Against the odds

There is a quiet sense of purpose in the spacious new offices of the Palestine Red Crescent Society (PRCS) headquarters in El Bireh, a town in the autonomous territories not far from Jerusalem. For this building stands as a potent symbol to a singular achievement. After decades of division and fragmentation during the time of Israeli occupation and the Palestinian Diaspora, the PRCS can now claim to have laid the foundations to becoming a united and well-functioning National Society.

This achievement is all the more formidable when you consider that the move towards peace in the region has been anything but smooth. The slow pace of implementation of the accord, unfulfilled commitments, suicide bomb attacks and outbreaks of violence have driven the process to the point of collapse and severely hampered the efforts of those, like the PRCS, who have been trying to go forward. The economy in the Gaza Strip and West Bank has virtually ground to a halt as repeated closures of the autonomous territories and limitations on travel between the two areas have led to massive job losses, spiralling prices and the collapse of local industries. For a Palestinian, just getting from the Gaza Strip to other parts of the Palestinian autonomous areas in the West Bank, which requires crossing through Israel, can be an affair of several hours and security checks.

In addition the PRCS has had its own internal difficulties: a dispersed leadership; branches accustomed to working on their own and in isolation; the need to develop new activities more in keeping with its role as a National Society. These were the challenges facing it in April 1995 when Red Cross, Red Crescent featured a story on the National Society. There were many expressions of good intentions, but no one denied that there were significant problems to overcome, and it would take patience and perseverance to succeed.

Building blocks

So far that patience and perseverance have paid off. The PRCS held its first general assembly in the Gaza Strip town of Khan Yunis in November 1996. In the course of the four-day meeting, representatives from the 19 branches in the West Bank and Gaza Strip (an increase from eight in 1995), as well as from PRCS branches in Lebanon, Egypt and Syria, elected their leadership, revised the statutes and established work plans for services and activities.

Now that unification is within grasp, the PRCS, with the help of the International Federation and the ICRC, has been making great strides in building the structures necessary to fulfil its role. “We can now concentrate on assisting the Society in building its capacity to provide services for the most vulnerable, especially in the areas of primary health care, public health, social and welfare services, and community-based first-aid,” says Ole Guldahl, Federation delegate res-ponsible for institutional development within the PRCS. “In 1997, we hope the PRCS will be close to fully operational in all these areas.”

The PRCS currently runs 35 primary health care centres in the West Bank and Gaza dealing with health education, mental health, social work, sanitation, environmental health and preventive medicine. It has a number of maternity hospitals, a paediatric hospital and rehabilitation centres for the care of the mentally and physically disabled. Its ambulance service also responds to some 90 per cent of medical emergencies in the autonomous areas (see box).

Headway has been made in strengthening the PRCS’s identity as a newly unified National Society and explaining the Movement’s inter-national dimension through workshops and seminars for staff members and volunteers from the different branches, organized with the support of the ICRC.

“We needed to dismiss the stereotype of the Red Crescent as a health institute and to reintroduce it as a humanitarian institution with a different set of priorities,” says Iman Hammouri, responsible for dis-semination at the PRCS.

Live and Learn

In September 1996, during one of the worst bouts of violence in the West Bank since the transfer to Palestinian authority, PRCS ambulances rushed to the scene. Israeli troops and Palestinian police and demonstrators were engaged in street battles including the use of live ammunition on both sides. The confrontations left 15 Israeli soldiers and 60 Palestinians dead and more than 1,000 wounded. PRCS workers, often under fire themselves, picked up the wounded and evacuated them to the nearest hospital. Blood donors and anxious relatives also converged on the hospital. The result was confusion and disarray.

Undoubtedly lives were saved by the ambulances’ prompt intervention, but for the PRCS Emergency Medical Department the incident was a valuable learning experience and highlighted the need for a clear and coordinated approach.

Even before these events, the PRCS had identified the need to improve the efficiency and effectiveness of its Emergency Medical Services (EMS). It had centralized despatch, established a 24-hour phone service on one easy-to-remember number (101) and placed radios in its fleet of 25 ambulances. With the help of the ICRC, it had opened a school in its El Bireh headquarters to train ambulance staff. The first class of 32 students had begun the ten-month course in April 1996. The emergency teams had received new blue-green uniforms courtesy of the German Red Cross, to distinguish them from victims and bystanders .

After the September clashes, further adjustments were made in equipment and procedures. The PRCS and ICRC designed “major emergency kits” which would enable the EMS teams to set up mobile health posts at the scene of an emergency. Sixteen of these kits were subsequently donated by the Netherlands government, comprising an assortment of medical supplies and logistical equipment.

The kits were put to good use when violence broke out again in early 1997. Between 70 and 100 patients were treated daily at each health post during the clashes, most of whom were suffering from tear gas or injuries from rubber-coated steel bullets.

“In the days of the Intifada, the ambulance would arrive, the patient would be thrown into the back and it would race off to the nearest hospital,” says Martin Hahn, the ICRC delegate seconded by the German Red Cross and an expert in emergency medical service management who has been working closely with the PRCS on this project. “It meant that many people were disabled as a result of their injuries. Now, ambulance staff learn to take the extra five minutes to fit a neck brace and apply adequate first aid, so that the patient is stabilized and comfortable before being evacuated.”

Future aspirations

To come this far, the PRCS has been fortunate in the support it has received from friends both within the Movement and outside it, such as governments and NGOs. In the future, however, it hopes to develop its own income-generating projects which will enable it to be self-sufficient — and more.

“The Palestinian population is very poor, especially in Gaza, and as such desperately needs our services,” says Fayeq Husein, PRCS Deputy General Manager. “We must also continue to relieve the misery of Palestinian refugees in Lebanon, who remain abandoned and forgotten by the rest of the world. But one day we hope to be in a position to extend our help to other National Societies and to needy people elsewhere in the world.”