The Arab revolution was in our minds during our regular visit to the West Bank for the Royal College of Paediatrics and Child Health (RCPCH) child health teaching programme. Would there be an occupied square in Ramallah? Would the youth be on the streets calling for political change? Would the doctors be out bravely supporting  demonstrators?  What would be the effect on the peace process?

However our first task was to contribute to two Gaza training courses partnered with the paediatricians : neonatal life support and educating educators. Two UK paediatricians ran these with the support of MAP (Medical Aid for Palestinians) and we were also able  to set up a video link with the West Bank and UK in view of the present restrictive FCO travel advice. Both courses were very well received with notable  participation from doctors of various specialities. The Gaza paediatricians are running their own Diploma course in child health and are wonderfully receptive to ideas from us about interactive teaching methods and curriculum development. They showed us their usual legendary hospitality too.

Following Gaza, we had two important meetings in the West Bank. The first was with the University of Al Quds with whom we are seeking accreditation. This will make it easier for the course to become sustainable since fees will be charged to the students, who presently pay nothing. The University administration  have expressed confidence in our application and we now have to prepare a business plan for the Diploma, which may also lead on to a Master degree in child health

The second meeting was with the managers of the primary care clinics where our students work. Our aim with the course is not just to increase the knowledge of the participants, but to improve the quality of care given to parents and children. This will require cooperation with the clinic managers in looking at outcomes. This meeting was remarkable for its enthusiasm and positive  attitudes. Suggestions for service improvement made by the managers included: spending more time with parents and children; giving nurses a greater role in the treatment of simple respiratory infections and diarrhoea; more health education sessions for families; and reduced use of antibiotics and cough medicines. They also had good ideas on how to measure these changes.

And what about  the revolution? Gaza was peaceful and the streets in Ramallah quiet apart from drilling to repair the roads; when we drove to Qalqilya to visit students in their clinics, we saw only the usual beautiful spring flowers and less beautiful settlement cities which are now spreading to the top of almost every hill. But the talk was all of the new thinking which is spreading across the Middle East. There are indeed young men demonstrating in the central square of Ramallah (Manara Square) and there is a tent where some stay throughout the night,  their aim being an end to the partition between Hamas and Fateh as well as an end to Israeli occupation. Both aims are supported by most Palestinians but so far there has not been the same impact as in Egypt or Tunisia.

We did see demonstrators protesting against the separation fence in Bi’ilin, which stops Palestinian villagers from reaching their fields  and remains despite an Israeli High Court ruling to move it. There is a weekly protest march by Bi’lin villagers joined by Israelis and international supporters.  This was courageous and extremely moving since the leaders of the march are subject to tear gas, water cannon with a foul smelling and clinging fluid, noise bombs, and rubber coated metal bullets from the large Israeli forces on the other side of the fence. There were  two stone throwers at one side but otherwise the march was entirely peaceful and non-violent. Does this really justify such a show of strength and aggression?

Among the Palestinians, there is little optimism that the US or Europe will show the leadership required at this dark time. But every day work continues, with courage , resilience, and humour.

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 neonatology, 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.