It was not easy to find Christmas this year in Bethlehem. Much of the city has closed, and the Masses on Christmas eve were limited to small numbers of congregants to prevent the spread of Covid-19. But at the Holy Family Hospital, the city’s primary maternity center, doctors, nurses and midwives are busy making sure that any pregnant mother who shows up at their door still has a place to give birth. Even as much of the city shuts down because of the pandemic, the hospital is determined to remain open.
“You know that in any hospital, if there is a spread of the virus, then the hospital has to close,” Elizabeth Anastis, the director of administration and finance, told me on a recent visit. “And our hospital did not close—not a single day.”
I arrived at the hospital the day before Christmas Eve to find it buzzing with activity. Women sat in the halls, waiting for their medical consultations. Mothers who had just given birth prepared to leave, cradling infants. A Christmas tree stood decorated near the entrance. Work in the hospital could not afford to slow down. Pandemic or not, mothers still needed to give birth to their babies.
Work in the hospital could not afford to slow down. Pandemic or not, mothers still needed to give birth to their babies.
Located in a beautiful, white stone historic building, with a statue of the Virgin Mary staring out from the roof and visible from much of the city, the Holy Family Hospital stands just 800 meters from the birthplace of Jesus. As its name suggests, the hospital prides itself on welcoming every expectant mother, without taking into account religious background, nationality or the ability to pay. Muslim and Christian, wealthy and poor, pregnant women come to the hospital from the city center, from refugee camps and from Bedouin settlements. The white, stone hallways—resembling religious cloisters in their architecture—are filled with mothers who reflect the full spectrum of Palestinian society.
“The mission of the hospital is that everyone is welcome,” Anastis explained to me. “We don’t ask about the religion, national origins, ability to pay or not to pay—that’s not a question. Holy Family Hospital is a place where you can see Christians and Muslims working together. We celebrate Christmas and we celebrate the Muslim feasts together. This is a hospital that spreads the message of peace, of living together.”
But like the rest of Palestinian society, the hospital’s work has been upended by the global pandemic. In March, Bethlehem became the first city in the West Bank to experience a Covid-19 outbreak, when it appeared among visiting tourists. As the city locked down, the hospital scrambled to create new protocols to protect patients and staff. As the only maternity hospital in the West Bank with a full neonatal unit, able to treat premature infants born as young as 24 weeks old, they had to make sure to stay open. Lives depended upon it.
“We have very, very small babies,” Anastis said. “Very sick babies. And because we have trained staff, and we have the equipment, we are able to save these babies. And that’s why we are not a reference center for Covid-19 treatment–we decided that this would stay a clean hospital, for babies and mothers who are not infected. But, as you know, Covid-19 is spread widely in Bethlehem. Every single patient is a suspected Covid-19 patient.”
The hospital prides itself on welcoming every expectant mother, without taking into account religious background, nationality or the ability to pay.
To decrease the chances of the virus spreading within the hospital walls, today they screen patients as they enter the hospital, quickly isolating any expectant mothers who might be positive. Since they are not equipped with an intensive care unit for adults, those women who are truly sick must be transferred elsewhere. However, those who do not require additional oxygen or an intensive care unit are still able to give birth at the hospital in a special area dedicated to them—following strict protocols to make sure that staff and other patients are protected.
“We want to make sure that patients are not infected in order to give them the proper treatment,” said Dr. Saba AbuFarha, who works at the hospital. “If they are infected, we also want to give them the proper treatment, taking into account all of the measures that we need to take in order to prevent the transmission to our employees and other people.”
Even with all of the precautions, some staff members have become infected—not only in the hospital, but in their own homes, as the virus has spread throughout Bethlehem. As doctors and nurses have quarantined or fallen ill, others have worked overtime. To reduce the risk of transmission, the regular three daily hospital shifts have been reduced to two, so staff now work 12-hour shifts. They are exhausted.
The hospital has also faced increasing financial challenges. As lockdowns prevented women from the nearby city of Hebron from traveling to the hospital, and many women, fearing Covid-19, stopped coming to the hospital for consultations, the hospital lost 30 percent of its income. Eventually, they were forced to cut staff salaries, even as staff worked overtime.
Now, the toll of the pandemic is increasingly visible in the mothers who arrive to give birth. More and more are unable to pay. They rely on the hospital’s Poor Case Fund, made possible by donors, that makes sure no expectant mother is ever turned away from the hospital.
“We have seen many cases of people who have lost their income,” Anastis said. “And the longer this pandemic is getting, the situation will get harder and harder. Can you imagine that there are people who, since March, haven’t opened their souvenir shop? Their olive wood factory? Hotels are closed. They have no work. The situation is really hard, and our social office is always full.”
Despite the challenges, this year the hospital delivered an estimated 4,300 babies. On Christmas Day, when much of the city was be closed, they were open. They were hoping to celebrate as in other years, delivering presents to women who gave birth the night before. As part of their tradition, the entire staff waits to see who the first baby born on Christmas Day will be.
“Christmas means hope,” Anastis said. “Christmas means that we are not alone. With every delivery, we send a message of hope, and faith, that God is good, that God is with us and will always save us. At the Holy Family Hospital, we celebrate Christmas on a daily basis.”
