What It’s Like to Be a Woman Doctor in Area C, Palestine
Not only is Dr. Fathiya Misyef one of the leading OB/GYNs in Palestine, she is also a well-respected female doctor who heads the Al-Walajeh Clinic. Al-Walajeh is a small Palestinian village in Area C of the West Bank, some kilometers northwest of Bethlehem.
I sat down with Dr. Fathiya to talk about life in the West Bank and what it’s like being a female doctor in a conservative society. Immediately, it was clear that Dr. Fathiya was unapologetically herself. I could feel her confidence and bold character before we even exchanged greetings.
As we began, she laughed, “I’ll be giving out autographs by the end of this interview!”
Was becoming a doctor your dream ever since you were a child?
When I was a child I grew up in a low income family, so although I was one of the best students in school, my options were limited for university education. I was planning on studying electrical engineering, and I applied to Birzeit University. On the day of the interview and exam, there were road closures, so I wasn’t able to reach Birzeit. It was during the First Intifada, and it was a difficult time. So I missed my interview, and the situation didn’t allow Birzeit University to redo the interviews and entry exams.
Did that bother you?
To be honest, I always had dreamed of studying abroad, whatever it was that I chose to study, so it wasn’t devastating that I missed my chance at Birzeit University. I got 93 on the matriculation exams, which was considered a fantastic grade at that time – like getting a 99 these days! A few months had passed, and one day, I was visiting friends at Bethlehem University, and my eyes caught a pamphlet calling for applicants for a scholarship abroad. I decided to apply without hesitation and without even telling my family! I told myself that if I wanted to study abroad, it had to be through a scholarship because my family could not afford it. A week later, the Ministry of Education called me and congratulated me on receiving a scholarship for medicine in Poland! I was excited. I finally had the chance to travel and study abroad!
Wow, that’s brave! So, your family did not mind you traveling by yourself abroad?
Well, it wasn’t difficult to get their blessings…
Because of the difficult financial situation?
Yes, but also because we struggled as brothers and sisters. My siblings and I grew up without a mother and father. My mom died when I was two, and my father abandoned us. We were eight children and we lived on our own. My older brothers left school to work and provide for us. The older five were my brothers, and the sisters were the youngest. My brothers made sure that all their sisters received an education while they worked.
That’s amazing. So how did they receive the news that you were accepted for a scholarship abroad?
One day, only after I made sure all travel documents and my passport was ready, I revealed the news to my siblings. I told them, out of the blue, “Hey, I got a scholarship abroad and I am traveling soon!” [Laughs]. They were surprised, that’s for sure. “What? Where are you going?” A discussion among my siblings ensued, but in the end, my eldest brother had the last call. He said, “Let her do whatever she wants. She was very good at school and we don’t have money for good education. Let her travel.”
Your brother sounds very supportive.
Yes. I come from a village called Beit Ummar, and at that time, it was difficult for a girl to travel on her own, and coming from a village is different from growing up in a city. My eldest brother was rationalizing it from a financial point of view. Why make me stay if my brothers were struggling to cover the basics and if I received a full scholarship? My brothers also knew I was self-reliant. I could survive on my own. So, in this regard, they were not worried. And away I went!
Were you excited to study medicine?
Although I wanted to become an electrical engineer, I believed that studying medicine was a wonderful opportunity to help others. People will always need doctors.
What kinds of challenges confront Palestinians living in the West Bank?
I find road closures and checkpoints a problem. From Beit Ummar to this clinic here in Al-Walajeh, I need over an hour on average. Without the checkpoint and road closures, I would need about 15 minutes.
Do you feel this creates a problem for you as a doctor when you are required to travel from one place to another?
Of course. I am late to work when there are unexpected road closures or changes.
How do you deal with cases of emergency when there are travel difficulties?
A good thing about doctors in the West Bank is that we know each other, and we know doctors from different areas. So, when I need to reach somewhere but cannot due to closures, I contact other doctors who can, and they take over.
Where do you currently work?
In the governorate of Bethlehem, in Al-Walajeh and Beit Jala. I also have a clinic in my village in Beit Ummar.
How would you describe your patients’ financial state?
Very poor. The people of Beit Ummar are mostly farmers, teachers or construction workers in Israel. Their income is very limited. Even the doctors have limited income. When I used to work in hospitals for 36-hour shifts, my monthly income never exceeded NIS 4,000 ($1,000). A doctor can reach an income of NIS 6,000 ($1500), which is still considered low for the effort and number of shifts and tasks we perform in the West Bank.
How do the tasks of doctors differ in the West Bank from other places?
