The Multiple Deaths of Nisreen Karim
By: Qassem Qassem
Published Friday, March 9, 2012
Her name is Nisreen Karim. Her Nationality: Lebanese, from the village of Deir Siryan. She is 34 years old. Family status: Married to Palestinian Kamal Sulayman and mother of four. Social status: Died on the road traveling between hospitals.
Her husband, Sulayman, accuses UNRWA of “negligence.”
Um Hussein is not the first patient, and certainly not the last, to die because of the delay “by the UNRWA doctor in giving her a transfer slip to get into a hospital,” her husband said.
Before Um Hussein, there was Maryam Akram Mohammad. She died last year, aged ten, at the gates of one of Sidon’s hospitals because her parents could not find US$500 to admit her. She passed away in her father’s arms.
There is yet another case, which is well-known to the people of the Ein al-Hilwe refugee camp. It is the story of Mohammad Nabih Taha, the child who also died in 2011 at the gates of one of Sidon’s hospitals because he was not given a transfer slip to be treated there.
Um Hussein was slightly luckier than Mohammad and Taha. After falling ill, her family was able to take her to one of Tyre’s hospitals, which refused to treat her at the expense of the health ministry.
According to her husband, the officials said the ministry’s budget was “finished.”
“Then admit her at the expense of UNRWA,” he pleaded, adding, “Bring a transfer slip from UNRWA and we will admit her,” hospital staff replied.
This is Sulayman’s version of what happened at the reception desk in the emergency room.
The “transfer,” is just a piece of paper signed by a doctor on call at an UNRWA clinic. The doctor writes that the UN agency will pay for part of the treatment – usually about 30 percent of expenses – and the patient is thus “transferred” from the UNRWA clinic to any hospital, which has a contract with the agency.
The family headed to the UNRWA clinic in the Shabriha area, where they live. But “the clinic was closed,” said Sulayman. So they took her to the al-Bass refugee camp clinic. The family thought that their problem was over and that the doctor was surely going to give them the “transfer.”
Unfortunately, the doctor was on call in the Mashouq clinic. So, off they went to the Mashouq clinic. There, the doctor claimed that he could not give Karim a “transfer” because she was Lebanese.
A Lebanese woman married to a Palestinian has the right to claim 40 percent of her treatment from UNRWA. The remaining 60 percent is paid by the health ministry. However, “the UNRWA doctor did not know about this law,” says a source familiar with the investigation being carried out by UNRWA to find out what was behind this case of negligence.
So the misery began all over again. When the doctors refused to give Karim the “transfer,” the family had to find a hospital to take her at the expense of the health ministry.
Their search started in Sidon. Karim had been in the car with them all this time, going from one hospital to another. Her health continued to deteriorate, so they took her to Beirut. There she was finally admitted to one of the hospitals, where she died.
After the “people got angry” with UNRWA, damaging their cars and clinics in Shabriha, a medical investigation committee was set up. One of the members of the committee said that the report will come out in the coming days and will reveal where things went wrong.
Palestinian humanitarian organizations, who are following the investigation closely, do not blame the UNRWA doctors, because the problem comes from the “top,” according to one official. The official refused to reveal his name until the investigation is over.
The doctors “sign the transfers, but because there are so few of them, they do not work in UNRWA clinics every day. They only visit them once a week.” He asked ironically, mocking this bitter reality: “Is the patient supposed to time their illness with the UNRWA doctor’s visit to the clinic in order to get a transfer?”
The investigation committee met with the UNRWA doctors who “refused to come down to see the patient in the car,” according to Muhammad Al-Shawli, public relations and media coordinator at the human rights group Shahed organization. He added that UNRWA “might find a loophole, which is that the patient was Lebanese and could have been treated at the health ministry’s expense.”
Others say: “This investigation was only set up to absorb people’s anger over the incident. The problem is at the top, so it has to be treated from above. We are determined to pursue the investigation until we find the truth,” said Yasser Azzam, the Hamas official in charge of refugee affairs.
He has maintained that the problem is “in the way UNRWA deals with the Palestinian people.” He also added: “What prevented the UNRWA doctors from leaving their clinics to see the patient?”
Azzam also said that another problem is the lack of “a permanent and clear plan between the hospitals and UNRWA to deal with an emergency without having to go through the bureaucracy of the agency.”
An UNRWA official, for his part, said: “Any Lebanese woman who is married to a Palestinian is treated at the expense of the agency if the Lebanese health ministry does not cover her expenses.”
What happened with Karim was “an error by someone. We do not know when we will find out who was responsible,” he said, adding, “The Director General of UNRWA is pursuing the matter himself.”
Thus, between UNRWA’s procedures and delays and the bureaucracy of the hospitals, the poor always lose.
This article is an edited translation from the Arabic Edition.