Choose: Food or medical care?

Every day we walk past poverty-stricken people on Israeli streets. Most of us glance at them only to avoid stepping on them, before we blink back up and continue on our way unphased. Perhaps we make a sour face, and tell ourselves they made poor choices – choices for which we cannot possibly be held responsible, and we believe, as such, that it is good enough to avoid kicking them while they're down. The real kicker is that this is only a sliver of the impoverished population, and is not representative of the collective. In fact, one in every four Holocaust survivors in Israel lives in poverty, and while many are not homeless, most of them – both on the streets and among us – go unnoticed. According to the 2018 Alternative Poverty Report – one of the major reports on poverty in Israel produced by the humanitarian aid organization Latet – 72% of the public believe alleviating poverty is a low priority or is not even on the national list of priorities for the government. There are fewer than 200,000 Holocaust survivors in Israel today. A shocking 50,000 of these survivors live in abject poverty and have nutritional, medical, and social needs that are not being met by the National Insurance Institute. Welfare authorities recognize these survivors to be in need; still, many of them struggle when they ought to be comfortable. Indeed, 92.4% of the elderly recipients of Latet aid state that their pensions do not enable them, or only partially enable them, to meet their basic needs with dignity. Nutritional insecurity is the most common effect of poverty, and is often characterized by subsistence on just bread and spread for lengthy periods, not knowing the next time a meal will be available. Hunger trauma sustained during the Holocaust influences food attitudes – and survivors often experience anxiety when food is not readily available, which may further contribute to ill health in survivors. Many survivors sadly go unnoticed, and are therefore improperly cared for. Isolation is detrimental to the physical and mental health of every living person but is unique in its effect on the elderly, many of whom are coping with a constant cycle of loss and grief. What does it mean to have few or no people available as support? Well, it can mean lacking an advocate to assist in connecting survivors with aid, especially in the age of Internet resources that require special tools to navigate. Social isolation can lead to being isolated from aid. An Israeli study of mortality and comorbidity found that Holocaust survivors overall suffer higher rates of chronic disease, including cancer, high blood pressure, coronary heart disease, heart attacks, obesity, chronic kidney disease and dementia, and are less healthy than the general population. Counterintuitive, however, the researchers found that Holocaust survivors outlive the general population by an average of seven years. Trailing alongside the expected decline in ability that accompanies aging and the regular expenses that dotage ushers in, survivors on average have more medical expenses that render their small pensions insufficient for managing their needs. Ida faced persecution during the Holocaust and left Ukraine, immigrating to Israel in 1968. She is 83 and resides in Holon with her husband, under stressful conditions. “We achieved a lot of things here, and we also gave everything that we could to our country,” says Ida. “The problem is that we are not healthy. It's very hard for me to move. My husband has Alzheimer's and Parkinson's. Besides that, he also has cancer. And the hardest of all is that in my heart, when I sit next to my husband – a lot throughout the day – I remember who he was, and of course it affects my spirit.” When one does not have the means to buy proper food and pay bills, they usually sacrifice medical care, such as dental care, hearing aids or glasses with up-to-date prescriptions. Feelings of confusion and isolation can increase when these needs are unfulfilled, leading one to be further disconnected from the world. Survivors typically abandon expensive dental care (on average 7,000 shekels ($2,000) as well, which can cause severe and even chronic pain. Small items, too, are lacking and can have significant repercussions. Many survivors have difficulty moving and stay at home, often without fans to keep them cool in summer and without warm blankets in winter. A survivor herself, Hamsa is homebound and lives solely on social security benefits and a small pension from her husband. This small income is mostly allotted to taking care of her son, who suffers from schizophrenia. A professional contractor found water-damaged walls, broken doors, and invasive mold. Repairs focused on these issues but also included the installation of new faucets, a new oven to replace the defunct one they found, and even a paint job of special anti-mold paint to ensure long-term well-being for Hamsa and her family. On average, these repairs cost 5,600 shekels ($1,600), an amount of money necessary to pay for these services but far more than is affordable by impoverished survivors. Even if the survivors were able to access the appropriate administrative forms and understand the jargon to submit them, there is no denying that it is impossible to pay 5,600 shekels if, at present, your bank account balance is closer to 0 shekels. This is the reality for 58% of the elderly Latet aid recipients who need home renovations in order to adapt to their medical conditions safely. This population has been given insignificant attention, but there are a few NGOs that have recognized the myriad impediments to the well-being of Holocaust survivors like Hamsa and Ida. For 10 years, the Latet organization has employed a holistic model of intervention that tends to survivors with immediate, dignified and effective aid. Latet believes that responsibility for the circumstances of survivors is shared by both the government and citizens alike. Through this understanding, as well as with support from devoted volunteers, Latet's Aid for Life program distributes to over 1,000 Holocaust survivors the first complete aid package of its kind, with monthly food boxes, emotional support, and financial assistance through the Emergency Fund. The contents of the food boxes are chosen based on advice from leading nutritionists. Social support is provided through phone calls and weekly visits from personal volunteers like Ira, who visits Ida regularly in Holon. “We have a really, really good relationship,” says Ida. “And it distances us from our daily problems. It gives us a lot. We love one another...Also for my husband, even though he's sick, in his own way, he's smiling all the time...These people, from the Latet organization, when they come and enter our house, they bring in a new atmosphere, new air, a different mood. We feel with them, we feel good.” The Emergency Fund – as indicated by the name – is used for crucial expenses beyond food expenses. Whether the necessity is a home renovation, dental surgery, new hearing aids or glasses, this fund manages full costs and logistics, either bringing the service to the home of the person in need, or arranging transportation for the individual. Such quality of care is integrated in Latet's approach to aid, and enables the provision of nourishment in the greatest sense of the world. Since 2008, Latet's Emergency Fund has provided 14,280 items and renovated 1,550 apartments, including Hamsa's home in Netanya. Chaim is a survivor of the Holocaust who at one point could only afford to live on bread and spread. “Latet gave me their heart,” he said. “They called me, and said, 'Chaim, can we send you someone? Someone who can talk to you during the day, so you won't be home alone in silence?' I'm telling you, you are saving people who can't talk for themselves.” With all due respect to Chaim, the problem lies not in survivors' inability to advocate for themselves, but in greater society's unwillingness to listen. When it comes to the Holocaust, we vow to “Never Forget,” yet forgotten is precisely the word that comes to mind when referring to those living below the poverty line. It makes no difference whether survivors speak for themselves if they are not heard. Now we must recognize their needs and face the music of the ticking clock, which is steadily counting down the 10 years we have to take action and care for the remaining survivors in Israel. Let this clock be a reminder to never forget that the time to help is always now.

Choose: Food or medical care?

Studies indicate longer life but poorer health for Holocaust survivors – and the responsibility to take care of them falls on NGOs like Latet.

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