IN-DEPTH FEATURES
Misgav Ladach is Closed

The Misgav Ladach hospital served Jerusalem for 122 years. Now, its saga seems to have reached its end. The history of this hospital encapsulates that of the Jewish yishuv over the past century. It was founded within the walls of the Old City as an alternative to the missionary hospital, and served all of Jerusalem's residents. At that time, Bikur Cholim Hospital (which was older than Misgav Ladach), accommodated only the Ashkenazic community and also demanded a high hospitalization fee. The Misgav Ladach Society engaged in chesed and help for the Jewish community, and as the Jewish yishuv in Jerusalem developed, so did Misgav Ladach.

During the War of Independence, it rallied to the aid of the besieged residents of the Jewish Quarter until the quarter's bitter end, when it was captured by the Arab Legion. The story of this venerable hospital which is about to close, is a fascinating, edifying slice of history.

Founding

"How vividly we recall that period during which we were suddenly motivated to found some sort of a small bikur cholim society. Seeing the numerous cases of infirm and afflicted [Jews in Jerusalem] and the abject poverty which prevailed in the homes of those unfortunates, and seeing that no one cared how they lived or was mindful of how they struggled with their ailments or of how they writhed in their narrow, dank and dark cellars, contorted by the intensity of their pain and the severity of their illnesses [we were spurred to act]. In those murky waters, it was easy for the fleet hunter, the British mission, to snare many fish. And so, we decided to found the Misgav Ladach Society."

That was in 5639 (1879). Today, in 5761, the saga of the well known Misgav Ladach Society, better known as the Misgav Ladach Hospital, may have come to an end. The hospital, which functioned for nearly 120 years, closed down under not very favorable circumstances, and all that remains of it is a fascinating slice of history.

The First Kupat Cholim

Rabbi Ephraim Levi, who knows nearly all there is to know about Misgav Ladach and willingly shares his knowledge with others, relates: "The Misgav Ladach Society was founded in 1879. This society was actually a medicine gemach. But unlike current gemachim, Misgav Ladach didn't expect the sick or their family to return the medicines they had taken. The founders of the society simply wanted to help."

The opening paragraph of this article was taken by Rabbi Levi, from an old book -- with only one copy in existence. [Throughout the article, more quotes from this tome will be presented.] Those festive, somewhat ecstatic words were written in honor of the 25th anniversary of Misgav Ladach, the hospital.

Its founders were a group of immigrants who had made aliya from the Greek city of Salonika. The group was headed by Rav Shem Tov Elchassid and his son Shlomo. "In Salonika that group also engaged in helping and supporting the infirm," says Rabbi Levi. "They brought their chesed enterprises with them to Eretz Yisroel. The thread merchants who made aliya from Greece were outstanding people. The father of the family, Rav Shem Tov Elchassid, was one of the kabbalists of the Beis Keil yeshiva, and a contemporary of HaRav Gagin."

They were wealthy people. Their initiative was admirable, and they possessed the means to realize it, or at least to lay the foundations. That was how the Misgav Ladach Society for the Sick came into being.

The members of the society not only dispensed medicines. "Every single trustee," says the old book from which Rabbi Levi quotes, "was obligated to do chesed himself physically, by visiting, when necessary, each sick member of the society in his own home, trying to ease his affliction and to provide as much help as the society's fund could extend." This was the first Kupat Cholim in Israel. In its first two years, nearly three hundred people joined the Misgav Ladach society. In its third year, it already had 1300 members.

Free, but for a fee, was the policy of the Misgav Ladach Society. The payment of dues entitled members to medical aid and medicines, as well as to house calls made, when necessary, by the society's doctor.

The well known Greek physician Dr. Mazaraki, for example, belonged to the Misgav Ladach Kupat Cholim. When he visited a sick member of Misgav Ladach, he would charge a quarter of the fee he demanded from nonmembers.

Today, things are a bit different. No modern Kupat Cholim brochure makes assertions like those of Misgav Ladach of that period: "Lehaskil el kol dal -- To be aware of the needs of every impoverished and sick person and to support him on his sick bed by providing him with doctors, medicines and also money if he needs it."

Many of the members of this society needed help. Its founders clearly saw how essential the chesed society they had established was for the impoverished Jewish settlement. The Misgav Ladach society grew and developed.

