Israeli doctors in the north are dedicated to saving Syrians

A visit to a Nahariya hospital treating victims of the civil war is both healing and harrowing.

By SHLOMO MAITAL
August 25, 2017 09:24
Israeli doctors in the north are dedicated to saving Syrians

An IDF medic administers initial treatment to a wounded Syrian in a military ambulance near the Israeli-Syrian border. (photo credit: REUTERS)

It is midnight on a cold winter night in the Syrian part of the Golan Heights. A strange caravan wends its way along a rocky path toward a secret location on the border with Israel. Mothers in hijabs and parkas carry babies and small children swathed in bandages.

Some children, crudely bandaged, ride in panniers slung over donkeys. Many have no accompanying parents because they are dead. There are wounded men, too, limping along, helped by their friends.

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The procession walks silently. Finally, they reach the border. Awaiting them is an IDF medical team that quickly administers first aid, stabilizes the wounded and puts them into ambulances that speed off, sirens screaming, to hospitals in Nahariya and Safed. Soon, teams of nurses and doctors begin to heal the enemy – rebuilding faces and hands and treating wounds that are almost indescribable.

The “enemy?” To the Israeli medical teams, these are simply human beings who have been bombed, gassed, shot, sniped, mortared and maimed by their countrymen, who call them terrorists and supporters of terrorism.

Syria is still at war with Israel. So, this is a rare instance where a nation treats the wounded of a neighboring country that seeks its destruction, heals them and sends them home.

The Israeli government has decided not to let in Syrian refugees, but in 2013 it did decide to treat the wounded from its neighbor to the north.

As a result, some 3,000 wounded Syrians, a third of them children, have been treated by Israel, including some 1,700 at the Galilee Medical Center, or GMC, in Nahariya.

And more arrive every day.

These numbers may seem like a drop in the bucket compared to the horrendous human toll of Syrian wounded, but I believe they are immensely symbolic and meaningful.

Dedicated Israeli surgeons, doctors and nurses treat terrible wounds of a sort they have never seen before. In the US, hospital emergency rooms regularly treat gunshot wounds − Chicago, for instance, is notorious for daily gun violence.

Bullets fired by hand guns travel at low velocity – 830 feet per second (253 meters per second). Syrian snipers, in contrast, use high-velocity weapons. An M16 rifle fires bullets that travel 3,300 feet (one kilometer) per second. The shock wave created by such high-speed bullets inflicts massive damage to human tissue, blowing away huge chunks of flesh. It is this travesty that many of the Syrian wounded suffer, both children and adults, and that the Israeli surgeons work to repair.

All the patients know they eventually will return to the chaos and bloodshed of their country ‒ a country that has turned fiercely against them.

BACKGROUND

Modern Syria emerged from a World War I deal between Britain and France known as the Sykes-Picot Agreement, which divided up the Ottoman Arab provinces. In 1920, the Arab Kingdom of Syria was proclaimed ‒ a hodge-podge of Druze, Alawites and Sunni Muslims ‒ and was given to France as a mandate. At the end of World War II, France gave Syria its independence.

Syria’s disastrous civil war broke out more than six years ago on March 15, 2011.

Many experts predicted the imminent fall of President Bashar Assad. They were wrong.

Just when Assad’s fall looked close at hand, Russia came to his aid with air power in September 2015. Russia, under Putin, misses no opportunity to poke a finger in the eye of the US and its leaders.

The human toll of this bloody civil war has been immense. The Syrian Observatory for Human Rights estimates that some 500,000 persons have been killed, many or most of them civilians. The United Nations High Commission for Refugees claims 7.6 million Syrians have been displaced from their homes, and nearly 5 million refugees have fled the country.

IN THE SHADOW OF ROCKETS

Galilee Medical Center-Nahariya is just a few miles from the Lebanese border, in spitting range of Hezbollah Katyusha rockets.

