Hospital no longer wants to be a well-kept secret

Nationwide, Bnei Brak’s Ma’aynei Hayeshua Medical Center is probably the least-known in the country, even after 23 years.

June 22, 2013 22:55

JANETTE ZUCKER 370. (photo credit: Judy Siegel-Itzkovich)

Although it’s located in the country’s 10th-largest city and with 1,000 monthly births runs the third-busiest delivery rooms, the 23-year-old Ma’aynei Hayeshua Medical Center (MHMC) is the hospital that almost no one has heard of. Unless you live in or visit Bnei Brak, are haredi or otherwise Orthodox or especially believe in preserving human life at all costs, you probably have never been to MHMC.

Even the taxi driver who took me there recently for five hours of visiting departments and interviewing staffers at management’s invitation didn’t know if its existence, let alone its address. With a nearly unpronounceable name that comes from the Book of Isaiah and means “Wells of Salvation” in English, MHMC has 312 beds (not including newborns), 140 nurses, 350 nurses, 150 paramedical staffers and 270 office workers. Although more than 70 percent of all patients are in the obstetrics, gynecology, neonatal (including intensive care) and pediatric departments, it is more than a maternity hospital. There are growing departments of internal medicine, surgical, orthopedic and anesthesiology and a small emergency room. There are also 11 outpatient clinics with 17,000 visits a year and a new dialysis unit.

A just-opened cardiology institute will eventually be housed in a large building that will fill a large hole near the main entrance.

Across the street, a massive mental health center for acutely ill patients and outpatients is now under construction. Management would be happy to name new facilities in honor of generous donors.

Ma’aynei Hayeshua’s “unique mission,” according to its 85-year-old haredi founder and president, Dr. Moshe Rothschild, is to provide modern and sophisticated medical services that adhere to Jewish law and tradition, with a strong conviction that the sanctity of life is a supreme value.

The former immigrant from Switzerland, who comes from the German branch of the Rothschild family, believes that that a city like Bnei Brak – with 180,000 mostly ultra- Orthodox residents – needed a medical center that would provide its inhabitants with high-quality professional medical services while strictly adhering to the values of the sanctity of life and human dignity.

It had never before bothered to send an invitation – or even a press release – to the secular press, but now it wants potential donors and patients to hear about MHRC.

“I took it upon myself to build a community hospital, and everybody said it was crazy,” said Rothschild – with a gruff, businesslike manner – who greetedThe Jerusalem Post by saying: “You have 10 minutes; what do you want to ask?” A physician as well as businessman who was involved in real estate, the father of 17 children (aged from their 50s to 20s, and all from his wife Rosa) donated some of his own money to the project and also amassed donors. The original 150-bed facility has expanded so quickly that the facilities looks like a patchwork quilt, as departments are suddenly shifted to more spacious quarters when they become more crowded and open spaces are turned into closed ones. Unlike in the country’s big-city and donor-rich medical centers elsewhere, aesthetics is not an important consideration.

“There are excellent medical centers not far from here,” said Rothschild – Sheba, the Rabin Medical Center-Beilinson campus, Tel Aviv Sourasky – “but we especially value life and the extension of life. There are premature babies that many doctors would say have no chance of survival, but we try. And we do the same for elderly patients. We have an institute of medicine and Halacha, and we have a rabbinical board to decide all Jewish- law issues.”

The name of the hospital’s administrative director, Rabbi Gershon Lieder, is well known from his 33 years in the same position in Netanya’s Laniado Medical Center, which is a general hospital for all but was founded by the rabbi of Sanz and is run under a haredi administration. Not long ago, he went on pension at Laniado and was called in by halachic Bnei Brak sage Rabbi Shmuel Wosner.

“I thought he invited me to wish me well in retirement,” Lieder recalled, “but he placed in my hands a letter of appointment as administrative director of MHMC! I didn’t have time even to consult with my wife.”

“Yet I’m not sorry,” he said. “This is an important hospital. It’s the only one that hasn’t received or even asked for government help. We are holding our own, but because we are building and expanding so rapidly, we need state financial assistance for infrastructure.

IN THE cafeteria, because of strict rules of modesty set down by the rabbis, men and boys sit at tables on one side of a divider and women and girls on the other side. In the wards, male and female patients are kept far apart.

Even though such things give MHMC a strict, otherworldly and old-fashioned image, it’s a Israeli pioneer in the field of computerized medical records. Data can be transferred directly to the patient’s computerized record from the various departments within MHMC as well as from outside. The system reduces the number of errors, enables the concentration of all the patient’s medical data in one computerized file and makes possible the collection of information for research purposes – all the while protecting the patients’ right to privacy. In the future, the hospital will be integrated into the national medical information interface program.

It is also the first hospital here to develop unique medical applications for iPads, which are used to monitor patients’ medical conditions from anywhere and at any time. They can also use it to receive test results so they can make real-time decisions about treatment.

A dialysis unit for adults suffering from kidney failure opened just a month ago in a facility safe from bombing. It is run by Dr. Philip Shull, a former South African immigrant.

“So far, we have four patients who come in three times a week. Before we opened, the only dialysis units were at Sheba, Beilinson and Sourasky, as well as in the private Assuta Hospital. Eventually, there will be room for 14 patients at a time and enough shifts and manpower for 80.”

