Dr. Areej Khatib, Trailblazer in Health Leadership for Palestinian Women (with VIDEO)
Dr. Areej Khatib grew up in Nablus in the northern West Bank, and earned her medical degree from the Jordan University of Science and Technology. She also earned a specialty certificate in pathology from the Hadassah Medical Center in Jerusalem. Khatib worked as the head of the department of pathology and laboratory medicine at the Augusta Victoria Hospital in east Jerusalem. She serves as an assistant professor at Bethlehem University, where she also directs the research of master’s students. Khatib is currently completing a master’s degree in international management in health leadership. She is the married mother of twins, and she writes Arabic poetry.
In the run-up to International Women’s Day, Khatib spoke with The Media Line’s Felice Friedson about her research on vitamin D variants in the Palestinian community, becoming a leader in working to reform the Palestinian health care system, and her hopes for Palestinian women and all women.
The Media Line: Dr. Areej Khatib was born and raised in Nablus, and received her medical degree at Jordan University of Science and Technology, and earned a specialty certificate from Hadassah Medical Center in pathology, but this is only the beginning. Dr. Khatib, welcome to Facing the Middle East.
Khatib: Thank you, Felice! It’s a pleasure to be with you here!
TML: When I last met you in Ramallah, you were involved in clinical trials and looking at the entire body completely. What was the outcome of those trials?
Khatib: Yeah, when you met me last year, we were starting to look on the Palestinian genetic profile. And it was an interesting journey, because during the last year we found out a lot of genetic variants that are very peculiar for the Palestinians. And we are now working on this with my students in the master’s program of Bethlehem University and with local companies, pharmaceutical companies, to try to get something practical out of these peculiar variants, for example, as we have a peculiar variant for vitamin D for example, in the Palestinian population.
TML: Why is that?
Khatib: So, the vitamin D genetic variants that prevent you from activating them, the vitamin, to be useful for body is not new; it’s known, but what amazed me is the prevalence that we have these variants in the Palestinians, it reaches about 95%, which is a huge number. It is a big number, but my theory, which I think is right, is that we always married the same ethnicity. Like, Palestinians marry Palestinians, and so on so the gene is kept, the variant is kept in the population, unlike other ethnicities, where you have, you know, this mixed marriages so you can like modify the bad fat hand, but in Palestine, it’s very prominent. It’s like my, my five clients that had a normal variant, they always had somebody foreign in the family like a Greek grandma, a Russian mom, something more. So that’s what’s so amazing, that it’s at a very high rate because of the very interethnic conditions.
TML: That’s very interesting! You don’t think it has anything to do with just not being in the sun enough; being covered up too much?
Khatib: That’s what everybody was saying. So, we had the long journey through the last 10 years trying to figure out why. Some people like claim that we don’t have enough vitamin D in the diet. So, I think the UNESCO, I’m not sure, like they had a project with the Palestinian Ministry of Health, and they tried to fortify our bread with vitamin D. It went through like three years, a huge project, and in the end of the three years, nothing happened; like the same rate of deficiency stayed the same. They said, OK, maybe because the women are covered. Of course, we are one of the sunniest countries in the world, so the sun is there, but they said, “Oh, you know what? Maybe because the women are covered,” but come on. Also, the men have the same prevalence of vitamin D deficiency and they are not covered. So, it wasn’t me all the time.
And actually, I found out about this accidentally, like I was doing all this genetic profil[ing] for general health and wellness, all the vitamins, all the minerals, other genes, and I kept finding this variant all the time. So, it came to my attention that we should go through that, and yes, we did. We did a large-scale study and we are about to publish it, and then we are now performing a clinical trial of giving the Palestinians that have the genetic variant known, the active form of vitamin D, which is not the usual form that you find in the market. So, we are in the middle of the trial and I hope we can get something out of this.
TML: What are you currently giving them?
Khatib: The active form of vitamin D, like the vitamin D that you take, you buy over the counter in the market. It needs to go through your liver to get activated. This is the normal pathway. The genetic variant that we have is the less active, let’s say, variant of a gene that works in your liver to make this vitamin D active. So now we are like bypassing this and giving the active form immediately. And this is only the start, you know? We are going to go through other vitamin deficiencies. We are going through pharmacogenetics. Some, we have some genetic variants that are related to some drugs that the Palestinians should not take, or they should take with a lot of caution. So, it’s a long journey. It’s a treasure of data.
