Visiting Israel’s wounded at Soroka

Soroka Hospital  picture: Eyal Yitzhar
Soroka Hospital picture: Eyal Yitzhar

Soroka Medical Center in Beersheva, the Israeli hospital closest to Gaza, bears the medical brunt of Operation Protective Edge.

Monday morning, August 4, Soroka Medical Center in Beersheva. It is a relatively quiet day for our troops on the front, as well as at home. There were no sirens in the city, or injured in Gaza. Soroka deserves a break: a thousand injured, 600 of them soldiers, have passed through Soroka, the closest hospital to the front - an 8-9 minute flight away (hospitals in central Israel take seven minutes longer to reach, which can be critical). That morning, there were 22 soldiers hospitalized, five in serious condition, and five civilians, including two Bedouin girls.

Prime Minister Benjamin Netanyahu just concluded a visit, along with members of the press, which disrupted the routine somewhat, but once the screens are lifted, everything comes back to life in a minute. The atmosphere, and this may sound a bit weird, was kind of festive. There are simply dozens of people, civilians and soldiers, wandering around the hallways with sweets, flowers, and gifts for the injured, and a good spirit of solidarity and good deeds blows through the corridors. I am swept up by it, and I pass through the wards and the rooms. It is easy to spot the room of an injured soldier: balloons, sweets, and lots of visitors. I walk in, ask ‘how are you,’ say ‘thank you,’ wish good health. The families are overwhelmed by the support, thank everyone, hand out flowers.

The soldiers themselves look a little more shy, understandably so, but many are smiling, even if with difficulty, and are grateful for the visit. It’s pretty embarrassing, but really emotional. Here and there I cling to the remnants of my façade, but it slips away from me more than once. Sometimes, when it is difficult to do alone, I join a group of girls from the B’nei Akiva youth group who came from far away, or trail a group that came from some workplace or other (these guys bring the best gifts - even tablet computers!). And, of course, the hospital workers, who exhibit outstanding patience towards the visitors, and, of course, the wounded. The injured and their families sing the staff’s praises, which, for its part, exhibits a Soroka southern pride that is really nice to see.

It’s a little sad walking past rooms of patients who are not soldiers, just regular people like you and me, but sicker as of this moment. No one brings them a tablet, or chocolate. Sometimes, in looking for a wounded soldier in the desire to do good, people walk into the room, peer inside, and their faces take on this strange expression, almost disappointment, when they see it’s just a civilian like them. They are not really disappointed, I know, I know… but still.

"It’s not an isolated encounter”

The hottest atmosphere, I would almost say party-like, were it not the complete opposite, was in front of the intensive care unit (ICU), named after Sammy Ofer, where those with serious injuries are. There are a many people, families, friends, a big spread of food and drinks, volunteers handing out sandwiches from carts and flowers from baskets. This is where the important people come, from all around, to visit.

There are sixteen beds in the ward. Dr. Moti Klein, who runs the unit, is energetic despite the exhaustion. The five injured who are left, he says, are in serious condition, and they will be in the ICU for a long time before they are transferred to rehab. “We did good work,” he says, “This is our calling.”

I ask to hear more about the calling. It is always nice to hear from people who have one: “Listen,” says Klein, “If the trauma unit is a 100 meter sprint, the ICU is a marathon. It is not an isolated encounter; many times there are long, difficult stays here. The people in the ICU - nurses, doctors - it’s something else, special people. Not private-medicine people, people who work endless hours, often without seeing good results. Unlike with other units, patients don’t leave here and go home. They go to rehab. So, often, you never see them heal. It is a difficult experience - one that the patient and the family want to forget. We need strength of spirit.”

You’re OK.

“Yes, we are OK.”

Tzipi Jan is the only social worker in the ICU (and the neurosurgery unit). She calls the wounded soldiers “kids” and, sometimes, affectionately, “soldierlings.” How are you? “I still don’t know, I feel like I can’t sum it up yet, and certainly not fall apart - I won’t fall apart. There is a ton of motivation.” Jan, who lives in Meitar, says that her personal struggle in the operation was hardest when two boys from Meitar were killed in the war. “We didn’t have many sirens.” Like everyone here, she also exhibits supreme Soroka patriotism. “We are used to being unpopular,” she says, “But maybe now they will appreciate….”

How is social work different in the ICU from other units?

“You meet families in extremely difficult situations. Often young people, and often when they are unconscious, so most of the work is with the family. It’s classic crisis intervention work. Many times, families whose son is hospitalized have small children at home, and the distance from them is difficult, and guilt-ridden. You share very difficult moments. You also work with the injured. There was a soldier here who woke up and wanted to know how his friends were, who had died, but the family could not tell him. It was an extremely difficult struggle.” Jan has seen dozens of families during the latest operation. “I also worked during Operation Cast Lead, but we didn’t have this many injured.”