Shull noted that some patients undergo peritoneal dialysis at home, with survival rates that are no lower than when dialysis is performed in the hospital. Infections are always a possible complication, but today, these are much less frequent than they used to be.

The need for dialysis facilities in Bnei Brak was urgent, as residents tend to suffer from numerous poorly controlled chronic diseases – from hypertension, vascular problems and obesity to diabetes and heart disease. Only one of the four is suited to a kidney transplant, Shull pointed out. There are no TVs at all at MHMC to keep patients entertained during four-hour dialysis sessions, but there are screens with piped-in, censored videos.

Patients also pray or study religious texts. He added that large amounts of salt in the diet is clearly a contributor to kidney disease in the population.

THE STAFF voice only praise for the hospital and make no complaints about round-theclock service in the neonatal intensive care unit, the delivery rooms and other facilities.

Janette Zucker, the nurse in charge of treating premature babies, praised management for “giving us all the latest equipment we need. It’s like a family.”

She noted that the unit is known for preventing pain in the newborns, especially by giving glucose; not long ago, pediatricians treating such tiny babies used to think they couldn’t feel pain because their neurological systems are not fully developed, but it has been discovered that this is not true.

Dr. Ran Neiger, the Israeli-born head of the high-risk pregnancy department who after graduation from Ben-Gurion University’s Faculty of Health sciences underwent advanced training in various cities in the southern part of the US, says that about one in 10 pregnancies is high risk. Women or their fetuses may have medical problems, or the waters may have broken prematurely, or the women could suffer from gestational diabetes, premature labor or have a history of repeated miscarriage.

Israeli women in general, says the secular physician, suffer a lot of anxiety during pregnancy; they would undergo endless ultrasound scans just to calm themselves if they were allowed to. Neiger is opposed to women with high-risk pregnancies lying in bed for months at a time. In long confinement, their muscles weaken, they could suffer from blood clots and lose calcium.

“They should be up and around; just being in bed endangers them,” he declared, adding that sewing cervixes shut to “hold the baby in” until it reaches term is unnecessary and that he refuses to do it.

If a leak of amniotic fluid is treated and halted, the woman is fine, and she is not in danger, he added. Only in relatively rare cases do high-risk-pregnancy women have to be hospitalized so urgent care if available at all times.

He is proud of the fact that only 10 percent of MHMS deliveries are by cesarean section, even though many other local hospitals have a rate twice and even triple that. Haredi women will do anything to avoid cesareans, as it can limit the number of babies they can safely have. Neiger has gotten used to the involvement of rabbis, who are consulted before something unusual has to be done.

“The women tell their husbands, who speak to the rabbis, who give notes to the husbands, who give them to the wives, who hand them over to the doctors.”

While there are secular women who come from as far away as the Golan Heights and the Negev to give birth naturally, most of the women in the delivery rooms are ultra- Orthodox. No jacuzzis are available in the delivery rooms.

“There are private deliveries, as Sharap is permitted here, and we welcome doulas who do massages and calm women down, as long as they don’t interfere with the delivery,” said Ayelet, one of the midwives. But she absolutely opposes planned births at home, which she regards as always being potentially dangerous. And she herself wouldn’t dream of delivering babies in the Red Sea’s dolphin center in Eilat.

Dr. Benny Chayen, who is chairman of the obstetrics/gynecology branch, said that MHMC does not have an in-vitro fertilization (IVF), unlike all the other public general hospitals and private hospitals in the country. “We don’t have to do it, as there are enough units, but if everyone else has one, why not us?” He said such a unit in Bnei Brak is inevitable, as the process has many halachic issues.

About half of all deliveries include epidural anesthesia. Some women don’t want it, while others want it but because deliveries can go so fast when one has already had many children, there is just not enough time, said Chayen. To try to avoid cesareans, there are several doctors who are experts in turning fetuses into the head-down “launching position” near the end of pregnancy.

Three new delivery rooms are being built to keep up with the ever-growing demand of haredi women for a place to give birth.

Courses for childbirth preparation are attended only by women, while Chayen and hospital rabbi Yosef Hoffner give separate lectures to men about once a month. “We encourage husbands to be in the room with their wives, even though they must stand behind a curtain in the final stages.”

If a tragedy occurs and there is a stillbirth, the dead fetus (or a whole uterus in gynecological surgery) cannot be removed without the rabbi giving his permission.

DR. OREN Agranat, who has worked for years at Sheba, is the new head of the cardiology department, whose future Heart Center will be constructed in the “big hole.” He joined MHMS in January. There was a clinic, but management now wants a fully-fledged department.

“We have outpatient clinics, not yet beds, but a big facility is needed. A catheterization room will open. There are so many heart patients who are treated in internal medicine departments because there isn’t space. We are planning six intensive care and 14 intermediate care beds.”

The aging of the population in the area is responsible, but there is also the problem that most of the haredi community is unfamiliar with and even hostile to healthy lifestyles including smoking cessation, regular exercise and proper diets. Even schoolchildren don’t get exercise breaks and are not taught about health promotion.

Going from the country’s largest hospital (where he will still work part time) to its least known is not a step down, says the secular cardiologist.

“I feel good to start new things. There is satisfaction. And unlike working in a big center, I have freedom of action.”

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