(New York, NY -- August 08, 2006) On July 24, Nahariya Mayor Jackie Sabag met Hadassah team members outside City Hall. "Many medical institutions promised to help us,” he said. “But it’s you who came."
That day was the third on which personnel from the Hadassah-Hebrew University Medical Center in Jerusalem traveled the 112 miles north to Katyusha-struck Nahariya — as they’ve continued to do every weekday since.
“We’ve fallen into a routine which we all hope will end as rapidly as possible,” says Ron Krumer, head of the Medical Organization’s External Relations Division. “Hadassah staff volunteer for this trip north, forming teams that comprise a physician (usually an internist), a child psychiatrist, a clinical psychologist, a social worker and a medical clown.”
Clad in helmets and bullet-proof vests, the team moves through the town from shelter to shelter, reaching out to Nahariya’s traumatized residents. To date, Hizbollah has fired more than 1,600 missiles into northern Israel, hundreds of them targeting Nahariya.
“We entered each shelter, introduced ourselves and asked if anyone needed help.”
“Anxiety is a central issue here,” says Dr. Motti Muszkat, a clinical pharmacologist and an attending physician in Internal Medicine at Hadassah. “People need help dealing with it, and help sleeping.”
Dr. Muszkat served on one of the first Hadassah teams to go to Nahariya. “There was no one from City Hall to take us to the shelters when we arrived, so we found our own way,” he says. “We entered each shelter, introduced ourselves and asked if anyone needed help. People were very responsive, and very appreciative that we’d come so far to help.
“Medically, the work was straightforward — most often, measuring blood pressure, prescribing painkillers and antibiotics, and writing prescriptions. Our role was more one of reassurance than advanced health care, but with everyone we met, it was clear how supportive they found our visit.
“Anxious to reach everyone we could help, we asked people we met if they knew of anyone nearby who was alone or needed help. That way, we’ve reached many people who are sick, bedridden or housebound, or simply too terrorized to leave their homes, even for the shelters. Some we can help on the spot. For others — there was one unfortunate woman, I remember, with preexisting physical and mental problems, who was too afraid to move — we alerted Nahariya’s Crisis Control Center.
“During the hours I was in Nahariya, the bombardment was light. I heard three explosions, loud enough to startle, but none of them nearby. Working and living in Jerusalem, the war seems unreal. It was good having an opportunity to help those on the front line, and I hope to join future teams north.”
“Within minutes, she was laughing at me, and beginning to calm down.”
Jerome Aroush, one of six medical clowns who works at Hadassah, also plans to go back to Nahariya. “Once wasn’t enough,” he says. “I can help people there, so that’s where I want to be.”
Aroush’s help is as unorthodox as his clown suit. “In the first shelter we visited, one young mother was in a state of panic, hardly able to breathe,” he says. “I sat next to her and went into ‘panic’ myself — but as a clown panics, waving my arms and legs around, and so on. Within minutes, she was laughing at me, and beginning to calm down.
“My aim is to massage the soul… to show that no matter what’s happening, you can always return within yourself to places of joy, if only for a few moments. I try to convert the crisis these people were experiencing into something they could handle. A boy — 11 or 12 years old? — was restless. He couldn’t take the confinement any longer and wanted to leave the shelter. So I started throwing things at him — pieces of paper, bits of clothing, whatever came to hand. Every time I threw something, I yelled: ‘KATYUSHA! A KATYUSHA IS COMING!’ He dropped the idea of leaving.
“With younger children, I played or made animal noises. Some of the older people just wanted to talk, and I was happy to listen. One or two were aggressive: ‘What do you want from us?’ they demanded. I answered: ‘What would you like from me?’ and within minutes, they were pouring out their feelings.
“Just as in the hospital, I don’t consciously decide how to relate to each person or think about what I’m going to do. I respond to the individual and to the moment, and most often it works….”
“We social workers are uniquely qualified for this kind of interventional role”
Rita Abramov, Director of Social Work at Hadassah, traveled to Nahariya with the Hadassah team to volunteer in the City’s Crisis Control Center. “In normal times, the Center’s 30 phone lines handle local problems with water, housing or electricity,” she says. “Now, most are given over to social welfare difficulties.
“I answered one call from the mother of a family of four. Her eldest is a young man of 22, with severe mental retardation and behavioral problems. He was terrified of the bombardment but wouldn’t go into the shelter, and she didn’t know what to do. I took her phone number and got back to her within two hours. By then, we’d arranged transportation to Jerusalem for the whole family, and a one-week stay in a hotel there.
