A hospital in Safed has given much-needed medical treatment to around 550 Syrians – both fighters and children. Judith Field hears some of their stories…

Thousands of Syrian refugees have fled the country, including injured fighters and children

Thousands of Syrian refugees have fled the country, including injured fighters and children

Over the past two-and-a-half years, around 2,000 injured Syrian fighters and civilians have crossed the border into Israel and been admitted to Israeli hospitals. Most are men, but up to 17 percent are children.

Since the start of the civil war in Syria in 2011, 70 percent of the country’s medical community has been killed or fled and many healthcare facilities have been damaged or destroyed. Six- and-a-half million people have been displaced to neighbouring countries where they live in semi-permanent refugee camps with only basic hospital facilities.

The closest Israeli hospital to the Syrian border – around 40 minutes away in a fast ambulance – is the Ziv Medical Centre in Safed, a university 331-bedded hospital owned and funded by the government. It is the only hospital serving the 250,000 residents of the Upper Galilee and northern Golan Heights and has treated about 550 Syrians to date.

Learning to walk  (Identities have been hidden for their safety)

Learning to walk (Identities have been hidden for their safety)

“It all started one night in February 2013,” said Professor Anthony Luder, director of paediatrics. “An IDF ambulance pulled up at the emergency department and staff were astonished to see inside a group of injured Syrian fighters.”

Although the Israeli Defence Ministry described this as an isolated event in which Syrians were being treated as exceptional cases, more soon arrived and what started as a trickle of patients has become a steady flow. IDF patrols pick up the wounded at UN transfer points on the border on the Golan, or in places where the fence is absent or minimal. Staff at the hospital do not know where the patients come from, nor do they want to. “We’re doctors and they are our patients. All we want to do is to treat them,” said Professor Luder.

Patients might be suffering blast or shrapnel injury, gunshot wounds or a combination of these and other traumas. Treating such people, often with massive injuries, has its own challenges, not least of which is trying to work out what has happened.

“Only two have arrived with any sort of information: blood-stained notes pinned to their blankets. Often diagnosis involves guesswork,” he explained.

Some patients, while not injured, are still victims of the breakdown of the Syrian medical system. “A young girl was admitted with a massive ovarian tumour,” Professor Luder said. “We removed the tumour but the reality was that, if we sent her back to Syria, she would receive no treatment. So we kept her at Ziv for three months’ chemotherapy, and then sent her to a summer camp for Israeli children with cancer.” 

Patient with medical clown   (Identities have been hidden for their safety)

Patient with medical clown (Identities have been hidden for their safety)

It takes time for staff to gain the trust of the Syrian patients, and there is a language barrier, although the staff are of multiple ethnicities, matching the make-up of the local community: Jews, Muslims, Christians, Druze, Circassians and Bedouins. After a while, the patients begin to talk to the Arab and Arabic-speaking nurses. Many patients are terrified, having been told that Israelis are devils. One man, for example, refused to take his sheet off his face for a week.

The new head of the hospital held a meeting at which it was agreed more or less by all to continue treating Syrians. Staff felt they had a professional imperative to do so and that it might help build bridges. It would also develop their skills for use should they need to treat such severely injured Israeli people.

Patient - rear view copy

(Identities have been hidden for their safety)

It has not always been easy for staff to balance the medical ethical obligation to treat Syrian patients with their personal feelings. Some thought: “If they can do that to each other, what could they do to us?” Others, though, felt a connection, saying that it reminded them of what Jews went through in the Holocaust. 

Many of the male patients deny they are fighters, but it is impossible to know. It would be good to be able to say that, following treatment, the fighters have a change of heart about Israel. This, however, is not the case – they might thank staff on leaving, but some still say they will be back to kill them.

Others, however, have a different attitude. Luder told me about a girl who was admitted with an amputated right leg and a shattered left leg. The local people donated a prosthetic limb. “She was discharged after eight weeks. Her mother expressed gratitude and a wish to meet again one day, when this troubled region is peaceful,” he recalled. Perhaps the children – some of whom have been born in Israeli hospitals – will share her attitude.

In military ambulance  (Syrian patients treated in Israeli field hospitals. Identities have been hidden for their safety)

In military ambulance (Syrian patients treated in Israeli field hospitals. Identities have been hidden for their safety)

Perhaps the seven-year-old boy who had been told, following 17 unsuccessful operations in Syria, that he would never walk again, will remember how he regained the use of his leg after one operation at Ziv.

Word has spread in Syria that people can access medical help over the border from people they consider the enemy and Syrians are filling up beds at Ziv. Syrian patients often stay in the hospital for months, longer than a local person would need, because usually there is no follow up treatment so rehabilitation must be started in the hospital.

They leave with a discharge letter in English and all trace of Hebrew and Israel removed from anything they take with them, often including expensive equipment that would normally be returned to the hospital.

The treatment of the local community is sometimes delayed and, naturally, people grumble. But they have also responded with generosity. Individuals and businesses have donated money and goods, for example clothes, toiletries, toys and reading material. Each child has a tablet computer to use while in hospital.

Treating the Syrians has cost the hospital $33million (£21m) to date. Although there is no clear answer as to where the funding will come from, Luder considers healthcare a humanitarian imperative. “Medicine has no borders. It can serve as a bridge between people. We will continue to provide life-saving treatment to the Syrian casualties for as long as it is needed.”