Backing the activists who ran it were the gedolei hador of that time: HaRav Chizkiyah Medini, the author of Sdei Chemed was an ardent supporter of Misgav Ladach. As a genuine friend of the hospital he contributed large sums to it, mentioned it in his will, and donated his large library of thousands of seforim to it. This hospital supported the Sdei Chemed yeshiva from his funds. (The link between one of the gedolei hador and the hospital is clearly written in the regulations book of Misgav Ladach.)

A General Hospital in the Old City

In the beginning, Misgav Ladach was merely a bikur cholim society, and no more. However, in 5649 (1889), ten years after the founding of the society, it became a hospital, or as the author of the book in Rabbi Levi's possession says: "a home of healing -- beis refu'os."

What motivated the founders of Misgav Ladach to establish the hospital? The simple fact that the Jewish hospital which had functioned in the Old City -- the Rothschild Hospital -- had moved to the new city.

The yishuv in the Old City remained with only one active hospital -- Bikur Cholim. It is very likely that the small community in the Old City really needed only one hospital. But its specific character was a little problematic, as the author of that ancient book calls it: "the Bikur Cholim hospital of our brothers, the Perushim, Ht"v."

In other words, it was specifically an Ashkenazic hospital in the Old City, and it had two serious shortcomings: "Bikur Cholim, which had 25-30 beds, could in no way fully realize the great mission [of Misgav Ladach], because in addition to the fact that its doors were closed to non- Ashkenazic patients, even every Ashkenazic patient had to pay two francs a week for his hospitalization ("kofer nafsho")."

These simple words point to a rather unpleasant picture. Already then, the members of the Sephardic community had complaints about discrimination. The first complaint was that Bikur Cholim did not accept non-Ashkenazic patients. The second complaint was that the hospitalization cost money. In fact, to a Lithuanian Ashkenazic Jew hospitalization cost two francs a week, but a Chassidic Ashkenazic Jew had to pay double -- four francs a week.

Faced with such a situation, the members of the Committee of the Sephardim felt that they were obligated to fill the void. They decided to found a general hospital in the Old City, and the stress was on "general," as the author of the book says: "Without discrimination between Jew and Jew, and without any hospitalization fee." In brief, it was hospital for all who needed its service, and those services were free.

In was in that manner that Misgav Ladach started a hospital in the Old City. For twenty thousand francs, the members of the society bought the courtyard where the Rothschild Hospital had been located and opened their Misgav Ladach Hospital.

How did this first hospital look? The rooms were "small, subsurface, meager and with low ceilings," says the author of the book. The directors of the hospital found it difficult to understand how the Rothschild Hospital had used this building for so many years. But in that period, there wasn't a large selection of suitable buildings, nor was there money to build a new one. As a result, they reconciled themselves to reality, opened a new hospital with seven beds, (no, this isn't a mistake) and hoped for the best.

Those seven beds weighed heavily on the patrons of the hospital. They were not an easy burden for them. But soon Sir Moses Montefiore, through his Mazkeress Moshe veYehudis Society, came to the hospital's aid, and granted it a loan of four hundred British pounds, to be repaid at a rate of 50 pounds a year.

With such financial problems, the hospital didn't manage to flourish, although the number of patients steadily increased. In 5653 (1893), due to a dispute between the various hospitals which functioned then, the philanthropists' support of Misgav Ladach was increased and the hospital's plight was alleviated. The old Rothschild house was renovated "from the foundations to the rafters," and they even built a "large upper double on top of the house," in other words, the hospital acquired a second floor. This hospital now had fifty beds.

That, perhaps was the period in which Misgav Ladach thrived. The hospital improved and gained fame primarily for the extreme need for it.

The Battle Against the Missionaries

During that period, hospitals played very important roles not only in the medical arena. The Jewish hospitals were the spearheads for the battle against the missionaries.

"Until the 1830s," writes Reuven Kashani, one of the directors of Misgav Ladach in new Jerusalem, "there were no Jewish medical institutions in the city. Jerusalem was an impoverished, sparse and squalid city."

In an article about the first medical institutions in Eretz Yisroel, the historian, Benzion Gat describes the city's sanitary conditions: "Its waters were murky and scant. Its narrow streets were dirty, and as a result were like nests for epidemics which frequented it often. There was no doctor in the city."

