General Discussion

War and peace: Israeli physicians treating Palestinian patients

For the past three decades, we—along with other Israeli Jewish and Arab health-care professionals—have worked with Palestinian physicians residing in Gaza and the West Bank to provide clinical care for patients. To advance this cooperation, in November, 2021, the Rambam Health Care Campus, a tertiary-care, academic, governmental medical centre in Haifa in the north of Israel, launched a mission to bridge the gap between Israeli and Palestinian communities and offer services, including paediatric and adult haemato–oncological services, to Palestinian patients from both Gaza and the West Bank. To that end, we established a special coordination unit to facilitate optimal clinical and administrative management for these individuals. Severely ill patients were referred to the Rambam Health Care Campus by their local treating physicians for therapeutic modalities that were unavailable in Gaza and the West Bank. 34 paediatric patients (aged 2 months to 13 years) and 84 adults (aged 16–74 years), mainly with life-threatening diseases, such as acute leukaemia and bone marrow failure, received medical care at our institution. 15 paediatric and 48 adult patients underwent the most comprehensive medical treatments, including allogeneic stem-cell transplantation and novel immunotherapies. These intensive therapies are inherently associated with substantial adverse effects, demanding close medical monitoring in both inpatient and ambulatory settings and continuous communication with patients, caregivers, and Palestinian medical staff. To facilitate such cooperative patient management, we opened an in-hospital housing facility, fully equipped to address the multifaceted, long-term needs of these patients, matching their actual clinical and psychological status and their cultural identity. Apart from medical care, we have taken upon ourselves the task to address a broad array of other needs not otherwise covered for this population, such as food, housing, clothing, and medically necessary health care of their accompanying family members, transportation from checkpoints to the hospital and back, religious services, and free-time activities for the younger patients. Moreover, with the aim of providing autonomy in health care to the highest degree, we provided residency and fellowship-level training to Palestinian physicians in Gaza and the West Bank. Graduates maintain ties with the Rambam Health Care Campus and have gone on to be able to deliver many aspects of care close to the patients’ homes.
Following the heinous attack by Hamas terrorists on Oct 7, 2023, who brutally murdered 834 innocent civilians1 and more than 350 soldiers, and took 239 hostages2 (including babies, children, women, and older people, many of whom have complex medical conditions and require medications and care), our world has changed. Yet, despite the war, we keep providing the full range of clinical care, including medical and social support, to the Palestinian patients in Israel who are unable to return home and sometimes have little contact with their families. Importantly, even in these difficult days, patients from the West Bank continue to be referred to the Rambam Health Care Campus and are warmly accepted by the multicultural staff (ie, Jews, Muslims, Christians, and Druze) of the paediatric and adult haemato–oncological divisions. For some of the patients who can no longer travel to our centre, we are providing remote medical consultations.
Despite the murderous crimes committed by Hamas, we believe in the strength of humanity and are doing our best to render medical and support care to those in need at our doorstep and within our facility, irrespective of the patients’ religion or nationality. The same is true in multiple clinical departments at the Rambam Health Care Campus and at medical centres throughout Israel. We demand from Hamas an attitude of care towards our hostages and call for their immediate release.3 We call upon the International Committee of the Red Cross to intensify its efforts to conduct humanitarian visits to the hostages to deliver them the required medical assistance and ensure connection with their families. We expect the entire international medical community to stand with us and condemn this inhumane attack. The human spirit will prevail and good will triumph over evil, which will enable us to resume the mission of professional and human cooperation for the sake of the patients, to which end we have sworn our physician's oath.