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How Israeli and Palestinian Medical Volunteers Work Across Borders to Save Lives

Israeli security forces inspect a Palestinian Red Crescent ambulance at a checkpoint in the occupied West Bank, on August 19, 2023. Credit - Jaafar Ashtiyeh—AFP/Getty Images

Days before Vivian Silver was killed by Hamas in the Oct. 7 attacks, the 74-year-old Israeli-Canadian peace activist was planning to drive six critically ill Palestinian patients to a hospital in Jerusalem. A longtime member of Kibbutz Be’eri, Silver often volunteered with Road to Recovery, an Israeli NGO that enlists volunteers to drive buses of Palestinian patients who are unable to access specialized medical care in the West Bank and Gaza to Israeli hospitals.

“You could see that my mother was doing something very significant for Palestinians in need of those services,” says Yonatan Zeigen, Vivian Silver’s son.

The medical administration of the occupied Palestinian territory—divided into the three regions of Gaza, the West Bank, and East Jerusalem—faced limitations in resources and expertise far before the recent outbreak of war. According to Project Rozana, close to 100,000 Palestinian patients seek specialized treatment in Israeli and East Jerusalem hospitals every year, including children who require treatments like chemotherapy or pediatric dialysis.

In East Jerusalem, six hospitals administered by the Palestinian Ministry of Health currently provide many advanced medical specialties that the West Bank and Gaza are unable to provide. But an elaborate exit-permit system—administered by the Israeli government before the end of the 1967 Six-Day War, along with the newly-restricted access of ambulances through security checkpoints since the beginning of the recent war—means that Palestinian residents are often restricted in their freedom of movement, with the World Health Organization stating that obtaining Israeli permits is a process that is “neither transparent nor timely.”

Since Oct. 7, the situation has only devolved. WHO’s latest data estimates that since the war, there have been 804 attacks on patients, healthcare workers, and facilities, resulting in 693 deaths and 970 injuries in the occupied territories.

As the need for healthcare increases, volunteers and patients alike see these efforts as crucial acts of humanity—not just to fill the gaps in a collapsed healthcare system, but to cultivate grassroots relationships between Israelis and Palestinians.

“The volunteers want to build bridges,” says Ronit Zimmer, the CEO of international NGO Project Rozana, whose Wheels of Hope initiative manages the volunteers. “And they continue to show resilience and belief in the value of cooperation.”

Wheels of Hope, which was founded five years ago, coordinates buses and other modes of transportation with a network of volunteer drivers that are part of organizations such as Road to Recovery, Humans Without Borders in Jerusalem, the Green Land Society for Health Development in Hebron, and Smile of Hope in Gaza.

“For my mother, the act of driving felt so simple and straightforward,” recalls Zeigen. “But she would always come back and say she felt enlightened by the experience.”

Adam Abu al-Rob, a six-year-old Palestinian eye cancer patient, is carried by his father Mamoun as they meet with Road to Recovery volunteer Yael Noy at the Rehan checkpoint between Israel and the occupied West Bank, driven by her on their way from the Palestinian village of Jalbun to Shiba Hospital Tel Hashomer near Tel Aviv, on May 22, 2023. <span class="copyright">Jack Guez—AFP/Getty Images</span>

Driving for humanity

Every year, thousands of Palestinians are referred by their doctors to hospitals outside the occupied territories for necessary, often life-saving medical services. The majority of these referrals are for diagnosis and treatment services in five common specialties: cardiovascular diseases, oncology, orthopedics, neurosurgery, and ophthalmology. In just the month of July last year, for example, the Palestinian Ministry of Health issued 9,698 referrals, according to WHO.

But the approval rate for patients receiving permits has varied considerably over the past 15 years—ranging from 94% in 2012 to 54% in 2017, according to the U.N. The U.N. further estimates that from 2019 to 2021, only 65% of patient permits were approved in time for the patients to reach their hospital appointments, even in cases where the patients had severe health conditions.

There have also been cases where patients were denied exit permits, in what the U.N. has said may amount to “collective punishment.” As a result, the United Nations has defined those in need of medical referrals as a vulnerable group, particularly when they face delayed or denied access to specialized medical services.

