By Norbert Goldfield
Approximately six months ago, I asked an astute long-time American observer of the Israeli-Palestinian conflict whether we had come to the end of the road for a two-state solution. He replied that we had come to the end of that road in 1967. Putting it differently, Zhou Enlai, the premier of the People’s Republic of China under Mao Zedong, when asked what he thought of the French Revolution, reportedly replied that it was too early to tell.
Despite these challenges, it is certain that groups and individuals throughout the world will continue to pursue peace and attempt to resolve conflicts in new and innovative ways even when, as in the case of the Israeli-Palestinian conflict, there may be no apparent way forward. In the face of this bleak outlook, US-based not-for-profit Healing Across the Divides takes a bottom-up approach to the Israeli-Palestinian conflict and provides grants that will have the following effects:
Improve the health of individual women and/or increase individuals’ control of their chronic diseases such as diabetes (today’s epidemic) via community-based interventions. We hope to see this happen both on an individual basis and on a system-wide basis if the community-based intervention succeeds in a local area.
Increase the organizational and technical capacity of community-based organizations (CBOs) to impact their communities and hopefully beyond.
Strengthen the leadership of these CBOs with the hope that some of these individuals will have an impact beyond their communities.
Peace-Building Through Health
According to a recent meeting at the United States Institute of Peace, peace-building through health can produce “an environment that increases people’s investment in peace and can reduce, if not relieve, tensions that contribute to conflict.” Developed by health professionals working at the World Health Organization in the 1990s, peace-building through health advocates have developed a number of intervention “tools,” including:
- Strengthening communities
- Communicating knowledge
- Extending solidarity by use of health professional clinical skills
- Personalizing the “enemy”
- Constructing common goals
- Non-co-operation and dissent
In brief, Healing Across the Divides has attempted to strengthen communities via grants and the communication of knowledge. That is, we provide technical advice to CBOs pertaining to outcomes evaluation on approaches to community-based health improvement. We have also attempted to personalize the “enemy” by inviting both Palestinian and Jewish grantees to the United States. They speak before diverse groups across the entire political spectrum of the Israeli-Palestinian conflict. In addition, groups we have funded, which traditionally have not worked together and are from different ethnic groups, have begun to work together (e.g., a CBO representing Ethiopian Jews and another working with Israeli Arabs).
Governmental and Private Organizational Roles in Health Improvement
The June 30, 2011 issue of The Economist published an article with the following headline: “Privatising peace: Governments are increasingly handing over the early stages of conflict resolution to independent organizations.” While the article in The Economist went on to detail the increasing role of private non-governmental organizations (NGOs), the reality is that the resources that these private organizations can command is paltry compared to funding from governments. Thus, without European and American subsidies, the Palestine Authority would cease to exist, while the American government’s foreign aid budget to Israel is the largest to any country in the world.
The Economist article also highlights the nimble and non-bureaucratic ability of NGOs to facilitate change such as improvement in the health of women. While we do not bring to bear even a fraction of the resources that a government does, NGOs such as Healing Across the Divides can fund pilot programs which, if successful, could constitute the seeds of system-wide change. Healing Across the Divides has funded a number of pilot programs for community-based organizations both in Israel and the West Bank.
A Sampling of Project Initiatives Healing Across the Divides
Healing Across the Divides has provided extensive training to community-based groups on both sides of the Green Line on evaluation of health care interventions, quality improvement techniques, and organizational capacity building. In peer-reviewed publications and at conferences, community-based organizations partially funded by Healing Across the Divides have documented health disparities and programmatic impacts on the health of Palestinian diabetics, Orthodox Jewish women, and Palestinian women in the West Bank.
We have supported approximately 15 community-based organizations, including the following:
- Beit Natan represents Orthodox Jewish women in Jerusalem working on breast cancer. Orthodox Jewish women have a higher rate of breast cancer diagnosed at a later stage of the disease. The project we funded focuses on increasing the early detection rates of breast cancer through community outreach h and the training of female physicians in “clinical breast examination,” a technique that can substitute for mammography but needs to be done by a female health professional.
