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Last update - 20:15 23/02/2006
Twilight Zone / Patient X
By Gideon Levy
Franz Kafka would have made a story out of it. Y., an AIDS patient from a remote village in the south Hebron Hills, a poverty-stricken man who until recently was a construction worker in Israel, has to hire, at his own expense, two armed bodyguards and a vehicle as a condition for receiving treatment at Hadassah University Hospital in Ein Karem, Jerusalem. Y. has no money to hire the guards, and were it not for the assistance of Physicians for Human Rights (PHR), Israel would abandon him to his fate, to die from his terrible disease. I have seen AIDS patients who were abandoned to their fate in Myanmar and Cameroon, but there is probably nowhere in the world where AIDS sufferers have to obtain financing for armed guards to protect others from them. Y. was required to supply guards because in his youth, about 25 years ago, he was once arrested during a demonstration in his village. After that, he worked for 22 consecutive years as a laborer in Israel, and never had problems with the law or the security forces, except for a few times when he was caught as an illegal resident - and released immediately. Nevertheless, security comes first: In recent months, his entry to Hadassah hospital was prevented four times for "security" reasons. Late last Wednesday afternoon, after an exhausting administrative and legal battle, Y. entered the secured car awaiting him in Halhul and, together with his guards, traveled to the AIDS clinic of Prof. Shlomo Maayan, Hadassah?s AIDS expert, who waited until evening to see his patient, whose arrival was delayed. Y.?s wife joined him, too. He is sick and she is a carrier, but she is lucky: She is not "a prohibited person for security reasons," as he is. Y. is not alone. In Gaza, there is another AIDS patient whose entry for treatment in Israel is not permitted at all. His fate is sealed. A shockingly decrepit home on the main road, wide open to the cold winds. Little children with runny noses, some of them covered with wounds, one of them apparently retarded - six years old and still not talking - and sick parents, in a remote village in the south Hebron Hills. The cracks in the windowpanes are covered with plastic; an old, stained Hadassah Hospital sheet serves as a curtain in the living room. The few shabby plastic flowers climbing up the damp wall only add to the sense of misery. Y. refuses to allow his full name and photograph to be published, solely because of his children. In their society, he says, a father who suffers from AIDS is liable to be a badge of shame. He is 40 years old, with seven children, and defines his profession as "builder" in his laborer?s Hebrew, after all the years of construction work he has done in Israel. Since falling ill, he can no longer work, and the family is on the verge of starvation. Last September, he began to feel weak. "On the last day of work in Israel, in stone construction, I didn?t feel very well.? His condition quickly deteriorated and he went to a clinic in Hebron, which sent him to the city's Alia Hospital. He could no longer stand on his feet and suffered from diarrhea, shortness of breath and chest pains. After a series of tests he was diagnosed at Alia as having AIDS, and was immediately placed in isolation, in difficult and humiliating conditions. The hospital staff did not know how to treat an AIDS patient; Y. himself had never heard of the disease. After 24 days of hospitalization at Alia, after he had already lost consciousness and was on the verge of death, he was transferred to Hadassah Ein Karem, at the expense of the Palestinian Authority. When he awoke, he discovered that he had already spent 12 days at Hadassah. Y. emotionally expresses his gratitude for the devotion of the staff there, headed by Prof. Shlomo Maayan, who is also active in PHR. But his disease makes him feel that he has to keep on apologizing: "I didn?t do anything bad ... I didn't go around here and there, you understand ... I told Maayan that I'm in a situation where I need help, and therefore I would have told him everything. But there was nothing. It's from God." Whether from God or not, Y. apparently received an infected blood donation when he was hospitalized 10 years ago at Alia, and afterward at Makassed Hospital in East Jerusalem. Prof. Maayan reached that conclusion only last week, after Y.'s first visit to the clinic and the long conversation they held. Y. suffered from a blood disease; his spleen was surgically removed and then he received 11 units of blood in those two Palestinian hospitals. One of them was apparently infected. After about a month in Hadassah, during which his condition improved, Y. was released to his home with recommendations for treatment, prescriptions for medications and other instructions. His children were tested during his hospitalization and were found to be healthy, including his newborn son. His wife turned out to be a carrier. He was released from Hadassah weighing less than 40 kilograms - a walking skeleton who was unable to stand on his feet. His brother carried him home in his arms. From a torn plastic bag hanging on the door of the room, he removes his basket of medications, the cocktail that saved his life and improved its quality beyond recognition. Y. received the drugs from the Palestinian Health Ministry, in accordance with the Hadassah prescriptions. Three drugs, six pills a day in all. They have worked wonders; within a few weeks he was once again standing on his feet. Since then his condition has improved, and there are almost no signs of the disease evident on this smiling man any longer. Said Y.: "When Maayan saw me, he was really pleased. 