With all their hearts

June 2, 2021

Only in the often insane reality of Israel will doctors and nurses find themselves devoting themselves to treating babies from Gaza with life-threatening conditions while terrorist factions in Gaza fire rockets at the hospital.

Lama Al-Manar, 36, doesn’t remember what she put into the small bag she was carrying when she stepped into a Red Crescent ambulance, other than medical documents. She doesn’t remember the last words her husband, who was riding with her, said to her before they separated at the Erez crossing. She doesn’t know whether he followed them with his gaze when she walked toward the crossing and passed from the Gaza Strip to Israel, where a Magen David Adom ambulance was waiting for her.

From the moment she left Shifa Hospital that afternoon, until she arrived at Sheba Medical Center at Tel Hashomer some five hours later, Lima’s eyes never left the incubator that was holding her son, Abdullah, 2.5 months old, whose tiny body was receiving oxygen.

She also wouldn’t have remembered what day it was if they hadn’t explained how lucky she had been. It was Monday, May 10, 2021, the day on which Operation Guardian of the Walls against Hamas infrastructure in Gaza began. The ambulance that brought her and her son to Israel was the last allowed through Erez crossing before it was closed for 13 days.

Three children are waiting for her at home. Two years ago, she gave birth to a stillborn child, and when she became pregnant for the fifth time, she was eager for the new baby to bring joy back to the home. But Abdullah was born two months prematurely with a complicated heart defect and Lamaand her husband realized they would need to fight for his life.

“I was afraid. His condition wasn’t good,” Lama says. “He lost weight, and his breathing and other parameters slowed. I prayed to God to heal him. To fight for his little life. A doctor at Shifa Hospital recommended that we send him to Israel for treatment. My husband reached out to the Shevet Achim organization to help us get him there.”

Thursday afternoon, the 11th day of the Gaza campaign. The radio reports a rocket alert in Ashkelon, and then a direct hit on a residential building. We arrive at the parking structure attached to the labor ward at Sheba Medical Center, which is next to the Edmond and Lily Safra Children’s Hospital. The children’s ICU was transferred here on the fifth day of the fighting for fear of rocket hits.

We go down one floor. After walking through the gray halls lined with oxygen tanks at the ready, we encounter a colorful sign decorated with a drawing of a sun and a kite: “Protected Children’s ICU.” Reality stays outside.

In the parking structure, which was filled with cars the previous week, there are 40 small beds. Each one takes up two parking places, and holds a small baby who is hooked up to medical equipment. Nearby is a treatment station, a computer, and a lounge chair for adults.

The beds are separated by flowered curtains that were hung on the metal pipes that line the parking garage’s ceiling. No one closes the curtains. There are also hanging screens that are attached to monitors that fill the space with dim beeping.

In the center of the improvised unit are a dialysis cart and another cart that holds equipment for chest drainage. Sometimes, a baby’s cry can be heard. It is weak, and starts and stops quickly.

Over bed No. 26 a sign reads: “Abdullah Al-Manar. Date of birth: Feb. 26, 2021. Weight: 1.6 kg (3.52 pounds).” Lamasits on the chair and watches Shani, the nurse, take off Abdullah’s cloth diaper, exposing a large incision that runs from his chest to his belly. Shani changes the dressing, rubs cream on it, puts his medicine into the IV bag attached to his small arm, and covers him gently.

In the next bed lies three-month-old Rana, who is recovering from her third open heart surgery, which she underwent two days earlier. On the left is Yazen, a month old, who had a catheterization.

Dr. Evyatar Hubara, 43, a senior doctor on the unit, moves from bed to bed. He slept three hours the night before due to the number of cases.

L-R: Raida, Lama, and Samira at the pediatric ICU at Safra Children’s Hospital at Tel Hashomer (Kfir Ziv)

“The three children from Gaza suffer from complicated heart defects,” Hubara explains. “They came to us in serious condition, among other reasons because it took time from when the problem was diagnosed in Gaza until their transfer to us could be coordinated, all the permits received, and that’s without changing ambulances at Erez and the bumpy journey. Right now, all three are in an acute stage. We still haven’t gotten to the rehabilitation state, which will begin here and continue in Gaza,” he says.

Hubara stops by Abdullah’s bed and looks at him warmly. “Abdullah was born prematurely and was incorrectly diagnosed in Gaza. The doctors … performed the wrong operation on him when he was two months old. A week after the operation, he began to decline, and a week after that he reached us. In the first few hours we needed to stabilize him and keep his blood pressure steady with medication.

“We started to look into the problem. We did an MRI and other tests. Before every stage, we explained to his mother what we were going to do. She trusted us from the beginning. After we stabilized him, we found that the true defect he was suffering from was an aortic valve stenosis. It turned out that in Gaza they had tried to close the ductus, but closed one of the main arteries by mistake.

