Lina

by Dorothy Naor

Lina spunky and cute, [was] 4 years old on March 26, 2006. She lives on the West Bank, in Qira (population 1,200), with her dad (Farid), mom (Amina), 7 year-old brother (Eyad), and large extended family. When Lina was 1 year old, physicians informed her parents that she had end-stage renal disease, and would eventually need a kidney transplant to survive. On October 2, 2005 the transplant took place. During the two and a half intervening years Lina spent many days in hospitals due to side effects that accompanied kidney failure: hypertension, hernia (caused by accumulation of fluids in her small body), and so on. Her weight remained 24 pounds for over a year. Her limbs were as thin as toothpicks. Time was not in Lina's favor. This is her story--its upside and its downside.

Background

Lina was 2 years old when dialysis began--performed by Amina at home 5 times a day, daily. The transplant was looming. Three immediate problems faced the family: finding a donor, finding a hospital, and finding funds to pay for the transplant. 

The donor

Anna (a peace activist from abroad), Farid, and I (a Israeli) met in April, 2003 at the Mas'ha Camp Against the Wall, where Palestinians, Israelis, and internationals had come together to protest the expropriation of 92% of Mas'ha land, study the subject of the wall, and educate others. Several months later a worried Farid told Anna and myself about Lina's condition, and that neither he nor Amina were suitable donors. Anna returned home but remained in contact with the family. In November 2004 she volunteered to donate her kidney. In April 2005 she returned to the West Bank to undergo medical examinations, which showed her compatible with Lina, and a suitable donor. Anna again returned home until a hospital and funds were found.

The Hospital

Hospitals in the Occupied Palestinian Territories are not equipped to perform transplants on children of Lina's weight, nor is Augusta Victoria Hospital in East Jerusalem, where Lina had been hospitalized several times. Even Israel has only a single hospital that regularly performs pediatric transplants: Schneider Children's Hospital. But its fee was prohibitive, $40,000, money that Lina's family did not have. 

Anna, Farid, and I began searching elsewhere for a hospital when Lina was 2 years old, sharing information as it came in, checking out hospitals in various countries. The traffic in organs has caused many countries to prohibit transplants from donors unrelated to the recipient. Almost a year passed. Failing to find a hospital elsewhere, we returned to Israel, where unrelated donor organs are allowed on the proviso that the donor is an "altruistic donor" (i.e., one who gives rather than sells an organ).

Funds

While searching for hospitals, Anna, Farid, and I sought also for funds. Of 40 charitable organizations that we appealed to, only four responded, three advising that they dealt solely with organizations, not with individual cases. One offered $2,000 if we could raise the rest. Our appeals to private parties touched many hearts, but brought only about $5,000. The Palestinian Authority pays for transplant surgery if the donor is related to the family. Eventually, it agreed to help Lina, too, with $20,000--a big step forward, but this still left $20,000 more to raise. Then, the Peres Center for Peace agreed to donate $10,000 on the proviso that the hospital would lower its cost an equal amount. At last, we were making headway.

Lina's condition was worsening. The transplant would be needed soon. But Schneider Hospital refused to lower its costs. 

In desperation, we decided to solicit other Israeli hospitals. The first hospital we tried, Hadassah Hospital at Ein Kerem, saved the day. Professor Ahmed Eid, chief surgeon of the transplant unit, responded that theoretically the transplant was possible. Dr. Yuval Weiss, the hospital's Assistant Director, agreed to the Peres-Center condition and reduced the fee by $10,000. These 10-minute phone negotiations went so quickly and smoothly that we were speechless. After almost a year of searching, we had found the solution, right here under our noses.

The Upside

Time was short, not only because of Lina's condition, but also because October 3 would usher in a month of Jewish holidays, a period during which the Israeli military usually imposes closure on the West Bank, not allowing Palestinians to enter Israel. On August 29 th , Professor Eid examined Lina and agreed to operate. We had a month to complete pre-surgery details. Thanks to the transplant unit's capable coordinator, Hani Steinberg, things moved swiftly.

Anna, who had postponed her wedding because of the impending transplant, finally decided not to wait any longer. Then, just 2 weeks after the ceremony, the call came: "come immediately." She arrived in Israel September 11, began medical examinations the same day, and during the following week appeared also before committees to ascertain that she was indeed an "altruistic" donor--a process lengthened several days by an unfortunate incident. A kidney donor at another Israeli hospital died following surgery. He had represented himself as altruistic, but turned out not to have been. The incident, though in no way tied to Anna, caused the final committee to delay its decision, which added to the tension. Every day counted. Finally, just a week before surgery, Anna received the ok.

Lina Returns Home

On Thursday, October 27, 2005 at 4:00 PM, with Farid's car horn blaring out the good news to Qira, Lina returned home, a new child. She had been hospitalized for four weeks and a day--from Wednesday, September 28 till Thursday, October 27. 

Lina is a very different youngster from the one that went into the hospital. Previously, she had been wan and tired, had needed to be carried most of the time. Now Lina hops, jumps, skips, and runs happily. Before, she lacked appetite. Now she eats with gusto, and her limbs and body are filling out. In brief, she has transformed from a very ill child to a normal little girl. This is the miracle wrought by the doctors who performed the kidney transplant, Anna, who donated her kidney, and all those whose financial help made the transplant and follow-up care possible.

