The Gaza Strip on the Mediterranean coast bordered by Israel and Egypt is just 41 kilometres in length and 8-12 in width. It is home to approximately 1.8 million Palestinians, 500 of which have kidney failure and are in need of dialysis. 60 of these patients are children.
Best medical practice for dialysis patients is kidney transplantation. It significantly improves and extends the patients' lifespan. On average, transplantation bestows a further 15 years of life compared to those remaining on dialysis. A kidney given by a live donor can extend this life expectancy further to 20 years.
At present, the Al Shifa Hospital in Gaza City – Gaza’s biggest public medical facility – offers dialysis to the Strip’s renal failure patients while the Al Rantisi Specialized Paediatric hospital accommodates the children. Those fortunate enough to progress to organ transplantation have to travel to Egypt or Israel for the operation. A venture fraught with difficulties and often enough with less than optimum results. On numerous occasions the Al Shifa had to deal with unsatisfactory transplant operations when providing the aftercare for those patients returned to the Strip.
This is the situation the Liverpool International Transplant Initiative is stepping in to. The UK based NGO (Non-Governmental Organisation) aims to equip the Al Shifa and its medical staff with the infrastructure and expertise to perform organ transplantation themselves in the Gaza Strip. The surgical team and support staff from Liverpool visit Gaza about every six-month. So far they have successfully undertaken 12 kidney transplant operations. 11 members of medical staff from the Al Shifa have visited The Royal Liverpool and Broadgreen hospital in the UK to receive 2 months of intensive training in the treatment of Kidney failure and its related medical disciplines and procedures.
Head of the UK team is leading transplant surgeon and LITI’s founder Dr Abdul Hammad, an Iraq born British citizen who has been living and working on Merseyside in the UK for the last 25 years. Initially, an anaesthetist from the Shifa approached Hammad about getting involved in a project that would alleviate suffering for Gaza’s dialysis patients. However, it was central to the surgeon’s plans that more should be achieved than simply visiting Gaza to provide the surgical procedures. Gaza itself needed to be equipped with the local staff, facilities and expertise to "go solo", as Dr Hammad aptly describes it.
The recent military hostilities following Israels "Operation Protective Edge" have postponed the LITI teams last planned visit. It has now been rescheduled for this coming December. Six kidney transplants are planned as well as further endeavours in developing tissue typing facilities in Gaza, an essential part of the aspirated complete transplant service.
The next ‘big’ decision will be the allocation of a Gazan surgeon for 3 years of medical training at the Royal Liverpool hospital to become proficient in the surgical techniques associated with organ transplants. Much discussion has gone on between LITI and the Gazan Ministry of Health, on who should be the right candidate. "They must have their heart in Gaza", is how Dr Hammad describes the main concern, to make sure the appointed candidate returns to Gaza to pass on skills and knowledge.
The long-term aim of the NGO is to train doctors and nurses in Gaza to carry out entire organ transplant operations themselves. The last words should go to Dr Hammad as he reflects on the need for this vital medical procedure to be available to the Strip’s citizens: "Being on dialysis and needing a kidney transplant is debilitating enough, but in Gaza it’s another level of suffering".
The 2016 Visura Photojournalism Grant
The set of images I have submitted are from a project in the Gaza Strip with the ‘Liverpool International Transplant Initiative’ working at the Al Shifa Hospital in Gaza City. I travelled to Gaza on 4 separate occasions to document their work from June 2013 till my last visit in May 2015. LITI is a UK based charity, which aims to equip the Al Shifa Hospital and its medical staff with the infrastructure and expertise to independently perform Kidney transplantation in the Gaza Strip. They are organising for one of the Gaza surgeon’s to attend the Liverpool Hospital for 3 years to learn the procedures for Kidney transplantation and then return to Gaza to train fellow surgeons. The idea being that the programme becomes self supporting and no longer relying on outside surgical visits to perform the life saving operations.
However, the story I would like to pursue, if awarded, with the Visura Grant is the ‘Hand in Hand’ schools with in Israel.
Hand in Hand schools founded in 1998 by two educators, one Arabic and one Jewish. Amin Khalay and Lee Gordon, observing that the two communities of Arabs and Jews within Israel lived segregated and polarized lives set out to counter this with the creation of a shared bilingual learning experience for Jewish and Arab children. It’s goal, to foster a spirit of national co-existence with in the two communities through a shared educational experience.
Hand in Hand have two teachers in each class conducting all lessons in Hebrew and Arabic. The schools are a 50/50 mix of cultures. Christian, Muslim and Jewish religious festivals and holidays are all observed and each cultures traditions and beliefs are given equal weight within the classroom.
The Jerusalem campus is the flagship offering education from kindergarten through to graduation. It has a further 5 schools throughout Israel catering, at present, to students up to the age of 12. All schools are fully recognized by the Israeli Ministry of Education and students regularly outscore their peer’s in Israel’s matriculation exams and additionally attain a higher rate of college attendance. They present integrated teams within sporting events and promote adult education programs geared to learning the two community’s languages, customs and traditions. These ex-curricular activities within the context of the lives of two disparate cultures of Israel are unique and aimed at nurturing broader public and social inclusion.
This would be a very positive and visual story of an attempt to bring understanding and acceptance to the seemingly intractable historical problems of the region by a grass roots organization and the spirit of reconciliation of the students, teachers and parents of both Jews and Arabs involved.
Hand in Hand approach the divide and absence of trust between the two communities of Israel in the best possible way. Allowing children and parents to meet interact and grow together. The organization doesn’t avoid the myriad of problems and challenges this creates but proceeds’ slowly and carefully through dialogue. As Shuli Dichter the Executive Director of the ‘Hand in Hand’ Foundation eloquently explains: "When Jewish and Arab children don’t meet each other in their day to day lives and they’re being raised within a war zone, how do you make sure they don’t grow up to hate every person from the other side? – You have to bring them together and let them learn and play side by side. This is what we do everyday in Hand in Hand. Where Jews and Arabs can live and learn together there is hope for a shared society."
After my time spent in Gaza and additional assignments with in Israel and neighboring Jordan it becomes easy to be jaded and believe the ‘mantra’ of there is no solution with regards to Israel and the Palestinians. However, in my own lifetime and background of growing up in the UK I remember the same things being said about the Northern Ireland conflict. However, the fruition of the Good Friday agreement of the 10th April 1998 and the accompanying plebiscite from Southern Ireland and the North of 22 May 1998 of an acceptance of the other’s viewpoint was historical The clause of acknowledgement of the other was:
1.) That the majority of the people of Northern Ireland wished to remain a part of the United Kingdom.
2.) That a substantial section of the people of Northern Ireland, and the majority of the people of the island of Ireland, wished to bring about a United Ireland.
Both of these views were held to be legitimate and within the working arrangement of the European Union the border issue became an irrelevance do to the process within Europe of unimpeded travel between countries. The ‘troubles’ moved to the recognition of the other community’s point of view as the only way forward for peace with in the province to stand a chance.
This is the beauty of Hand in Hand. It has a long-term generational view of re-conciliation. The ripple effect of the contact of the young people passing through its schools and the parents and staff that are also touched by its message is the logical solution to what seems now as an unworkable peace.
I have been in contact with Hand in Hand informing them of my application for this Grant. I intend the resulting images from the project to be used by Hand in Hand as a permanent record of their work and additionally a resource they can call upon for internal use and promotion of their educational program. On completion of the project I would also endeavor for the work to be exhibited within Israel with the help of Hand in Hand as a platform for further debate and a visual narrative of what is possible.