Tony Waterston: Going against the grain in Gaza

Tony WaterstonAt a time when the news coming out from Gaza is deeply depressing, it is good to report some entirely positive developments in relation to paediatric teaching.

Ten years ago, the Royal College of Paediatrics and Child Health tried to establish its teaching programme in the occupied Palestinian territories. This was due to commence in Gaza in 2001, as at that time, the Minister of Health was based there and all the planning meetings took place in Gaza city (at that time not the subject of an embargo by Israel). For many reasons the teaching programme did not commence until 2006, and by then access to Gaza was becoming very difficult. The course is going very well in the West Bank, and thirty students have so far graduated with a Diploma of the RCPCH in Palestinian Child Health.

We have maintained the contacts in Gaza and now that the situation is more stable there, whilst the health problems continue to mount, it seems the right time to think again about our aborted teaching programme. But can we do it without personal visits? Though a number of our team are happy to travel into Gaza with the backing of “Medical Aid for Palestinians,” the RCPCH is not prepared to approve official visits whilst the FCO travel advice states: “We advise against all travel to Gaza. If, despite this travel advice, you decide to travel to, or remain in, Gaza, you do so at your own risk.”

So, we decided to explore what we could do through video conferencing and the use of the web. A very successful video conference this week with the Gaza paediatric team and members of the Islamic University medical school showed how resourceful they have been in developing their own ideas for postgraduate teaching, based partly on the model we have used in the West Bank.

They are now commencing the third annual entry for their Diploma in Child Health and Nutrition with 15 doctors drawn mainly from primary care. The course is fully accredited with both the Palestinian Medical Council and the Ministry of Higher Education in Ramallah (something we have yet to achieve in the West Bank) and there will be salary enhancement after successful graduation. As a result, fees can be charged which will make the course sustainable, although outside sponsorship has also been obtained. The course is comprehensive and over subscribed – this year there were over 60 applicants for the 15 places.

Further support for this successful teaching programme is being sought from RCPCH, and we hope to run a teaching skills course in the New Year and perhaps assist course development with some of our web-based materials. Once the border is opened and goods and people begin to flow more easily, then there will be scope for cross fertilisation with the West Bank paediatricians. However, at present we have been told that it would be easier for the Gaza paediatricians to reach London than it would be for them to reach Ramallah, in the West Bank, which is only 50 miles away, owing to Israeli border restrictions.

When and if the embargo is ended, the Gaza paediatricians will make a fine impression on the medical world with their ingenuity and tenacity on behalf of their patients.

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.