Among the diseases which frequented Jerusalem were malaria, dysentery and influenza. Every few years, too, cholera and the plague would break out.

The missionaries perceived the vast potential, and they sent missionary doctors to Jerusalem. Most of these doctors were Jewish apostates. One of them, a physician named Dr. Gerstman -- an apostate and a missionary -- had come from Germany. He rented a house in the Old City into which he brought beds for the sick. The first real hospital for Jews was established by a representative of the London Society for the Spreading of Christianity Among the Jews.

Jews who fell ill -- and in that period epidemics broke not infrequently -- found themselves in the shadow of the cross. Don't think that the rabbonim of Jerusalem shut their eyes to this situation, cholila. They battled these hospitals with every available means. They issued prohibitions against receiving help from the missionaries, promulgated bans, and in the 1840s even forbade Jews to enter missionary hospitals.

The manifesto which the rabbonim issued bore the names of all of the rabbonim of that time. All of the Ashkenazic and Sephardic rabbonim of the era signed the prohibition, among them HaRav Shmuel Salant, the rav of Yerushalayim, and the Yisa Bracha, the Chacham, HaRav Yaakov Shaul Elyashar.

But some Jews were unable to withstand the difficult nisoyon and turned to the missionary hospitals for medical help. The intensity of the danger which threatened the Jewish community in the form of the missionaries is particularly manifested in the following extraordinary story:

At that time, the Chacham Bashi, the Chief Sephardic Rabbi, HaRav Chaim Gagin (HaRav Ag'an) contracted a very serious illness. Residing in Jerusalem was a specialist who was also a missionary. The Chacham's relatives wanted to summon that doctor to the rav's home for a consultation and treatment. But the desperately ill Chacham Bashi refused to avail himself of the missionary's service, even if it was rendered in his own private home. The Chacham Bashi died of this illness.

This deplorable situation was changed by the Jewish hospitals: one founded by Montefiore which was, in essence no more than a clinic, the Rothschild Hospital and, of course, Misgav Ladach, which moved into the vacated hospital building, Rothschild Hospital when it moved away.

Among the founders of the Misgav Ladach hospital were Rav David Pappu, Rav Shmuel Meyuchas, Rav Yaakov Shaul Elyashar, Rav Yaakov Mayer and others, and of course, the members of the Elchassid family, in particular the wife of Rav Shem Tov Elchassid, Mrs. Luna Elchassid who initiated the idea to found the Misgav Ladach society.

The foremost aim of the hospital was: "to prevent our brothers from knocking on the gates of the hospital of the inciters" -- the missionaries. In addition, the hospital, as indicated by its name, aspired to be "a shelter for the poor."

Regulations

Following are the regulations of the Misgav Ladach Society, as they appear in its Sefer Hatakanos: Ten men directed the society. They were supposed to meet once a month, "in order to supervise its activities and insure their smooth running." The activists had to present "open books" ("transparency," as we call it today), including records of the income and expenditures. They also had to meet every rosh chodesh and to study Tehillim and seder mishmoro. In addition to this, general convocations were held four Shabbosim a year.

If one of the members was sick, the society had to send an attendant to take care of him (something like a nurse), as well as to provide him with a doctor and with everything else he needed, regardless of whether he was rich or poor.

The book enumerates the rights of the sick and the obligations of the society, such as: "performing top-notch operations." In addition to this, the society was obligated to attend to seasonal problems, such as providing Jerusalem's residents with coal when it was cold.

Misgav Ladach offered good services to everyone -- Jews, non- Jews, Ashkenazim and Sephardim. As the needs increased, so did the appeals to philanthropists, generally in direct proportion. Some responded, evidence of which may be found in the "letters of thanks" which were published in the regulations book. Among those who were thanked for their donations were those like R' Shimon Wolf, known as Baron Wilhelm de Rothschild (who was known as the righteous Baron), as well as "HaRav Hachaham Hatorani R' Eduard Rosenheim" (Rabbi Eduard Rosenheim) and others. HaGaon Senior Moshe Cohen, Hy"v for example, is mentioned in the report as the one who donated 29 (liras, apparently) to "help distribute coal during the cold days."

