Following his graduation Al Aker worked in Kuwait as a physician between 1970 and 1973.[1] He continued his profession at Makassed Hospital in Jerusalem after completing his training in London.[2]
Al Aker was a member of the Palestinian delegation in the Peace Conference held in Madrid in October 1991 and in the following negotiations between Palestinians and Israel.[2][3] He was part of the Palestinian group who developed the Oslo Accords in 1993.[4] However, he left it due to the fact that the proposed agreement did not contain any item to stop Jewish settlements in the West Bank, to have a shared control over the Jerusalem municipality and to free all Palestinian prisoners arrested by Israel.[4] Because of these he became a critic of the Palestinian Authority in 1994 when it was founded.[1] He has also criticized the policies of Israel in the West Bank.[4] He was made a member of the Palestinian Higher Education Council in 1994 and held the post until August 2018.[2] He headed the PA's human rights organization in the 2000s.[5]
Al Aker was the vice president of the Birzeit University and was involved in the establishment of the first Palestinian Medical School at Al Quds University in 1995, being a member of its steering committee.[2] He is a consultant of urology at the Augusta Victoria Hospital in East Jerusalem.[6]
Al Aker has been a member of various organizations.[7] He is the cofounder the Mandela Institute for Palestinian Political Prisoners and served as the vice president of the Palestinian Independent Commission for Citizens' Rights.[4] He is the treasurer of the Ramallah-based Barenboim-Said Center for Music.[8]
Al Aker was arrested by the Israeli forces several times. They accused him of having connections with the Palestinian resistance groups, and he was imprisoned in 1991 without any formal charge.[4] He was arrested in 2002 and imprisoned for 40 days in solitary confinement.[4]