Doctors in the West Bank many times performs tasks that are not within his or her specialty. For example, a doctor can take over a whole department when required. She receives patients and cases, performs the task of a midwife especially if the patient is giving birth to her firstborn, performs a C-section, receives urgent cases, writes reports and so on.
Why do you think this is the case?
Because of the shortage in doctors. We have many students who graduate from medicine and cannot wait to work. The problem is that they are not offered jobs due to the Ministry of Health’s inability to cover their salaries. So us working doctors end up taking up as many tasks as possible in order to get things going at clinics and hospitals. Even when a doctor takes sick leave, or has to take some time off, many times s/he is not replaced.
As a female doctor in a male-dominated field, what other challenges do you face?
The biggest challenge I personally find is when it comes to convincing patients that there is no difference between my capabilities as a female doctor and a fellow male doctor.
How do you deal with this challenge?
In the end, you have to prove yourself. Patients are used to male doctors performing surgeries, sutures and stitches. I have had to prove myself as a doctor, and now all my patients are aware of my abilities. Thankfully, people have gotten used to me in the areas I work, and that is progress for a female doctor and for female doctors in general.
Patients are becoming more accepting of female doctors with the passage of time.
What about challenges you face with male doctors?
Unfortunately, as a female doctor, you get the feeling that the male doctor believes he knows better than you and that their experience is also more extensive than yours. But, this too, is improving. The more time they spend interacting with female doctors, the more they understand that we are no less, and maybe even better.
Would you say that being a woman is a constant motivation for you to work harder?
Yes. It is a motivation to keep working harder, to prove myself, to be a role model. My daughter is still five years old, so she is not yet as conscious as my sons.
Now my eldest son finds the idea of a mother and woman being a doctor a very normal thing, which is great, because it is normal. He also wants to become a doctor like his mother!
Do you regret studying medicine and becoming a doctor?
No, I don’t. What fuels my motivation and gives me a great sense of fulfillment is that I truly believe I am of service to my community. Whenever the political situation deteriorates and Palestinians are injured or shot, I am there to help out. I even receive many urgent cases that do not have anything to do with political situations. One time, a mother frantically came to me with her one month old child in her arms, panicking and yelling that her child is not breathing. I tried everything that had to do with first aid to no avail. I thought that I lost him, but I gave it one more chance. I resorted to an injection to the child’s heart. Two minutes later, the baby woke up. I cannot describe the feeling I had, or how it felt to see the look of immense gratitude and genuine relief on the mother’s face .
Wow. I cannot imagine how wonderful that must have felt… Can you tell me about the hardest case you had to deal with?
The hardest case I’ve had to deal with was operating on a dying friend, who died right in front of me.
I am very sorry. May he rest in peace… When was that?
In 2014. We were in an ambulance and we knew he was not going to make it. A bullet had entered his chest and gone through. He was a dear friend and my cousin’s husband. May he rest in peace.
Were you the only doctor available?
Yes. I had to be the one.
May he rest in peace…
Can I ask about chronic disease patients? What kinds of chronic issues are you seeing and what is causing them?
Diabetes and hypertension are the most common chronic diseases. The main causes are lifestyle, including the patient’s diet and whether they exercise. Patients of chronic diseases usually lack awareness of proper lifestyle.
How would you describe the state of health care overall in Palestine?
The health care system is lacking. There are many gaps that need to be filled. For example, we talked about the shortage of doctors. Some clinics in the West Bank manage to provide medicine for their patients but experience delays in the arrival of this medicine due to economic difficulties. It takes time to reach a sufficient budget to buy medicine. Personally I find that good management can facilitate many of these difficulties. Good management can assign a certain budget for medicine, for equipment and tools, for the different needs of clinics and hospitals.
Which aspects of the health care system would you like to see improved?
I would love to see clinics that are fully-equipped and integrated, and which offer all services that patients seek. I do not like to send patients to travel from one place to another to undergo different tests. Sometimes I end up sending patients from Al-Walaja to Bethlehem for some tests. Clinics should be comfortable and complete for both its health care staff and its patients. This is something that should be improved in the West Bank. There is also another aspect that the Palestinian medical system must pursue. The medical staff should be offered constant training on medicine, medical tools and equipment, and other relevant issues so as to constantly develop and improve services.
Dr. Fathiya, as a closing question, I would like to ask you what is your vision of the future of medicine in Palestine?
Fully-equipped medical centers with well-trained, constantly up-to-date staff that each work in their specialties and who are able to provide complete and comfortable service to their happy patients.
Thank you, Doctor, for a great time and a very interesting interview. We hope your vision will soon become reality.