The Turkish Army "Captures" Misgav Ladach

The hospital which functioned during a difficult period was confronted with very harsh circumstances. In the report he published in 5689 (1929), Rabbi Michlin, who was the hospital's secretary for more than forty years, related that a number of years before the outbreak of World War One (during the Ottoman rule), the Arabs libeled the hospital. The report states that the Jews suffered from acts of aggression and animosity, but that "thanks to the swift efforts of our friends in Constantinople," the acts of hatred were curtailed.

At the outbreak of World War One, the institution seemed on the verge of collapse. Its directors dispersed, because some of them were citizens of the enemy country (Turkey) and some were so poor that they were forced to support their families by means of employment outside the hospital, whose income had become increasingly meager.

During that period, the Turkish army seized the hospital, stealing all of the hospitals' wooden items which it used as firewood, and plundering everything else of value. The operating apparatus, the medicines, the clothing -- all vanished. When the Turks left, the British entered and the directors of the hospital renovated the destroyed hospital, but not without hardship.

The List of Pledges and Contributions

Every year, the hospital published its inventory in a special pamphlet. The inventory included: "Income and expenditures, as well as pledges and contributions which were secured in the synagogues and botei medrash of the kehillos in Jerusalem, Tel Aviv-Yaffo and the settlements, from rosh chodesh Tishrei until rosh chodesh Elul."

The pamphlet in our possession was published in 5690 (1930). The members of the committee of that year were: HaRav Yaakov Mayer, its president, the Rishon Letzion; HaRav Binyamin Alkutzir; Rav Yosef Chai of Penizhel; its treasurer Yaakov Chai Tajar; and its secretary, Chaim Michel Michlin.

These are well known names. But not only accounts of the incomes and expenditures of the hospital, but also much vital information, such as, "the number of patients the hospital accepted (670), the overall number of days in which patients were hospitalized (9875), the amount of medicines dispensed (10435), and the number of patients who visited the hospital's polyclinics -- the historical forerunners of today's outpatient clinics -- which was approximately 8846, including Moslems and Christians. These polyclinics functioned twice a week, and offered free treatment. One of the doctors of the polyclinic, Dr. N. Korkidi, was severely injured by shots fired at the hospital during the riots.

The name of the Benedito Mussolini (Il Duche), the ally of Hitler, yimach shemo, might nearly have appeared on that list. Rabbi Michlin, the secretary, learned that a Jewish woman from Monte Carlo, Emma Pollack, had left behind an estate of five million Italian liras, which she had designated for tzedoko and chesed purposes. In his letter to Mussolini, Rabbi Michlin mentioned that in the past, Misgav Ladach had received special support from his royal majesty, Vitorio, the King of Italy.

No money resulted from this effort. Rabbi Michlin was summoned to the Italian consulate, where he was notified of Mussolini's reply of, "I'll consider your request another time."

A Hospital in the Middle of the War

The hospital developed with time. In 1935, its new director, Emanuel Proper, introduced electricity into the hospital. He also originated the idea of the "on-duty doctor," which is today self-evident, but at that time was a significant innovation. As a result of his efforts, doctors were present in the hospital twenty-four hours a day.

In 5708 (1948), the regional Haganah headquarters was stationed in the Misgav Ladach hospital. It was the only hospital available to the Jews of the Jewish Quarter and the soldiers who fought there. In his description of the bombing of Rabbi Orenstein's house by the Arabs, A. Liron portrays a scene of havoc and destruction: "A large cavity opened in the house, and the rav fell into his basement. The rebbetzin was asked to maintain quiet, so that the Arabs wouldn't hear, and Menashe the commander told the soldiers: `Go to the Misgav immediately and bring help: people, stretchers and medical equipment.' " The wounded were brought to Misgav, of course.

The medical staff was very sparse during the war days in the Jewish Quarter. Two medics, three doctors, one certified nurse, and two female medics worked in shifts. There was only one hospital -- Misgav Ladach -- and it had two clinics, one at the beginning of Yehudim Street and the other on Chabad Street. The hospital itself was near the Porat Yosef yeshiva. With the prolongation of the siege on the Jewish Quarter, the need for medical help on the site increased. And so, an operating room was set up in the hospital. Later on, a dentist was sent to serve the residents and the soldiers.

In addition to its medical function, Misgav Ladach also served as a community center. A general kitchen was opened in the hospital. The British knew that Haganah men were located in the hospital and after the battle between the Haganah and the British army, the headquarters were moved elsewhere. The amount of those who ate in Misgav Ladach's kitchen decreased, but not the number of portions which were prepared there. That food was sent to the military outposts.

