Health

How Ramallah Cares for Its Elderly Citizens

Ramallah, under occupation in the West Bank, faces the same challenges of an aging population as other cities – but has a different solution that transcends generations

How Ramallah Cares for its Elderly Citizens

Every Monday Saad Sifri, a retired English language teacher, meets a clutch of people, both young and elderly, in the two-story community center “Forum of Expertise” in the Old City of Ramallah. At 88, Sifri teaches them tatreez, a form of traditional Palestinian embroidery that uses cross stitches. In the same building, Emile Ashrawi, 74, runs a community choir of old and young members, and Kamal Shamsum, at 82, is a sport and physical education instructor.

“I am 65 years old and Kamal was my sport teacher at the university,” says Ghasan Jarrar with an ear-to-ear smile. Jarrar is an elected member of Ramallah’s municipality, and monitors the impact of the Forum of Expertise, a unique community-led initiative of senior citizens like Kamal who volunteer to give aging a meaning in Ramallah. 

I meet Ghassan Jarrar and Feletcia Adeeb, the director of the Forum of Expertise, during the WRLDCTY forum in Bilbao, Spain. They are taking part in one of the panels and are among the finalists of the newly-launched Bay Awards. I suggest going to a table in a discreet corner to talk. Our encounter feels like a miracle to me. While a full-on war rages in the Middle East, Jarrar and Adeeb crossed five check-points to reach Amman, Jordan, to then fly to Bilbao – all as hurricane Kirk was heading towards their final destination here in Spain.

But here they are, at an international forum of cities, in Bilbao, proudly representing their grassroots initiative. Despite all the difficulties, their positive attitude warms the room. “The real hero is Feletcia Adeeb,” points out Jarrar as we start our conversation. “This woman closed her clinic and came to work for the Forum of Expertise.” An eager smile on her face reveals no regret.

Born in Jerusalem, Adeeb grew up in Jericho, a city located in the middle of the West Bank. She went to high school in Jerusalem, and she graduated as a general practitioner with a Masters in Community and Public Health from Birzeit University. Back in Jerusalem, she began to practice as an intern at the well-known Meqqasad Hospital, then worked for several NGOs before founding her own clinic, and later the community center of the Forum of Expertise.

“I’m 22 years old, although my son is 23,” Adeeb jokes. Aging has stopped for her, she says. Yet the number of people above 65 years old in Ramallah is steadily increasing, and according to the local statistics, accounts for 6% of the total population – less than other cities, but growing. Moreover, as life expectancy increases, 60% of Ramallah’s elderly citizens are independent and capable of self-care, explains Adeeb. “However, the city was providing services only for the 40% who were dependent on care services,” she adds, while private donors have usually funded projects that primarily focus on children and women.

For many reasons, Adeeb explains, there was an urgency to step in and give attention to senior citizens who were aging well and have been partially forgotten.

***

Senior citizens increasingly live alone in Ramallah. “Despite living under Israeli military occupation, our community confronts the same challenges of an aging population like in any other cities,” says Adeeb. She goes on to explain that, with retirement, people do lose their status, their connections and therefore, they lose their sense of belonging to the community. Also, she says that usually when children graduate from university, they move abroad away from their parents. But if they decide to stay in Palestine and have their own families, they mostly move to cities, where they can find more jobs, and bring their parents, who often live in rural areas, to stay with them in the city. But that comes at a price. The feeling of isolation that elders experience is all too common. During the day, everyone leaves the house. Husband and wife go to work and their children to school.

At times, this situation leads to ill health. From a local governance perspective, says Adeeb, it is less expensive to concentrate on preventive measures that support the well-being of elderly citizens, whether their physical, social, or psychosocial well-being, than building services to manage chronic diseases or help them after a fall. “What we’re doing in Ramallah is to make our senior citizens stronger, more resilient and active in the course of aging so that they remain independent, and strong enough to deal with their own physical and psychosocial health,” says Adeeb. 

But aging in the West Bank comes with additional grievances. Jarrar is also a member of the Forum of Expertise. He lives alone. Since December 2023, his wife, the women’s rights activist and Palestinian MP Khalida Jarrar, has been in administrative detention in Israel, for the second time, under very harsh conditions. Before her 2023 arrest, Khalida Jarrar had already served five years in Israeli jails, explains Ghassan Jarrar as he tells the anecdote of his wife receiving a letter from the granddaughter of Nelson Mandela while in prison. Jarrar and his wife have two daughters; one passed away and the other one lives in Canada.

