By Maya de Vries and Laila Abed Rabho

In the meetings that we held with women in Dar al-Hawa, we found that most of them were suffering from various health problems, the most common ones being high blood stress, diabetes, back, and leg pain. When going to one of the local public health clinics in Dar al-Hawa, clinics that are managed by local Palestinians as well as subsidised by the Israeli Ministry of Health, they are likely to get good quality treatment both in terms of their health problem as well as in terms of their own understanding of the process, as these clinics operate in Arabic.

However, the situation is much less convenient when they are required to visit one of the Israeli hospitals in Jerusalem to receive treatment – not because they will not be seen for their health problem or accepted as patients, but rather, in their own words, will not be able to understand large parts of what is being said to them by doctors, nurses and other staff. Sitting in a doctor’s office or treatment room is a stressful situation can be a stressful situation regardless of the health issue that is being investigated. When the issue of a language barrier between the patient and healthcare staff is added to the equation, the patient(s), in this case, older Palestinian women, can be made to feel even more uncomfortable as he/she is required to seek help with translation.

Hospitals are highly stressful places where many types of individuals (whether patients or staff) belonging to a variety of social groups intersect on a daily basis. These meetings can constitute points of friction or moments of acquaintance between groups of people who may ordinarily be fairly indifferent to each other. In al-Quds, Israeli hospitals, this tension between Jews and Arabs has existed for many years, as we found out from some of the women we spoke to in Dar al-Hawa. One expression of this tension is the absence of the Arabic language from the hospital space.

This situation makes the women of Dar al-Hawa more dependent, as patients, than they already are: presently, most of them have to rely on either their husband, their children, or their grandchildren to accompany them to the hospital, or on a translator provided by the hospital – usually, there is only one on the ward. There is also the possibility that an Arabic-speaking doctor or a nurse may be around to facilitate translation, but this is not certain. What does make the experience a bit easier is the fact that all signs at the hospital are usually written in Hebrew, English, and Arabic. However, our participants told us that this is not going far enough – something that even the women in our group who do speak Hebrew agree with.

Dina, 58, remembers her period of hospitalisation:

“I stayed in the hospital for some time, they used to give lectures in Hebrew, I hope they bring doctors that give lectures in Arabic, because there were Arab patients who had had an open heart surgery but did not show up to the lectures because they didn’t understand Hebrew, many Arabs don’t understand Hebrew, or they do, but not to the extent that that they are able to answer the nurses.”

Sireen, 42, adds that other than the language barrier, she does not have any complaints about the hospital:

”I usually don’t go to hospitals; I used to go the hospital just to give birth. Honestly, during the period that I was in hospital, I felt that the staff and the service in the hospital was very good, I didn’t face any problems except for the language.”

On the other hand, Nasreen, who is 76 and speaks good Hebrew, recalls seeing people her age struggling whilst in hospital:

“I understand, read and write Hebrew. Other people who come to the hospital and do not know Hebrew bring people with them to help them and translate for them, it’s hard that they don’t give information in Arabic.”

Mona, a 60-year-old research participant, described the language problem in a more nuanced way, stating:

“Since we are treated at Israeli hospitals and the language that is used is Hebrew, sometimes I can’t communicate with them [doctors] or understand what they are saying, if there is someone that can translate that can help…or if the information is written in Arabic, all the medication package inserts are written both in Arabic and Hebrew, but in the hospitals, not everything is written in Arabic.”

Taking into account the stories told to us by our participants, we think that the language gap points to a more fundamental, less spoken-about problem: that of racism. Even though the issue of racism is familiar to the Ministry of Health and there is an official protocol that aims to reduce racism against patients and healthcare staff within the hospital[i], the women we spoke to think this is still an issue. Rabab, 63, says:

“I want them to treat me like any other person, I don’t want them to underestimate me, we are exposed to racism in the Israeli hospitals. For me, Hebrew is an obstacle, when I visit the doctor, I take my sisters or my children with me so they can translate. I would prefer if everything will be in Arabic. Once, my husband felt pain in his eyes so we went to Shaare Zedek medical center, I heard the doctors speak, they said that there is no ‘use’ to his eyes , so I told him in Hebrew that I didn’t understand what he meant, he answered <<you don’t live in Iraq, you live in Israel, so you must learn Hebrew>>. I wrote a complaint and sent it to the hospital.”