“In the insane Israeli reality, we had to protect ourselves against rockets from Gaza along with the babies who come from here,” he says.

“I remember one siren that caught me on the unit, before we moved to the parking structure. All the mothers, Jewish and Arab, just grabbed their babies – the ones that weren’t hooked up to machines – and ran to a safe space. I shouted, ‘We have time, 90 seconds, go slowly so you won’t fall with the kids.’ Everyone gathered around in the safe space. Staff members and patients, Jews and Arabs together. The shocking sight of the mothers who ran there with their babies doesn’t leave me,” Hubara recalls.

Not all the mothers were able to take their babies to a safe space. Abdullah, Rana, and Yazen, as well as another 12 Israeli babies, are on respiratory equipment, and they were unprotected during the first rocket alerts. This is why the hospital administration decided to move the entire department from the sixth floor to the underground parking garage. Here, the sirens can’t even be heard.

We go with Lama, Raida, and Samira into the staff room, located at the exit. The room has a big refrigerator full of popsicles donated to the children and the staff who care for them. Every few minutes, a parent or a staff member comes in and takes one.

About a year ago, when the COVID pandemic was still raging in Israel, a COVID unit opened in this same parking structure to ease the mass of patients that was overwhelming the hospitals. That event seems like ancient history, and the only thing that remains of it are the letters of thanks stuck to the door. It seems as if this is the last place in the country where people are careful to wear masks, and wear them properly.

The three Gaza women are embarrassed. They aren’t used to being interviewed. All three are wearing abayas, long dresses that include head coverings, as well as hijabs and surgical masks. Since they arrived in Israel, they have been sleeping here, on the unit, in the recliner chairs next to their children’s beds. They are also given meals. Once every few days, they allow themselves to go upstairs and shower. None of them speaks any language other than Arabic, with the exception of a few words of Hebrew or English. Moshe Ravid, 26, a nursing student from Jaffa and a volunteer with the Shevet Achim organization, translates.

Raida (Umm Ahmad), 48, is from Khan Younis. She is Rana’s grandmother, a housewife and mother of six.

“My daughter-in-law, Rana’s mother, came to Israel with her in February, two weeks after she was born,” she says. “After two weeks, she was tired and not feeling well. Because she has a four-year-old at home, she called me and asked me to switch with her. She went back to Gaza, and since then, I’ve been here. Three months already. This is my first time in Israel.”

Q: Were you afraid?

“No, why should I be afraid? My husband worked in Bat Yam for 20 years. Every day, he went from Gaza to Bat Yam, until the disengagement in 2005. After that, he found work in Gaza. He told me that there are good people in Israel, that everyone here is all right.”

Abdullah’s mother Lama, 36, is wearing a brown abaya accessorized with a shining silver star. Her smartphone has a pink cover. She works in a laboratory, and her husband is a producer for Palestinian television in Gaza. She has two other sons, 11 and six, at home, as well as a three-and-a-half-year-old daughter.

“My mother had cancer. She went to Israel to be treated, and recovered,” Lama says. “She told me that everything is good here. When Abdullah’s condition got worse, the doctor recommended that we come to Israel. My husband reached out to Shevet Achim. Now he and my mother are watching the three other kids at home.”

Q: What do you tell your families about what is happening here?

Lama: “They’re afraid for us, and we’re afraid for them. When they call to hear how we are, I answer, ‘Al Hamdullah,’ so they won’t be scared and worry, and when I call to ask how they are, they say the same thing. We talk about the boy, how he ate, how much he ate, how much he slept.

“I tell them that the doctors here are good, that they treat us well, answer all our questions. I tell them that the food is excellent, that the women have nice clothes, about their hairstyles. I like the fashion in Israel, and the grilled chicken breast and salad they serve at the hospital.”

Raida: “The medical staff thinks only about the children – whether their condition has improved, what they ate, how they slept. We sit next to their beds, don’t know how they’ll be from one moment to the next, whether they’ll get better at all.”

Q: Do they send you pictures of the strikes on Gaza?

“They send me pictures of the special Ramadan sweets,” Raida answers, with a smile.

Samira, 62, is the grandmother of Yazen, who is only a month old. “I have nine grown children, and my son has four children other than Yazen. Their mother needs to take care of them, so they asked me to accompany the child. At home, when we talk about Israel, we only talk about the medical treatment we want to get here.”

Moshe, the translator, tells them in Arabic not to be frightened, that they can speak freely. They all answer at once: “We aren’t afraid, we’re speaking honestly. Everyone wants peace. We want it to be all right.”

Samira: “Inshallah, things will calm down. We aren’t dealing with politics.”

