Where is Qalqilya you ask? Located in the West Bank/Palestinian territories it is a city of 40,000 almost entirely surrounded by the wall. Since the early 2000s, there is only one road which is managed by a checkpoint. The heart of the city is cut off from its surrounding communities and farms, creating much distress for the farmers and residents who work outside the city. Our hosts, who are college students in Nablus, talked about the long waits at times to get to and from the University due to checkpoint closures which occur out of the blue. See Interactive West Bank Map: https://www.ochaopt.org/maps

Four years ago the city launched the Guava festival on the Zoo grounds to support their farmers and create fun for families. It is the only zoo in Palestine and I noticed a "safe" playground built thanks to the Bill & Melinda Gates Foundation. Guava is the Arabic word for quince. Booths sold boxes and boxes of quince along with other vegies including avocados and tomatoes. We were given free coffee at the local coffee roaster--Al Rasheed Coffee. If I tried to buy a kilo they would have given it to me, so I took a picture and promised myself I'd purchase a bag in the future. Espresso lovers, it is rich as tasty.

Our host was the student of another Fulbright scholar who teaches English to engineering and nursing students. Our gracious host, much to my chagrin, would not let us pay for anything. The festival committee had arranged our transport, about an hour between Nablus and Qalqilya; paid for our dinners; a kilo of quince for each of us; and all the coffee we wanted to drink. Typical Arab hospitality and they won't take no (or La).

We arrived mid-afternoon, and it was easy to wander around the uncongested festival grounds. We shopped, sampled honey and sweet treats, and visited the animals who were sleeping in the shade on this warm, sunny day. By dusk one moved very slowly among the packed streets and the area in front of the stage where families waited for the start of a traditional dance troop. We dined on barbecued chicken and lamb with sides of humus and pita bread as well as a pickled cabbage and beets. My companions than headed upstairs to the open-aired smoking area to smoke fruit-flavored tobacco in the shisha, hookah, also known as the nargila. I tried it once a few years ago, and don't imbibe. But I had an interesting conversation one of our college student hosts who was studying French. She educated me about smoking in Palestine.

Men routinely smoke in public. Coffee houses are filled with men playing cards, backgammon or just chatting as they sip coffee and smoke cigarettes or shisha. Most of our male Family Medicine physicians smoke cigarettes as do the taxi drivers and both have offered me cigarettes or asked me if I mind them smoking. Women do smoke, but in private. The student told me she smoked cigarettes and shisha and her mother introduced her to both at age 16. It is clearly a social activity, inhaling from the water pipe and chatting with your companions as you chat. The scents are really quite lovely.

A few days later I was part of an interesting discussion about smoking between the 6th year medical students on their community health course and the Family Medicine faculty. One student posed: How do you respond when your patient asks you if you smoke. The faculty member who does smoke, suggested deflecting the question. Another said it was an ethical issue, could you lie? They asked my opinion.

My response: "First I try to practice what I preach, exercise, wear a bike helmet, not smoke, etc. If I did, I wouldn't lie, rather I suggested responding--I'm embarrassed to say I do smoke."

So life here in the West Bank continues to fill my heart with the goodness of people trying to make the best of a difficult situation, wrestling with familiar challenges--healthy life style decisions and ethical questions--in a very difficult and challenging environment.