Last Christmas in Bethlehem

With its Christmas displays cancelled, Bethlehem resident Christy Anastas writes about a bleak future for its Christian Palestinian community.

Christy Anastas

Christy Anastas is a Bethlehem resident. She is a Palestinian advocate for nonviolent ways of mediating a more stable Middle East.

A church gable featuring a cross, a Madonna and angel Christmas decorations.

2017 Christmas decorations on the Church of the Nativity, Bethlehem

Jana Humeedat, CC BY-SA 4.0, via Wikimedia Commons

Religious minority groups, like Christians, represent about one per cent of the overall Palestinian population. We feel stuck between a rock and a hard place in this conflict. As a consequence of this war, many of us are already planning to emigrate once the opportunity arises. If this happens, Bethlehem will virtually become a non-Christian city. This would be a sad outcome given it was the birthplace of Jesus Christ and that in the early 1900s the Christian population used to be just under 85 per cent. Now Bethlehem's population is approximately five per cent Christian. After this war we fear that these statistics would decrease even more. The main source of income of the city heavily relies on tourism, with almost 70 per cent of Bethlehem’s GDP due to religious pilgrims from all over the world visiting Jesus Christ’s birthplace, especially during Christmas.

This is the first year for decades, when all Christmas festive displays have been cancelled in Bethlehem. This decision taken by Bethlehem municipality and the Palestinian church is a sobering and poignant one and comes with a financial heavy price paid by locals. Such traditions have been kept for decades, even during the second Intifada, so that between 2000 to 2005 a Christmas tree in Manager Square was still displayed each year. Even the Covid-19 pandemic did not stop Bethlehem from decorating the entire city. However, today many Palestinian Christians are not in a festive mood. The Israel-Hamas war is in its second month and has already a higher death toll than during the whole of five years of the second Intifada.

A ceasefire is what Palestinian Christians will be praying for during this Christmas, alongside praying against the perpetual cycles of death, violence, and destruction.

In my opinion it feels fitting to stand in solidarity with those who mourn, inspired by Paul’s letter to the Romans encouraging Christians to “Rejoice with those who rejoice; mourn with those who mourn”. During such devastating circumstances of the civilians in Gaza, Palestinian Christians are heartbroken at the enormity of lives lost and the desperate conditions experienced especially by children. The desire to celebrate the birth of the most important child in Christianity’s history is dimmed by the death toll of children in Gaza during this war. An ancient biblical proverb offers a powerful depiction of what it would be like for us Christians to celebrate Christmas as usual. It would have felt “like one who takes away a garment on a cold day, or like vinegar poured on a wound, is one who sings songs to a heavy heart.”

However, the announcement of the cancellation issued by the head of Bethlehem municipality, was made exclusively in honour of Palestinian “martyrs”, in Gaza and the West Bank. This disappointing statement distorts the church’s role in the region as a peace builder and the bridge amongst different communities and ethnicities. In fact, it is an utterly missed opportunity for the church to demonstration its ethics and values in the region, especially when confronted with losses of lives across all ethnicities and religions. A more inclusive nuanced statement that could have honoured the suffering of all, could have been worded along the lines of offering tributes to the devastating losses of lives in the Israel-Hamas war since the 7th of October, without any discrimination or prejudice. That old proverb continues to say, “if your enemy is hungry, give him food to eat; if he is thirsty, give him water to drink.”

The exclusivity of the statement's approach made by the churches was a lost opportunity to express a more authentic side of Christianity to the world revealed from its birthplace. It could have counteracted the way the church was portrayed in Europe during the Holocaust. It could have been the chance to respond in a less indifferent manner to the plights of the Jewish people in the region, rather than reiterate a similar stance of the European churches during World War II.

A ceasefire is what Palestinian Christians will be praying for during this Christmas, alongside praying against the perpetual cycles of death, violence, and destruction, inspired by what our brothers and sisters in Gaza have conveyed to us in private communication. Christians in Gaza are pleading for peace and stating that as a community, they oppose violence. The zero-sum approach towards this war has made it difficult for us Christians to be true to our faith without being condemned or oppressed for it. When we call for a ceasefire, we are accused of supporting terrorism and denying Israel’s right to self-defence. However, when we want to acknowledge the suffering of the Israeli side during the 7th of October, we are deemed to be traitors. Our objective isn’t to attempt to prevent Israel from defending itself; rather, to suggest that the consequences of inflicting violence and bloodshed in retaliation could reinforce a stronger hold for violence and extremism in the region.

Therefore, most Palestinian Christians do not feel they have the freedom to stand for their beliefs and the churches in the region are not portraying the best paradigm. In my opinion, this is one of the main factors behind the drastic decline of the Christian population generally especially in Bethlehem. It is also why they no longer hold as much power as they used to in influencing the culture and mindsets in the area. Their roles became more politicised which has gradually led them to neglect standing up for truth until it has become too dangerous to even express it. This could well lead to a reality where this would be the last Christmas in Bethlehem for a majority of Christian families.