Q: What did you do when people in Gaza fired rockets toward this area?

Raida: “What everyone else did. The nurses took us to a safe place. The babies stayed on the unit, hooked up to respirators. I was worried about them, that they were alone, but everyone calmed us down, said that it would all be fine.”

Lama: “We tried to talk to the other people in the safe area, without understanding one another. Everyone wants to know how the other’s child is doing. He’s sorry about my son, and I’m sorry about his.”

Q: Did your families leave their homes because of the airstrikes?

Raida: “No. Everyone is in his own home.”

Q: Are any of your family members involved in the fighting?

All three shake their heads, no. “Not everyone in Gaza enlists in the army,” Raida says. “My husband worked in Israel. Half of Gaza used to work in Israel. You must have seen the workers who would come from Gaza.”

Samira: “My father and my husband used to work in Israel.”

Q: In Israel, they cancelled school because of the rockets. Do the children in Gaza go to school [now]?

Raida: “No, but that’s nothing new. It’s been that way since COVID started.”

Lama: “In the past two months, the COVID situation has been really bad. On weekends, Gaza is under a lockdown.”

Raida: “There are no vaccines in Gaza.”

Lama: “Even if there were vaccines, I wouldn’t get vaccinated. I’m afraid of the side effects.”

From the moment they arrived in Israel, they haven’t set foot outside the hospital grounds. The farthest away they’ve been is to the little shopping center that is on the premises. They see Israel as a little bubble inside Sheba, not the other way around.

Q: What does your day here look like?

Raida: “There’s not really a schedule. We don’t really sleep. The doctors and nurses come in around the clock to check on the children. We’re always awake. Most of the day I pray and ask God to cure Rana.”

Samira: “It’s hard to rest. We always have our eyes on the children, what happened with the ECO and the other tests.”

Rana, age three months, has already been through three open-heart surgeries. “When I was waiting for her to come out of the third surgery, an Israeli woman came up and asked how my granddaughter was,” Raida says, moved. “I don’t understand Hebrew and she doesn’t understand Arabic, but I understood her question from her eyes. I knew she was hoping for good news. I asked her about her daughter.”

Q: Have you learned any Hebrew since you arrived?

“”I’m trying to learn,” says Raida, and adds in Hebrew, “I know how to say ‘grandma.'”

Q: When are you going home?

Raida’s eyes fill with tears. “Rana’s chest is still open from the last surgery. I’m sitting with you and laughing, but my heart is crying. So I’m telling you that my every thought is for the baby. That’s our situation.”

Lama: “Today, Dr. Evytar said that Abdullah has an infection in his right lung, which was good. Until now he had one in his left lung. I hope it works out. I’ll go back to Gaza when he gets better, but I don’t know when.”

Hospital Director Dr. Itai Pessach says that every year, the center treats about 500 children from Gaza and another 2,700 children from the Palestinian Authority. “They range in age from a week to 18. Some of the children arrive through the Shevet Achim organization, and others through our own coordinator.”

“During the last military operation, our doctor colleagues in Gaza reached out to us about children in serious condition, and we fought to bring them to Israel during the operation. Unfortunately, we didn’t succeed, and that’s very sad. I’m happy we’re getting back to normal,” Pessach says.

According to Pessach, “we don’t see any difference between a child who comes from Gaza, Nablus, or Tiberias. Our treatment looks at all the child’s needs, including emotional needs and school work at the school that operates on the hospital grounds. A year ago, a nine-year-old boy with cancer arrived from Gaza who didn’t know how to read and write. He returned to Gaza last month, after a year-long hospitalization, healthy and knowing how to read and write in Hebrew, Arabic, and even English.”

Q: How did the patients respond to this during the Gaza fighting?

“A family from Gaza arrived two days before the operation started, and we diagnosed their son with a rare disease, one that only seven children in Israel have. By chance, two rooms away there was a Haredi family with a child who had been diagnosed with the same disease two months ago. While the rockets were falling, the Haredi mother insisted on meeting the mother from Gaza and teaching her everything she knew about the disease and how to treat it.”

PICU head nurse Boris Fizdel, next to the bed of little Rana (Kfir Ziv)

“There is a truly shared fate here. They feel that they’re fighting against something bigger than rockets. To get better, a patient needs to feel secure, and that’s what we’re doing. A hospital is a home for all the patients.

“I’m happy to say that the external tensions didn’t creep into the work. There was no tension between the staff and the patients. The good of the patient always comes before everything else. Even at administration meetings – everyone put aside their own political views and we managed to provide a quality medical response and protect the safety of the staff and patients,” Pessach says.

The funding for the Gaza children’s treatment comes mainly from donors – mostly American Christians, and some Israelis.

