The Holy Land. Pt.1.

 Wanderings in the Negev Desert.

It was in 1996 when I took a year of sabbatical after having been the chair of the Department of Family Medicine at the University of Saskatchewan for ten years. I spent half my sabbatical at Duke University in Durham, North Carolina, working with their renowned stroke prevention unit, with Dr. David Macher and his colleagues at Duke University. I had been involved with a similar unit at the University of Saskatchewan that was focused on stroke prevention as applied to primary care.

The second half of my sabbatical, starting in January, 1996, was spent in Israel as a visiting professor at Ben Gurion University in Beer Sheva, the gateway to the Negev Desert. Historically an intriguing area, the odds are that when you stub your toe, the object you hit dates from long before the Christian Era (you can read your bible if you want to know more!). It was regarded as a bit of a backwoods then, apart from its outstanding Ben Gurion University. Extensive building was going on everywhere and still is and friends who have visited since tell me I wouldn't recognize it. I was working as a visiting professor in the Department of Family Medicine and since the provision of health care in remote northern areas of Saskatchewan was provided under the aegis of my department, one of my interests was in outreach medical care in remote areas. Because of my experience in this area, the Dean of. Medicine at BGU requested that I review and comment upon outreach medical services in the Negev Desert and make any recommendations that I thought appropriate.

It was after a presentation to faculty when we were discussing issues of providing medical care in remote areas, that I was approached by Dr. Mahmoud Maroud , a senior resident in the department of family medicine at BGU. His resident project was a study of medical care to patients living in remote places in the Negev. He had heard my presentation regarding the role the department of family medicine played in developing medical care to people in Northern Saskatchewan.

Saskatchewan's 651,036 square kilometres of land area, (population about a million) is larger than all but two states Alaska, which is almost three times the size, and Texas, with a population of less than 20,000,000 at that time. The Negev, on the other hand, is an area of 13,000 km squared, with about half a million population, about 25% of which are Bedouin. Dr. Maroud, a Bedouin, observed that many of the issues in delivering health care to the native population in remote parts of Saskatchewan were similar to the issues of delivering health care to the remote desert Bedouin, despite the great difference in area served, and of course the climate. Half of the Negev Bedouin lived in unrecognized villages in traditional Bedouin nomadic tent communities and half of them lived in towns built for them by the Israeli government between 1960 and 1980. Dr. Maroud, invited me to accompany him on his tour to visit and comment on Bedouin communities and their health care issues. I enthusiastically accepted his offer, ecstatic at the prospect of having a guide who spoke Arabic, Hebrew and English fluently and who, as an insider, would provide access to people and places I would otherwise have little chance of meeting. He informed me that he would contact me for his next foray into the desert. I informed him that my wife and companion was interested in coming along and he responded by pointing out that this would be fine in most but not all of the places that we were to visit, emphasizing the dress code and a number of other issues with which my wife and I were well familiar, that would make an accompanying woman's presence tolerable in the Bedouin culture. Several days later, he phoned.

Here my journal notes start and I share them with only small corrections:

On January 16th 1996, at 3.10pm the phone rang at the apt. It was Dr. Maroud, and he arranged to pick us up later that same afternoon to visit a fairly near-by Bedouin settlement and introduce us to the Bedouin way of life. He was a tall, dark, man with a strong face who looked to be in his mid thirties, dressed in modern style and spoke accentless English. I introduced him to Irene, and we both climbed into his small car to begin what was to be an eventful and unusual day. We drove out onto the road from the small modern town of Omer on the periphery of Beer Sheva where we had rented an apartment. The setting was more reminiscent of California than Israel and we drove towards Shoket Junction while Dr.Maroud gave us a short history of the Bedouin and of himself.

He told us his uncle was a member of the communist party and he himself had gone to medical school in Czechoslovakia and then came back to Israel for his postgraduate training.

His off the top of his head population figures, and remember this was 1996 were as follows. There were approximately one hundred and ten thousand Bedouin in the Negev, and another hundred and ten thousand in the north of Israel. There were approximately two and a half million in total, mostly in the surrounding Arab countries, but extending as far as Cuba. We could not imagine how they came to migrate there, but as the story unfolded we were later able to gain some insight as to why that happened.

When we reached S.Junction we turned left and headed to Leguia, and pulled off the highway onto a dirt road. The dirt road appeared to have no distinguishing features. We seemed to be driving across oceans of sand with no identifying landmarks and the idea did cross my mind that we could perish in the desert if the car broke down or worse. (No mobile phones in those days!)

"How do you know you turned off the highway in the right place?" I asked. This was in the days before GPS. "It all looks the same to me."

"We should see a water pump in about another five minutes and then turn right," he said.