Do you have some sort of interim report on the families?

“One of the things that stood out to me was that many of the families had a history of serving in combat units: the grandfather fought in the War of Independence, the father was in a combat unit, and then the son. Families with deep roots and strong values. At this point, the question of ‘Why me?’ never arose, although it comes up a lot in traffic accidents, for example. It’s possible that it will arise at later stages. There also weren’t questions like ‘What were we doing there? Why did we need this?,’ etc. Most of the families know that you can get wounded in war, and they have tremendous strength and even, I don’t know how say this, faith in the righteousness of the path. A sort of sense that there is no one else who will do the job, and it’s not right to even ask for such a thing.”

Don’t you want a calmer, happier unit, like the maternity ward?

“I never considered it. But there are also happy occasions here, sometimes. At the beginning of the operation, a soldier was injured by a mortar shell, he’s okay now. One of his officers came to talk to the family, he pointed at me and told them: you are in the best hands. It turns out he was hospitalized here for three months. I didn’t recognize him, because here, you know, the patients don’t look so good. That was a nice moment for me.”

I leave the ICU and make another round. I leave invigorated, as they say. It feels good to see the good side of people. It’s too bad you need to go to a hospital to see it. Soroka looks like the farthest place from Facebook, and that’s not a bad thing.

Either peace, or resources

The next day, I catch up with Soroka Medical Center Director Dr. Ehud Davidson: How are you? “Great,” he says, “The personal level is not an issue. We do our jobs. The team is amazing, and we find the energy and the adrenaline. Dedication, both professional and emotional, is always there.”

Davidson was not director of the hospital during Operation Cast Lead, but the difference between the two operations, he says, is mainly in the number of wounded, and the severity of their injuries. “We had 70 helicopter evacuations, many cases with multiple wounded, and they of course required a lot of resources. Not only personnel, but also equipment. But Soroka is a big hospital, big enough that we didn’t even need to dip into personnel reserves.”

Do you have an estimate how much this operation cost you?

“Our estimate at the beginning of the week was damage of NIS 26 million. These are ongoing losses, loss of routine activity, personnel costs, etc.”

Soroka’s budget is NIS 1.4 billion a year. That’s 2%.

“Correct. I’m not saying it’s a fatal blow. In Pillar of Defense, damage to the hospital was NIS 11 million, and we never got a single shekel, so in any event, it’s an argument about how much we won’t get.”

The conversation naturally turns to relationships and the gap between central Israel and the periphery, which, in healthcare, is particularly pronounced: residents of southern Israel have fewer doctors, fewer hospital beds, fewer facilities, and they die younger. Not everything can be blamed on the healthcare system. The population is poorer than in central Israel, and if you have to choose between food for your kids or healthcare, the choice is clear.

Another thing: At Soroka, unlike hospitals in central Israel, there is no cancer center. “We just started building it,” said Davidson, “It costs $170 million. As of now, we have only $70 million. I can already see that it will be halted.” And it’s not only a cancer center Soroka is missing. Though it is the area with the highest birth-rate in Israel, its neonatal unit is outdated (it is 25 years old) and is not reinforced for rockets. During the operation, everyone was moved elsewhere.

“What needs to happen in order for there to be a new neonatal unit,” Davidson says, “is either peace, or resources. Peace is not exactly on the horizon, and resources….”

Everyone came through here - the prime minister, all the ministers, Knesset members, and more. Did you take advantage of their listening ears and their repeated declarations about ‘embracing the south’?

“I don’t like the ‘take advantage,’ but, of course. I hope they won’t forget us after the operation.”

The gap is not only expressed in the government budget. The big donors, and this has been proven time and time again, would rather have their names on a building on Weizmann Street in Tel Aviv than on Rager Avenue in Beersheva. “Yes,” nods Davidson, “The location is not the most attractive to them." An exception is Sammy Ofer, may his memory be blessed, who dedicated the intensive care and cardiac surgery units. It may sound strange, but Davidson said that the fact that the unit with the plaque bearing his name was shown so much on TV honored Ofer’s memory, “as he deserves,” and may help bring future donors.

Davidson is also optimistic on this front, and says there has been progress, and that “An awakening can be seen.” The Friendship Fund donated reinforced operating rooms; a group of Israeli businesspeople donated millions of dollars. “Soroka,” he says, “needs to be a national project. Not the sole responsibility of the health funds, which are in trouble, as everyone knows. We hope for the best, that all that was promised won’t be forgotten when the excitement wears off.” We are trying to be optimistic, with partial success.

Published by Globes [online], Israel business news - www.globes-online.com - on August 21, 2014

Soroka Hospital  picture: Eyal Yitzhar
Soroka Hospital picture: Eyal Yitzhar
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