Founded in the early 1950s as a tiny hospital housed in Swedish huts, it has since become a world leader in the treatment of severe war wounds. It has 2,700 workers, and is one of the largest employers in the Galilee. Of these, 1,180 are nurses, 450 are doctors, 250 are paramedics, 800 are caregivers and 600 work in maintenance and cleaning. There are 300 volunteers, a large group of which act as translators for the Syrian patients.

I toured the hospital and was struck by its clever modern design. Many of the buildings have atriums, or central courtyards, so that sunlight spills into the rooms. In the pediatric emergency room, children lying in beds stare not at blank ceilings but at panels that show clouds, sky and balloons.

For 18 years, the legendary Dr. Shaul Shasha was its director, until he was succeeded the current head, Dr. Masoud Barhoum.

Among other decisions, Shasha built an entire hospital underground for emergencies, a decision for which he was mocked at the time. But when a Katyusha rocket scored a direct hit on the hospital during the 2006 Second Lebanon war, no one was hurt because, thanks to Shasha’s prescience, all the patients and staff were safely underground.

The remnants of the rocket are on display in the hospital’s entrance. Today, all the hospital’s patients can be whisked underground to safety in about 20 minutes and the staff regularly practices these evacuations.

Because the identities of the Syrian wounded are carefully guarded against those who would do harm to them and their relatives back home, I saw wounded patients only on surgeons’ computer screens.

In the office of Dr. Leonid Kogan, head of cosmetic surgery and burns, I saw a picture of the young Syrian man described above, much of whose face had been blown away by a sniper’s bullet. I had to look away.

For me, the sight was almost unbearable. I could barely imagine the pain and suffering that young man endured.

The doctors and surgeons go to work to heal and rebuild what has been destroyed, with compassion and amazing skill, and for some, a few tears. Incredibly, this particular patient’s jaw was largely reconstructed.

Kogan studied medicine in Samarkand, Uzbekistan, and made aliya in 1991 after the breakup of the Soviet Union. He has invented a unique material for treating burns that is based on algae. I promised to try to find those who can commercialize it.

I asked him how he and the other doctors deal with the mental stress of treating horrendous wounds. From his response, I understood that he brought to the task a challenging mixture of immense compassion and dispassionate professionalism.

PUBLIC RELATIONS VS. SECRECY

Clearly, Israel could reap major public relations benefits by widely disseminating the story of how we treat wounded Syrians, but the story has been rather underplayed, in part because such publicity endangers the patients who must return home after treatment.

If it becomes known they have been in Israel, retribution is severe.

Recently, there may have been a change of heart, however; President Reuven Rivlin drew much media attention when he visited the hospital on Passover.

In 2013, a filmmaker named Racheli Schwartz began filming Syrian patients in the hospital. She filmed them for three years, and her project was to be aired on Channel 1 on May 18. Hours before, however, Israel’s army censor called a halt and insisted that certain segments be removed lest they endanger those whose faces were shown and have since returned to Syria. After some editing, the film was finally aired on June 27, and can now be found on YouTube. Parts of it are difficult to watch. 

I spoke with Dr. Eyal Sela, head of ear, nose, throat, head and neck surgery at the hospital. Sela is featured in the film “The Syrian Patient.” As we chatted, I could not help thinking about the prolonged visceral battle at Jerusalem’s Hadassah Medical Center in Ein Kerem between the hospital management and Health Ministry, and parents of sick children and the doctors who resigned from the child oncology-hematology department. Clearly, some very big egos are involved in this struggle, together with medical principles. At GMC-Nahariya, I found no such egos.

Sela explained that the hospital’s culture is one of close cooperation among doctors, a culture shaped in large part by Barhoum, a Christian Arab and fervent Israeli patriot.

Everywhere there are Israeli flags. On the walls, one finds the quote Barhoum loves most: “People treat people … like people.” The quote is from former Supreme Court Justice Aharon Barak, who once, famously, said, “adam l’adam lo ze’ev, adam l’adam lo mal’ach … adam l’adam, adam.” Translation: People [should] treat each other, not like wolves, and not like angels, but… like people.”

