The heart of the matter

Palestinian pediatric cardiac patients are treated and their doctors trained by Israelis.

By ARIEH O’SULLIVAN / THE MEDIA LINE
December 21, 2011 17:56
Save a Child's Heart

Save a Child's Heart 311. (photo credit: Courtesy of Save a Child's Heart)

 
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Weakly, little Adam stares out from his crib, his dull, three-month-old eyes revealing the rough road life has been for him so far. He struggles to cough. He is a Palestinian infant from the West Bank who was born with a bad heart.

But he’s been brought to a hospital in Israel for a life-saving operation – free of charge – by one of a number of humanitarian organizations that specialize in mending hearts.

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At a time of political stalemate between Israel and the Palestinians, and when animosity between the leaders is high, hearts are still being fixed and bonds of semi-normal relations are being forged between the people.

“I thank the Wolfson hospital who is making my son healthy. I am glad that this organization exists. Despite the borders between Israel and Palestine I am very thankful that we can come here,” Adam’s mother, Samar, from the West Bank city of Nablus told The Media Line.

Israeli humanitarian organizations like Save a Child’s Heart (SACH) and A Heart for Peace, offer free life-saving heart surgery to children from the Palestinian areas and developing countries.

Operating out of Wolfson medical center in south Tel Aviv, Save a Child’s Heart was founded in 1996 and has treated some 2,700 children from 40 countries. While it has reached as far as China and Uganda, most of the focus has been on the Palestinians - and not just the patients, but doctors as well.

“The idea is let’s treat as many children as possible at the same time let’s offer training opportunities for doctors and nurses from different countries here in Israel and at the same time let’s put together medial teams to travel to these countries to operate and teach locally to share the skills required,” Simon Fisher, the executive director of SACH, told The Media Line.



Dr. Sion Houri, head of the pediatric intensive care unit at Wolfson hospital, said that Israel has come a long way in child heart care and now wants to help others.

“In a way we are trying to replicate our own experience,” Houri said. “When I was a young resident in pediatrics I saw Israeli children die needing heart surgery that was not available at that time in Israel. Today you cannot see that anymore. For every child needing heart surgery you have a couple of surgeons fighting to see who is going to do that. So we solved that problem from our point of view. But the problem still exists in many, many countries.”

The ground floor at Wolfson medical center has a number of children waiting or recovering from heart surgery, including young patients from Romania and Uganda, sharing rooms with Israelis and Palestinians. SACH this week opened an exhibit featuring the work of two Israeli and two Palestinian photographers documenting the treatment of Palestinian children in Israel. Gathering at the Arab Jewish Community Center in nearby Jaffa, notables were quick to sing their praise, but were disappointed that the Palestinian patients were too weak to make the trip.

“The Palestinian doctors are being trained; the kids are being brought from Gaza and from the West Bank to receive the best possible treatment at Wolfson hospital; and I think the training and the institutional linkages which have been created between Israeli and Palestinian doctors and hospitals and volunteers, that is really fantastic,” Andrew Standley, the European Union’s ambassador told The Media Line.

The EU is one of many sponsors for the medical treatment, which costs upwards of $30,000 per patient. Gracious is a nine-month-old baby from Uganda who was born with a missing vein in his heart. He’s in Israel waiting for surgery. His mother, Stella Adu To, a devout Christian, said she was delighted to come to the Holy Land.

“Everything I put in God’s hands,” she said. “When I heard that I was coming to Israel and for us in Uganda we know that Israel is a religious country, we were all happy and I hope my child will be safe.”

“When you look at the pictures in this exhibition you are seeing the stories of some of the kids who are coming in sick and who are getting a new life, a new future. It is really inspiring,” Standley said.

Veteran photojournalist David Silverman worked together with Wissam Nassar, Nati Shohat and Jafar Ashtayeh to portray the lives of the patients during their treatment. Silverman, who has covered bloody and hard news for two decades, said he was particularly moved documenting these stories.

