Peace Building Through Health- Focused on the Israeli-Palestinian

Conflict

Norbert Goldfield, M.D.

Course Description

• An examination of the multiple links between health and peace, concentrating on the strategic use of health initiatives to encourage peace in zones of actual and potential armed conflict with a focus on the Palestinian-Israeli conflict.

Difference between Peace-Building and Peace Initiatives

• Health professionals working in their professional capacity can contribute to peace-building

• Peace (through health or any other area) is a political process and requires the intervention of individuals/groups that have political standing

Knowing is not enough; we must apply

Willing is not enough; we must do - Goethe

Successful politics is always the art of the possible. It is no less

true, however, that the possible is often achieved only by reaching

out towards the impossible which lies beyond it.

Max Weber

The health of the people is really the foundation upon which all their happiness and all their

powers as a state depend

Benjamin Disraeli

Readings will be

• A combination of readings handed out one week in advance, readings on reserve,

• Important for tests and will help you with ideas for your papers.

Course Requirements

• Mid-Term – 20% of grade• Final – 30% of grade• Short Paper (5-10): due end of October 13 – 20%

of grade• Final Paper (10-15 pages): due one week before

Finals and will be handed back the day of your finals. – 30% of grade.

• Text: all on the web and/or a small amt on reserve

Assumptions in this course behind the link between Peace-

Building and Health

Structural violence is the indirect use of economic, political and social power to

disempower others. This takes place through systems and institutions, causing disadvantage and harm. Structural violence may be evident in a number of different but interlinked ways

(e.g. unequal access to resources, political power or health care). Inequities in health

status are an important indicator of structural violence within a community. Violent conflict

may be a visible manifestion or response to underlying structural violence.

Peace may be defined

• not merely as the absence of war or violence (direct, indirect, structural or cultural), or harm to others, but in a systemic way as engendering a state of integration and positive, nurturing, respectful and co-operative relationships.

A New Definition of Health by the European Region of the World

Health Organization• Health is the extent to which an individual

or group is able , on the one hand, to realize aspirations and satisfy need, and, on the other hand, to change and cope with the environment. Health is therefore seen as a resource for everyday life, not the objective of living; it is a positive concept emphasizing social and personal resources as well as physical capacities

Peace-Building Through Health:Potential Roles of Health

Professionals

LESSONS LEARNT• When there is an underlying genuine thrust towards peace

and reconciliation, Health can play a role as catalyst in the peace process.

• Health and humanitarian assistance can be explicitly linked to peacebuilding processes.

• Neutrality and impartiality cannot represent a deviation from the principle that health assistance should be delivered proportionally to the needs.

• An effective contribution to the sustainability of peace can be ensured by addressing the root causes of conflict.

• Humanitarian assistance cannot ignore the situation of human rights.

LESSONS LEARNED cont.

• Development and emergency assistance must not be separated.

• Lack of comprehensive and locally-owned strategy can generate inconsistent, short-lived and even counterproductive outcomes.

• It is essential to shift from vertical to horizontal technical programming in order to involve people in the reconciliation process.

• Different Partnerships – public/non-profit, central/peripheral, and international/national – are crucial elements for effective peace building.

Lessons Learned (cont

• Coordination facilitates a common understanding of respective roles/responsibilities.

• Complex emergencies call for new expertise from humanitarian workers.

• Decentralized cooperation/twinning/social partnerships among local communities is a tool to promote human development and peace.

• Training activities can involve professionals from different conflict groups.

Parallel Israeli – Palestinian Narratives.

• West D. Myth and Narrative in the Arab-Israeli

Conflict. World Peace Foundation • Quota S and Odeh J. The Impact of Conflict on

Children: The Palestinian Experience. Journal of Ambulatory Care Management

• Anderson M and Olson L. Confronting Lessons – Critical Lessons for Peace Practitioners.

Healing Across the Divides

Executive DirectorNorbert Goldfield, M.D.

It is important for Israeli and Palestinian health professionals with the assistance of outside professionals from outside the

Middle East to identify:

        concrete health and ethical problems,         research questions that are significant,

need resolution, and are         resolvable by the parties coming to

the meeting and join forces to form a common strategy to tackle the problems.

Healing Across the Divide (a not for profit organization) represents the American

counterpart bringing together all appropriate constituencies (including Christians, Muslims, Jews in addition to interested individuals) “to

assist Israeli/ Palestinian health care organizations to improve the health of Israelis and Palestinians via increased

health professional mediated health and human rights improvements and

policymaker decisions.”