TML: How are you educating the Palestinian people that they need to partake in boosting vitamin D?
Khatib: We are doing all what we can. We are broadcasting. I’ve been interviewed by many, many, local TVs. We are now running a real campaign with the local pharmaceutical company to convince the physicians, first of all, and to let them know that we have this issue so they can advise the patients.
TML: Is the government with you? Is the government behind you?
Khatib: I’m doing this with my students in the university. The local pharmaceutical company is providing, or is sponsoring the clinical trial. I’m not sure that the government is aware of that yet. Although, the Endocrinologists Association of the Medical Council are aware and are our partner in that trial.
TML: Shouldn’t the government be involved, and you can get us more assistance through the Health Ministry?
Khatib: I think, yeah, I think they should, but we are in the middle of a trial. Our data is not published yet. So, I think they will be on board at one stage, but it’s, it’s a bit early now.
TML: You left Ramallah to complete a master’s degree in management, and during the height of COVID. Are you still in the midst of this master’s degree? And why do you need it? You’re a physician. What’s your goal?
Khatib: I’m about to graduate. It’s the final stages, and it’s the best decision that I ever. You always find a problem in the Palestinian system when you work as a clinician. I am a senior pathologist since 12 years. I’ve worked in the best hospitals in the area. I did the private practice also. I taught a lot of students. But we have perfect physicians, well-educated nurses, technicians, paramedicals, but the system does not help you. It does not help you to go to studies. It does not help you to set a real international system for doing the right thing, and it’s always the leaders. It’s always the leadership. So, I’m studying international management in health leadership. It’s a very specific program for health leadership. I felt bad. I can work as a clinician for ages. I can do a lot of studies. Nobody will read. Nobody will take notice of that, but if I could study to be a real leader, I think I might be able to change something.
TML: Palestinian women are highly educated, but how do they fare in the sciences?
Khatib: Hmm, now this is the difficult question. Scientists in Palestine are not very lucky. As I told you, the system, the leadership, the atmosphere does not really give you the motivation and the means to do what you know very well to do, [there is] no financing. The administrations do not care. And so on. Imagine, if it was a woman on top of all of these difficulties that face a regular scientist, if she’s a mom, if she’s a wife, if she’s even a young girl who was single, and she should you know, tell her not to stay late in the labs, not to travel alone. She has kids. Nobody can take care of them, and really it’s a harsh journey.
And this is why we made a very promising chapter in Palestine now. So, me and my colleagues, female scientists from different universities in Palestine started something called the OWSD [Organization for Women in Science for the Developing World] Palestinian chapter. It’s an organization of women in science for the developing country. It’s one of the agencies that are under the umbrella of the UNESCO. It has like 32 chapters all over the world, and we are very proud that we announced one year ago, we had the announcement of the Palestinian chapter. We are now a nearly 100 member[s], women scientists in this chapter, and we have two-hour ordeals, international ordeals in science in this chapter. I’m very proud of this. We’re trying to do our best to back up the ladies and the girls in science. I hope we will be able to do that.
TML: What’s lacking? I mean, this is really in the middle of COVID with so many problems. The Palestinian Territories are having a very difficult time in terms of vaccinating their people.
Khatib: I think what is lacking in general in the Palestinian health care system is a real responsible leadership. Leadership that is really technical; technical more than political. You can’t manage a health care system without well-educated leaders and managers, and if you have an idea, it’s mainly like driving or giving a Mercedes to someone who is barely able to drive. The system is not going in the right way, because I think we have a problem in the leadership. It’s more political than technical. In some ministries that’s fine, but in the Health Ministry, I think technical expertise is essential.
TML: How did your studies that had Hadassah Medical Center help to shape your path working with Israelis; working with Arabs, Israeli Arabs; working also with Palestinians and others?