To work around these restrictions, Wheels of Hope has continuously transported patients through an elaborate maze: A Palestinian volunteer driver picks up a patient from their village and takes them to the checkpoint on the border of Israel. There, the patient will cross the checkpoint with an Israeli volunteer driver to reach the hospital where they are receiving treatment.

“What the Wheels of Hope program does is enables a very good facilitation of that process, and the relationships that are built through it between the drivers and the patients are often very beautiful,” says Zimmer.

Amy Yourman, the director of Humans Without Borders, first became involved in the program as a volunteer in 2019. Within months, Yourman, who is originally from the U.S. but has lived in Israel for 37 years, became a passionate advocate for the patients she was helping transport.

For five years Yourman has helped transport a family with a now-12-year-old boy to cancer treatments in East Jerusalem. One day, while waiting at the checkpoint for the Palestinian volunteer driver to pick up the family, Yourman and the patient’s mother struck up a conversation. The mother recounted their long and arduous three-hour journey before the volunteer program was put in place: a taxi from her village outside of Hebron, then three different buses from Hebron, Bethlehem, and Old City.

“It became clear how this made a tremendous difference in her life—not just time and comfort, but also the greater safety for a sick and immunocompromised child,” she says.

In the Hebron region of the West Bank, physical therapist Mohammad Hammouri has also volunteered with the program through the Green Land Society for years. Hammouri says he became involved after his cousin was diagnosed with cancer. “I wanted to do something for patients like him,” says Hammouri.

Since then, he has formed countless bonds with patients and volunteers he sees regularly. “I have a patient named Lena, who leaves her home at 4 a.m. so she can reach the hospital in time for her appointment,” he says. “But every morning, she insists that we drink a cup of tea together before leaving.”

In all the time that volunteers and patients have spent together, the impact has been significant. Last year, 84 volunteers at Humans Without Borders made 5,955 trips to help 112 families. From Hebron, the Green Land Society’s 41 volunteers made 5,823 trips to help 172 individual patients.

“The volunteers are amazing people who are willing to give out of the goodness of their hearts,” says Diana Shehade Nama, the Director of Programming at Project Rozana, “but they are also politically conscious and active peacemakers, who are especially passionate about the disparities of the services and rights for Palestinians.”

Until Oct. 7, Wheels of Hope also operated buses in Gaza, with their last trip made on Oct. 6. “A lot of the patients on that last ride were stranded in Jerusalem and ended up staying at the hospital longer than needed,” recalls Nama. Patients who completed their treatments were taken to the West Bank to stay with relatives, while the caretakers of those who passed away were sent back to Gaza. Since then, the NGO has been unable to keep track of those patients, says Nama, highlighting the complete collapse of healthcare in the besieged territory.

Adam Abu al-Rob sits in the backseat with his father Mamoun on May 22, 2023. <span class="copyright">Jack Guez—AFP/Getty Images</span>
Adam Abu al-Rob sits in the backseat with his father Mamoun on May 22, 2023. Jack Guez—AFP/Getty Images

An urgent need for health diplomacy

As Israel’s bombardment of Gaza continues, experts say the dire situation in the West Bank is also likely to deteriorate further. Given the escalating situation, other organizations like the U.K.-based charity Medical Aid for Palestine, or MAP, is working to equip frontline emergency medical services and deliver emergency and lifesaving disposables, fluids, and drugs to Palestine Red Crescent Society emergency teams.

Project Rozana is similarly training medical personnel in the occupied territories in emergency medical care for neonatal and pediatric patients, and previously trained Palestinian nurses in Israeli hospitals. “The best thing we can do is make these services available where they are, rather than having patients go through all of these hurdles,” says Nama.

Zaegen says that these initiatives underpin his late mother’s mission as he carries her legacy forward by lobbying world leaders to rally for peace with the Alliance for Middle East Peace. “These organizations bring something a lot bigger than just two communities meeting,” says Zeigen. “When people get into your car, or you get into someone else’s car, you have to create trust.”

He continues, “The issues may be huge and complex, but the solution for peace is very simple.”

Write to Astha Rajvanshi at astha.rajvanshi@time.com.