A healing place for children

Two-year-old Mahmoud Rasmi developed an immediate rapport with one of the first nurses he encountered at Schneider Children’s Medical Center of Israel – even though she couldn’t understand Mahmoud’s request in Arabic for a present, his father said as the …

Two-year-old Mahmoud Rasmi developed an immediate rapport with one of the first nurses he encountered at Schneider Children’s Medical Center of Israel – even though she couldn’t understand Mahmoud’s request in Arabic for a present, his father said as the toddler recovered from a cardiac operation.

Mahmoud was being treated for a narrow vein in his heart that was preventing him from breathing properly, after a doctor at another hospital recommended that the family take him to Schneider, in Petah Tikva. During an operation in January, his parents slept on foldout beds next to Mahmoud, which the hospital provides as part of its policy of involving parents in their children’s treatment.

“I felt like I was in a hotel,” said Mahmoud’s father, Abu Fur Rasmi, 41. Rasmi, a factory worker from the Israeli Arab village of Jatt in the north, spoke to ISRAEL21c from a glass-enclosed room in the center of the corridor, where medical staff have meetings while remaining visible to the patients. On the other side of the glass, a maroon-hatted clown entertained a child in a hospital bed just past a doorframe painted in bright yellow and purple hues.

Schneider is the most independent and comprehensive pediatric tertiary care hospital in Israel. Unlike other children’s hospitals in Israel – like those affiliated with Rambam Medical Center in Haifa, Sourasky Hospital in Tel Aviv and Sheba Medical Center in Tel Hashomer – Schneider is not part of a larger hospital and has all its own facilities, including a surgery department and advanced imaging such as MRIs and CAT scans.

Some say it was the first local hospital to recognize the need for such extensive facilities dedicated solely to children.

“[Schneider] succeeded in making the public conscious that children are not small adults, and need a different approach,” said Amos Etzioni, the director of Meyer Children’s Hospital at Rambam. “They were really pioneers in Israel.”

One of the elements that make Schneider stand out, said Etzioni, is its physical structure. The lobby, a glass-ceilinged atrium that is visible from all seven floors of the building, is decorated with colorful hanging mobiles, and huge stuffed animals peer down on visitors. The hospital floors include classrooms for children needing long-term hospitalization, as well as play areas. On one floor, a man led a young boy attached to a drip tube to a red plastic slide as two Arab women in headscarves looked on. Elsewhere, an ultra-Orthodox man accompanying a boy in a wheelchair stopped for a hallway chat with a woman in jeans.

Schneider opened in 1992 after a couple from New York, Irving and Helen Schneider, contributed close to $75 million to build the hospital, a sum Schneider director Marc Mimouni said constitutes the largest civil donation to Israel. The hospital is modeled on the Schneider Children’s Hospital on Long Island and developed from the pediatrics department in Beilinson Hospital, located next to Schneider.

The 376,736-square-foot hospital was built after the Schneiders commissioned a survey in the late 1980s that found that pediatrics departments within general hospitals were insufficient and that “there was a critical necessity for a modern tertiary care hospital solely dedicated to children in Israel and the Middle East.” Tertiary care involves specialized treatment, usually on referral. The Schneiders also decided to make the hospital a “‘bridge to peace,’ linking this nation to its many neighbors.”

But at the time, the Israeli medical establishment wasn’t convinced of the need for such a large medical center for children, Schneider officials said. However, the numbers prove them wrong. The Schneider emergency room was built for 18,000 children – 8,000 more than were being treated at Beilinson – but in the last few years has been treating at least 50,000 patients a year.

Schneider is a national referral center for oncology and cardiology; its pediatric cardiology institute is the country’s largest center for the diagnosis and treatment of heart illness in children. It has the only dialysis unit dedicated for kids and treats nearly 80 percent of Israeli children with juvenile diabetes. It is also the only hospital that carries out children’s organ transplants in Israel.

