Healing Bodies to Healing Relations

Nurses From Gaza Train In Israel

By David E. Kaplan

In the first week of January 2020, five nurses from the Gaza Strip, joined eleven fellow Palestinians from the West Bank who arrived in Israel for four days of intense but innovative medical training.

It was conducted by Israeli physicians through a collaboration between Physicians for Human Rights Israel (PHR) and the Medical Simulation Center (MSR) at Sheba Medical Center, Tel Hashomer.

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Top Training. Israel’s Sheba Medical Center, the hospital training the Palestinian nurses is one of the finest hospitals in the Middle East, treating over 1,500,000 patients annually from around the world.

The training programme proved a revelation to all sixteen participants, particularly to those from Gaza.  “It’s different than I thought,”  Akram Abu Salah, a nurse from the Gaza Strip told The Jerusalem Post. “The people are very nice. You have Jews and Palestinians working together. It minimizes the gaps between us.”

Clearly, there is no substitute for direct contact as Salah reveals.  “I could not imagine how this country would be or how it works.”

While there has been collaboration between MSR and PHR for a number of years training Palestinian physicians and ambulance drivers, this was the first time that training was extended to nurses.

The sixteen participating nurses learned new practices in the field of primary medicine, focusing on skills they might require in emergency situations such as how to  stop bleeding, intubation  – the placement of a flexible plastic tube into the trachea to maintain an open airway – and chest drains. A special session was held on advanced cardiovascular life support.

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Training To Save Lives. Palestinians, Farid Mustafa from Nablus (left) and Akram Abu Salah from Gaza train on a high-tech mannequin at Sheba Medical Center in central Israel. (photo credit: Marc Sellem)

This ‘life-saving’ training would end each day at 5.00pm whereafter in the evenings, the Palestinians engaged in social activities with their Israeli counterparts.

Four out of five of the Gazan participants had never been outside of the Gaza Strip, so the trip had been quite an experience.

All were amazed by the size of Sheba and the sophisticated training available through MSR.

The 2,400-square-meter Medical Simulation Center was founded in 2001  to lead a nationwide effort to introduce new standards and innovative approaches in health care training and patient-safety education for the benefit of the people of Israel. A press release on the center describes the facility “as a virtual hospital” that “encompasses the whole spectrum of medical simulation modalities – from role-playing actors for communication and clinical-skills training to cutting-edge, computer-driven, full-body mannequins that enable team training for challenging and high risk clinical conditions.”

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Medical Simulation Center (MSR) at Sheba Medical Center, Tel Hashomer.

 

It was “action stations” – close to real live situations. Teamwork is essential. One of the participants carefully placed an oxygen mask on the $100,000 blonde-haired dummy while another started to perform CPR as a third set a pulse oximeter around the dummy’s finger.

Communicating in English to each other, the Palestinian nurses continued to attempt to resuscitate the mannequin, as their Israeli instructor observed them. Minutes later, the “patient” woke up from ‘its’ cardiac arrest – ‘its’ condition stabilized.

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MSR – Simulation of Emergency Department Sheba.

Exposure to this kind of intense and innovative simulated training is invaluable.

Amitai Ziv, the founder and director of the Center for Medical Simulation, said that the courses at the facility aim to allow the health professionals to learn in a safe atmosphere.

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Visionary. Amitai Ziv, the founder and head of the Israel Center for Medical Simulation.

With a third most common cause of death worldwide being medical errors – estimates show 250,000-400,000 people die annually in American hospitals because of them – Ziv, a former pilot in the Israeli Air Force, explains:

The message embedded in the programs here is let us err and reflect on our errors in a safe environment.”

Working Together

“I am very happy for the chance to attend this advanced trauma course. In Gaza, we have plenty of problems, and there is so much we can learn from Israel,” said Abu Salah.

He was clear that the  Gazan Ministry of Healthwants to me to absorb this experience in Israel and bring it back to Gaza.”

Salah reveals that hospitals in Gaza are often understaffed and lack basic necessities and medications, including chemotherapy drugs.