Reem, a 50-year-old participant, talks about her experience in a maternity department in an Israeli hospital:

“We saw there were volunteers who came to help Jewish women and teach them how to breastfeed. We did not see anyone who spoke Arabic. There is a shortage of volunteers who do such work for Arabs, and even the Arabic language was not spoken. Only Hebrew.”

To conclude, our interviewees point to the importance of the language as an important parameter that should be taken into consideration in healthcare settings and when considering the quality of care, especially in al-Quds, where the public health system is fairly well-developed due to being part of the national Israeli health system. Treatment can and should be better when it comes to not just the medical treatment itself, but also the details of patients’ symptoms and the diagnosis. In order to get a comprehensive and accurate picture of a patient’s medical problem and decide on the best course of action in terms of care, it is very important to understand ‘the little details’, and for that to happen, understanding the spoken language of health at the point of care is a must.

Below, we show two examples of the home pages of two relevant, major hospitals in al-Quds, Hadassah Hospital and Sharee Zedek Hospital. Although both are available in Arabic, Hadassah’s home page only allows the user to select a different language if the user already speaks English – the different options for languages are written in English letters: ‘EN’, ‘AR’, ‘RU’. Sharee Zedek displays the different language options in the ‘mother tongue’ itself.

 

[i] see for example this page published in the website of the MOH: https://www.health.gov.il/English/Topics/Equality_in_Health/racism/Pages/default.aspx) See also an important article about separation in maternity departments: https://www.haaretz.com/israel-news/.premium-though-illegal-jewish-arab-segregation-plagues-israel-s-hospitals-1.6725140

 

Blog post by Laila Abed Rabho and Maya de Vries

This blog post is available to read in English as well as Arabic (please scroll down for the Arabic language version).

As home-based self-isolation has become the most common way of avoiding the COVID-19 virus, in many households, anxiety has set in as a result of the acceleration of the spread of the pandemic around the world.

Although quarantining at home will not prevent the spread of the virus altogether, it does help distribute the number of cases over a longer period of time, which is important from the perspective of the distribution of health resources and the provision of medical care to those who need it. However, home quarantine has both negative and positive consequences, at least according to some of the people in Al-Quds that we talked to. On the one hand, it may lead to a breakdown in social contact, especially for individuals who are most threatened with isolation and loneliness, including the elderly, people with special needs or those suffering from various conditions. At the same time, the Corona crisis has helped us see the elderly differently. They are our family and the family of our friends, as well as being the ones who have worked hard all their life provide those who come after them with a decent life – at the very least, they deserve the appreciation of others as well as the guarantee that they will be safe.

Recently, many local initiatives have emerged to help elderly people who are unable to shop on their own or who need help with household matters. Also, a large number of young people have committed to self-isolating at home to protect the elderly from the risk of infection with the Coronavirus. This has shown us that in times of crisis, we need each other more than ever.

Life before and after the pandemic set in

The elderly are accustomed to a certain lifestyle. The community of elderly people in Dar el Hawa, which is a village in Al-Quds and the fieldsite for our research, used to regularly go to a club for seniors, where they would spend time doing various activities, whether this is attending religious, cultural, educational and educational lectures or just having conversations with one other. However, because of warnings from the Ministry of Health, they were forced to stay in their homes, which negatively impacted both their mental and physical health, mostly due to the lack of direct contact with their friends and children. However, friends and children did check in on them via their smartphones, knowing that, during the Coronavirus pandemic, they were likely to undergo physical and hormonal changes as well as being psychologically affected (and more likely to develop depression and anxiety).

In general, locally, aid and donations to the needy are offered at specific times, especially in the month of Ramadan or during festive periods, but the pandemic has fostered a sense of social solidarity as some families experienced financial and economic difficulties and donations and money were collected and distributed to those most in need, as a way of topping up the aid coming from government institutions. Grandmothers who regularly took care of their grandchildren and who used to go out shopping or for breakfast or lunch with one another from time to time and who would visit each other’s homes to have coffee at least once a week are now confined to their homes, avoiding going out because they believe the virus is deadly as this is what they hear on the news on a regular basis. In addition, communication between them has been restricted to phone calls. All of these factors have had a psychological impact on their daily life.

On a more positive note, however, some of them tried to fill their free time by making food and sweets and selling them online for some additional income.

Examples of baked goods made and sold during lockdown. There were also those for whom the quarantine meant that they had the opportunity to escape daily stress and rearrange their thoughts – a rare opportunity for calm. It also gave others the opportunity to discover some of their hidden talents – after all, experts say that boredom is what encourages innovation. Some women have embroidered masks in order to encourage their use. In addition, a woman had crocheted a strap that had the benefit of better fixing the mask onto the face.

Loss of freedom, the COVID-19 stigma and spending more time with family members

If we look at the negative impact of the virus on individuals, families and society, we can observe that some older customs and traditions within the community may have contributed to this. For example, there have been cases of people in the village being infected with coronavirus and not disclosing it, as doing so would be seen as a mark of shame and would make them the target of bullying and mockery, which might, in turn, have a negative effect on their psychological wellbeing. When this practice becomes widespread, it can lead to an increase in cases, even though there have also been many examples of responsible and conscious groups that have warned everyone around them when they contracted the virus in order to protect their families and members of their community (especially those who have elderly people at home) by preventing them from getting infected.

The lockdown has also made our research participants feel a certain loss of freedom, as they are forced to stay in their homes, which has contributed to increasing their anxiety and tension.  On the other hand, there were also members of the community who found this to be positive because it gave them the opportunity to spend time with their family members, dedicating more time than ever to their families.  Parents who normally work full-time were finally able to spend time and play with them. Indeed, some of the members of the Dar el Hawa community turned the free time they had with their children into a positive, setting up different activities for them, including sports, games or even simply playing pranks on unsuspecting family members – they did not let their children get bored.

Whilst preoccupied with work and life matters, some may forget and others may ignore their social relationships, whether this is to do with family, friends or neighbours. Some have re-evaluated the importance of friends in their life, especially during moments when they spend most of their time at home with their family. Humans are social beings, and the lockdown has caused some to reconsider their priorities.

Husbands who previously complained that their wives were neglecting the home have come to understand how much women actually do in terms of housework, especially if there are other pressures such as employment outside the home. One example of this situation was the husband of one of our research participants, who was finally able to experience how tiring it is to clean, cook, raise children and teach, in addition to working outside the home. This has led to more sharing of household duties, with the husband taking over more of the cooking and childcare. This is someone who, previously, would not see much of his kids due to his job, which requires him to work long hours, often returning late in the evening.

Silver linings and benefits of the pandemic: online learning and sharing of household duties

The Coronavirus pandemic has had a positive effect on young people and low-income families who do not have the financial means to help their children get married, for example. Young people who were about to get married but wanted to comply with advice coming from the Ministry of Health (which warned against gathering in large numbers) were able to hold smaller-scale events with a small number of attendees in order to prevent the spread of the virus. The pandemic has meant that people gathering to celebrate a specific event were able to save on the cost of hosting these, whether we are talking about lunches or other celebratory events.

In addition, we must not forget about one of the other benefits of the pandemic (perhaps one of the most important ones), which is the fact that pupils moved entirely to distance learning after schools were physically shut. In Al-Quds, this has led to an improvement in terms of families adopting modern technology such as Zoom and online exams. Although distance learning has improved pupils’ skills and abilities in terms of using computers and smartphones, it has also had a negative impact on families who have multiple children but did not have enough devices to participate in the educational process. Providing the necessary tools for educational participation is something that needs to be taken into account by the Ministry of Education if it wants to increase educational inclusion.

In Al-Quds, as elsewhere, the Coronavirus pandemic has had both negative and positive effects on all segments of society.

 

الاثار السلبية والايجابية لجائحة كورونا

 

يسيطر القلق على كثير من الناس نتيجة تسارع وتيرة انتشار فيروس كورونا المستجد حول العالم، حيث بات العزل المنزلي طريقة لابد منها لتجنب الإصابة به.