Elderly-population-Palestine
Members of the Forum of Expertise exercising with Kamal Shamsum at the community centre / Photo courtesy of Forum of Expertise

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Every year young people leave because they don’t want to get old in Palestine. “We don’t have a social security system and we lack comprehensive health insurance. If we leave our elderly people alone, they will have to leave too,” says Jarrar. So with his initiative, he says, “We’re sending a message to the youth: Aging in Ramallah is rewarding. Aging in Palestine is important, and you can have it similarly to any other place in the world. We would like you to stay in Ramallah. That is part of our resilience.”

And resistance too. The Forum of Expertise also aims at perpetuating senior citizens’ knowledge and “inventory of experiences,” as Jarrar puts it, that can be passed to younger generations. Their knowledge, experience and wisdom, acknowledges Jarrar, have shown some grit. With an offer of activities in after-work (or after university) hours, young people have engaged with their fellow senior citizens to learn skills and listen to their elders share their experiences in discussions about social issues and problem solving.

What kind of experiences do they share? I ask Jarrar. “ Experiences in every dimension of life. Resilience in itself, it’s an experience,” he replies. “You find this wisdom in the elderly people. It is very important that they pass it down to another generation.” It allows senior citizens to navigate their way out of isolation while simultaneously recognising that the transfer of their valuable experiences is the crucible of Palestinian existence, and won’t die with them.

This is, so far, a word-of-mouth endeavor – but also one in black and white. The Forum of Expertise came with the idea of a collective book that documents the stories of 25 of its members. They write about their experiences of getting out of the West Bank through Jordan during the Nakba (the mass displacement and dispossession of Palestinians during the 1948 Arab-Israeli war). Others talk about how poor they were during their childhood, and describe their parents and grandparents, while trying to highlight the traditional part of living during that era. “They wrote the stories. They are not writers. They were the housewives, the teachers, the principals,” says Jarrar. They are the contemporary witnesses of history, I say. And Adeeb smiles as she reveals that a second edition will come soon.

“At the beginning, when they told me about publishing a joint book, I was like, well, this is a bit too much. But, as Ramallah’s municipality, our role is fostering these initiatives and providing a platform where it can be done,” admits Jarrar.

Our conversation is coming to an end, and I can still see, I think, the hangover of last night’s awards gala in Jarrar’s and Adeeb’s eyes. “You know,” Jarrar suddenly says, “our participation in this summit [as panelists in the WRLDCTY forum and finalists in the Bay Awards] means a lot to us. Because despite the difficult circumstances that our people and our institutions are undergoing and suffering from, we municipalities in Palestine like Ramallah, are still doing our best to build modern, civilized, clean, and resilient cities that provide their citizens with high quality services according to international standards that qualify us to reach and to participate in many international forums. We are part of the conversation. We didn’t give up.”

In fact, I believe it would be more accurate to say that they will never give up. Jarrar and Adeeb explain how infrastructure like pipes of sanitation and electricity in Palestinian cities of the West Bank, under military occupation, has been damaged several times over the years, even completely demolished. Jenin, Jarrar’s hometown, has apparently been severely damaged in the past months. “They did what they did in Khan Younis, the same thing, but silent,” says Jarrar.We, the Ramallah municipality, sent our tools, our machines, our teams, our workers to Jenin and helped rebuild the town.”

When the community choir of the Forum of Expertise, led by Emile Ashrawi, recently gave a concert to raise funds for the rebuilding of Jenin and Tulkarem, it all came full circle. Suddenly, Saad Sifri’s embroidery lessons were not just a class on how to do cross-stitching, but rather “about trying to explain the pattern, what it means for our cultural heritage to preserve an ancient art, and telling our story and tradition in a different way to make sure that it’s being transferred from generation to generation. It’s embedded in our blood,” says Adeeb.

As for Ghassan, says Feletcia Adeeb, “we are trying to find some suitable time for him to teach Hebrew language at the center.” “Do you speak Hebrew?” I ask him. “Yes, I learned it in jail. I spent 10 years of my life in a jail in Israel, so I deeply learned the Hebrew language and its grammar.”

“Learning Hebrew is crucial because as we are trying to cross any checkpoints, we are interacting with a language that nobody understands,” says Adeeb. “Sometimes we lose our life just because we didn’t understand the instructions. Believe me, it’s very important,” she deadpans as she and Jarrar leave, back to Ramallah.

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