Khatib: It was a life transformation experience. I learned how to think constructively. They told me how put [together] questions to say why towards my first gate, not only for specialization, and also for research, because you learn there how to ask why and everybody can. This is what is amazing. The science in this hospital is truly up to one of the best international levels, and there’s something else. They don’t care who you are. This is my experience, at least. They don’t care if you are Palestinians, if you are Muslim, if you are Christian, it doesn’t matter. In this institution, they care if you are good, if you want to learn, and they give you the opportunity, and this taught me how to be so professional in thinking and not to judge anybody according to any ethnic or religious background.
TML: So why is it that the politics always pushes everything back?
Khatib: Yeah, that’s the question that every scientist, every doctor and every professional ask. If we could do well in research with the Israelis, or with the Europeans, or with the Americans, or with whomever, and if we can work together as residents, as specialists, as [a] health care team, why we could not live together? I don’t know. I think both sides need to answer this question.
TML: Dr. Khatib, what is your hope for the Palestinian women in general?
Khatib: I hope that the Palestinian women in general could express what they have. They have a huge potential, and yes, of course we are much better than many Arab countries, but we deserve even more. I know that the Palestinian women are more independent, are very educated, have a rim of freedom, which is more than most of the Arab countries, but believe me, Palestinian women could do more. They could really compete, and I saw that. I saw it when I worked in science in Israel. I saw it when I did a fellowship in the United States. I see it in every congress, in the European or other countries. Palestinian women can do more.
TML: International Women’s Day is upon us. It is an important time to reflect and look at where women are at large. What would you say to young women that are really trying to rise up in the sciences or other fields? What should they be doing that they have not done? Who should they be reaching out to?
Khatib: I would like to say to them, free your minds. Free your minds from the barriers. There is no barrier because you are a woman. This is nonsense. First of all, they should free their minds of the preset laws, preset social image, preset constructions. If they free their minds from these preset issues, I think they could go – the sky is the limit. They could go to a very high level of achievements.
TML: Why did you become a physician?
Khatib: It’s a nature when you are raised up in an atmosphere where you see that people need help and I know that this is the usual sentence that the physician says all the time, but I had like one of my idols. She’s a pediatrician, and she’s now in the United States, in Chicago. She’s one of the best pediatricians ever. Her name is [Dr.] Mohayya Khilfeh. She’s now 70-something, and she was my pediatrician, and I looked at her taking care of the kids, smiling with all the science that she had, and all the ambition, and all of this energy, so I always wanted to be that woman who can do something.
TML: What is the hardest thing you ever did?
Khatib: Making people look at me as a human being, and not as a woman, and this was not easy. Accepting me for what is inside and what I look like, and not putting these barriers in front of me because I don’t look like them, or I don’t think like them, and just to treat me as a real human being with things inside me, not because I am a woman who looks liberally or who does not cover her hair, or who is not so conservative. This was not easy. I had a huge problem when I started my career, and I started my career as a director. My first job was a director of a unit, and though I left that hospital with so much love and so much trust from my team, but the start was not easy. [It was] like having thirty men in the unit with a young female as a director. Believe me, that was not easy.
TML: Where was this? In what unit?
Khatib: My first job was in Augusta Victoria hospital in Jerusalem.
TML: Tell me about your family life, mom and dad growing up, to just get a sense of you.
Khatib: My father is a lawyer. He was a famous lawyer and he taught law in the university, in An-Najah University. My mom is a teacher. She’s an Arabic teacher. She loves poetry so much. By the way, this is one of my very good skills. I write professional Arabic poetry. So I grew up in … I have like three brothers, [but] no sisters, and I grew up in a family that respected me as a smart sibling. That’s it. They did not have any constriction on anything. Go learn. Do whatever you think is right. So, I think my raising was in favor. I was so lucky to be born to such parents who believed that there are no barriers. If you want to do something, there’s no sex barrier, there’s no religious barrier, there’s no social barrier. I think I was so, so lucky.
Then I got married to a gynecologist, and he also helped me a lot in pursuing my specialty. He did not have a big problem taking care of my twins to travel, to go for congresses, to study. All of the family, in fact, was so supportive. So, I think that this helped me a lot. I was lucky.
TML: Dr. Areej Khatib, it’s been a pleasure learning your story and hopefully inspiring many others. Thank you so much for joining me here, on Facing the Middle East.
Khatib: Thank you, Felice! It was a pleasure meeting you too.