Barhoum told Haaretz, “We admitted these wounded [Syrians] because they are human beings. This is the beautiful face of Israel overseas. Today, my hospital is the most experienced in treating war injuries after four years in which almost every morning an ambulance arrives and all the medical crews enter the emergency room to treat them. We have about 40 wounded people every day. We’ve amassed enormous experience. We have a patient for whom they’re building a face using a 3-D printer!” Sela trained at McGill Medical Center in Montreal, Canada, as did several other of the hospital’s surgeons. He told me his wife was in tears after watching “The Syrian Patient.”

I asked him why, and he answered that she had not known that he had been treating wounded Syrians, including children, with such horrible injuries. He explained that he chose to leave the horrors at the hospital rather than bring them home to share.

Sela recounted the case of H., 33, who reached the hospital in a state of unconsciousness with a tear in the main artery leading to his brain.

“We operated on him and repaired the damage,” he explained. “The bullet had fused with his spine, because of its intense heat. When he awoke, he was unable to speak and, instead, wrote on a pad: ‘Why did you save my life? The last thing I saw before being shot was my two children, ages three and five, being shot and killed.’ The whole medical team was utterly devastated by this. We were in tears.”

He continued, “Normally, surgeons have a detailed plan for each operation but with the Syrian patients this is not possible because they often arrive in terrible condition, requiring immediate surgery and have no documentation. So, we surgeons have to improvise based on what they see on the spot.”

They can do so, he said because GMC is no small peripheral hospital.

“We serve 600,000 people in the Galilee, more than Soroka Hospital serves in the Negev. At one time, our most seriously ill patients were shuttled to Rambam Hospital in Haifa. Today, often, it is the opposite – their patients are brought to us. Our doctors are in great demand, but we choose to remain here. We have 720 beds but need many more.”

Sela has three children. The oldest, a son, is 17. I asked if his children will become doctors, like him. He told me he once asked his son this question. “Abba,” replied his son, “I want to be home to raise my children.”

“But perhaps one of my daughters may choose medicine,” he said.

The wretched stream of Syrian wounded that reach GMC-Nahariya are products of a civil war that seems endless and infinitely barbaric on all sides. There is deep concern in Israel that the Syrian chaos is approaching our borders like a plague of locusts and that when the killing stops, Syria as we know it will no longer exist. In truth, Syria already no longer exists.

WHO CONTROLS SYRIA?

Today, the Assad government holds about one-fourth of Syria, in territory, but around 70 percent of its population, including Damascus, the capital, a city of about 2 million.

ISIS holds more land than Assad, but only 6 percent of the population because civilians have fled. The Syrian Democratic Front (SDF), a motley alliance of Kurdish, Arab, Assyrian, Armenian, Turkmen and Circassian militias, holds one-fourth of the land and one-seventh of the population.

One-fifth of the land is held by rebel groups including Jabhat al-Nusra. Syria has become the proverbial omelet from which the original eggs cannot be reconstructed.

DO NO HARM

Assad’s father Hafez Assad ruled Syria for 30 years, from 1970 to 2000. On February 2, 1982, the elder Assad killed 20,000 Syrians in the city of Hama to quell a Muslim Brotherhood uprising. Robin Wright, in his book, “Dreams and Shadows: The Future of the Middle East,” called this “the single deadliest act by any Arab government against its own people.”

But the son, for years a fashionable London ophthalmologist, has far outdone his murderous father. With barrel bombs dropped on civilians from helicopters, among other barbarities, Bashar has murdered many times more people than his father, and mocks the physicians’ oath he took to “utterly reject harm and mischief.”

Writing in The New York Times, Kamel Daoud outlines several strong arguments for keeping Bashar Assad in power. Maybe democracy is too costly. The devil you know (Assad) is better than the one you don’t. The alternative to Assad might be far worse. Democracy in Syria would usher in a new form of Islamism and jihadism, as it did disastrously in Egypt, so it would be better to keep a brutal dictator in power.

