Ohad Oren and Michal Oren on the “Cordon Sanitaire Hospital:” A vision being fulfilled

Credit: Herbert Bishko
Credit: Herbert Bishko

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Seven years ago, we outlined our vision of a humanitarian hospital. As Israelis who had witnessed the suffering of the citizens of Gaza, we felt compelled to develop a model that would improve their overwhelming deficiencies in medical care. We envisioned a medical facility that would be dedicated to the care of wounded Palestinians at times of war. According to our model, deployable medical teams of all nationalities, would provide high quality emergency care in the framework of this hospital. We described our vision in a blog and published it in The BMJ. The responses were instantaneous. A pulmonologist, a surgeon, and a paediatrician were among the many who shared their enthusiasm and motivated us to “cross dividing lines and serve humanity.” One sensed a “glimmer of hope” in a relentlessly bloody conflict. Another believed that our dream was possible if “enough people take up the call.” One even wrote that our blog should be “circulated to Israeli and Palestinian leaders and to many more.”

We then spent several more months planning what we called the “Cordon Sanitaire Hospital” (Cordon Sanitaire is a french nomenclature referring to a barrier preventing the spread of disease). We delineated its components, created illustrations, and pondered about the logistics. We imagined a medical institution that would be built at the border line of Gaza and Israel and be incorporated into the fabric of the security wall. This, we assumed, would facilitate patients’ urgent access to care while meeting the security needs of Israel.

Then came the daunting task: translating our ideas into actions. We started by sending packages with our two articles and a cover letter to countless public health organisations. We were perhaps naive to expect to receive encouraging responses, as we received no response. We sent reminder e-mails and tried to make the case using phone calls. That did not work either. We asked third party activists to help promote our idea. But that also did not materialise. So we forwarded letters to less well known human rights groups. Disappointingly, our mailbox remained empty. The road ahead seemed obstructed.

Four years after our articles were posted, a first-of-its-kind humanitarian hospital was set up by the Israel Defense Forces (IDF). This facility, a field hospital erected at the border of Israel and Syria, recently started treating Syrian refugees wounded in the civil war. Israeli physicians and nurses with expertise in emergency medicine and surgery now provide urgent, often life saving, medical care to Syrian children and adults. In particularly complex scenarios, patients are first stabilised and then transferred to civilian hospitals within Israel for definitive treatment.

This commendable provision of medical care by the IDF has already been the target of intense criticism in Israel. Some argue that investing in the medical care of the “other side” may represent a non-strategic waste of resources. Others go as far as claiming that such treatment is essentially a “gift” to the enemy. But this is far from being the truth. These acts not only are gratifying and morally justified, but may create important bridges for understanding and communication between people. The implications of this healthcare support certainly transcend the medical milieu.

Utilising the fruits of medicine is indeed the answer. Not only does it prevent catastrophic health consequences at the individual level (which may propagate and lead to further downstream havoc at the country level), but it may also forge trust. When a maimed Syrian citizen receives compassionate care from an Israeli physician, hearts soften and minds change. Patients and doctors learn to appreciate each other’s humaneness. Modifying pre-conceptions is key to lowering adversity.

But it takes a lot of courage to work in such a hospital. The one in the Golan Heights that serves the Syrian refugee population is situated in a perilous area. Mortar fire from Syria has already reached this very territory, injuring several Israeli soldiers. Despite these real dangers, young women and men continue to commit themselves to this important mission.

The Israeli humanitarian hospital is a step in the right direction. It reinforces the notion that medicine is a conflict-independent endeavour that should be pursued vigorously by all nations. It proves that treatment of battle injuries can be devoid of patriotic connotations. And it reminds us that our unyielding fight is against the one and only opponent: morbidity and mortality.

We should recall the words of Maimonides, the Jewish physician of medieval times, who wrote that healers should “help and support rich and poor, good and bad, enemy as well as friend.” In the last segment of this verse, composed more than 800 years ago, Maimonides asserted that doctors should endorse equal care for all: locals, foreigners and even enemies. It is not an idealistic enterprise, according to Maimonides; rather, it is the mandated human behaviour. His wisdom is still as relevant today.

Ohad Oren is a graduate of the Ruth and Bruce Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa, Israel.

Michal Oren is a final year medical student at the Sackler School of Medicine, Tel Aviv University, Israel.

Competing interests: None declared