"And what if we don't?" I asked.

He laughed."then we'll just have to stop and ask someone!. You think that there's no one to ask, don't you?"

He was quite right, we hadn't seen anything or anyone since we had left the road.

"Now, I'll just point out some things as we drive along. Oh, and there's the pump just popping its head over the sand dune almost straight ahead."

M. pointed out to us the galvanized iron huts and tents on the one side of the road, so well blended in with their background we would never have noticed them if they were not pointed out to us by someone who knew where to look. On the other side of the road were some new houses built by the Israeli government. He commented that though the new houses looked lovely from the outside that the inside was not correspondingly furnished, and usually contained the furnishings typical of the interior of the tent. The new houses, known as planned settlements, had electricity and running water, while the old shanties had no such provisions, although many of them had small generators.

The car climbed up a small hill. We got out to look around.From the top of a hill we were standing on, Mahmoud pointed out a fine, affluent home that would have looked quite in place in California and informed us that it was being built by one of the wealthy members of the tribe and it needed to be large because he had three wives. He commented that many of the young men were reverting to having two or three wives if they could afford it. I asked him jokingly if that was what he had in mind. He laughed back,

"I don't think my wife would let me -she's a Czech!"

I asked why some of the Bedouin have new homes in settlements (the so-called planned settlements), while others stay on in tents - the old settlements. Apparently, the issue is one of giving up land in exchange for resettlement homes, and according to M. there is some pressure on the Bedouin to resettle. The reason for this is ascribed to 'security reasons'. We then headed east toward Ksifr and turned south across land where no life could be seen, unless trained eyes were there to point them out. M. pointed out more Bedouin tents that were almost invisible against the background of the rolling hills of sand and some green. The green, I was later to find out is wheat, somehow shlept out of this sandy, stony terrain and looking pathetic when compared to the lush prairie wheat fields where some of the farms were nearly as big as Israel. We continued up a meandering stony path, which I wondered if the car could negotiate, Finally we arrived at the high point, overlooking several Bedouin tents. Out of nowhere a white car appeared, a menacing man behind the wheel. M indicated to me that I should lower my window, and started talking to the driver of the other car in Arabic. Once he identified himself as a fellow Bedu, the animosity vanished instantly, and the man came around and shook his hand, ignoring me. M. showed us some olive trees, explaining to us that the Bedouin don't usually grow trees but the land ownership act stipulates that if there are trees growing on the land it implies ownership. He also explained to us that the Bedouin build permanent structures inside the tents, another sign of land ownership.

We continued driving over this harsh, pitted, rutted, uneven terrain, over mounds of rocky sandy earth that I was sure the car could not negotiate. I could picture the undercarriage hung up on some huge sandy knoll. M. however seemed to have no such worries, seemed to know every inch of the terrain and traversed it with complete confidence, everywhere pointing out with pleasure Bedouin tents invisible to the casual eye. Back onto a road where we drove to another resettlement road, beyond the new dwellings, some of which looked very nice, There was a magnificent timpressive looking mosque. We stopped to look at it, and I asked M. if I could take a photograph.

"Of course!" he answered. I pulled out my camera and took a photograph. I was just getting back into the car when a rather aggressive young Arab man came over to ask what we wanted. Again M. responded in the Bedouin dialect, introducing himself. The man asked in Arabic some questions.. (I confirmed this with M. later). "Are you Bedouin?"

M answered in the affirmative, entering into a short discussion. The young man was obviously dealing with a person of some status. After which much shaking of hands (including mine!) and friendly farewells. I don't think I would have felt very comfortable stumbling into this by myself. I asked M. what would have happened if he wasn't there, he answered that we would have just been told to move on.

He looked at the magnificent mosque I had been photographing.

" Where do you think the money came from for this mosque," he asked me.

"Where?" I asked, not wanting to offend him with my opinion.

"From fundamentalist countries like Iran and Iraq. They are trying to foster fundamentalism among young Bedouin. The Bedouin are traditionally non political, but there is some fundamentalism arising among the young people, who feel their needs are not being met and they are in danger of losing their land."

We pulled out towards the road again.

"See how far the school is from the village?" he asked, "why do you think that is?"

"I don't know," I answered.

"It's because the teachers don't feel safe with the school being right in the village," he said, "in the case of any trouble the school could become a fortress. "There is the Kupat Cholim clinic, also quite far from the village, for the same reasons." He pointed out the medical clinic to me. It looked nice and modern and clean, but there was nothing going on in it. Certainly no doctors or patients visible. How was that?

He explained to me that women could not come to the clinic unaccompanied by a relative - usually male. He pointed out that many preferred ritual healers and avoided modern medicine if they thought they could.

More next week.

medicalmanes.com

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