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Care

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21 June 2023

5 min read

The healing touch in an era of personalised medicine

As data powers a revolution in personalised medicine, surgeon David Cranston asks if we are risk of dehumanising medicine?

David Cranston

David Cranston is emeritus Professor of Surgery at Oxford University. As well as publishing academically, he has has also authored books on John Radcliffe, and mentoring.

A doctor looks thoughtful will holding a stethoscope to their ears.

Photo by Nappy on Unsplash.

In 1877 Arthur Conan Doyle was sitting in one of Dr Joseph Bell’s outpatient clinics in Edinburgh as a medical student, when a lady came in with a child, carrying a small coat. Dr Bell asked her how the crossing of the Firth of Forth had been on the ferry that morning. Looking sightly askance she replied;

“Fine thank you sir.”

He then went on to ask what she had done with her younger child who came with her.

Looking more astonished she said:

“I left him with my aunt who lives in Edinburgh.

Bell goes on to ask if she walked through the Botanic Gardens on the way to his clinic and if she still worked in the Linoleum factory and to both these questions she answered in the affirmative.

Turning to the students he explained

“I could tell from her accent that she came from across the Firth of Forth and the only way across is by the ferry. You noticed that she was carrying a coat which was obviously too small for the child she had with her, which suggested she had another younger child and had left him somewhere. The only place when you see the red mud that she has on her boots is in the Botanic Gardens and the skin rash on her hands is typical of workers in the Linoleum factory.

It was this study of the diagnostic methods of Dr Joseph Bell led Conan Doyle to create the character of Sherlock Holmes.

A hundred years later and I was young doctor. In 1977 there were no CT or MRI scanners. We were taught the importance of taking a detailed history and examination. Including the social history. We would recognise the RAF tie and the silver (silk producing) caterpillar badge on the lapel of a patient jacket. We would ask him when he joined the caterpillar club and how many times he had had to bail out of his plane when he was shot down during the war – a life saved by a silk parachute. We would notice the North Devon accent in a lady and ask when she moved to Oxford.

The patient’s history gave 70% of the diagnosis, examination another 20% and investigation the final 10%. Patients came with symptoms and the doctor made a presumptive diagnosis – often correct - which was confirmed by the investigations. Screening for disease in patients with no symptoms was in its infancy and diseases were diagnosed by talking to the patients and eliciting a clear history and doing a meticulous examination. No longer is that the case.

At the close of my career, as a renal cancer surgeon, most people came in with a diagnosis already made on the basis of a CT scan, and often small kidney cancers were picked up incidentally with no symptoms. The time spent talking to patients was reduced. On one hand it means more patients can be seen but on the other the personal contact and empathy can be lost.

Patients lying in in bed have sometimes been ignored. The consultant and the team standing around the foot of the patient’s bed discussing their cases amongst themselves. Or, once off the ward, speaking of the thyroid cancer in bed three or the colon cancer in bed two. Yet patients are people too with histories behind them and woe betide the medic, or indeed the government, who forgets that.

With computer aided diagnosis, electronic patient records and more sophisticated investigation the patient can easily become even more remote. An object rather than a person.

We speak today of more personalised medicine with every person having tailored treatment of the basis of whole genome sequencing and knowing each individual’s make up. But we need to be sure that this does not lead to less personalised medicine by forgetting the whole person, body mind and spirit.

Post Covid, more consultations are done online or over the telephone -often with a doctor you do not know and have never met. Technology has tended to increase the distance between the doctor and patient. The mechanisation of scientific medicine is here to stay, but the patient may well feel that the doctor is more interested in her disease than in herself as a person. History taking and examination is less important in terms of diagnosis and remote medicine means that personal contact including examination and touch are removed.

Touching has always been an important part of healing. Sir Peter Medawar, who won the Nobel prize for medicine sums it up well. He asks:

‘What did doctors do with those many infections whose progress was rapid and whose outcome was usually lethal?

He replies:

'For one thing, they practised a little magic, dancing around the bedside, making smoke, chanting incomprehensibilities and touching the patient everywhere.? This touching was the real professional secret, never acknowledged as the central essential skill.'

Touch has been rated as the oldest and most effective act of healing.

Touch can reduce pain, anxiety, and depression, and there are occasions when one can communicate far more through touch than in words, for there are times when no words are good enough or holy enough to minister to someone’s pain.

Yet today touching any patient without clear permission can make people ill at ease and mistrustful and risk justified accusation. It is a tightrope many have to walk very carefully. In an age of whole-person care it is imperative that the right balance be struck. There’s an ancient story that illustrates the power of that human connection in the healing process.

When a leper approached Jesus in desperation, Jesus did not simply offer a healing word from safe distance. he stretched out his hand and touched him. He felt deeply for lepers cut off from all human contact. He touched the untouchables.

William Osler a Canadian physician who was one of the founding fathers of the Johns Hopkins Hospital in Baltimore, and ended up as Regius Professor of Medicine in Oxford, said: