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Tony Waterston and Jean Bowyer on doughnut rounds, children’s rights and house evictions

1 Mar, 10 | by BMJ Group

Tony Waterston Ten years after the inception of the Royal College of Paediatrics and Child Health teaching programme in the occupied Palestinian territories, the third 2 year cycle is about to start. The purpose of the team’s visit was to offer an Education for Educators course for new tutors. This was a two day course covering educational principles and practice in large and small group teaching, from buzz groups to the doughnut round and including educational appraisal.

One lecture on children’s rights was pulled apart by colleagues – first in the old style of negative criticism, and then using Pendleton’s rules of ‘what went well’ and ‘what could be improved next time?’ The students (among whom were the medical school Dean) jump into using the first method but agree on the benefits of the second, which for the person delivering the lecture is a welcome relief. We were delighted when the Dean said he would like to offer the course to many of his colleagues.

The course is a welcome respite for the participants after the daily struggle to get to work and face the recurring headaches of transport, procurement, and referral. At Makassed Hospital, the main teaching hospital in the West Bank, children are regularly referred from Gaza but the red tape is hard work, and parents are often not allowed to accompany their child. Although in Ramallah the economic situation has improved a little, in Gaza it worsens by the day as a result of the blockade and lack of employment, exacerbated by electricity cuts for three quarters of every day and an uncertain supply of bottled gas and water.

Yet the ambitions of the Gaza paediatricians are high, and we are asked to help with the new Diploma in Child Health and Nutrition course which they have developed, as well as to collaborate over a new course in child mental health. A child psychiatrist describes the continuing impact of last year’s war on children who still can’t sleep and families restricted by fear as well as by road blocks and barbed wire.

Before our departure, we visited an extraordinary scene in Sheikh Jarrah, in East Jerusalem just a few hundred yards from the famous American Colony hotel where Tony Blair has his HQ as EU Peace envoy. The Palestinian owners have been evicted by the police – three families in houses built by UNRWA (the UN agency for refugees) in 1956, and now housing three generations. Settlers have squatted in each house with the police’s tacit approval, preventing their owners from returning. The families are now camping nearby, accompanied by members of the International Solidarity Movement, and face regular harassment and fines by the municipal authorities, as well as pepper spray from settlers. They say that this is part of a deliberate and extended plan by the Government to remove Palestinians from East Jerusalem, an area which until 1967 was predominantly Palestinian.

Our last day was spent discussing collaboration between Palestinian and British paediatricans over the new modular child health course. The Palestinians are keen to take on real ownership of the course and we feel that there is a genuine partnership and impact– one of the Makassed tutors is keen to continue the teaching of child development himself, not just to the paediatricians on the diploma course but also to the medical students. This is indeed the kind of outside help that can make a difference.

Tony Waterston is a paediatrician in Newcastle-upon-Tyne, working mainly in the community with long term conditions, disability, child abuse and social and mental health concerns. His interests are in child public health, children’s rights and global child health and he leads the RCPCH teaching programme in the occupied Palestinian territories. He co-wrote this blog with his colleague, Jean Bowyer.

Jean Bowyer is a paediatrician with a particular interest in neonataology, including neonatal cardiology and neurodevelopmental follow-up, and she was for more than twenty years a consultant in the UK. Before that she worked in Lebanon and Saudi Arabia for four years, and she has spent the last two years working with children with HIV in Kenya. Teaching paediatrics has been a major interest in all these posts.

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  • Gonca Yilmaz

    You are wonderful Dear Tony!

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