US-Israeli medical drill 248.88.
(photo credit: Courtesy of the Jewish Agency )
Dr. Edward L. Goodman is an expert on two things: preventing the spread of infectious diseases like swine flu, and persuading his medical colleagues in Dallas to come to Israel to learn how to get ready for any possible emergency.
Goodman came here recently to lecture about the H1N1 swine flu virus to the staff of Western Galilee Hospital in Nahariya, which serves the Acre and Mateh Asher region that is partnered with Dallas and a consortium of 15 other American Jewish communities through the Jewish Agency's Partnership 2000 program (P2K).
For Goodman, the doctors and nurses who listened to his lecture were already longtime friends, because he was participating for the seventh time in a P2K program called the Emergency Response Group (ERG). The program brings top American medical personnel from the partnership communities to Israel to learn from its unfortunate experience in dealing with mass casualty incidents.
Goodman serves as medical director of infection prevention and antibiotic utilization at Texas Health-Dallas, a consultant in infectious diseases for Texas Health Resources and a clinical professor of internal medicine at University of Texas Southwestern Medical School. Since first participating in ERG in 2002, he has brought 10 specialists from his hospital group, including its CEO, to join him on the program.
"My goal is to make sure that every hospital in the Dallas-Fort Worth region sends someone in emergency management on this program, because there is nowhere in the US where they could get this training." Goodman said. "Thank God, the US doesn't have missiles constantly aimed at it like Israel does. But the Fort Hood shooting proved that you don't have to be at war for a madman to create mass casualties.
"Israel is a model, and they are willing to teach us, so all we have to do is come to Israel, participate and bring the wisdom that we've learned from the Israelis back to the US."
GOODMAN'S H1N1 lecture allowed him to return a favor to the staff of Western Galilee Hospital that has given him key information about preparing for emergencies that he has implemented at work back home.
It's that equal exchange of information via the so-called living bridge of doctors like Goodman that Partnership 2000 takes pride in.
The bond between the Acre-Mateh Asher region and the 16 consortium communities in Texas, Ohio, Indiana, Nebraska, Iowa and Kentucky is just one of 45 thriving partnerships initiated by the Jewish Agency 13 years ago.
ERG is one of many successful programs of the partnership of Acre-Mateh Asher with what is called the central areas consortium.
There are also exchanges of policemen, firefighters, students, camp counselors and even artists.
"The ties between Israel and American Jewry have come a long way from the notion of rich US Jews helping poor Israelis and have really become a two-way street," said P2K director Liat Cohen. "The partnerships are intended to strengthen Israel and the connection between the Diaspora and the Jewish state. ERG does both. It helps Israelis and American Jews realize the importance of each other."
ERG began nine years ago as an effort to train American Jewish doctors in handling mass casualty events so they would be able to take the place of Israeli medical personnel who get drafted into the army in a time of war. Following the September 11, 2001, tragedies and the damage of Hurricane Katrina, the Americans realized that they needed to prepare their own hospitals for such incidents and that no one was more experienced in this field than the Israelis.
More than 150 top American medical personnel from all faiths have taken part in the program, which has 16 to 20 participants annually. The participants spend most of their time with their counterparts in their specialty departments at Western Galilee Hospital, but they also visit world-renowned facilities at other hospitals and tour Jerusalem and the North.
Since the program began nine years ago, more than 60 doctors and staff from Western Galilee Hospital have been invited to come to hospitals in the partnership communities in the US for observation and learning exchanges.
Judith Jochnowitz, the hospital's international liaison, said she has seen firsthand the positive impact ERG has made on both Israel and the US. For instance, a neurologist from Dallas found that his counterpart in Nahariya was doing research on the same matter. He invited him to Dallas, they combined their research and published it together.
"Terrorism is unfortunately international now, so they might experience what we have," Jochnowitz said. "The questions they ask us lead to us making improvements. A few years ago an emergency doctor from Indianapolis came on the program, saw our mass casualty carts and asked for the list of what was on the cart. That led us to computerize the list and add flagged expiration dates."
