Introduction

Based on the audited data and evidence collected and experienced over many decades in Gaza and the West Bank, IMET2000 has decided to concentrate its advanced training and research projects over the next year which it hopes could lead to a new curriculum and discipline for all healthcare workers badged as Extreme Healthcare. The combination of the COVID-19 pandemic, severe economic deprivation, military law injustice, brutal military occupation and violence, arbitrary detention and incarceration, desperate refugee camps and restrictions on travel and communication with the international community makes Palestine a unique laboratory for working up this project. In particular, we have emphasised the physical and mental trauma suffered by child refugees, victims of military violence and natural disasters and pandemics.

The Programme

It is impossible to describe in any detail the many projects we are designing and supporting in full partnership with the Palestinian Ministry of Health, the Universities and many Healthcare Associations. However, the most urgent are listed below.

• Covid-19: Management of critically ill patients with COVID-19 through advanced training and provision of life-saving oxygen delivery systems as has been the case over the last two years will again be a priority. Many UCL-Ventura CPAP respirators as well as small oxygen generators which suck in atmospheric air and provide medical grade oxygen to the patient have been donated to both Gaza and the West Bank. IMET2000 with its UCL engineering colleagues is now developing a new respirator which is efficient running off 10 litres/minute instead of 50 litres /minute. It is also developing tiny patient monitors which can be attached to sick patients and replace expensive and bulky patient monitors currently in use worldwide.
• Neurosurgery Training: IMET2000 is sponsoring the training of surgeons to international standards from both Gaza and the West Bank to specialise in Neurosurgery with a combined programme in busy units in China and in Egypt followed by short periods of training in the UK led by our CEO, Dr Malik Zaben. This programme is of great importance because the trauma to brain and spinal cord caused by the Israeli military is leading to large numbers of patients presenting for urgent treatment but faced with insufficient number of surgeons available to cope.
• Child Mental Health in Palestine: IMET2000 is supporting children with mental health problems in both the West Bank and in Gaza. It sponsors mainly poor and needy children in three different Centres in the West Bank and is building up a much needed Child Mental Health Centre in Gaza run by four psychologists and two psychiatrists. This Centre has been financed over 4 years already but the existing clinic was bombed on May 14, 2021 so we have had to start all over again.
• New Ambulance in Jenin Region: The Minister of Health has asked IMET2000 to raise funds for one brand new ambulance for Jenin and the surrounding area. At the moment there are only two for the whole region and we are keen to donate a vehicle capable of providing urgent transportation of patients and as a mobile clinic resource to serve distant villages over poor roads.
• Clinical Research in Palestine: IMET2000 has been running seminars, webinars and on-line tutorials for clinical audit, basic clinical research and training the trainers for many years and these have proven so successful that our CEO Dr Malik Zaben has set up a Palestinian Research Club and attracted over 600 membership of Health Sector workers, mainly nurse and doctors at undergraduate and post graduate level. The current Palestinian Minister of Higher Education, Professor Abu Mowais, is urging us to build this programme up as a priority as he sees it as one powerful tool for improving patient care in the area.

Conclusion

 By expanding a culture of audit and evidence-based healthcare and encouraging clinical research, especially at undergraduate and early postgraduate level, IMET2000 intends to collect a mass of data in Palestine which will then be analysed and published and eventually pulled together as a textbook of value worldwide where health workers are struggling under extreme conditions. Apart from all the problems already described in Palestine, the world now faces huge challenges through climate change and environmental crises which will necessitate flexible adaptation of humankind not least in healthcare provision. Palestine could be the hub of a matrix of adaptation urgently needed already.