الحجر المنزلي لن يمنع انتشار الفيروس، لكنه يساعد في توزيع عدد الحالات على فترة زمنية أطول، ما يجعله مهما بالنسبة لتوزيع الموارد الصحية وتقديم الرعاية الطبية لمن يحتاجون إليها

لكن الحجر المنزلي له تبعات سلبية وايجابية بحسب البعض، إذ قد يؤدي إلى انهيار التواصل الاجتماعي، خصوصا بالنسبة للأفراد الأكثر تهديدا بالعزلة والوحدة، بينهم المسنون وذوو الاحتياجات الخاصة أو من يعانون من أمراض

أزمة كورونا جعلتنا ننظر للمسنين بشكل مختلف، فهم أهلنا وأهل أصدقائنا، هم من عملوا بجهد في شبابهم ليوفروا لمن بعدهم حياة كريمة، ولذلك يستحقون من الآخرين التقدير والحفاظ على سلامتهم

فقد ظهرت في الأونة الأخيرة العديد من المبادرات لمساعدة كبار السن غير القادرين على التسوق بمفردهم أو من يحتاجون للمساعدة في تدبير أمور المنزل. كما التزم عدد كبير من الشباب بالعزل المنزلي لحماية الأكبر سناً من خطر الإصابة بعدوى فيروس كورونا. وهو ما أظهر لنا أنه في وقت الأزمات يحتاج كل منا للآخر.

فالمسنين اعتادوا على نمط حياة معين فقد كان كبار السن يذهبون الى نادي للمسنين لقضاء وقت لل ترفيه وفعاليات مختلفة كحضور محاضرات دينية ،ثقافية،توعوية وتبادل الاحاديث فيما بينهم لكن بسبب التحذيرات من وزارة الصحة  التزموا بيوتهم مما اصر سلبيا على صحتهم النفسية والبدنية بسبب قلة تواصلهم المباشر مع اصدقائهم وابنائهم وكان فقط الاطمئنان عليهم عبر الهاتف الذكي علما بان المسنين دون جائحة كورونا بسبب التغييرات الجسدية وتغير الهرمونات وكبار السن يتاثرون نفسيا وبتعرضون للكابة والقلق  فما بالكم بوجود جائحة كورونا وتاثيرها على نفسيتهم

بشكل عام كانت المساعدات والتبرع للمحتاجين يكون في وقت معين خاصة في شهر رمضان او في فترات الاعياد لكن في جائحة كورونا ظهر التكافل الاجتماعي والشعور بالاسر المحتاجة فكان اهل البلد يجمعون المونة واحيانا النقود لتوزيعها على المحتاجين بالاضافة الى المعونات التي كانت تاتي من المؤسسات الحكومية

الجدات اللواتي يحتضن احفادهن كن يخرجن احيانا للتسوق مع بعضهن او لتناول وجبات فطور او غداء سويا واحيانا يتبادلن الزيارات لاحتساء القهوة يوم بالاسبوع في منزل كل واحدة مرة بالاسبوع لكن بعد جائحة  كورونا والخوف من هذا الفيروس الذي يعتقد البعض انه فتاك بسبب تهزيل ما يقال عنه في محطات التواصل الاجتماعي، فقد التزمن بيوتهن واصبح التواصل بينهم عن طريق الهاتف فقط وهذا له اثر نفسي على الحياة اليومية لهؤلاء النساء

ومن ناحية اخرى  جزء منهن حاول التغلب على وقت الفراغ بعمل انواع معينة من الماكولات والحلويات وعرضها عن طريق الاونلاين من اجل بيعها وتمكين انفسهن اقتصاديا

وقسم منهن أتاح لهم العزل المنزلي بعض الهدوء في حياتهم، حيث أعطاهم الفرصة للابتعاد عن الضغط اليومي وإعادة ترتيب أفكارهم. كما أتاح للبعض الآخر فرصة اكتشاف بعض المواهب الدفينة لديهم، حيث يقول الخبراء إن الملل قد يدفع البعض للابتكار.، حيث قامت بعض النساء بالتطريز على الكمامات بهدف الترغيب في استعمالها بالاضافة لهذا فقد قامت ايضا احدى النساء باختراع قطعة من الكروشيه (صنع يدوي )لتثبيت الكمامة عليها

لقد كان للعادات والتقاليد البالية أثر سلبي على الأفراد والعائلات والمجتمع من قبل المصابين بفيروس كورونا، والسبب هو ان من يتبين لديه أنه مصاب بفيروس كورونا لا يقوم بالإفصاح عن ذلك باعتبار هذا وسم عار عليه وعيب حيث يخاف من التنمر والاستهزاء اضافة الى توجيه كلام قد يؤثر على نفسيته وهو اعتقاده بأن الكثير سوف يتشمت به فهناك فئة لم تعلن عن اصابتها مما ادى الى زيادة الحالات وهناك فئة اخرى مسؤولة وواعية تعلن عن اصابتها من أجل تجنيب عائلاتهم وابناء مجتمعهم من الاصابة وخاصة من لديه كبار سن في البيت مثل الأب والأم والاجداد.