At the end of last year, Schneider doctors carried out a multiple organ transplant on a 12-year-old Palestinian boy from Jenin who was fatally shot by Israel Defense Forces soldiers in November, in what the army said was a mistake; the boy was holding a toy gun during an exchange of fire between militants and soldiers. After the boy’s parents decided to donate his organs, Schneider carried out five transplants in one night (a sixth was performed at Beilinson). Organ recipients included an 3-year-old ultra-Orthodox girl and a 12-year-old Druze girl.

The ability to carry out multiple organ transplants is one of the accomplishments that induces the greatest pride in Mimouni.

Twenty years ago, Israeli hospitals would send children to the United States for open-heart surgery rather than perform them here, recalled Mimouni. Today, not only does Schneider perform open-heart surgery, but now that the hospital carries out multiple organ transplants, the director said, “I have often been asked, ‘How did you manage to do what we can’t do in the United States?’”

Multiple organ transplants are difficult in part because of the manpower needed: about 15 medical personnel must carry out each transplant. For the November transplants, Mimouni had to bring in 75 people at the same time.

Israel’s size is a factor in the need for multiple organ transplants, hospital officials said. In the United States, said Mimouni, “you can send the heart to Washington and the lungs to New York.” But in Israel, he said: “There’s one hospital that knows how to do transplants for children. That’s here.”

Despite what he called the “severe overcrowding” at Schneider, Mimouni said he is eager to treat more children from neighboring Arab countries and better fulfill the Schneiders’ vision of a “bridge for peace.”

Thirty percent of Schneider’s patients are Arabs from Israel or the Palestinian Authority, about 10 percent higher than the proportion of Arabs in the Israeli population. The proportion of Arab patients is much higher than that in Dana Children’s Hospital (part of Sourasky) – which had about 1 percent Arab patients, mostly from the Gaza Strip, in 2005 – but about half that of Meyer Children’s Hospital. Meyer said 50 percent to 60 percent of its patients were Arabs, with its spokeswoman attributing the high proportion to the large Arab population in the Galilee and the lack of hospitals in the north compared to the center of the country.

Schneider also has a few dozen patients a year – “not enough,” said Mimouni – from Arab countries, mostly Jordan. The hospital occasionally has patients from Saudi Arabia too, and last winter, an Iraqi teenager underwent surgery at Schneider to correct a congenital heart defect.

Schneider also runs child development centers located in Israeli Arab towns that, among other tasks, help train residents to provide the chronic care needed for patients with thalassemia, a chronic blood disease prevalent among Arabs. The hospital recently held a child development seminar for Israeli Arab kindergarten teachers, and runs a program to conduct cardiac catheterization on Palestinian children.

In addition, Schneider participates in the Middle East Hearing Association, which includes professionals from Jordan and Israel who compare results of research on the early detection and treatment of hearing loss in children in the region. But although Israelis have traveled a few times to Jordan for the program, it is now “on a low flame,” said Mimouni. Citing a fear of Islamic extremists, Mimouni said Arab personnel involved with the program “don’t really dare to put the emphasis on a connection with Israel.”

“It’s problematic – there is no situation of peace,” he said. “I hope for a better, more positive future.”

Nonetheless, it appears that just having Jews and Arabs in the same place, facing similar situations, is a start to building the bridge the Schneiders envisioned.

Abu Fur Rasmi recalled the moral support he received from a family of other patients he had never met before. When Rasmi’s son came out of the operation, attached to various medical devices and not moving, a Jewish family began to calm down the worried parents, with one family member saying, “I had an operation on my head and I’m alive and fine.”

The patients sometimes come in with particular antipathy toward the other – such as Jewish Israeli victims of terror attacks and Palestinians shot by Israeli soldiers. But once the patients are in the hospital, “suddenly you enter a totally different world,” said Nagah Zaid, the head nurse in the intensive-care unit and himself an Israeli Arab.

“It’s a type of model that I don’t know how to define,” he said. “Here the families’ pain is very great, and that’s essentially what unites them.”