“Saving the life of the child is an entire world,” says Jonathan Miles, founder of Shevet Achim. Miles arrive in Israel from the US in the 1990s, as a journalist, and started to volunteer with the group Christian Friends of Israel.

“We welcomed Russian immigrants to Israel. We wanted them to understand that the Jewish people have friends in the world. One day a mother from Ukraine whose child’s life was in danger came to me. She had no money for medical treatment, and she begged me to help. I started raising money to help him. Wizo helped a lot, as did other people, both Jews and Christians.

“After that, I heard about sick babies in Gaza, and in 1994 I founded the organization. We bring children from Muslim states to Israel for treatment.”

Amar Shami, 32, who coordinates the transfer of children from Gaza to Israel for Shevet Achim, lives in Jerusalem.

“The families who go back to Gaza tell each other about the treatment in Israel,” he says. “One mother tells another. When the child has a problem, they reach out to me. Sometimes the doctors reach out directly.”

Shami was born in the village of Batir, near Bethlehem. He takes temporary jobs and has volunteered with the organization for four years. “I got to know the organization through my father, who volunteered with it before me. I saw what they do and I wanted to help children, too.”

For every child, Shami submits a request to the IDF to allow them through Erez crossing. The request includes their medical documents, a recommendation from Gaza doctors that they be treated in Israel, and details about the accompanying adult, who must be cleared by the Shin Bet security agency.

Shami says that sometimes the adult is rejected, and he is told to submit a request for another one. “There are cases where the army coordinators recommend that I switch the accompanying adult ahead of time, even before the refusal comes through. Mostly when they’re young men, who apparently pose a bigger security risk. In general, we get approval within 48 hours, but there were cases when a child in critical condition had to leave Gaza the same day, and we got approval for it.”

Q: And what happens when there is an escalation of fighting in Gaza?

“It’s hard. The crossing is closed. Children who were supposed to go back to Gaza after an operation stay with their adults in apartments the organization owns in Jaffa and Jerusalem, because we can’t send them back. During the latest fighting, we got at least 15 requests for children who needed urgent, lifesaving treatment, but we couldn’t bring them over. We brought them in as soon as Erez crossing opened.”

In the children’s ICU, there are no stuffed animals or balloons. Each family hopes their child will wake up and be transferred to recovery and rehabilitation on the pediatrics ward.

“My feeling during the Gaza fighting was mixed, or to put it gently – unpleasant,” says Boris Fizdel, 39, head nurse on the pediatric ICU, who lives in Ashdod.

“At home in Ashdod I have a wife and two children, ages six and nine, and work is my second home. During the Gaza operation, I was torn between the two. I was in Ashdod only three hours a day because we were so busy on the unit, so the hospital became my first home.

“When I leave for work, I hope that the rocket siren won’t go off while I’m on the way. It happened once. It was strange to hear on the radio that there were sirens in Ashdod and also see an Iron Dome interception off to my right. At the hospital, we put politics aside, separate it from our work. We really do everything we can to provide the best treatment. I don’t care where they come from, if it’s during a war or not. There are children here from all over the world, with every medical problem that exists. We’re human beings.

“When rockets are fired at Ashdod, what I care about is that my kids are in the safe room. I stop work to call my wife and ask what’s going on, and go back to treating patients. And then there’s another siren, I call home again, and back to work. I make sure that the treatment I provide isn’t influenced by what’s happening at home,” he says.

Dr. Hubara arrives for another round of the unit. Next to Rana’s bed, I ask him if heart defects are more common in Gaza than in other places.

“The sense is that yes, because of the complexity of the defects as well, but the matter hasn’t been studied. In any case, heart defects are more common in populations that don’t do genetic screenings and prenatal screenings.”

Q: And what happens after they return home?

“We contact a hospital in Gaza and instruct the staff. Treatment that can be given in Gaza, is given in Gaza. They have resources, but not always high-quality. Children come back to us for observation after a month or two and are seen by a cardiologist and the rehab staff. Some children need a series of operations, and when they come for the second one, they need to go into it in optimal condition. That doesn’t always happen. Then, either the surgery is postponed, or they go into the second and third surgeries in serious condition. It’s a very complicated reality.”

Q: What goes through your mind while you’re busy providing treatment and rockets are flying outside?

“Inside the hospital, we detach. We only want to help them. When you go out you realize that reality is different. We hope that when the families from Gaza go home, they will sort of be our emissaries, say good things about Israel.”

The night that the ceasefire between Israel and Hamas took effect, Rana’s heart stopped beating, despite the doctors’ best efforts. Her grandmother, Raida, left the hospital weeping. She was driven to a Shevet Achim apartment in Jaffa. When Erez crossing opened, she returned to Gaza with Rana’s coffin.

This new originally appeared in Israel HaYom.

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