ان الحجر أيضا  احسهم بفقدان الحرية لأنهم ماكثون في بيوتهم مرغمين لا بخاطرهم وباختيارهم مما يزيد من قلقهم وتوترهم ولكن من ناحية اخرى هناك الكثير الذين وجدوا في ذلك ايجابية بسبب الفرصة التي توفرت لهم للمكوث مع أفراد أسرهم حيث الدفء العائلي وهذا شيء جميل حيث أصبح وقت للأب والام العاملين أن يجلسوا مع أطفالهم واللعب معهم وفعلا هناك من استغل الحجر بصورة ايجابية ولم يترك اطفاله يشعرون بعدم الحرية عن طريق وضع برامج لهم منها الرياضية ومنها اللعب وعمل مقالب مضحكة مع أفراد اسرته وغير ذلك..

ففي ظل الإنشغال بالعمل وأمور الحياة، قد ينسى البعض ويتجاهل آخرون علاقاته الاجتماعية سواء مع الأهل أو الأصدقاء أو الجيران. الآن تجلس الأسرة الواحدة معاً، وتظهر قيمة الأصدقاء في حياة الفرد. فالإنسان كائن اجتماعي من الدرجة الأولى، والعزل الحالي جعل البعض يعيد ترتيب أولوياته مرة أخرى.

حتى الزوج كان يتهم زوجته  دائما بالتقصير بالبيت لكن مع جائحة كورونا والحجر الصحي عرف الزوج وقدر ما تقوم به المراة من اعمال منزلية وضغوطات بالذات عندما تكون المراة عاملة خارج المنزل

واصبح يشعر معها كم هي تتعب في داخل المنزل من تنظيف وطهي وتربية اولاد وتدريس بالاضافة الى عملها خارج البيت مما ادى الى مشاركته لها في بعض الاعمال المنزلية كالطهي والطبيخ اضافة الى الترابط الاسري والتقرب الى ابنائه ،بعد ان كان احيانا لا يراهم نتيحة خروجه من البيت مبكرا ورجوعه متاخرا

هناك اثر ايجابي لجائحة  كورونا على الشباب والاسر الفقيرة التي ليس لديها امكانيات مادية كافية من أجل اتمام فرحتها بزواج ابنائها وبسبب المصاريف الكثيرة التي يتحملها الشباب وعائلاتهم من اعباء مادية لا يقدرون عليها

استغل الشباب المرتبطين اتمام عملية فرحتهم وبالزواج ممن يرغبون متقيدين بتعاليم وزىرة الصحة بعدم التجمهر وعدم التجمع باعداد كبيرة من اجل المحافظة على سلامتهم وسلامة افراد مجتمعهم وبأقل التكاليف المطلوبة لتوفي الغداء والضيافة للمعازيم .

علينا ان لا ننسى الفائدة العظيمة والاهم من كل شيئ وهي أن لجائحة كورونا والتي بسببها اغلقت المدارس حيث انتقل الطلاب للتعلم عن بعد مما ادى الى تطور في تعلم  استخدام التكنولوجيا الحديثة كالزوم وتقديم الامتحانات عن طريق اون لاين مما أكسبهم مهارة وقدرة على استخدام الحاسوب والهاتف الذكي ولكن من ناحية اخرى كان لذلك اثر سلبي على العائلات التي لديها أكثر من طالب حيث لم يتوفر لديهم اجهزة كافية من الحاسوب والهواتف الذكية من أجل التواصل مع العملية التعليمية وهذا يجب ان تقوم وزارة التعليم بحله بتوفير الادوات الازمة للعملية التعليمية

هكذا نرى ان لفيروس كورونا آثار سلبية واخرى ايجابية على جميع شرائح المجتمع