MONHANDAS Karamchand Gandhi (known as Mahatma, meaning Great Soul) once said: “The simplest acts of kindness are by far more powerful than a thousand heads bowing in prayer.” 

In 2010, a group on pilgrimage from Sheffield visited Bethlehem, where they saw for themselves the deprivation and struggles faced by the local community. This and subsequent visits moved them to turn their prayers into action out of solidarity with the Palestinian people and their struggle for freedom and the right to forge their own future.

It soon became apparent that there was a pressing need for specialised palliative treatment as none was available due to an acute lack of resources, yet Bethlehem is a city with the highest reported incidence of cancer in the Occupied Palestinian Territories (OPT). 

Seven out of every 10 diagnoses of cancer in the region come too late for curative treatment, leaving many to face terminal illness without the dignity and comfort of appropriate care.

In 2018, the Bethlehem Care and Hospice Trust (BCHT) was founded in response to an urgent request from the Christian community, with a view to providing desperately needed medical care that was open to all, irrespective of faith or none. Unable to fund a dedicated hospice facility, it was decided to develop a home-based care model instead, and so in 2023, the trust became the only licensed palliative care provider in the OPT.

An operations board supported by clinical and financial governance committees was set up, licences were obtained, local medical staff were recruited and trained, and the service was officially launched. Patients are of all ages and backgrounds, and at the time of writing, the youngest patient is two years old and the oldest is aged 85.

In the heart of the OPT, medical supplies are scarce, and families struggle to afford medicines or follow complex treatment plans. The healthcare system in the entire region is underdeveloped, and healthcare delivery is patchy. Therefore, a significant challenge confronts many when facing life-limiting illnesses.

As the only organisation providing palliative care in the OPT, the faith-inspired trust is dedicated to bringing holistic end-of-life care to people who would not otherwise have access to it. Its expert services cover a wide range of support to ensure the comfort and dignity of its patients, addressing both their physical and emotional needs. 

These include nursing care, pain management, symptom relief, emotional support in the form of listening and counselling, assistance with daily activities, helping patients to maintain their independence, and respectful and personalised spiritual care to meet individual beliefs and needs.

The trust works with key partners at the Augusta Victoria hospital and others to find ways of collaborating and co-ordinating care, and is also exploring opportunities to work with the World Health Organisation and the Palestinian ministry of health to advocate for integrated palliative care across the West Bank in the hope of systemic change.

Just two months after the opening of the hospice at home service, the socio-economic and security environment deteriorated significantly with the traumatic events of October 7 2023. The OPT essentially shut down as tourism dried up, businesses were closed, and high levels of poverty increased even further. 

In a region where nearly 30 per cent of people survive on less than £1.34 a day, unemployment rocketed. More severe restrictions on movement added another layer of difficulty to delivering healthcare, leaving the small team of nurses to navigate on a daily basis many of the 198 checkpoints that have sprung up around Bethlehem.

Despite these enormous challenges, the hospice at home service persisted. Beginning with just 11 patients, the team of dedicated nurses have since made over 3,200 home visits, caring for 227 patients, and supporting their families during their most difficult times. 

Now entering its third year, the service is currently supporting 95 patients and continues to build compassionate communities across the Bethlehem Governorate. But the need is still far greater than the service’s current capacity.

The theme of this year’s World Hospice and Palliative Care Day, held each October, is “Achieving the Promise: Universal Access to Palliative Care.” If that is true of the OPT, then it also applies to palliative care here in Britain, which is in crisis due to a lack of funding, research and development, despite the fact that we are the sixth wealthiest country in the world. 

This is especially critical now that the Assisted Dying Bill has received its second reading in the House of Lords without a vote. As a result, it is passing through an agreed committee stage that has to report back by November 7, before being passed back to the House of Commons. 

And so the issue of palliative care once again moves up the agenda for those arguing for a real and preferable choice for those contemplating assisted dying, and for those who believe that placing the right to die in the hands of a state that operates on the basis of profit before people will exercise it in its own ruling class interests, and not those seeking the means to ending their own lives.

As for the work of the BCHT, its mission statement, written by its founder Joe McNally, is a reminder that every person regardless of background or circumstances deserves to be treated with compassion and receive the highest quality of care so that they can live out the remainder of their lives with dignity and in comfort. It states: “Providing compassionate palliative care in the Occupied Palestinian Territories; life before death matters.”

In light of the genocidal conflict that has taken more than 67,000 lives in Gaza, with many bodies still buried under the rubble, together with over 167,000 injured, including 42,000 with injuries that are life-changing, life before death really matters. 

In the case of the attacks on Palestinians in the occupied West Bank, who are beaten, killed and driven from their land and homes by colonial settlers, with the complicity of the police and the army, life before death really matters.

Amid the current hardship suffered by Palestinians throughout the OPT, the BCHT’s medical team is demonstrating that compassion transcends barriers and that caring for the sick is itself a form of peace-building. Palliative care really matters. And it matters here in Britain too. 

Perhaps the last word should go to Dr Abdallah Alawi, head of anaesthesia at Al-Quds University in Jerusalem, who sums up the work of the BCHT by saying, “A quiet revolution in care giving is emerging — rooted in compassion, driven by dignity. 

“In a place often associated with suffering, this initiative is sowing seeds of healing, presence, and human connection. True care is not only about healing, but about companionship, listening and honouring life until its last breath.”

Father Geoff Bottoms is a retired Roman Catholic priest writing in a personal capacity as a supporter of the BCHT, having been a Chaplain at Trinity Hospice in Blackpool for 11 years. For more details, visit www.bethlehemcareandhospicetrust.org.