Now 11% of the US adult population is fully vaccinated and over 22% have at least one dose. My own family has done well thanks to their essential worker status (teachers and doctors) and being long term care residents. We’ve had our trauma with COVID, 2 members infected and recovered, and others on the front lines of bringing children back to school and in clinical care. But nevertheless we are privileged. Despite the chaos of President #45, the US has moved forward under steadier leadership and by listening to science.

This week I helped my Palestinian colleagues edit a manuscript about vaccine hesitancy among Palestinian nurses. After an initial survey of health care workers showed that only 28% of nurses were willing to be vaccinated for COVID, I suggested the researchers convene focus groups to understand why. One of the objectives of my US Fulbright award is to help the Family Medicine department in Nablus, Palestine improve their qualitative research skills. The workshop I planned for Spring 2020 never happened because COVID sent me packing back to the US. In fact, I was traveling maskless on international flights exactly one year ago today, naïve to all that was to come.   

Two Palestinian researchers conducted the focus groups with almost fifty nurses via Zoom and face-to-face. They translated the Arabic into English so I could help analyze the data. What we found was that a third were accepting of vaccines, a third had no interest, and a third would have vaccines if they had better information. The nurses wanted to understand the science. The Ministry of Health had not done that because they didn't know which vaccines were available.

While many have suffered in the US with COVID and we have seen poor leadership nationally and in many states, we are privileged. We knew COVID vaccines were coming and we had access to good data. Although some leaders ignored science, and in some venues it was drowned out by “fake news,” the path forward was clear: Vaccines were developed rapidly, but a number were available and safe.

Palestine has not been so lucky. Even today, leaders still struggle to secure vaccines. It is hard to educate about vaccine side effects and efficacy if you don’t know what the government is purchasing. The uncertainty has kept the Ministry of Health from educating health care workers and citizens about their options. As a result social media, a popular source of news in Palestine, has been flooded with conspiracy theories and false information on vaccines. The nurses in the study asked for vaccine information from evidence based sources from scientists and trustworthy leaders. It sounds like a simple ask.

Working with my Palestinian colleagues reminds me to recognize my privilege and be grateful.

Palestine is one of the nations to received vaccines through the World Health Organization COVAX effort. That depends on nations like the US providing funding. The UN and others are also holding Israel accountable to provide vaccines for Palestinians because of obligations in the Oslo Accords. Israel, the most highly vaccinated nation in the world, is supposed to vaccinate Palestinians according to the peace agreement. Israel disagrees, but will conveniently vaccinate the Palestinians who enter Israel to work. Palestinians call this the COVID passport. Russia is promising some vaccines, but data on their efficacy and safety is only recently available. When some vaccine became available in Palestine, the corrupt leadership made it available to a favored few.

As my Palestinian colleagues work virtually, in the middle of their third lockdown, I remind myself to be grateful for my fortune and also to do all I can to share what I have. Encouragement, my qualitative research knowledge, my English grammar skills seem like inconsequential offerings. However, I am reminded of the concept of témoignage, or bearing witness. This is a central pillar of Doctors Without Borders.

The ethical responsibility to offer our unique first-hand perspective about what we are seeing and doing on the ground, and to speak out with a sense of urgency to prevent greater harms.

While DWB encourages speaking out in a public way, there is another part to being present that I experienced when I was on the ground in Palestine. I refer to it as standing alongside, recognizing the stress and strain of the injustice on the daily lives of my colleagues. In the vaccine hesitancy article, it was helping the researchers see that part of the uncertainty was due to Palestine’s not knowing where their vaccines were coming from. I had to point this out as an issue. They were overlooking that detail.

Join me in bearing witness and standing alongside in any way you can with those less privileged. Today, Covid has made us well aware of the haves and have nots in the US and around the globe. Standing alongside may be praying, donations, words of encouragement, volunteer work, or some other form. In doing so, I am reminded of the tremendous resiliency of the human spirit, and both humbled and awed by the strength and humor of those who are less lucky than me.