In the West Bank
Mejd Azzeh
When I walked through the shattered streets of Tulkarem refugee camp the day after a military incursion last November, the air was heavy with dust from demolished homes and bulldozed streets. I am the Palestine director of 1for3, a Boston-based non-profit organisation that works in Palestinian refugee communities. I was in Tulkarem to meet our team of community health workers at al-Awda Centre. The centre’s director guided a small group of us through the camp to see the wreckage caused by the Israeli military.
Having watched Israel’s war on Gaza on TV and online from my home in Bethlehem, it was strange to see similar scenes of destruction in the West Bank first-hand. But as we walked through Tulkarem camp, we saw residents of all ages – still able to muster a smile – clearing up the wreckage or checking on elderly neighbours to see if they needed anything.
Health is inseparable from politics, especially in a refugee camp like Tulkarem. Refugees should be treated not as victims or passive recipients of aid, but as experts on their own conditions. Given the resources and space, they are able to lead the way in building systems of care that are both culturally rooted and sustainable. When access to healthcare is obstructed by economic hardship, military attacks, checkpoints and other restrictions on movement, community health workers are essential. Bridging the gaps in a fractured healthcare system, they provide home-based care, chronic disease management, paediatric care and psychosocial support. In Tulkarem, they have also become key figures in community cohesion and emergency response.
In circumstances where systemic violence is designed to fragment and isolate populations, community health work has become a form of resistance. It is not only a model for survival, but a way to assert the right to live in dignity. Despite Israeli efforts to erase and displace them, community members remain, adapt and support one another. After the mass displacement of over 80 per cent of the population of Tulkarem and Nur Shams refugee camps in February, residents of Tulkarem city opened their doors to strangers from the camps.
Last September, during an Israeli military incursion into the camp, one of our community health workers was shot while saving one of his colleagues and protecting residents. He has spent several months in hospital rehabilitation. His story is not exceptional but a reflection of the daily risks that community health workers face.
After the ceasefire agreement in Gaza in January, Palestinian refugee camps in the West Bank saw the most intense attacks in a generation. Military incursions, home demolitions, mass arrests and killings became routine. Since Israel launched ‘Operation Iron Wall’, nearly nine hundred military checkpoints have been installed, crippling movement between Palestinian cities and cutting off access to healthcare and essential services. Israel has also established military barracks in the camps.
With hospitals inaccessible, home visits from community health workers – often displaced themselves – have become more important than ever. They also, at some risk to themselves, co-ordinate between the Red Crescent and the military to allow ambulances to carry the elderly, injured and disabled to safety.
The violence threatens to shatter not only individual lives but the structures of care and support that hold communities together. The city of Bethlehem is now facing similar threats as Tulkarem and other areas in the West Bank: there has been an increase in military activity and markings on the walls of homes, which may be destroyed soon to pave the way for more settler-only roads. But we will not give up. As one of the community health workers put it, ‘our community is everything. Even when we have nothing else, we have each other. And as long as that is true, we will find a way to keep going.’