Israeli Hospitals: A Model for Coexistence

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By Daniela Feldman

A true melting pot of cultures, Israel’s population is comprised of immigrants from the four corners of the earth. Often international news reports are filled with clashes and curtailed hopes of peace, staggered by the inability for productive dialogue and intolerance to difference. Nonetheless, in every major city in Israel there is at least one place where religious and political tensions are set to rest, because life is at stake: the hospital.

Haifa, a true multicultural city, is known to be Israel’s bastion of tolerance – with historic significance for Jews, Muslims, Christians and Baha’i’s. Haifa residents are known for their friendly nature, and the city has a long history of integration. Bordered by a stunning port, Haifa, with its calm and unique culture, is a fair alternative to the bustling cities of Tel Aviv and Jerusalem and ranks as Israel’s third largest city. In recent years, the municipality has invested millions of shekels in revamping many of Haifa’s neighborhoods, adding in new housing, classy cafes and international shops.

The streets of Haifa vibrate from the rhythms of its eclectic residents and the breathtaking views of beaches and mountains illuminate the city, where local residents roam on their daily business. Like in most places in Israel, Haifa’s residents come from all over the world and represent a variety of political, religious and personal outlooks on life. This is especially evident in the corridors of Haifa’s largest hospital, Rambam Health Care Campus — a microcosm of the city it is nestled in.

At Rambam, patients and staff come from all walks of life. As the largest full-service facility in Northern Israel, it is the major treatment hospital with state-of-the-art tools for surgery and revolutionary innovations to care for the entire region. Its practitioners provide the utmost attention to patients, moving the institution to the status of an international frontrunner in medical research and development.

According to 2009 census data, more than 2,130,000 people live within Rambam’s regional span. At least 1,175,000 of these people are Jewish, but 655,000 are Muslim, 123,000 are Christian, 123,000 are Druze and another 75,000 are not affiliated with a religion.

Specifically at Rambam, employees represent the different populations of Northern Israel and bring a diverse set of perspectives and experiences to treat patients, indiscriminately, within the hospital’s walls. Of the hospital’s 4,600 employees in 2012, 80 percent were Jewish, 9 percent were Muslim, 7 percent were Christian and 1 percent was Druze, according to the hospital’s 2012 annual report.

“Rambam is committed to spreading universal Jewish values by delivering the highest standards of health care for everyone,” said Prof. Rafi Beyar, CEO and director general of the Rambam Health Care Campus. “We treat all of Israel’s residents, regardless of religion or background, with thorough and compassionate care,” Beyar explained. “At Rambam, developing cutting edge innovations and advancing medical research are also among our top priorities and we have many research groups working on population-specific diseases.”

Despite the negative reputation of Israel among international news agencies, this June the Israeli Health Ministry announced an initiative that is yet another step toward complete equality within the health care system. The law now requires that all Israeli hospitals open Muslim prayer rooms within the next 18 months, in response to a petition submitted to the High Court. Both Rambam in Haifa and Soroka University Hospital in Beer Sheva have Muslim prayer rooms already in use, while all of the other hospitals will need to allocate space on site to meet the national requirement.

Meanwhile, as tensions have been brewing on the northern front, Israel has reaffirmed its commitment to humanitarian aid. Some 100 wounded Syrians have crossed into Israel for health care since the fighting began in 2011. Many Syrians are treated at Ziv Medical Center in Safed, while others are treated by an Israeli Defense Forces field hospital in the Golan. According to Israeli news sources, a small number of more severe cases are transferred to larger hospitals, like Rambam, though government and hospital officials prefers to keep these events quiet for security reasons.

This is not an exceptionally unique situation for Israeli hospitals. While rockets from Gaza fell into Southern Israel last fall, pediatricians at Rambam were busy treating four Gazan children who were awaiting kidney transplantation and had severe complications from organ failure. Mahdi Tarabia, head nurse at the pediatric nephrology unit, said the children received “lifesaving” treatment while at Rambam.

“The hemodialysis treatment that these children were given before their arrival at Rambam was associated with medical complications, resulting in a worsening of their condition and many hospitalizations,” he explained. “Now [after care at Rambam], these families have the skills to administer peritoneal dialysis, which represents a significant improvement in the children’s circumstances and will enable them to function almost normally.” Tarabia added that there was great cooperation between the staff at Rambam and the local medical authorities in Gaza.

