Treating the enemy

Two elderly Beduin women from Syria hover over their grandchildren's hospital bed in Israel's Western Galilee Hospital in Nahariya. They hail from a village near the Israeli border and have been fixtures at the hospital for a month and a half keeping an eye on the children, aged 13 and 10, who were seriously injured in separate bombing attacks on their village. “We always heard that Israel wants to kill us, to murder us, but now Israel is being more merciful to us [than Syria]. They are taking care of us. The Syrians are terrorists. We are afraid to go to the hospitals there. Here, we feel comfortable. There, we are always afraid,” one of the grandmothers tells The Jerusalem Report. Though she defiantly says she does not mind if her name is used, names and personal details about the patients are withheld in this article for their protection – the hospital knows of at least one incident where a former patient was killed in the streets of his village for having been in Israel. Though they are now enjoying moments of calm and quiet, their thoughts are always back with their families in Syria, says the grandmother. “There is war all the time,” she says, her sunwizened face somber as tears begin to form at the corners of her eyes and she wipes them away with her palm. “I am afraid of what is happening to my children. I don't know where they are, in Jordan or Lebanon. I don't know what will happen.” The younger child recalls arriving at the hospital, alone at first, in pain, afraid, and crying for four days before the grandmother was able to cross the border and come to the hospital. Now, the impish youngster is a darling of the hospital staff and spends time on the computer and dabbling with paint and Plasticine. For the older child, arriving at the hospital, ironically, has provided an opportunity to return, even briefly, to her studies and reading. She reads books about “Juha,” a popular Arabic storybook character, and studies at the hospital's school. Four years of violence in Syria has left the educational system there in shambles. Upon their discharge from the hospital weeks later, the Beduin children were given wheelchairs procured by the hospital's overseas Friends organization. According to the Health Ministry spokesman, the cost of medical care for Syrian wounded treated by Israeli hospitals is covered for the most part by the Health and Defense Ministries and the President's Office. Patients arrive with only the clothes on their backs. According to the hospital, the Red Cross made an appearance once in October to hand out some flip flop sandals, underwear and toothpaste. Many American Muslims, reading about how the hospital is treating the Syrian patients, are making earmarked donations for Syrian patients through the hospital's Friends organization, the hospital says. After three years of a bloody war on the border with its one-time menacing foe, Israel has found itself in the unlikely position of providing medical aid. Indeed, some Israeli NGOs also are providing humanitarian aid across the border to refugee camps in Jordan where a huge influx of some 600,000 Syrians has put enormous strain on the kingdom's financial and social welfare systems, already overwhelmed by the previous wave of Iraqi refugees. Other countries, such as Turkey and Bulgaria, also are struggling to accommodate the enormous number of fleeing Syrian refugees. A year ago, days after opening its new neurosurgical department (the only one in northern Israel), Syrian wounded – mostly combatants, but also civilians – began arriving by IDF ambulance at Western Galilee Hospital, as well as Ziv Medical Center in Safed and, to a lesser degree, Rambam Hospital in Haifa and the smaller regional Poriya Hospital, near Tiberias. Because of the new department and the hospital's location closer to the border, the worst of the cases are sent here by the IDF, which is the first point of contact for the wounded, often through their field hospital. Within months of opening, the neurosurgical department found that some 20 percent of its patients were Syrian. To date, the hospital has treated some 250 Syrian war wounded, most with horrendous trauma, including head injuries indicating attempted execution-style shootings and attempted machete beheadings. One patient arrived with his whole lower jaw missing and was unable to communicate in any way because he was illiterate. It took 17 hours of surgery with medical experts from around the country to rebuild his jaw from part of a leg bone. The hospital also has treated women and children, civilians injured in the violence. “[At the beginning you could] see the shock initially when they opened their eyes,” says the Christian Arab general director of the hospital Dr. Masad Barhoum. “But after a couple of days they felt at ease and comfortable.” It helped that many of the doctors and nurses at the hospital are Arab Israelis, or at least speak some Arabic. Despite the historical animosity between the two countries, Barhoum says it was natural for him to accept the request from the chief military medical officer of the IDF Northern Command to treat wounded Syrians at his hospital, no questions asked. “We have to do this,” Barhoum tells The Report. “It is our professional privilege and it is our moral obligation. We see the tragedy that is going on in Syria with more than 120,000 dead and more homeless suffering from disease and injuries without the ability to receive treatment. But what we are doing is a drop in the ocean. I thank God I have the opportunity to treat these injured.” Early in the conflict, the Syrian government made it illegal for Syrian doctors to give medical care to anyone suspected of supporting the opposition and many doctors have been targeted for attacks. A Physicians for Human Rights (PHR) report estimates that more than 15,000 doctors (almost half of Syria's doctors) have fled the country. According to the report, upwards of 60 percent of the hospitals have been destroyed. Of the 1,171 doctors who used to practice medicine in government hospitals in Aleppo, which today is in the hands of the opposition, only 292 were left as of last September, according to PHR. In eastern Ghota, just outside Damascus, only 