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A concrete barrier may physically separate the Israelis and Palestinians, but it will never stop the fear bubbling into hatred and spilling over both sides. Helen Taylor talks to a British-based organisation offering help and the hand of friendship to the people of the Middle East

Wailing wall

There is no cruder symbol of the failure of cultural co-existence then the erection of a wall or security fence. From the Berlin wall, to Cyprus's green line and the 'peace lines' of Northern Ireland, such structures are physical and psychological barriers to communication and interaction.

Now, in the Israeli-occupied West Bank, the most blatant and grotesquely oversized wall so far is snaking its way through Palestinian towns and villages.

This concrete 'security' wall, being erected by the Israeli government, is 116km long and 100m wide and is costing £1m a mile.

It is, agrees Belinda Coote, chief executive of Medical Aid for Palestinians (MAP), "shocking, extraordinary, perplexing" at a time when peace is long overdue in the Middle East.

Rather than follow the existing border or green line between the West Bank and Israel, the wall is looping backwards and forwards, eating up vast amounts of Palestinian land in the process.

"It is carving up communities," says Coote. "People are finding that their land is one side of the border and their homes and villages are on the other. Just outside Jerusalem, the wall has even carved its way through the middle of a university campus."

An estimated 10% of West Bank land will be confiscated by the time the wall is completed and Coote is doubtful it will achieve the security Israel wants.

What it will achieve certainly is further devastation for the Palestinian people.

It is another example of the desperate conditions faced by Palestinians living in the Occupied Territories of Gaza and the West Bank. And it illustrates the difficult context within which MAP tries to work.

MAP came into being in 1982, after the Israeli massacre in the Sabra and Shatilla Palestinian refugee camps in Lebanon led to the deaths of thousands of refugees - many of whom were women, children and the elderly.

A number of British medics were working in the camps at the time and came away from the experience determined to continue to support the Palestinians. MAP was the result.

A non-religious organisation, it sees itself as a bridge between Britain and Palestine, and a practical way for British people to express friendship and generosity. MAP works with Palestinian and international non-governmental organisations on health projects in the Occupied Territories and in Lebanon, targeting the most disadvantaged and worst affected communities.

Its priorities in the Occupied Territories are mobile clinics for rural areas, the provision of food to impoverished communities in Gaza, psycho-social support especially of women and children, and disability.

In the refugee camps of Lebanon, MAP is addressing long-term health needs by training medical staff.

So why work on health when the political situation is so desperate? Because it's a way of addressing a very real tangible need and is a way into the bigger political issues, explains Coote.

"We focus on health but we have a pretty clear idea what the problems are - and the causes and effects," she says. Cause and effect is only too clear for the stranded communities of the West Bank and Gaza, who are unable to reach medical facilities because they are prevented from doing so by the Israeli occupation. Closures and curfews in the territories make movement more and more difficult - which means the mobile clinics supported by MAP are vital.

Training local medical health professionals and outreach work in rural communities are also an important part of MAP's strategy.

"I've been to packed clinics in rural areas, full of people desperate for medical advice - sick children, elderly people, who can't get to a local doctor but have to wait for the weekly clinic," explains Coote. "It has to be making a difference."

It is no surprise that in these damaged communities there is also a huge demand for psycho-social support, another priority of MAP's work in both the Occupied Territories and the refugee camps of Lebanon.

Violence, displacement and despair have taken a heavy toll on many Palestinians and MAP is particularly concerned with the ways in which young people have been affected.

"We do focus on children," says Coote, "but also on women, because they are the ones who have to cope with the next generation who are growing up experiencing daily humiliation and violence."

She is also worried about the mental health of refugees in camps in Lebanon, who have lived for two or three generations with no security and no prospects.

"It's a forgotten problem," she says. "The camps in Lebanon are a very sad situation because those people are stateless, can't work and are dependent on handouts. They're a disaffected group of people."

The youngest and brightest emigrate to the US or Europe, leaving behind an angry and vulnerable community of about half a million refugees, who are barred from working in 72 professions in Lebanon, due to fears they will take jobs sway from the Lebanese and then demand citizenship.

Alongside mental health issues, malnutrition is a big problem for the Palestinians, caused by a lack of income and an inability to access food. And Coote is clear that - unlike in areas of the world where environmental and economic conditions lead to poverty - ill-health and malnutrition health problems like this are a direct result of politics.

"These health problems are almost entirely down to the occupation and the political situation," she says. "It is a politically driven catastrophe and poverty has arisen because of it."

This poverty can be seen clearly in some of the refugee camps in Lebanon, where MAP has found itself involved in basic public health work. It has constructed housing, put in clean water supplies and developed economic empowerment strategies as ways to make a wider impact on health.

And the work is much needed. A quarter of children in the camps suffer from diarrhoea-related illness and a 10% of refugees have been diagnosed with some kind of eye disease.

In such a desperate situation it is important to look for glimmers of hope. And Coote thinks of the many Israelis who do not support their government's actions - such as the soldiers who refuse to serve in the Occupied Territories, and the Israeli and Palestinian women who come together to protest at the violence. She is also heartened by projects such as the Elwedad Association for Social Rehabilitation in Gaza City, which is supported by MAP.

Elwedad is concerned with the psycho-social rehabilitation of the community, particularly women, children and disabled people. It is a simple project, that inhabits a few rooms in an old building, yet seems to make a difference by using a combination of structured out-of-school care, play and therapy. For some it's an opportunity to play in a safe environment, for others it's a place to talk about their fears.

"You see young boys sitting around singing songs and playing games and what Elwedad is doing for these kids is giving them a sense of hope, of possibility," says Coote. "That's terribly important."

She also thinks it's important for those of us in Britain to continue our support of these projects and of the Palestinian people by taking responsibility to understand the political situation, lobbying government and demonstrating support and concern for the Palestinians.

Coote admits the situation is desperate at the moment but is inspired by the initiative she sees in war damaged communities and the resilience of the Palestinians in the face of conflict and inequality.

"That is what will pull them through in the end," she says. "It's important to support that and engender that wherever possible. It's important to help them survive the conflict."

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