“Even though it is covering open heart surgery, which is not the nicest thing to look at, it is an emotional experience. It is a wonderful experience to go in there, to follow the kids when they wake up in the morning, to go down into the theatre with them, to be in there with the surgeon, shoulder-to-shoulder during the surgery and then of course the magical moment when they take the kid off the heart-lung machine and they restart the heart and you see the blood oxygen level goes up to 100 percent and the heart starts beating and there is a sigh of relief. There is nothing that can match that,” he said.

In the early 1980s, Israeli hospitals used to treat Palestinians all of the time and the civil administration would pay for it since they were under “administered territories.” However, with the outbreak of the first intifada in 1988, and the establishment of the Palestinian Authority as part of the Oslo peace accords in 1994, this stopped. The Palestinians chose to put their limited funds toward projects that would benefit more people and expensive heart surgery became rare and primarily for the wealthy.

One of the goals of these Israeli organizations is to train doctors from developing countries in pediatric cardiology. Dr. Wafiq Othman of Nablus, in the West Bank, is doing his residency at Wolfson to be a pediatric anesthesiologist. It’s a tough job.

“When you take the baby from its mother and go with it to the operating room and sometimes it is very difficult to do something. It is very stressful and when they ask you after the operation… it is very emotional. I am a doctor. I am not a politician. My job is to help.”

Dr. Othman, who watched his own brother suffer with a congenital heart defect, said the change in the children after an operation is like night and day. They run; they play ball. He also noted that since there is no public health insurance in the Palestinian Authority, many people can’t afford heart surgery.

For many, their only hope for survival is to be brought to Israel for treatment. The Palestinian children do not have to pay for the treatment because the cost is covered by donations made to organizations like Save a Child’s Heart, from the European Union and by the government of Israel itself.

“Just now we’ve completed another training course for another six Palestinian physicians who are returning to their hospitals and the vision a few years down the road is for them to actually have an independent medical center,” said SACH’s Fisher.

At Hadassah medical center in Jerusalem, A Heart for Peace, a French-based organization, sponsors treatment for about 50 Palestinian children a year and also trains Palestinian doctors in pediatric cardiology. Set up in 2005, they have treated about 400 children so far.

Prof. Azaria Rein, director of the Pediatric Cardiology Department, said they have had much success in training doctors from the West Bank. One even works part-time at Hadassah and the rest of the week travels to villages examining children with heart defects using equipment donated by A Heart for Peace.

“We provide free care. We provide training. We provide equipment. We also provide some urgent medication,” Rein told The Media Line. “At this moment, we still need to provide - all Israeli hospitals including Hadassah, still need to provide - at least surgery and therapeutic intervention.”

Rein said that some of their funding also came from the European Union and that there had been those who criticized giving it to Israel accusing Israeli doctors of “training” on the Palestinian kids. It is a charge that Rein dismissed with disgust, saying that Israel has a 70-child waiting list for heart surgery and it was doing the Palestinians a favor by moving them to the head of the line. Rein said the Palestinians lack pediatric cardiac surgeons and in many cases those who devote years to train for that abroad usually don’t return to the Palestinian areas. He also said that Palestinian physicians from the West Bank were afraid to go to the Hamas-controlled Gaza Strip.

“They don’t go there. They will never go there. They are afraid,” Rein said.

While many organizations from the West provide health care in the developing world, both A Heart for Peace and Save A Child’s Heart believe that is only half the task and that these countries’ doctors must also be trained.

“We think it is charitable and important [to travel to other countries and treat their patients], but we think it is counterproductive. It is counterproductive because it is still a form of paternalism, if you will. It is still a form of ‘We will help you.’ We want them to be helped by themselves,” Rein said. “What is important is to be sure that you do not do it through paternalism or colonialism; and that you try to provide the Palestinians with their own autonomy.”

Ultimately, the doctors insist, Palestinian mothers know that Israel is no demon and they return to their village with the message that hearts can be mended in Israel.

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