30 doctors of 1,000 remain, the report said. Nurses, ambulance drivers and paramedics also have been forced to escape because of targeted attacks on medical facilities by both government and opposition forces, according to press reports. While Syrian refugees are not fleeing to the Jewish State as they are to Jordan, Lebanon and Turkey, word about Israel's medical care has spread to communities in Syria and hundreds of injured have made their way to the border in search of treatment. The procedure of reaching the border and crossing over to the Israeli side involves coordination with the IDF, and the process is shrouded in secrecy. Col. Dr. Salman Zakar, director of the IDF field hospital that processes and treats the wounded, says that at the start of the conflict, there already was an inclination in the IDF to provide medical assistance to Syrian wounded, given the IDF's experience with war wounded and setting up field hospitals in places of natural disasters. “It was so close to home and we were seeing the pictures coming out of there,” Zakar tells The Report in a phone interview. “We couldn't go into Syrian territory but it spoke to us as doctors, it is part of our ethos.” In early 2013, the first seven wounded Syrian fighters arrived at the Golan Heights border with Syria. “The IDF medical ethics are clear,” says Zakar. “We gave them help.” Suddenly soldiers, who had been trained to guard the borders against Syrian attack were in the position of enabling medical treatment for Syrians. On the other hand, Syrians, who had been taught to hate Israelis, found themselves being treated by these very people. “But they needed help and they came to the border fence,” says Zakar. Initially, the IDF doctors, medics and paramedics gave emergency treatment and then transported them to Ziv Medical Center. They quickly realized that more injured could be arriving at the border with wounds that needed immediate attention and that a field hospital would be necessary to provide emergency medical care. A field hospital equipped with an operating room and a team of emergency-room and surgical-room nurses, doctors (including surgeons, orthopedists, anaesthesiologists), paramedics and medics, and X-ray and laboratory technicians was established in an undisclosed site on the Golan Heights near the border When a flare up of violence is observed on the Syrian side of the border, or if wounded begin to arrive at the fence, the emergency team is assembled and within three hours they can be at the field hospital, says Zakar. A doctor assesses the wounded and determines whether immediate treatment is needed or whether they can be transferred to an Israeli hospital. Arabic-speaking doctors and nurses in both the IDF field hospital and Israeli hospitals play an important role in allaying Syrian patients' fears, notes Zakar, and he takes care that there is always at least one Arabic speaker on staff at any given time when the field hospital is functioning. Zakar is aware of the question many would be quick to ask: Would Syrians do the same if the tables were turned? He admits he does not know the answer, but says he tends to the Syrian wounded with love because of his own ethical standards. “Enemy or no enemy, we give them medical treatment as needed,” he says. “This is an encounter between people – people who want to help and people who need help.” Zakar est imates they have taken almost 1,000 Syrians into Israel for medical treatment – some 450 have been treated at the IDF field hospital and the rest at hospitals inside the country. They even once found themselves in the surrealistic situation of protecting their Syrian patients from Katyusha rockets fired into northern Israel from Lebanon by Hezbollah, he says. “In this world, we hope that someday there will be peace, but now we are 'enemies,'” he says. “For them, it is being told we, the enemy, are Satan and then seeing how suddenly it is not true. They see professional, ethical people who are doing everything they can for them.” Zakar scoffs at the idea that the field hospital is being used to promote public relations for Israel, noting that for the first six months in operation it was kept secret, even from his own family. Israeli NGOs have organized to provide items including care packages and warm winter coats to Syrians in refugees camps via a campaign through the Noar Oved v'Lomed youth movement. Some of the NGOs insist on not being named, but Shachar Zahavi, founding director of IsraAid, has no qualms, admitting that his NGO is working with Syrian refugees in Jordan via a Jordanian NGO, which remains nameless. “We don't look at who they are,” he says of the refugees. “We see them as people in need. We are not a political group.” His group began to provide aid to the Syrian refugees in the beginning of 2013. In addition to material and financial packages, perhaps more importantly, IsraAid has begun to provide psycho-social therapy training to local volunteers to enable them to treat the unseen scars of war – the psychological trauma rampant in the refugee community in Jordan and elsewhere. In March, IsraAid sent a team to Bulgaria to help the government set up a psycho-social program in response to a call for help in dealing with the some 11,000 Syrian refugees who have arrived there. For the doctors who treat the Syrians, success in aiding in their recovery is bittersweet. After rebuilding hands and jaws, reconnecting broken limbs, caring for amputations, and bringing patients with major head trauma back to a functioning life, they must be discharged – without any letter attesting to the treatment they received or instructions for continued treatment – knowing they are sending the patients back into a battlefield where they most likely will be unable to receive follow-up care and where they may once again become victims of the war. “I don't know what happens after they go back,” notes Western Galilee Hospital neurosurgeon Dr. Samuel Tobias. Many of the some 65 injured he has treated have direct evidence of close-range, deliberate shooting – including child victims, he says. “What we are seeing here is an indiscriminate lack of respect for human life.”

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