Daoud rejects this logic and I agree.

Should not moral principles trump geopolitical sophistry? To plead my case, I call on former US president Bill Clinton.

A million people were slaughtered in the Rwanda genocide over a 100-day period from April 7 to mid-July 1994, or as much as 70 percent of the Tutsi population. Upon leaving office in 2001, Clinton said his decision not to intervene and stop the massacre was the one he most regretted. It still weighs on his conscience.

In March 2013, Clinton told CNBC he believes that, had the US intervened even marginally at the beginning of the genocide, at least 300,000 people might have been saved.

Former president Barack Obama and President Donald Trump will share the blame for the continued slaughter in Syria, as will Israel and all of us who remain silent. How many of those 500,000 dead could have been saved? How many maimed and wounded children could have been left whole and healthy? WHO PAYS? No story would be complete without the obligatory feud between government ministers.

In February, Health Minister Yaakov Litzman threatened to stop treating Syrian patients if the government did not pay the extra costs involved. Litzman says the Syrians should not be treated at the expense of sick Israelis and the IDF and Defense Ministry say they need not bear the cost.

So, in the end, who paid? No one. The hospital has spent 300 million shekels to treat wounded Syrians, reflecting the high cost of nearly 30,000 days of hospitalization at 10,000 shekels a day; two to four operations per patient; and average stays of 23 days though a few have stayed for a year or a year and a half.

In return, the hospital has been compensated with just 54m. shekels. This has left a huge hole in its pocket, and for the first time in the hospital’s tight-ship history created a deficit in its budget.

Amir Yarchi, head of the Friends of Galilee Medical Center, a non-governmental organization that raises funds in Israel and abroad, told me that among the leading supporters of GMC are American Christian evangelical groups that give up to half the total contributions. Treatment of the wounded from an enemy apparently deeply resonates with people of the Christian faith.

Donations to GMC run at about 10m. shekels annually ‒ half from abroad – but they far from cover its needs.

Yarchi emphasized, however, that these contributions are not used to pay the costs of treating wounded Syrians. “We did get designated grants for that purpose – but this is a drop in the bucket of the overall cost.”

REASONS FOR HOPE

As I write this, there are reasons for some hope. A ceasefire has been declared along parts of Syria’s southern border with Jordan and western border with Israel through a deal between Russia, the US and Jordan.

Such ceasefires have not held up in the past, but perhaps this one will. It may lead to a de facto partition of Syria into regional fiefdoms.

For Israel, cardinal importance attaches to keeping Iran and Hezbollah away from its Golan Heights border.

There should be no forgiveness for the Syrian barbarians led by Assad, the London opthalmologist who swore to “do no harm,” and his henchmen who have slaughtered, bombed and gassed their own citizens. Nor is there forgiveness for all of us in Israel, the US and the West who have watched the carnage and not lifted a finger.

As an economic journalist whose job is to string words and numbers together, I struggle to find words to describe the anger and shame I feel in the face of the suffering that human beings endure in Syria. Anger, at the barbaric cruelty, and shame at the reluctance of the US, Israel and the West in general to put an end to the bestiality of Bashar Assad, the butcher of Damascus.

I cannot fathom the depravity of a Syrian sniper who lines up a small child in his sights and pulls the trigger. If this is what they do to their own people, what in the world would they do to us, if they could? Lacking my own words, I found strong ones in a poem by Hayim Nahman Bialik, written more than a century ago. In 1904, Bialik lived in Odessa, Ukraine. After a violent pogrom in Kishinev, Bessarabia that killed hundreds of Jews – men, women and children ‒ Bialik was asked to visit that city and write a report.

He never did write it. But, even before he left for Kishinev, he wrote a poem, “The Slaughter,” in Hebrew, with these fierce words: A curse on any who says: Avenge this! Fit revenge for the blood of a child Satan himself has not yet invented.

The writer is senior research fellow at the S. Neaman Institute, Technion and blogs at www.timnovate.wordpress.com


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