It is planting season in Palestine. For the last few weeks Shatha al-Azzeh and her colleagues in the Environmental Unit at the Lajee Center in Aida refugee camp outside of Bethlehem have been working with young people from the camp to set up new rooftop planters. At an open day of activities on March 27 members of the public and residents of the camp could view the planters potted by the youth volunteers with lettuce, cauliflower, sage, onions, mint, thyme and geraniums, the latter as insect repellents. Vines and saplings included passion fruit, loquat and varieties of citrus.
Why is the Environmental Unit at Lajee doing this and why, with their U.S.-based partners 1for3, should they regard healthy, locally produced food as so important of an issue when there are many other things to be concerned about in the refugee camps?
Since the Oslo Accords the produce market in Palestine has been increasingly dominated by Israeli produce bringing with it a number of problems. Palestinian products are limited in comparison to Israeli goods. Palestinian dairy often spoils much quicker than Israeli dairy because Israel prevents the import of market-safe preservatives and industrial supplies. Israeli surplus fruits and vegetables flood the Palestinian market. On top of this, Israel has complete control over Palestinian exports and often blocks trucks at checkpoints for sufficient length of time that can render the cargo worthless.
Palestinian agricultural production has fallen over the years since Oslo, partly because of the increasing encroachment of settlements in Area C amounting to 61 percent of the West Bank which is under total control of Israel; and partly because Israel controls 80 percent of the water from an aquifer that is mostly under the West Bank, and prohibits Palestinian farmers from drilling new wells or even catching rainwater. Oslo further established a system where Palestinians would buy back their own natural resource from Mekorot, the Israeli national carrier, at a significant premium. Finally, severe restrictions on the use of fertilizers (deemed to be potential explosives) are reckoned by the United Nations agency, UNCTAD, to have been responsible for a 20 to 33 percent decline in yield between 2002 and 2015. Because of all these restrictions and privations, Palestinians who have previously made a living off the land have now been forced into wage labor in Israeli construction and, ironically, the agricultural sector.
Faced with this situation, the original and continuing displacement of populations and the confiscation of land, the resulting impoverishment and an unhealthy dependency on the charity of international NGO’s, the Lajee Center in concert with 1for3, its U.S.-based non-profit partner, has initiated programs promoting community self-empowerment. The rooftop gardens program is a case in point. Growing vegetables domestically is not only economically attractive it also promotes a healthy family diet. The main challenge in the refugee camp is that there is almost no space to plant and grow other than on flat rooftops.
Over the last few years, the Lajee Environmental Unit, with support from the Palestinian non-profit, ARIJ and the active participation of other local organizations, has installed more than 40 rooftop gardens throughout the Aida and Azza refugee camps. There are plans for more installations, including an expansion into the beleaguered al-Walaja village nearby. These installations consist of planters, some of them in open air, some of them in a standardized 2.5-meter by 3-meter greenhouse that has a small bore pipe providing drip irrigation. Typical crops include lettuce, cabbage, spinach, cauliflower, squash, grape vines, and various potted fruit trees.
The planters are immensely popular. Even last November, not the most productive time of year, a visitor was shown with pride squash gourds hanging from a pergola, various colder weather leafy greens and even, amazingly, a strawberry bed. What is it that engenders such pride? Even at this small scale, the crops contribute to the family food budget and owners are more aware of the dietary benefits of what they are growing and even what they are discarding – home composting is part of the program. Not least, however, is the reconnection with an agricultural heritage from which the refugees have been cut off for more than two generations. The pride with which a father was showing his children how to care for the crops was palpable.
The rooftop garden project is but one of many being promulgated by the Lajee Center and 1for3, each linked to the others as part of a comprehensive vision for what it will take to build a proud and resilient society. The project is one of the ways in which oppression from the occupation can be resisted. The Environment Unit in conjunction with Tufts University undertook in 2016 and 2017 a comprehensive analysis of the water supply in Aida and another Bethlehem area camp, Azza. Samples from the central community tanks and individual tanks were tested for coliform and other bacteria, and chlorine content, the results published last month with the intention that this will lead to better informed environmental control of the water supply to these populations. In addition to the final product, and perhaps more importantly, an entire cadre of young people at pre- and post-university level, has been trained in the water monitoring methodology – another way of taking back control of the terms of one’s existence.