Under the guidance of a Board of Directors and Board of Scientific Advisors, Healing Across the Divides will pursue initiatives that will result in:

• Documented improved health status of the population served

• Increased clinical knowledge base for both Palestinian and Israeli health professionals but particularly the former

• Increased knowledge base and exchange of ideas on issues pertaining to violence and its prevention particularly for health professionals and health care students.

Board of Directors as of January 2005

• Heidar Abu Kteish, MPH, Director of Prevention Programs, Union of Palestinian Medical Relief Committee, Ramallah, Palestine

• Ziad Asali, M.D., Executive Director, American Task Force on Palestine, Washington DC

• Paul Hassoun, M.D. Johns Hopkins University School of Medicine, Baltimore, MD

• Alfred Khoury, M.D., Chair, Medical Committee, ANERA (American Near East Refugee Aid), Washington DC

Board of Directors (cont)

• Larry Lowenthal, PhD, Executive Director, American Jewish Committee, Boston Chapter, Boston, MA

• Margaret O Kane, MPH, President, National Committee for Quality Assurance, Washington, DC

• Leonard Rubenstein, J.D. Executive Director, Physicians for Human Rights – USA, Washington, DC

• Hadas Ziv, Executive Director, Physicians for Human Rights – Israel, Tel Aviv Israel

International Committee of Expert Scientific Advisors

Examples of projects we will pursue beginning in 2005 include joint:

• Initiative to improve health status of diabetics and hypertensives

• Training program to enhance medical ethics among health professionals

• Training and Research on coping with psychological trauma and disaster.

• Course on Peace-Building Through Health at an American college, Spring 2005

By improving the health of Palestinians and Israelis we are

attempting to accomplish this via a human rights lens and thus enhance the dignity of each

human being impacted by these programs.

Initial Project Partners

• Union of Palestinian Medical Relief Committees

• Physicians for Human Rights – Israel.

Examples of potential roles for Palestinian/Israeli academic institutions

• Assist in identification of appropriate projects – prevalence of chronic illnesses among Palestinians. Ongoing study (?) at Al Quds on prevalence of chronic illnesses

• Assist/ direct evaluation of initiatives

• Assist in ongoing evaluation/ critique of project models.

Examples continued

• Collaborative projects between Palestinian, Israeli and American students.

• Collaborative research projects on topics not related to Healing Across the Divides programs

• Cross training programs and courses (one week professorships for example) by American/ European professors in Palestinian and Israeli institutions.

To move even slightly from pessimism of the intellect to

optimism of the will we need to successfully implement at least one project on a small scale that measurably improves the health of both Palestinians and Israelis.

Final Exam

• There are no right answers. I am interested in your thinking process and the information you bring to bear to the important points you wish to make

Forgiveness is an important part of peace-building. Or is it? Please describe some of the challenges and opportunities to implementing such a concept today in a peace-building through health project

applied to the Israeli-Palestinian conflict. In which ways do the challenges get

easier or more difficult if an American NGO participates? What are the psychological obstacles to peace

building in the Middle East? What is the role of the third party in general and

American NGOs in particular.

Orientalism, as articulated by Said, is a concept much lauded and criticized. How does your understanding of the

term fit into any peace building through health efforts as they might impact

groups such as Israeli Palestinians and Israeli Jews on the one hand and

Palestinian Muslims and Palestinian Christians on the other. How should it affect American foreign policy in the

Middle East?

Dual Loyalty is a term that we bandy about and yet health professionals continue to violate their

Hippocratic Oath in favor of their duties to their nation and to their immediate supervisor. What are some of the common challenges facing Palestinian

and/or Israeli health professionals pertaining to dual loyalty? What are the difficulties American and/or European health professionals have in dealing with these challenges? To make it clear-Torture is not a

dual loyalty problem. It is forbidden-full stop. DL is a different problem in which third party presses the health worker to give up his prior obligation to the patient but all within legal and ethical framework

like between individual and society, individual and

workplace or army, etc..

Go to PHR-Israel’s web site. Read about some of the projects that they are engaged in pertaining to peace-building with Palestinians. Briefly provide suggestions on how they

might improve any of their projects in light of the readings, discussions

and speakers that we’ve had.

I have pessimism of the intellect, optimism of the will – Gramsci,

1920’s