The multidisciplinary trauma unit is on call for all of the specialist staff for speedy diagnoses and treatment.
By WENDY BLUMFIELDThe group from Homerton Hospital stands in front of the plaque of Maimonides at Rambam Medical Center.(photo credit: WENDY BLUMFIELD)
There is a vast demographic, geographic, cultural and historic difference between Haifa and Hackney in east London, but listening to the guest health specialists from Homerton Hospital in Hackney discussing their work with their hosts at Rambam Medical Center makes it clear that they have much in common.Haifa is twinned with Hackney, an area with a large Jewish population that dwindled as the immigrants of the early part of the 20th century moved out to the greener and more prosperous suburbs.The weeklong visit was organized by London-based Martin Sugarman, in charge of the twinning program, and Nancy Black, coordinator of special projects at Rambam. In addition to seeing the work of the hospital on-site; tours of the campus, including the new underground protected hospital area; and field trips, the group was greeted by staff members who described the work of their departments. Here the similarities between the two countries served by a national health service became evident: despite budget cuts, the dedication and skills of the staff produce state-of-the-art health centers.Rambam serves some 2.3 million people in the North with innovations and research that attract patients and specialists from all over the world. Readers of Judy Siegel-Itzkovich’s columns in The Jerusalem Post will have read of many procedures carried out for the first time in medical history in this Haifa hospital.Luisa Cabrero-Moreno, a pharmacist at Homerton Hospital, describes a smaller district hospital affiliated with Barts and London School of Medicine and Dentistry with 450 beds serving some 200,000 people. But the diverse population of multicultural immigrants presents many of the challenges also seen in Israeli hospitals throughout the country.The focus on community services coordinated within the hospital is something that Israel would be wise to follow. Clinical psychologist Dr. Ian Moran runs therapy and support groups in family doctor clinics in the neighborhoods, making them far more accessible than if they were based in the hospital itself.“We have a haredi population of 20,000 in Hackney and although we were told it would never work, the men from that community have willingly attended support groups for fathers and other therapy programs.”He also talked about community-based therapies for children and adolescents, but lamented that services for the elderly were included in social services rather than health. If they are anything like Israel’s National Insurance Institute, he is justified in his lament.Midwife Gitty Blum is happy about the high haredi birthrate in Hackney. Another significant difference between the UK and Israel is that home birth is accepted in the established health service. Homerton’s midwives work not just in the hospital but conduct all the prenatal and postnatal care in the community, as well as attending home deliveries when requested.“We have specific criteria for home births,” she said, “but we can only make recommendations, we cannot refuse to go to a home birth even if we advise against it.”Cho Salgado, a clinical research nurse, explained that while he works at Homerton and the hospital benefits from the research, the actual costs are covered by outside health institutions that provide a wider scope for their work.It is obvious by these names that the staff at Homerton is multicultural. Kasia Stegienta-Harmer, a clinical nurse specializing in gastroenterology, and radiographer Ingrid Smit were impressed by the description of the use of imaging technology in the detection and treatment of disease at Rambam.As an inner-city hospital, Homerton receives victims of road accidents and street violence, and the visitors were interested to hear department head Dr. Hany Bahouth’s description of Rambam’s Level 1 Trauma Unit.“As Rambam is the only Level 1 Trauma Unit in the north, we get a far higher rate of admissions of the severely injured, both from local road and domestic accidents and street violence brought in by ambulance to the far-reaching northern victims flown in by helicopter,” he said.The multidisciplinary trauma unit is on call for all of the specialist staff for speedy diagnoses and treatment. When asked whether Israel’s military situation increases the statistics of severely injured, Dr. Bahouth’s reply was that apart from wartime, when Rambam becomes a front-line hospital, routine admissions from the army or as a result of terrorism account for no more than 3%.“Road accidents and street violence peak on Friday nights but keep us busy throughout the week,” he said. He regrets the 33% rise in head injuries caused by electric bicycles and hoverboards and is hoping that the Knesset will impose stricter laws for their use.The visitors from Homerton will take home some very interesting impressions of Israel and its health services and are also enjoying the warmth and hospitality of their hosts.
