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Bridging the Language Gap for Skilled Primary Care in Gaza

by Phil Josselyn

A physician assistant and an engineer have created a tool that will help medical workers provide care for people who speak a different language.

Medics working in remote areas and refugee clinics know the value of having core medical terms at hand to communicate with patients in their own language. Under the best circumstances, an interpreter may be available. But often none are, so the medic and patient must find a way to convey key facts about illness and injuries to one another—especially when under siege, where internet and electricity are not available.

Creating a tool to address these circumstances—and to enhance quality of health care for thousands of displaced patients in Gaza—is the idea that sparked a remarkably simple but useful initiative by Diana Reiss, PA-C, a Northern California physician assistant, and Yousef Nasser, a Palestinian chemical engineer.

They first began the Reference for Essential Clinical Terms for Primary Care, in Arabic and English, in October 2023, at the onset of the ongoing catastrophe in Gaza. During anguished conversations in those weeks about imminent humanitarian disaster, they brainstormed what action they could take to improve conditions for civilians displaced by the conflict and support restoration of Gaza’s public healthcare system.

“From past precedent, we believed that outside medical workers would soon arrive in Gaza—physicians and staff who knew little Arabic,” explained Nasser, who worked with the Red Cross inspecting and supplying food and medical supplies to refugee camps in the Middle East, including Gaza.

Both he and PA Reiss had seen the language gap hinder skilled medics from fully assessing patients. They wanted to design a tool to bridge this. Working with an initial base of primary medical terms, the two contacted an organic network of friends and associates—refugee health workers from around the globe—and began to assemble a concise reference to help outside medics better support the massively overburdened Gazan colleagues.

“Which 30 words are most indispensable to your medical practice there?”

This was what Nasser and Reiss asked medics experienced in refugee clinics. Colleagues from the West Bank, Gaza, Lebanon, Syria, Tunisia, the UK, the US, France, and Mozambique responded. The process produced a collection of 1200 “high-yield” terms and phrases that convey key symptoms, context, and medical history—the building blocks of diagnosis and treatment.

The Reference is a practical tool for clinical use, not an academic work or medical teaching manual, said Reiss, a migrant healthcare provider who served in North Aegean refugee camps and clinics in Peru and the West Bank.

It is also designed to be used in reverse—Arabic to English—by patients who need to convey information to their providers. For patient use, copies will be set out in clinics. Its Arabic terms (edited and translated by Monterey University lecturer Rana Issa, and translator Rania Abu Taima from Khan Younis, Gaza) are in Levantine dialect, using the everyday Gazan variant spoken in the Strip. English, the current lingua franca among international humanitarian workers, was chosen for providers.

To field test—with Gaza under bombardment—the Reference team turned to members of Modesto’s Syrian refugee community, Reiss’s former patients, to partner with them on the project. Uber drivers, mechanics, and high school students joined the effort. Syrian homemakers weighed in, along with female health workers from Gaza and Yemen. Together they reached consensus that explicit reproductive health illustrations must be included, while confirming they should appear on separate inserts, based on cultural mores.

Meanwhile, from the West Bank, friend Noha Khaled joined the project—researching traditional medicine with Palestinian elders’ groups. The creators of the Reference also turned to colleagues who had worked in Gaza under siege.

Healthcare in Gaza today

According to current 2026 World Health Organization (WHO) briefings, the vast majority of Gaza’s 2.1 million people have experienced multiple displacements. Most are now concentrated in less than 50 percent of the Strip. Two and a half years of non-stop conflict have ravaged the healthcare system. And though the nominal October 2025 ceasefire has reduced the number of traumatic injuries and allowed for limited recovery, bureaucratic blocks and border closings hinder all humanitarian efforts.

Beyond the officially recognized—and surely undercounted—tens of thousands dead, at least 170,000 individuals are officially classified as severely injured, a quarter with life-altering wounds. Epidemic risk remains high due to degraded water and sanitation. In addition, WHO reports, the conflict’s psychological impact means a million Gazans now require mental health and psychosocial support.

Monica Taranko, a Portland nurse practitioner and burn specialist, traveled to Rafah with a medical NGO in 2024. She was assigned to Al Shifa Hospital, coinciding with the Israeli invasion of that city. Upon her arrival, half of her hospital colleagues had left, preparing to flee with their families. Gazan staff who remained were overwhelmed with double shifts and triple patient loads.

“We had no anesthesia or medication for severe pain—just paracetamol [Tylenol] for patients with severe crush injuries, missing limbs, and full-body burns,” the nurse recalled. She was often on her own, with no staff free to translate.

“This project is amazing,” she commented after reviewing the clinical Reference manuscript this year. “I would have loved to have it available when I was in Rafah.”

What is appropriate technology in the context of an obliterated land? Some suggest artificial intelligence as a panacea for all medical challenges, regardless of setting. And while globally, in more affluent areas, AI is a part of the clinical workplace (recognized for labor-saving and research functions), in real-world application, its limits are also familiar to physicians—translation inaccuracies, data that must be checked, and device malfunction rendering service inaccessible.

These are reasons why sole reliance on AI in remote, low-resource clinics can be risky, Nasser pointed out—and why low-tech tools can affect actual health care delivery.

“AI can be very useful, but can’t substitute for the clinician’s role—trust and rapport built via direct provider-patient interaction are key, especially in understanding psychosocial contexts of illness and injury,” Nasser said.

The Gaza Reference—originally a simple laminated pamphlet—has expanded to a concise illustrated book designed to fit in a physician’s backpack. A website with voice recordings to practice Arabic terms is in development.

Set to print in California and Amman, the Reference will be brought to the Gaza Strip by NGO teams—for now, the main option for transport. There are plans for a pilot study. The first limited edition will go to clinics and healthcare workers who have agreed to use the Reference for six months. It will be revised again with their recommendations. For widespread use, a full-scale edition of 4,000 books will follow. A Creative Commons license will allow open use.

“The Reference’s first aim is to make an immediate, tangible impact on quality of care for Gazan patients,” Nasser said. “It can also be used at remote and refugee clinics elsewhere in the Middle East.” The Reference of essential clinical terms will likely also foster patient-provider understanding at community clinics in countries where patients, such as Modesto’s Syrian refugees who tested it, have settled.

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Phil Josselyn is a writer, a longtime anti-war activist, and member of Veterans for Peace.

Your support will help expand access to this practical, life-improving resource for clinics serving communities affected by war and displacement. 👉 To donate: visit the GoFundMe page
Endorsed by the Peace & Justice Center of Sonoma County

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