Jewish, Moshe went on to tell me how he hated serving in the army, and that it was a terrible life, but it was something that he felt was his responsibility to his country. He told me he went into the army as a boy and came out a man. I then pressed him on how he feels about the Palestinians, and he told me that he feels that they are the problem, and they do not want peace. He told me how he and his colleagues in the army dream of the day when they will live in peace and repeated this statement five times during the conversation. I then asked him how he felt about certain Israeli leaders — Sharon in particular. He said that Sharon is a hero, and that he is withdrawing from Gaza because this is what is best for Israel. I asked him about Netanyahu's recent resignation in protest of the withdrawal, and he called him a snake.

We continued the conversation, and then it drifted away from politics to Las Vegas. Moshe told me that he was going to visit New York, Philadelphia and Vegas and wanted to know what it was like. I told him that I had never been to Vegas, but still advised him to stay away from casinos. He told me that I was right in saying this because his friend had recently lost $30,000 gambling.

After about two hours of on-and-off discussion, I decided to share with him my background and what I was doing in the area. I told him that I was working in Bethlehem and the D'heisheh Refugee Camp to help Palestinian diabetics. Before I finished my statement, he immediately started saying, "I do no have any problem with Palestinians, personally, you know. I think that this is great that we can sit here together and talk like this." I could tell that he was a little bit embarrassed because he had been telling me for the last couple of hours that Palestinians were the problem, and here I was working with them.

I then said to him, "Moshe, I have spent my whole summer with Palestinians and have spoken with many types of people, and the one thing that stands out in my mind is that they told me the exact same thing that you told me moments ago. They tell me that they dream of peace and the day when they can live normal lives, but that the Israelis do not want it." He stopped and stared straight ahead for a minute before telling me that he believes that some Palestinians want peace, but groups like Islamic Jihad and Hamas do not. I told him that even in groups like these, there are those who may not outwardly express it, but who would welcome peace. I told him that it was my duty and his duty to work toward building understanding between the two sides. At that moment the clown passed by and bumped me on my head.

The flight from Tel Aviv to New York was 11 hours long, and Moshe and I talked about many different things along the way, during breaks from the in-flight entertainment. I also spoke with the man from Dayton, who told me that he was coming to Israel to meet with the Israeli Air Force as a representative from his defense company. Though I was not thrilled about the whole defense company thing, he turned out to be a very nice guy, and we talked about the food in the Midwest, and his travels in Israel. At the end of the flight, he switched seats with Moshe and me so that we could look out the window, because he said that he had seen New York a million times from the plane.

When we got off, Moshe told me that it was 5:15; my connecting flight was leaving at 6, and I still needed to pick up and recheck my baggage. Moshe told me that he would help me get my bags and make my plane, so together we ran to passport control, where a rude New Yorker told me that I should wait to be called, even though the security woman