About this time last year, the Israel Defense Forces sent a medical mission to assist the victims of the Haiti earthquake. Quite a few Hadassah doctors and nurses – and even one of our pediatric clowns – were part of that lifesaving effort, among them Dr. Ian Miskin of HMO’s Department of Clinical Microbiology and Infectious Diseases. After his return, Dr. Miskin collaborated with colleagues in the department, Dr. Ran Nir-Paz and Prof. Colin Block, and others involved in the mission, to ensure that critical lessons they learned in Haiti would reach professionals who might provide relief in similar catastrophic events.
From left: Atty. Ophir Shahaf, CEO of Hadasit Bio-Holdings Ltd; Esther
Levanon, CEO of the Tel Aviv Stock Exchange; Dr. Einat Zisman, CEO
of Hadasit; Esther Dominicini, HMO Board Member; Prof. Shlomo
Mor-Yosef, HMO Director General; Vincent Tchenguiz Chairman of the
Consensus Business Group, a major investor in Hadasit Bio-Holdings Ltd;
and Ambassador Zalman Shoval, HMO Board Member
Two weeks ago, the prestigious New England Journal of Medicine published their letter recommending modification of the existing guidelines for treating victims of earthquakes and other disasters. Their conclusions have already received a complimentary reference in the prestigious magazine Nature and a positive response from Médecins Sans Frontières, Doctors Without Borders, recipients of the Nobel Prize for their organization’s humanitarian medical aid.
In Haiti, working in rather primitive conditions, the IDF team set up a laboratory in one of the field hospital tents to analyze the cultures they collected from their patients, so they could determine the proper treatment for infected wounds. When they returned home, they further evaluated the cultures and determined that most of the infections were caused by Gram-negative rather than Gram-positive bacteria. This meant that, contrary to previous belief, in Haiti and apparently in previous natural disasters, the organisms causing wound infections were resistant to the antibiotics recommended by the World Health Organization (WHO) and U.S. Centers for Disease Control (CDC), the researchers wrote in their letter to the New England Journal of Medicine.
“If we had treated the wounds of people injured in the Haiti earthquake according to current recommendations, we would have had high percentage of failure,” said Dr. Miskin, who headed the research team. “When we saw what was growing in the cultures, we modified the treatment protocol using the broader spectrum antibiotics that we had with us. Later, we compared the cultures we brought home with those taken from victims of previous earthquakes treated in hospitals and confirmed that Gram-negative bacteria were indeed more of a problem than the expected Gram-positives.”
“Identifying Gram-negative bacteria is not straightforward,” Dr. Nir-Paz said. “Some of the bugs we saw were unique. They came from plant debris. We soon learned that Haitians often treat their wounds with plant dressings.”
In these situations, indeed in the practice of medicine, recognizing cultural differences, he concluded, is a major component of patient care. “You always need to know and understand the people you are treating,” he said. “We see it at Hadassah on a daily basis among the many populations we treat. The same holds true around the world.”
He also concluded that a laboratory is a necessity, not a luxury in disaster areas. “When you come in, you’re facing the unknown. We come in with what we know and what we think. Having a laboratory helps determine the treatment – and later on – helps provide the answers.”
Prof. Block concurred. “The on-site lab allowed early assessment of the bacteria cultured from the injuries. We put together bits of information from a number of different incidents and found the presence of Gram-negative bacteria was typical of earthquake associated injuries. In future such situations, medical disaster relief teams will have to take this factor into account and broaden the range of their antibiotic inventory.”
On January 2, Hadassah had the privilege of sounding the buzzer ushering in the Tel Aviv Stock Exchange’s first business day of 2011. It was a vote of confidence in Hadasit Bio-Holdings Ltd. (HBL), the portfolio of biotechnology companies traded on the Tel Aviv Stock Exchange as HDS. The companies grew out of research developed at Hadassah, research that was initially promoted by Hadasit, Hadassah’s technology transfer company.
This honor recognized HBL’s unique venture, but more than that I believe, it was a strong – and very public – statement about the strength of Hadassah’s research and the promise it holds for people everywhere. Some of the HBL companies are already completing the final clinical trials that would allow their products to enter the medical marketplace; others have a short way to go.
My friends, you and I know that some of Hadassah’s research has changed how surgeons operate, how patients are treated. The findings of these three infectious disease specialists will affect how hundreds of thousands of people around the world will be treated in the future. The treatments and technologies developed by Hadasit hold the same potential.
Whether sharing research results in leading medical journals to ensure that more people will survive terrible natural disasters or celebrating Hadasit Bio-Holdings Ltd in the Tel Aviv Stock Exchange, I am confident that the research Hadassah conducts will continue to make a difference for people everywhere far into the future.
Prof. Shlomo Mor-Yosef