Difficult days befell the Jewish Quarter, its residents and its hospital. Exploding bombs, shots, attacks, a lot of grime, a lot of noise and a lot of destruction were daily occurrences. People were injured and killed, and outpost after outpost was abandoned. The outpost near Misgav Ladach fell, was retaken, and then was finally overcome.

The upper floor of the hospital was emptied. It was too exposed to the falling bombs. The survivors of the bombings were crowded into every square meter of the hospital. The place was so cramped that the survivors were placed in the rooms of the sick and the injured, disturbing the work of the staff. The hospital floor was strewn with wounded -- mattress beside mattress, victim beside victim -- with not a drop of space between them.

The hospital didn't enjoy immunity to attack. When the bombs began to crash against the hospital's walls, Dr. Riss instructed the staff to hoist Red Cross flags. They bought red and white cloth and tore the red cloth into strips, which they fastened to the white cloth with safety pins, in the form of the symbol of that international organization.

Dr. Riss himself climbed up to the roof, hung the flag, and hurried downstairs. Other flags were affixed to different walls. However, those who pinned their hopes on the flags were quickly disappointed. The hospital became the focus of the Arab attacks.

The wounded were transferred from the main building to the first aid room, but the bombs did not bypass that room either. Bullets began to penetrate the rooms of the injured. A number of them were wounded anew by the flying shrapnel. In the pharmacy room, many people -- survivors who had fled their destroyed homes in the Jewish Quarter -- crammed together in the hope of finding shelter in the hospital. The air in the room grew scarce. The injured shrieked for help. The nurses did not know whom to approach first.

The hospital was in shambles. Rumors about an agreement, according to which Misgav Ladach would receive the protection of the Red Cross and that only women and children would assemble there, spread. But these rumors remained no more than rumors -- hopes in the heart. The hospital swarmed with hundreds of people who felt that at any moment they might be massacred by the Arabs.

Soon it was decided to evacuate the hospital of all civilians. Convoys left the hospital and transported the civilians to Batei Machseh. After the last group of people had left, the windows of the dining room were darkened. Nurses began to treat the wounded, and a wind-flashlight was brought into the operating room, because certain operations could not be performed by daylight.

The situation in the Jewish Quarter deteriorated steadily. Once again, a military outpost was stationed beside Misgav Ladach. The Arab Legion entered the picture and the end of the Jewish Quarter was imminent.

The hospital was in an appalling condition. Much blood had congealed on its floors. Red, black and most of all filthy, stretchers lay everywhere, and contaminated, dirty dressings were scattered on the floor. The stench of death and rot filled the hospital. The injured lay on the floor, breathing heavily. Bullets flew inside every now and then. People walked around hunched over. A soldier who wanted to come inside the hospital to rest, quickly left. "Send me to any outpost, just not to the hospital," he said.

The doctors operated on the wounded during the nights, and in the mornings they would rest on the surgery room's stone floor. The injured were brought to the hospital by civilian stretcher-bearers. Under these intolerable conditions, the doctors still sometimes managed to save lives.

The hospital was the target of incessant bombings for a number of days. In the end, the Haganah decided to move the hospital to another place. The injured were transferred in the wee hours of the morning. In the utter darkness, the stretcher- bearers walked down stairs and stepped over mounds of stones. The injured who could walk -- walked, accompanied by Dr. Riss, a steel helmet on his head, and a gun slung over his shoulders. The hospital was transferred to Batei Machseh, but it didn't remain there for long. The Jewish Quarter fell.

Misgav Ladach is Founded Anew

The survivors of the Jewish Quarter who hadn't been taken captive, concentrated mainly in the Katamon neighborhood where the Misgav Ladach hospital was rebuilt.

"But then," says Rabbi Ephraim Levi, "its prestige declined." At first it was situated in a temporary building, and in time it became only a maternity hospital. Its services were used by women from the entire gamut of Jerusalem's population, and many chareidi women gave birth there.

Later on Misgav Ladach moved to a new, large and luxurious building. However, this building did not advance the functioning of the hospital, which deteriorated until its recent closing.

We have chosen not to dwell on the reasons the hospital closed, and to remember only the good, the chesed and the beauty which Misgav Ladach radiated on Jerusalem during the 120 years of its existence.