- Al-Tufula in Nazareth, Israel has worked with Israeli Arab women living in villages in northern Israel with few, if any, municipal services. These towns typically have no access to health services. Although the towns may technically have a right to such services, the distance may be too far to access them. The project aims to help women improve their own health (through, for example, a walking club) while also approaching the health system to insist that they provide services such as gynecologic care.
- Dar Al Kalima in Bethlehem, Palestine Authority, focuses on Palestinian women’s health issues. Currently, they are beginning to work with a village in the West Bank near Bethlehem that has significant access issues because of the wall that separates Israel from the Occupied Palestinian Territories.
- The Palestine Medical Relief Society has focused on improving diabetes care using community health workers in numerous villages throughout the West Bank. Almost 15% of Palestinians have diabetes.
- Tene Briut, an Ethiopian Jewish organization, is dedicated to improving the health of Ethiopian Jews who have moved to Israel over the past 25 years. Almost 20% of Ethiopian Jewish adults have diabetes, a disease that was virtually non-existent when these Ethiopians lived in Ethiopia. Tene Briut has also used community health workers in this endeavor.
Given the fact that foundations have had a significant role on both sides of the Israeli-Palestinian conflict, we have tried to encourage policy engagement and financial partnership with foundations — wherever they might be and whatever their political inclinations. Thus far, we have worked collaboratively with two Israeli and one American Jewish Federation Foundations (city-wide Jewish organizations that fund projects both in the city in which the Federation is based and beyond).
Most recently, we collaborated with an American foundation to combine scientific engagement with significantly more resources to fund both Jewish and Arab women’s groups in Israel. The womens’ groups we will be funding include an Israeli-Arab women’s group that is focused on improving women’s health in the largest and very impoverished Bedouin town in Israel (Rahat); a joint Israeli-Jewish and Arab effort between community-based groups representing low-income physically handicapped women; and an Ethiopian Jewish effort to improve sex education among low-income female Ethiopian teenagers.
Healing Across the Divides is not a humanitarian organization. We have profound respect for organizations that perform this service, particularly for the large number of impoverished people living in the West Bank and Gaza and the increasing number of marginalized people in Israel. Our objective, however, is to promote, at a minimum, measureable individual health improvement which, while sounding humanitarian, is not; we insist that this be accomplished in a community context. The community-based grantees on both sides of the divide have had an impact on the lives of thousands of marginalized Palestinians and Jews. In addition, we aim for system-wide change; we seek societal change, such as improved care for breast cancer and diabetes at the national level.
We hope that CBOs will impact their own societies and beyond, such as the recent political alliance between an Ethiopian and an Israeli-Arab organization that we funded, which focuses on health rights issues. Hopefully, a similar alliance will be forged between Israeli and Palestinian politicians and eventually between community-based groups on both sides of the divide. In the words of Benjamin Disraeli, “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.”
. Leonard Rubenstein, “Peacebuilding through Health Among Israelis and Palestinians,” USIP Peacebriefing, No. 7 (January 2010), http://www.usip.org/files/resources/PB7%20Health.pdf.
. The Economist, June 30, 2011, http://www.allianceforpeacebuilding.org/news/68116/News-Sources-The-Econ….
. H.A. Ghosh, A. Shaar, J. Mashal, K. Dheidil, N. Barghuti, N. Shalaldeh, S. Aqabneh, and N. Goldfield, “Diabetes Control in 3 Villages in Palestine: A Community-based Quality Improvement Intervention,” Journal of Ambulatory Care Management, Vol. 30, No. 1 (2007), pp. 74–78; M. Khatib, S. Efrat, and D. Deeb, “Knowledge, Beliefs, and Economic Barriers to Healthcare: A Survey of Diabetic Patients in an Arab-Israeli Town,” Journal of Ambulatory Care Management, Vol. 30, No. 1 (2007), pp. 79–85.