'Is that you?'" he asked. "He didn't recognize me, he couldn't believe how quickly I had progressed." "After investigating the circumstances, we are considering giving the subject an entry permit, subject to being accompanied by an Israeli security company and two Israeli security guards during his entire stay in Israel (at his expense)," wrote Private First Class Anna Shmulevitz, a legal NCO from the Population Registry, on February 12, in the name of the legal adviser of the Israel Defense Forces, Judea and Samaria region. Added Shmulevitz: "The final decision has not yet been made. We will ask for details about the security company and the security guards who will be willing to do the escorting if it is approved (including a letter of commitment). We would like to make it clear that in any case, his entry will be approved only with the approval of the Israel Police (after receipt of the abovementioned details)." This was written after Y. made four unsuccessful attempts to reach Hadassah, and after PHR threatened to petition the High Court of Justice in order to obtain a permit for him. "Your demands, as indicated in the last letter, have been transmitted to the patient. And he for his part informed us that he cannot meet them. We insist that his entry into Israel for the purpose of urgent medical treatment be permitted immediately," wrote Tal Manor of PHR the next day. She, together with PHR's man in the field, Ibrahim Habib, spared no effort to bring Y. to Hadassah, an hour's drive from his house. "After considering the health situation of the resident on the one hand, and security needs on the other, the military commander believes that in spite of the significant security risk presented by the subject's entry into Israel, we can allow his entry for receiving this treatment, if he is accompanied by two security guards from an approved Israeli security firm. Thus a proper balance has been achieved between the resident's needs and security needs," wrote Major Liron Alut of the Population Registry, in the name of the legal adviser, IDF, Judea and Samaria region. "It should be emphasized that the treatment and the medical follow-up that Mr. Y. received are essential for his medical condition and his health; without them he is doomed to die, and they are unavailable at present anywhere in the West Bank. Therefore, in light of the abovementioned, and in light of the principles of administrative and international law, which are binding on the state in the occupied territories, I request your immediate intervention on this matter," wrote attorney Yohanna Lerman, the legal adviser of PHR, to Major General Yosef Mishlav, coordinator of government activities in the territories, the following day. She sent a copy of her letter to Osnat Mandel, head of the department for High Court petitions in the State Prosecutor's Office. The appointment made for Y. on February 13 passed, and Prof. Maayan gave him a new one. He wrote to the IDF authorities: "To my surprise, the AIDS patient did not appear for follow-up at the AIDS clinic at Hadassah University Hospital in Ein Karem, as decided in advance. There is great urgency to an orderly follow-up of this seriously ill patient, and the health authorities in the PA are unable to carry out essential tests for the patient, nor is there a specialist in the field in the PA. I would like to invite him and his wife to the AIDS clinic next Wednesday afternoon, February 15." When the PHR people saw that there was no chance of convincing the security establishment, and that every day that passed exposed Y. to new dangers, they decided this time to pay for the security guards, who were to receive NIS 2,000 for their work. They turned to the security firm Agudat Hashomrim, which agreed to carry out the assignment - but on condition that Y. would sit in one car, and the guards in a another. "What will happen if the patient suddenly coughs on one of the guards?" they asked fearfully at Agudat Hashomrim. Anna Shmulevitz, the legal NCO, was vehemently opposed to this arrangement. "The Israel Police told us that if the guards are in a car other than that of the person being guarded, the security is not effective and is not acceptable to them. The conditions of security, as mentioned, have been determined by the police. If you want to dispute these conditions, we suggest you approach them directly. As we have mentioned in the past, if you cannot meet the proper security conditions, we suggest that the patient ask to receive medical treatment abroad." Just before Israel was to send Y. for "medical treatment abroad," PHR looked for another security firm, whose guards would not be afraid to travel in the same vehicle as Y. Derech Eretz agreed to send its armed guards in the same car as Y. "We promise to take the patient from Hebron to Hadassah Ein Karem, to wait for him and to bring him back," they wrote to Shmulevitz. Shmulevitz was placated, and in her wake, the entire security apparatus was as well. The threat had been removed. Thus, last Wednesday, at 3:30 P.M., Y. and his wife set out from their home in a village in the south Hebron Hills, took a taxi to Halhul and from there traveled in the well-secured car that was waiting for them, with two armed guards wearing bullet-proof vests, to the AIDS clinic at Hadassah University Hospital in Ein Karem. "The moment they saw that I speak Hebrew they felt more comfortable, and I felt comfortable, too, and we drove to Hadassah," says Y. with his pleasant smile. Prof. Maayan invited him for a return visit on April 5.
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