Quality health care in the West Bank, Palestine

Diabetes and Ramadan

The close connection between the medical team and potential patients all over the West Bank is also key to the success of the mobile diabetes unit. In 2023, it served almost 5,000 patients. Nowadays, the bus is stationed in a small village in Bethlehem district. AVH doctors and nurses examine feet and screen eyes. Many patients are elderly and only seek treatment when their feet go numb, or their vision begins to blur.

"We will have to come back; these are all uncontrolled cases of diabetes," says Dr Maen Haj Ahmed, who recently joined the team. "Diabetes is a big problem in Palestine," Eddin adds. "Many patients come with very high blood sugar. They eat poor diets, do not exercise regularly, and take no or the wrong medication."

Unlike local clinics that may provide limited instructions, the AVH mobile team takes a comprehensive approach, educating patients on nutrition, sugar avoidance, and medication management. They also offer guidance during the Muslim holy month of Ramadan, advising patients on fasting practices and necessary adjustments.

The patients trust the team, and generally follow their advice – like Jamileh Fanoun, a 65-year-old woman. “I walk 20 minutes every day,” she proudly says, explaining in detail how she made dietary changes and now embraces healthier cooking practices. She learned about the mobile unit through social media and now diligently follows the advice of the diabetes team.

A systemic problem

The prevalence of diabetes in the West Bank is not merely a medical issue but it also reflects broader socio-economic realities. Limited healthcare resources, exacerbated by the recent conflict, hinder effective diabetes management: Mohammed, 49, and his son lost their jobs on an Israeli construction site in October after the Hamas attack. Mohammed used to buy the specialized medication he needed from his salary, but now he barely knows how to put food on the table. Other patients walk in simple plastic sandals, an elderly patient’s walking stick looks like it has been repaired several times.

Addressing diabetes in the West Bank is not just a medical intervention but takes a holistic approach. Apart from considering cultural issues like fasting during Ramadan, the bus also works with local clinics. The Ministry of Health, responsible for providing medication to diabetes patients, faces capacity constraints, often resulting in insufficient support and guidance. The mobile unit, therefore, also trains local nurses.

Some issues, however, are beyond their control. "I can avoid soft drinks, but I cannot avoid stress," Marwan (49, name changed) says. He then talks about the olive grove that his family owned. In October 2023, the military occupied the land and cut down the trees – an additional livelihood lost to his family.

"We want to feel safe. We want peace," he says.