The practice of humanitarianism: A village birthing clinic in Palestine

Abstract

Discourses and practices surrounding humanitarian organisations have changed over time. This is certainly the case for Palestinian non-governmental organisations, which have followed the structural and ideological transformations observed in local, regional and international contexts. There have been three successive but interlocking generations of groups active in health in Palestine: charitable societies, popular committees, and donor-based entities. Against this background, a village clinic in the West Bank is seen to have gone through various incarnations in the context of an emerging neo-liberal economic, administrative and political environment. Despite the critiques justifiably addressed towards them, non-governmental organisations may in some cases be functionally fluid. Communities and people continue to use them strategically in their relations with states, political groups, individuals and receivers of aid, making them potential networking sites in the context of an ongoing occupation.

Keywords:

• humanitarianism
• NGOs
• Palestine
• birth
• solidarity

Acknowledgements

I thank Joseph Dumit, Michael Fischer, Dahlia Gubara, Roger Heacock, Samer Jabbour, Harriet Ritvo, Rosemary Sayigh, Mayssun Succarie, Alexis Wick and Laura Wick for reading and contributing to my work. I received valuable comments from my colleagues in the Health and Society Group, AUB. A version of this article was presented at a conference on health and conflict co-organised by the Faculty of Health Sciences, AUB and the Middle East Studies Council, Yale University. The research upon which this article is based was partially funded by a grant from the MEA awards Program in Population and the Social Sciences, the Population Council, WANA regional Office in Cairo in 2003 and a University Research Board Seed Grant from the American University of Beirut in 2007.

Notes

1. The literature on these topics is ever-expanding: on development, see Escobar (1994), Ferguson (1994); on liberalism in its newest form, see Harvey (2007); on human rights, see Agamben (1998), Asad (2000), Spivak (2004, 2005).

2. Ten per cent of the budget of the Palestinian Authority (based primarily on foreign donations) goes to the Ministry of Health, with a per person expenditure of $135 (Mataria et al. 2009).

3. Countries such as Egypt, Jordan and Lebanon have also undergone a process of hospitalisation of birth accompanied by an increasing privatisation of medicine, a diminished role for midwives in relation to male physicians, a rising caesarean section rate, and lack of routine evidence-based childbirth practices (Choices and Challenges in Changing Childbirth Research Network 2005).

4. For further description of the development and significance of the birthing hotline as a part of the popular health movement, see Wick (2008).

5. Both the PA and the medical establishment tend to prefer high-tech medical care models even for normal childbirth without taking into consideration its safety, sustainability or appropriateness in the specific local context.

6. On the resurgence of village councils during the second intifada, see Malki (2005).

7. This does not negate the critique (on an entirely different register) of NGOs as having played a role (whether intentional or not) in the removal of active cadre from formal political activities.