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No Fuel, No Services. An employee of the Hamas-run health ministry in Gaza at the Beit Hanun hospital in the northern Gaza Strip, after it stopped its services on January 29, 2018, when it ran out of fuel. (Mahmud Hams/AFP)

However, because of the fluid security situation, it is quite a complicated mission bringing the participants from Gaza into Israel. It takes persistence and perseverance.

Despite advanced application and pre-approval, the Gazan nurses were nevertheless delayed entry for a day for reasons of security.

Abu Salah only received the call at 11 p.m. from the Gazan Ministry of Health the night before he was granted entry and told, “tomorrow, you will travel to Israel.”

He was sleeping when he received the call, “but I packed my bag and prepared to go,” he told local media. “My wife knows I am here, but my extended family does not know. I can only tell them when I get back.”

While Salah said in Israel his visit was supported by the Hamas-run health ministry, he admitted to being unsure how he would be received upon his return and uncertain of the  questions he might be asked by Hamas officials.

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Heartwarming. Together with Israeli instructors, a group of Palestinian nurses from the West Bank and Gaza Strip huddle around a high-tech mannequin that for the sake of the exercise has gone into a cardiac arrest

Going To Gaza

However, its not only Palestinian medical professionals coming to Israel but Israelis professionals traveling to Gaza.

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Professor Raphael Walden. Deputy Director of the Sheba Medical Center, in charge of Risk Management, Quality Assurance and Medical Education and recipient of France’s  “Officier de la legion d’Honneur”.

Israeli president for Physicians for Human Rights Israel, Prof. Rafi Walden, reveals how nearly every month he helps arrange missions of Israeli doctors to Gaza to perform advanced surgery and provide training to Gaza physicians by Israeli experts in the realms of gastroenterology, oncology and more.

It’s appalling,” Walden said of the situation in Gaza. “Just terrible conditions. The main hospital in Gaza has empty shelves; they are missing critical medications. There was a time they did not have the liquid needed to clean the skin before surgery. Everything is missing. It is a real humanitarian disaster there.”

Walden believes that despite the challenges, PHR is creating “a microcosm of goodwill and understanding in this crazy situation of conflict. Beside the medical aspect of the work, another aspect no less important is the opportunity to meet with people and establish common ground. It’s a peace building activity – and a little light and the end of the tunnel.” 

Physicians for Human Rights Israel covered the costs of the programme as well as the attendees’ expenses including hotel rooms, transportation and meals. Ran Goldstein, the executive director of the organization, said the total cost was approximately NIS 90,000 ($26,000).

Ziv explains that while the courses for the Palestinian health participants aims to substantially upgrade their standards of professionalism, there is also the invaluable benefit of building bridges between Israelis and Palestinians.

Since Israelis and Palestinians often meet on the killing and battle front, we strongly believe it is important that they meet on the health and education front,” he said, adding that he holds that “professional relationships among human beings can bring about trust and friendliness.”

One 42-year-old nurse from Nablus, Farid Mustafa, said that medicine is a field that transcends political and national divides.

It does not matter who you are — an Israeli or Palestinian, Jew or Muslim, local or foreigner,” he said. “In health, we see and treat everyone as a human being. We take this approach in our interactions with sick persons and our colleagues here and elsewhere.”

Supporting his sentiment, Farid recounted an incident when he had personally provided first aid to Israelis involved in a car crash near Ramallah in the West Bank two years earlier.

I saw that two vehicles had collided. I pulled over to the side of the road and helped them,” he said. “When I did that, the identity of the injured persons made no difference to me. All I saw were people in need of aid.”

So too for Ayman Ibrahaim Amaya, a 43-year-old nurse from Qalqilya , who said he hoped he would be able to return to the Center for Medical Simulation in the future.

This is my first time doing a training in Israel and it has been very beneficial,” he said. “So I wish that it will not be the last.”

Future lives depend that “it will not be the last.”

With the goodwill of people on either side of the divide, it will not be.

לבריאות  and  صحة جيدة (“To health!” in Hebrew and Arabic)