GOODMAN SAID he has learned something new on the program every year. On this trip, he learned from a drill at the hospital about treating victims of earthquakes and from a medical simulation with computerized dummies that respond to voice commands at Sheba Medical Center in Tel Hashomer.
"The theme of the program is always the same: How to deal with mass casualty events, which Israelis know far too much about and Americans not enough," Goodman said. "Whenever I come back home to Dallas, my hospital administrator asks what we can do better."
Goodman listed several improvements made to his hospital's procedures for dealing with mass casualties due to his experiences in Nahariya: More than 100 walkie-talkies were purchased because he learned that phone and cell lines fall during such incidents; drills need to be done for real with real people and not virtually; every employee must know his role in the event of each kind of disaster; and extra equipment must be used in rotation instead of kept in reserve in order to know for sure that every item is fully operational.
Following his lecture about swine flu at Western Galilee Hospital, Goodman saw five patients, including one who was in serious condition, and discussed possible treatment with his Israeli counterparts. More than 20 proven cases of swine flu have passed through the hospital.
"They were doing even more than I would have done to treat the H1N1 patients," Goodman said. "They were under more isolation than I would have put them. Everything the doctors did was completely fine. The H1N1 patients are all going to survive, in part because the treatment is so superb."
Rae Ann Davenport, the emergency/disaster management coordinator for Texas Health Presbyterian Hospital-Dallas's safety department, said her hospital's CEO encouraged her to come on ERG, even though she is neither Jewish nor a doctor. She described her job as making sure that the hospital is ready to function in the event of chemical, biological or terror attacks or any other major incident.
"We are lucky in the US not to experience any wars on our soil," she said. "We prepare and are proactive, but you have to be ready to be reactive too, the way Israel has been. What I want to bring back is how to respond and recover if we are ever forced into such a situation."
The lessons learned from Israel on Davenport's list include drilling emergency situations, keeping instructions for hospital staff simple and accessible and separating mere stress victims from patients who require immediate assistance.
"During the swine flu uproar, there have been a lot of people who weren't really sick but watched the news and got worried," Davenport said. "We need two different emergency departments to separate patients who need immediate care from those who just need a teddy bear and a hug."
She said she gained an appreciation of Israel and Israelis on the trip. She said she even found Israelis to be friendlier than Americans.
"Look at your location and what you've been through over here," Davenport said. "I sit in Dallas where everything is theoretical, but I know it's not a question of if but when. When I get back, I'm going to get on my soapbox and not get off for a while. This course was proof that there is so much you can learn and it's never done."
The itinerary of the group featured workshops with topics as diverse as "Psychological Aspects of Mass Casualty Situations," "Robotic-Assisted Hysterectomies," "Policy Analysis on Mercury Exposure from Broken Fluorescent Light Bulbs" and "Acute Stress Reaction in the Second Lebanon War."
Dr. Jeffrey Meltzer of the Indianapolis suburb of Carmel said he was surprised by how peaceful the North was. He said that even though they were shown where a Katyusha rocket that was fired from Lebanon had struck the hospital, it was still hard for him to imagine that a war had recently taken place in the area.
Meltzer, who heads the obstetrics and gynecology department and the ethics committee at Clarion North Hospital in Carmel, said he was impressed by how Israeli hospitals treat Arab and Jewish patients with a blind eye to their background.
"This program furthered what I know: that Israel does the right thing despite what the world says it does," Meltzer said. "We are bonded together by common roots and values, including treating everyone fairly at a hospital. This is the homeland of the Jewish people, and I have an open ticket to come here because I am Jewish. I am the son of an Auschwitz survivor. Israel is not just the refuge for victims, it's our future."
That camaraderie and responsibility Meltzer described is also the reason why Goodman was on the program for the seventh time.
"It's like coming home to family for me," he said. "It's almost impossible to come back from Israel without a greater understanding of the Jewish state and what it has going through. This program made me a Zionist."
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