“This was just the beginning. The family had no cash as Nahariya’s National Insurance offices had closed because of the bombing. We arranged for payment to be made through the Jerusalem office. The hotel provided only breakfast and supper, so we organized a midday meal for them — and accommodation in a second hotel once the initial week ended. And we found a Jerusalem organization for the handicapped to care for the retarded son during the day.
“Another call I took was from a Nahariya woman who’d already fled the town. She was at her wits end about her parents, Holocaust survivors aged 85 and 94. They’d refused to leave Nahariya with her, and now their caretaker, who brought them food and medication, had gone and the elderly couple was alone and housebound.
“The distressed daughter and I planned how to persuade her parents to join her in southern Israel. While I organized the details of their move with the Health Ministry, I arranged for volunteers to bring in their food and medicines.
“We social workers are uniquely qualified for this kind of interventional role. We’re experienced in working with the sick and the elderly, and we know how to calm people so they can explain their problems and think with us how to solve them. We also have the professional contacts with national health and welfare bodies. Like all the members of my staff who’ve gone to Nahariya, I feel I made a genuine contribution to the welfare of people in the town.”
“A series of conversations with this initially uncooperative youngster identified the cause of his anger”
“Certain kinds of situation tend to repeat themselves in Nahariya under bombardment,” says psychiatrist Forto Ben-Arroch, director of Hadassah’s Orion Center for the Treatment of Pediatric Trauma. “These details belong to a specific family, but my staff and I see many like them.
“Think of a single mother, who’s been sitting in a shelter for 20 days, with three young children, two of them with severe ADHD. She herself is terrified by the missiles, and at the same time is trying to cope hour after hour with hyperactive children in circumstances hard even for a normal child.
“I dealt with her problems on two levels. One was technical: adjusting the Ritalin dosages in this special situation, and dispatching a City volunteer with my prescription to one of the few pharmacies still open. The other was providing emotional support and guidance — supporting the distressed parent, giving her help and ideas about dealing with her children and her own fears. I also notified the City to give her children priority for any programs that would get them out of Nahariya and the shelters.
“Another situation which the City asked us to address concerned a family who had recently emigrated from Russia — a mother and children aged 12, eight and three — with no relatives in Israel. Several months earlier, the father had been in a car accident, and suffered a brain injury which resulted in an unpleasant personality change. He began exploding in bursts of uncontrollable anger several times a day. As a result, the parents had separated not long before Nahariya came under bombardment.
“The father’s accident, living with his unpredictable anger and the divorce had driven the children, particularly the 12-year-old daughter and eight-year-old son, into crisis long before the missiles began falling. In the shelter, however, the boy deteriorated, developing uncontainable fits of rage against his mother.
“A series of conversations with this initially uncooperative youngster identified the cause of his anger. He mistakenly believed his mother was keeping his father out of the shelter, leaving him defenseless against the Katyushas. The truth served not only to end the boy’s anger, but also to reconnect the children with their all-but-estranged father.”
“We watched the five-year-old play happily with the clown, and engage trustingly with her parents and sisters”
When the City asked Dr. Esti Galili-Weisstub, head of Hadassah’s Child & Adolescent Psychiatry Unit, to check on a five-year-old whose mother had reported her abnormally distressed, the Hadassah physician found the problem lay elsewhere altogether.
“This little girl is one in a family of six children, aged 14 years to 10 months,” she says. “They and their parents were living in a shelter, and all were feeling the pressure of being cooped up, day after day. According to her exhausted mother, the child was developing a high fever each evening. As no cause could be traced, the parent attributed it to anxiety.
“While the youngsters played with the medical clown who accompanied us to the shelter, we suggested to the parents that they establish a daily routine, even in the shelter. The mother wasn’t interested. ‘I’m at the end of my rope,’ she said. ‘I’ve no energy for that kind of thing. I just want out of here.’
“We watched the five-year-old play happily with the clown, and engage trustingly with her parents and sisters. We asked her to draw a picture, and she used bright optimistic colors. We asked her how she felt when she heard the Katyushas come, and she articulately described how her stomach clenches and she fills with fear, waiting for the noise to end.
In short, we saw a strong and well-adjusted child — with a mother at the end of her resources. Before we progressed further with a program of strengthening and helping her, the family found a host in Maalei Adumim and thankfully left Nahariya.”