Pregnancy in Palestine can be a highly hazardous affair, writes Johann Hari in Bethlehem
TOMORROW, a third of humanity will gather to celebrate the birth pains of a Palestinian refugee in Bethlehem - but two millennia later, another mother in another glorified stable in this rubble-strewn, locked-down town is trying not to howl.
Fadia Jemal is a gap-toothed 27-year-old with a weary, watery smile. "What would happen if the Virgin Mary came to Bethlehem today? She would endure what I have endured," she says. Fadia clutches a set of keys tightly in her hand, digging hard into her skin, as she describes in broken, jagged sentences what happened.
"It was 5pm when I started to feel the contractions coming on," she says. She was already nervous about the birth - her first, and twins - so she told her husband to grab her hospital-bag and get her straight into the car. They stopped to collect her sister and mother and set out for the Hussein Hospital 20 minutes away. But they found the road had been blocked by Israeli soldiers, who explained that nobody was allowed to pass until morning.
"Obviously, we told them we couldn't wait until the morning. I was bleeding very heavily on the back seat. One of the soldiers looked down at the blood and laughed. I still wake up in the night hearing that laugh."
Her family begged the soldiers to let them through, but they wouldn't relent. So at 1am, on the backseat next to a chilly checkpoint with no doctors and no nurses, Fadia delivered a tiny boy called Mahmoud and a tiny girl called Mariam. "I don't remember anything else until I woke up in the hospital," she says now. For two days, her family hid it from her that Mahmoud had died, and the doctors said they could "certainly" have saved his life by getting him to an incubator.
In the years since, she has been pregnant four times, but she keeps miscarrying. "I couldn't bear to make another baby. I was convinced the same thing would happen to me again." Since Fadia's delivery, in 2002, the UN confirms 36 babies have died because their mothers were detained during labour at Israeli checkpoints. But all across Bethlehem - all across the West Bank - there are women whose pregnancies are being disturbed, or worse, by the 39-year old military occupation of their land.
Hindia Abu Nabah - a steely 29 year-old staff nurse at Al Zawya Clinic, in Salfit district - says it is "a nightmare" to be pregnant in the West Bank today. "Recently, two of our pregnant patients here were tear-gassed in their homes. There had been a protest against the building of the wall [by the occupying forces, cutting through Palestinian territory], and the Israelis fought back. The women couldn't breathe and went into premature labour. By the time we got there, the babies had been delivered stillborn."
Many of the medical problems afflicting pregnant women here are more mundane than Jamilla's darkest fears. Some 30 percent of pregnant Palestinians are suffering from anaemia, a form of iron deficiency. Nobody knows why it is so prevalent, although the extreme poverty caused by the siege and now the international boycott seems to be a key factor.But then, earlier this year, conditions for pregnant women on the West Bank - already poor - fell off a cliff. Following the election of Hamas, the world choked off funding for the Palestinian Authority. As a result, the PA suddenly found itself unable to pay its doctors and nurses. After months of trundling on with almost no salary at all, the medical staff felt obliged to go on strike, refusing to take anything but emergency cases. For more than three months, the maternity wards of the West Bank were empty and echoing.
Some women were wealthy enough to go to the few private hospitals scattered across the West Bank. Most were not. So because of the international boycott of the Palestinians, every hospital warns there has been an unseen, unreported increase in home births on the West Bank.
I found Dr Hamdan Hamdan - the head of maternity services at Hussein Hospital, Bethlehem - pacing around an empty ward, chain-smoking. "This ward is usually full," he said. "The women who should be in this hospital - what is happening to them? Where have they gone?"
They have been reduced to giving birth in startlingly similar conditions to those suffered by Mary two thousand years ago. They have delivered their babies with no doctors, no sterilised equipment, no back-up if there are complications. They have been boycotted back into the stone age.
The strike finally ended earlier this month after the PA managed to raise funds from Muslim countries - but the effects of stopping maternity services are only now becoming clear.
But amidst this horror, one charity has been supporting pregnant Palestinian women even as their medical services fell apart. Merlin - one of the three charities being supported by the Independent Christmas Appeal - has set up two mobile teams, with a full-time gynaecologist and a paediatrician, to take specialist services to the parts of the West Bank cut off from medical services by the Israeli occupation.
I travelled with the team to the Salfit region. Amidst the dozens of nervous women and swarms of sickly kids, Rahme Jima, a strained 29-year-old woman, is sitting with her hands folded neatly in her lap. She is in the last month of her pregnancy, and this is the first time she has seen a doctor since she conceived. "The nearest hospital is in Nablus, and we can't afford to pay for the transport to get there through all the checkpoints," she says, revealing she is planning - in despair - to give birth at home. Even if she had the cash, she says she is "too frightened of being detained at the checkpoint and being forced to give birth there.
All the problems afflicting these twenty-first century Marys are paraded in Merlin's clinic. One terrified, terrorised mother after another presents herself to the specialists here, and leaves clutching free packs of folic acid, calcium, iron and medicine. Dr Bassam Said Nadi, the Senior Medical Officer for this area, says: "Along side other organisations who care about ordinary people in times of need, they are helping us survive this terrible period in ourhistory."
But Merlin can only maintain these mobile clinics with your help. They can be contacted at www.merlin.co.uk.org. (©Independent News Service)