In February, a 27-year-old man from Nablus was transported to Hadassah Medical Center in Jerusalem, following clashes between Palestinians, Israeli residents and IDF soldiers. Originally treated in a Nablus hospital, the man’s condition, caused from his severe gunshot wounds, deteriorated significantly and doctors suggested he get more sophisticated care at Hadassah. However, the patient needed to be transferred with an accompanying physician to monitor his anesthetics and respirator. Palestinian doctors did not have access to the appropriate equipment and called upon Hadassah for assistance. The situation got more complicated due to security restrictions for travel within Palestinian-controlled areas of the West Bank.

Dr. Micha Shamir, a senior Hadassah anesthesiologist, agreed to do the transfer. First, Shamir was driven and escorted by Palestinian security personnel to the Nablus hospital. The patient was put into a Palestinian ambulance and met Shamir prior to crossing a checkpoint outside of Nablus, where an Israeli Air Force helicopter flew them to Hadassah’s intensive care unit in Ein Kerem.

Such situations are not uncommon for medical professionals in Israel, according to Dr. Aaron Krom, a resident in anaesthesiology and intensive care at Hadassah’s Ein Kerem facility. “On the simplest level, by working side by side with Palestinians from the West Bank in the hospital, I’ve gotten to build relationships with people who I would not usually meet or talk to,” said Krom, who studied at Oxford and made aliyah from England last August.

“One of the most fascinating aspects of working in a multicultural team is the ability for the hospital to treat everyone equally and yet benefit from their differences,” he said. “On the one hand, we rarely discuss politics, and doctors from all different backgrounds care for Jewish and Arab patients the same. On the other hand, a hospital policy arranges that Jewish employees provide more coverage during Muslim festivals so that Muslims can take leave, and likewise, Muslim physicians cover patients during Jewish holidays for Jewish employees to take vacation.”

Cooperation is key in medicine, and there are countless stories of Israelis ignoring religion or race for the sake of saving a life and giving top health care. One such story occurred in May, when physicians at Rambam performed Israel’s first-ever “crossover kidney transplant.” In this procedure, one patient’s family member donates a kidney to another recipient whose relative donates a kidney in return to the first patient. It is a revolutionary alternative transplant surgery when no blood relative is a suitable match for donation.

Haifa residents Muhammad Akrat, 32, and David Ben-Yair, 57, had never met before they shared a hospital room following a kidney transplant. In a three-hour surgery, Akrat’s wife Rasha gave her kidney to Ben-Yair, and in return, her husband received a kidney from Ben Yair’s son Shmuel.

“Whoever saves a life is sacred, whether Jewish or Arab. G-d’s blessing will prevail,” said Muhammed Akrat about this extraordinary procedure.

This cooperation and commitment to providing aid reaches the burgeoning field of medical research. In conjunction with last year’s Ramadan holiday, Prof. Naim Shehadeh, director of Rambam’s pediatric unit and the pediatric diabetes and obesity clinic, released new research that found that fasting spurs health complications among diabetics. In his clinical study of patients using three types of insulin, Prof. Shehadeh found that the risk of health complications, such as dizziness, fatigue and low sugar levels, among diabetics is 7.5 times higher during the fast itself than during the non-fast period. This research has obvious implications for the Jews as well, given the occurrence of religious fast days throughout the year.

Overall, Israeli physicians, researchers and caregivers recognize that all residents – no matter what beliefs they hold, where they live and what their socioeconomic status is – have shared experiences. Even the worst of situations provide a platform for strangers to join together.

As a testament to Israel’s integrity and compassion, children battling cancer are given respite and support among their peers and with the help of social workers. At the Akko Beach Hotel, the not-for-profit organization To Fight Together hosted 17 children diagnosed with cancer and receiving treatment at Rambam for a therapeutic weekend camp.

In the program were workshops on issues, such as self image, fears, future planning, intimacy and interpersonal relationships, as well as fun activities. The staff, comprised of social workers from Rambam’s pediatric hematology-oncology department, remarked how the group of Jews and Arabs between ages 11 and 20 became so cohesive by the end of the weekend, and that they are sure that this program forged relationships among the participants.

These stories are just a sampling of what leaders in Israeli health care are doing to positively impact the country’s residents and its sometimes hostile neighbors. In a time when the news is constantly criticizing Israel, these leaders are shining light on how the country’s roots in the Jewish values of compassion, justice and integrity percolate the medical field. Tikkun olam – the Torah-based principle of repairing the world – and pikuach nefesh – saving a life — reach hospital wards and research laboratories both in times of crisis and calm.

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