The work of the Environmental Unit on the food and water supply complements the Community Health program, based at the Lajee Center, also in partnership with 1for3. Directed by two U.S.-based doctors working with 1for3, Bram Wispelwey from Brigham and Women’s Hospital in Boston and David Scales from New York Presbyterian in New York, both of whom make frequent multi-week visits, the day to day operations are conducted by Nash’at Jawabreh a registered nurse, with support from six young health workers serving over 100 patients in the two camps.
Dr. Scales talks of a typical patient, Widad*, who has hypertension and newly diagnosed diabetes,
“Her youthful face and welcoming smile easily hide her medical problems and her 50 years, but when she starts talking about her medical problems, she gets tearful. She recognizes most of them stem from the stress and anxiety of her sons cycling in and out of Israeli prisons, the economic challenges caused by paying the fines to get them released and the physical challenge of going to into Israeli prisons to visit them.”
He added, “Her blood pressure is often elevated when the CHWs [Community Health Workers] visit her, and she’s had chronic back pain for some time now, both of which she attributes to her stress.”
In additional to the mental and emotional strain that he sees in his patients, Dr. Scales is also concerned that in a privatized, neoliberal system of healthcare delivery, they get fragmented, divergent and sometimes completely contradictory advice and treatment from official clinics and health centers. His aim is,
“to push against this. We’d like to see the CHW program and all participants, including Widad, as partners in taking responsibility for their health, both immediately in the health of the individual, but also in the community vision of improving the health of all participants in the camp and camps beyond Aida and Azza. For Widad, this means streamlining her care with a smaller number of high-quality physicians who care about seeing her get better. And it means not just treating her hypertension, but advocating for the equal rights for all Palestinians to avoid the indiscriminate incarcerations and harassments that lead to so much trauma and stress.”
As with the roof gardens and the water projects, the overall aim of the community health program is, in Dr. Wispelwey’s words, “to see Palestinian refugee communities rejecting donor driven agendas and neoliberal health modeling in favor of collective organizing to secure grassroots-derived priorities in health access, care, and rights.” He adds in an email that, “In a fragmented health environment and very uncertain political future, this seems the most robust and community-centered approach, one that can be incorporated into any current or future health system.”
With this approach the team plans to scale this social-accompaniment community health model to serve all of the approximately 400 patients in Aida and Azza camps with difficult to control diabetes and hypertension, the major drivers of morbidity and mortality in Palestine. Wispelwey is greatly encouraged by the early outcomes data from the initial set of patients, with over 80 percent of patients seeing improvements in diabetes control since joining the program.
Implicit in all these projects is the issue of growth and replicability. Other communities such as al-Walaja and some farther afield, have approached the Lajee Center asking for help to start similar community health and environmental projects to encourage the involvement of young people, of local authorities, to create employment and to bring communities together in a broad movement of self-empowerment.
Under the joint leadership of Salah Ajarma, the director of the Lajee Center and Nidal al-Azraq, director of 1for3, there are in these programs models for communal self-determination, mutual support and shared responsibilities designed for liberation now, in the moment, in the tasks of living and eating and caring, as circumscribed as they are by the ongoing Occupation. Young health workers caring for their elders, elders teaching the young how to grow crops, college students caring for their community’s water supply, all these efforts and more, pick up strands from the philosophy of the First Intifada, an effervescent resilience in the face of oppression and a template for the future. They are planting the seeds of a new society.
On May 4, 2019 in Boston and Philadelphia, 1for3 is organizing a fundraising Walk for Water to support the programs at the Lajee Center. If you would like to participate in the walks, sponsor a walker or simply donate, please go to the website, or Facebook page.
*Widad is a pseudonym.