Lina Ta'amallah, photo by Dorothy Naor

That evening, Farid and Amina held a "hafle"--a party to celebrate this miracle and also Anna's marriage (Anna and her spouse would be returning home the next day). It was Ramadan, a month during which Moslems fast from before sunrise to after sunset. The party took place after sunset on an outdoor patio at Farid's brother's house.

Amina and Farid are very warm people, and so also are their extended families and friends. My spouse, I, and a few additional Israeli friends, felt totally at home, and privileged to have been there celebrating that wonderful exciting occasion.

Towards the end I wandered off for a few minutes, into the dark. In the distance the lights of the settlement of Ariel formed a line on the hill. Initially, I did not realize what they were--so remote Ariel seemed from the events that I was participating in. But recognition brought home reality: occupation, settlements, injustice. The quiet surrounded me, except for the distant sound of music and laughter on the patio. I blinked out the lights of Ariel and thought, 'this is what it should be--lightness and laughter and joy.

The surgery seemed distant that evening--the 7 hours of waiting till Anna was wheeled into the recovery room, the additional 2 hours until Lina followed suit. It had been an emotional day. But Lina now was on her way to good health. Still, not all is brightness and light.

The Down Side

The Hospital

Although much gratitude is due Hadassah, and its staff (Lina's surgeons, Professor Eid and Dr Gideon Zamir, came daily to check her, even on holidays--most unusual--and Hani was always available whenever needed), had there been no occupation, no Israeli military incursions, had Israel allowed Palestine to develop, Lina possibly could have had the transplant sooner, in a Palestinian hospital.

Freedom of Movement: Permits

Imagine that to be at your child's bedside necessitates going to a military base to plead for a permit, granted on FBI approval only, approval that often is not forthcoming. Imagine having to wait in line, sometimes for hours, sometimes for days, open to the elements, in order to obtain or to be denied the permit.

This is the situation that Palestinians wishing to enter Israel face. Furthermore, in hospitalization cases, a permit is normally given to but one relative. Besides, the General Security Service often denies Palestinians permits, even for humanitarian needs. During Lina's numerous hospitalizations in the 2 years prior to the surgery, Farid was consistently denied a permit on grounds that he was "prohibited." No reason was given why.

Moreover, the permit system does not allow for emergencies. Thus when Lina at 9 months suddenly became seriously ill, Amina was forced to walk 5 miles at night in pouring rain through hills, carrying Lina, in order to avoid the checkpoint where Israeli soldiers would have refused to let her through to the hospital in Nablus without a permit, even though the journey was from one Palestinian community to another rather than to Israel!

For the transplant, Hani saw to it that both Amina and Farid acquired permits valid for a month--a truly exceptional feat. The permits incidentally enabled us a few days prior to Lina's hospitalization to bring the family to our house and to go to the nearby beach. Lina had never seen the sea. Eyad had once as a toddler, before the El Aksa Intifada. The sea is no more than 30 miles from Qira, but the Mediterranean Sea coast is entirely in Israel. Palestinians do not receive permits to go to the beach.

Amina's mother permit-less braved the Israeli checkpoints and soldiers to get to the hospital the day of her granddaughter's surgery, determined to be at her daughter's side. Coincidentally, media people were on hand. Their cameras persuaded soldiers to let her pass through the checkpoint rather than be shown on TV refusing a grandmother the right to be near her grandchild during the kidney transplant. But who wants to depend on media help to be with one's daughter when a grandchild is undergoing surgery?

Possession of a permit is no guarantee against humiliation. farid one evening at the hospital went outside for a breath of fresh air, but was refused re-entry by the security guard. Hani had to intercede for Farid to re-enter.

Palestinian freedom of movement is nonexistent. Permits, checkpoints, closure, the whims of the GSS, of individual soldiers, police, and security guards eradicate it. If Lina should need to get to Hadassah hospital urgently in the middle of the night, it is highly likely that she would not be able to.

Freedom of Movement: International Activists

Anna is not Palestinian and needs no permits. But being a non-violent peace-activist was sufficient reason for the GSS [Israel's security service] to deny her entry into Israel, notwithstanding a letter from the hospital stating that Anna was donating a kidney. She was subjected to 4 harrowing hours of interrogation at the airport. Phone calls from the hospital finally persuaded the GSS to release her. In her departure from Israel, Anna was detained for 2 hours, despite official letters from the hospital informing the GSS that she had recently donated a kidney and was still in weakened condition.

Freedom of Movement: Vehicles

To reach the hospital from Qira requires driving on West Bank roads for Israeli-vehicles only. Palestinian vehicles, like Palestinians, require permits to traverse the roads. Permits are given primarily to public transport, seldom to private cars. Farid's car does not have a permit. The trip to the hospital from Farid's home is 1 hours, but due to checkpoints can take 4-6 hours by either public transport or private car. The family therefore has depended largely on Israelis to drive Lina and Amina to the hospital for her pre-surgery and post-surgery examinations. But, Farid and Amina would be much happier to drive in their car to the hospital than to depend on others.

Lina's future

Healthwise, Lina's condition gives hope. But even should her health remain stable, that does not guarantee her a bright future. Like any Palestinian child's, Lina's future is uncertain. Will Israeli government policy and the military permit her to grow into a happy healthy and productive adult, as she deserves? For this to happen, Lina needs not only health, but also an end to occupation.

About Dorothy Naor