Nursing Director, Ahmad Ma’ali, interviewed on a recent trip to London

Nursing Director, Ahmad Ma’ali
Friday, 30 July 2010

Ahmad Ma’ali made St John history on 1 October, 2009, by becoming the first Palestinian and the first male to be appointed to the position of Director of Nursing at the St John Eye Hospital Group. A post traditionally held by Ex-patriot women, his appointment to it marked the beginning of a new era. Talking now, in the Hospital Group’s London office, Ma’áli laughs, “In the nursing department the Palestinians have taken over”.

In the 1990s almost all of the nurses were ex-pats. Today, with the exception of a few (who have been living in Palestine for decades) all are Palestinians.

Fluent in both English and Arabic, Ma’ali is very comfortable in England, having spent a large part of his life studying here.  It is July 2010 and he is back in London interviewing for the post of Senior Lecturer Practitioner at the Jerusalem Hospital School of Nursing. Both candidates are British-Palestinians.

“It’s in the water. Once you drink it, you always go back,” Ma’ali responds when questioned about why these potential candidates would leave their highly-paid jobs and comfortable lives in the UK to go back and work at the Hospital. “It’s about the high standards; the humanitarian aspect of it all. The feeling you get from people who can see after being almost blind” he adds.  The willingness of these students to return to the Hospital is a testament not only to the Hospital, but also to Ahmad Ma’ali, their teacher and mentor.

Ma’ali’s own introduction to the Hospital was a coincidental one.  He did not plan to become a Nurse, it was a job he fell into. After completing secondary school (Tawjeehee) in Nablus, he worked for six months in Israel, during which time he learnt to speak Hebrew.  In 1990, a friend told him about the ‘Licensed Practical Nurse Training’ at SJEH and he impulsively decided to apply for it. “When he [friend] told me about it, I did not even know what a Doctor or a Nurse looked like.  [Nevertheless] I sat for this exam with my friend and I actually topped the class!” he exclaims. The Hospital Group, recognising his talent and aptitude, sent him to the London to further his learning.  As his qualification was not recognised in the UK, he started studying from scratch and it is from Greenwich University that he obtained his first degree in Nursing. 

Thus began a process of continuous education for Ma’ali.  After 2 years of working at the Hospital as a “Junior Charge Nurse,” Ma’ali was sent once again to the UK. This time he took a six months Specialist Ophthalmic Nurse Training course at the world-renowned Moorfields Eye Hospital.  Then, after another spell at the Hospital in Jerusalem, Ma’ali went back to the UK and studied for a ‘Nursing Tutor’ qualification at the Bolton Institute for Higher Education.

For the next nine years (2001-2009) Ma’ali worked at the Hospital in Jerusalem as the Head of the Nursing School. Not one to stop learning, he completed his Masters degree in Public Health Administration from the Al-Quds University in Jerusalem. He is currently enrolled in a distance learning PHD program at Leicester University: “I like to study and keep myself up-to-date.”

In 2009 came his promotion to the post of Director of Nursing, which he says is the biggest joy he can imagine. “I feel privileged being in this post. The best part is that most of my staff used to be my students”.

Ma’ali lives in the Hospital compound over the week and travels to Al Aqaba, Jenin to visit his family, for the weekend. He explains the travel restrictions and how the situation has improved: “Things have changed over the last year or so. People have it a bit easier because they [the Israeli authorities]are less strict with checkpoints. There was a time when I used to leave my home at 2am to get into the office at 7am. Now I leave at 5am.” SJEH along with the other five East Jerusalem Hospitals, including Makasid Hospital Group, liaise with the Israeli authorities to gain special passes for their staff. There is a daily shuttle service from the North West Bank that picks up 50-60 staff members and drops them at their respective hospitals in East Jerusalem.

“Now all healthcare professionals get special treatment. We can go through [checkpoints] without physical checks which makes travel much faster,” he explains. He also adds that the situation does keep changing and this improvement will probably not last forever. It really does depend on the whim of the authorities. Working at the Hospital eases Ma’ali’s journey as healthcare professionals are for the most part treated with respect and dignity. Being a member of the St John family is a plus as it is a much respected institution in the city.

Ma’ali’s day begins at 7 am and once he is at his desk, his first task remains “checking [my] 1000 emails,” he laughs. After his morning coffee, he commences checking the overnight reports and the theatre operating list for the day. Then he tackles the clinical handover and makes sure that all wards – male, female and children – are in order. He also communicates regularly with the Head Nurses in Gaza, Anabta and Hebron to make sure everything is properly managed there as well.

A big part of his day is consumed by dealing with patients who walk through the Hospital doors without a referral. Most patients are partially covered by the Palestinian Authority (PA) insurance, The United Nations Relief and Works Agency for Palestine Refugees (UNRWA) or the Israeli Sick Funds. However, the expenses of patients who have not been referred to the Hospital – or for some other reason do not fit into these categories – have to be covered in full by the Hospital Group.  Treatment of such cases is proving to be very expensive (it cost SJEH in excess of £ 350,000 in 2009. However, despite the financial issues, no patient is ever turned back. “We never refuse anyone surgery,” Ma’ali claims proudly.  “This is what I enjoy most about the work; being in the clinical areas and seeing the joy of people after they have been treated.”

A social worker has been hired by the Hospital Group to look after these people. “She is overwhelmed with work because there are so many cases!” Ma’ali exclaims. There are a few small funds that Ma’ali can dip into for these people. Some examples are the “Children in Need Fund,” “The PalTel fund,” and the ‘Salam-Ya-Saghar Fund.” Ma’ali looks into these funds and figures out how to accommodate all the people who have not been referred and/or do not have the resources to pay for their treatment. 

What does the future hold for the Nursing department?  Under Ma’ali’s leadership there is a big focus on quality of care, staff development and capacity building. “We are always encouraging staff to undertake further training. Actually four or five nurses are studying for their Masters Degrees and the Hospital Group tries to help them financially.”

Ma’ali’s goal is to train nurses to become A&E specialists in ophthalmology.  “The Hospital management wants to create a ‘Day Care Unit’ mainly for cataract patients. The nurses will lead on this. We want to train nurses to become qualified A&E specialists in ophthalmology.  In many cases a nurse can treat and discharge a patient without a doctor. If this training is provided, nurses would be able to see patients’ post-operatively and discharge them. If nurse practitioners could discharge patients, Doctors would have much more time to operate. “In trying to revolutionise the way the nursing department is run, Ma’ali in turn is having a big impact on the work of the Hospital as a whole. By relieving Doctors of discharging duties, Ma’ali is ensuring that more sight-saving operations can take place.

In fact, the nursing department at SJEH, under Ma’ali’s leadership, is recognised a pioneer in its field. Israel does not have a sub-speciality of ‘Ophthalmic Nurses.’ SJEH is currently planning to train a nurse from the Israeli Hadassah Hospital in West Jerusalem.

“I like the mission of the Hospital. I am a Palestinian, a Muslim. I have always witnessed what the Hospital has contributed to eye care and to Palestine. Everyone who walks into the Hospital is treated, regardless of whether they can pay or not. In my village people always come to me and say that they want to come to the Hospital. It is a cultural thing – they hear good things about it. People who do come are always satisfied. It is a big advertisement for the Hospital, word of mouth... even though the Hospital doesn’t really need it. That is my ultimate satisfaction. “

Faryal Awan
Fundraising & PR Officer (London Office) 

29th July 2010