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IN-DEPTH FEATURES
The opening of the new Maternity Ward at Maayanei Hayeshua
with hotel standards afforded us the perfect opportunity to
survey the sixteen-year-old Medical Center. The superb
appointments of the new wing are of secondary importance to
the most important factor for a hospital — medical
expertise.
Our very own hospital, the result of Doctor Rothschild's
vision and toil, is the Israeli and world leader in the total
number of Jewish births. It is credited with amazing
achievements by international standards in this field.
Yet the ignorance of the community concerning other
departments in Maayanei Hayeshua such as the Pediatric and
Internal Medicine Wards is unfortunate.
*
Can you tell us what possible reason could cause a
chareidi Jew to turn to a distant hospital when he is able to
receive high-class, top-notch medical care, more easily
available and carried out according to halocho, right
next door?
Appendicitis is a frightening enough occurrence even in the
middle of the day. But when you start writhing with pain in
the middle of the night, things are much more complicated. A
hurried telephone call to a doctor acquaintance confirms the
diagnosis — straight to the Emergency Room. You have no
choice but to go. You get there, teeth chattering with
fright, only to find that there is a long line, the place is
crowded with people in pain and, unless someone faints, they
are expected to wait patiently for hours until the on-duty
intern is free.
There is no shortage of traumas. Yesterday your ten-year-old
daredevil fell from a climbing wall. It was a relatively
short fall and, apart from a large bruise, everything seemed
fine. That is until the child suddenly vomited and then fell
asleep. The doctor's clinic has already closed, but you
suspect concussion and want to take him to the hospital for
an x-ray and diagnosis. Be'ezras Hashem everything
will be fine in the end, but meanwhile things are far from
simple. For a sweet cheder yingel who usually is safe
in Bnei Brak, to have to spend time in an environment like
that . . .
These sorts of incidents happen in every family. Your elderly
grandmother has a stubborn case of pneumonia which
antibiotics can't seem to cure. There's no choice but to
hospitalize her, despite all the complicated family logistics
of travel to and from a distant hospital.
You feel pain and pressure in your chest. The doctor sends
you to the hospital to have an EKG, stress test and
everything else needed to check on what's going on. No one
enjoys going there, but what choice do you have?
These are only some everyday examples. The common factor in
all the cases described here, and many others too, is the
basic question of why should someone look for medical
treatment in a distant hospital? He can receive more readily
available treatment, which is just as good as anywhere else,
at a top medical level. And all this at a chareidi center
next door which is faithful to halocho.
Achievements by International Standards
Unbelievable, but true: it is sixteen years since Dr. Moshe
Rothschild announced the fulfillment of his dream, with the
siyata deShmaya he richly deserved, of a chareidi
medical center. Until then it had been perceived as a
grandiose scheme in the form of a giant crane dominating the
Bnei Brak skyline as you approach from the Geha Road. Today
it is hard to imagine how we managed without it.
This article is designed to give an unbiased report of the
medical facts. We won't be giving you colorful descriptions
of our tour of designer rooms — which made us search
for signs of the room being in a hospital — and the
well- equipped and designed dining room. Nor will we
disseminate tidbits of information such as who a new mother
needs to know to get into the new wing. Instead, we will
focus on what is really important.
The superb conditions offered by the new wing are of
secondary importance to the most important factor — the
top medical expertise. The Maternity Unit at Maayanei
Hayeshua boasts of amazing achievements on an international
level. For your information, the records for the last two
years show that the level of Caesarean births at Maayanei
Hayeshua is among the lowest in Israel and the entire
world!
Professor Mordechai Ravid, the medical director of Maayanei
Hayeshua comments, "Maayanei Hayeshua, with 7,000 births a
year, is now the leading Israeli and international center as
far as number of Jewish births. The professional significance
is that Maayanei Hayeshua has the greatest level of
experience and expertise. Problems which in other places can
reach crisis level and end tragically have been dealt with
successfully here. There is no doubt about it that Maayanei
Hayeshua's delivery rooms are among the best in the
world!"
Dr. Benny Chen, Head of the Obstetrics and Gynecology Wing
reveals new and surprising statistics. "The national average
for Caesarean births as a percentage of all births is around
eighteen percent and that of the large hospitals in our area
is about 22 percent. Maayanei Hayeshua's Caesarean rate is
only 11.5 percent, one of the lowest in the world!"
The explanation lies in the attention paid to this issue by
the staff and the guidelines from the hospital's Va'ad
Hahalocho (in deference to medical decisions, of course),
as well as the expertise and experience which the hospital
has built up over the years. Although the risks and damage to
the health of the mother make a regular birth always
preferable, there are situations today in which an operation
is almost automatically performed, even though there is no
evident medical necessity. Residents who come here (with the
cooperation of the Sheba Medical Center at Tel Hashomer),
leave flabbergasted, having realized that they have plenty to
learn from us."
You have to admit that what you said is very interesting
given that people like to `accuse' Maayanei Hayeshua of
performing unnecessary Caesareans.
Dr. Chen replies, "We know all about that rumor. The source
is either ignorance or it is due to the hostility of some
groups towards the hospital. However the converse is true.
Those are the official statistics. At the same time it is
important to add that the maternal and neonatal death rates
at Maayanei Hayeshua are among the lowest in the country."
Maayanei Hayeshua is an unusual entity: a public hospital
with a unique standing, full of merits but also obligations.
As Professor Ravid jokingly adds, Maayanei Hayeshua has
spiritual fathers, but no father who foots the bill.
Hospital Director Dr. Yoram Lever espouses the idea that the
medical standards and needs of the community compel the
hospital to progress, extend its services and develop. He is
the one who initiated the opening of the new Maternity Ward,
at a cost of NIS six million.
The truth is that there was little choice but to expand,
because of the overcrowding in the existing ward. A week
after the new 40-bed ward was opened, it was fully occupied.
However, once they were expanding they went all out. Dr.
Chen, while reminding us of the close connection between body
and soul, notes that the new features will help the mothers
to recover physically and to rest.
Who then, will find herself in the new wing?
"No favoritism!" grin Dr. Lever and Dr. Chen. "Everyone is
equally entitled to be there, with no extra charges. At this
point it will be used for mothers and babies with no specific
medical problems."
"No Residents Here!"
It is well-known that Bnei Brak, together with its new
suburbs, is a city of children. If so how is it possible, we
asked the heads of Maayanei Hayeshua, that the maternity ward
is full to capacity while the pediatric ward manages with
eighteen beds?
The same question can be asked about other wards, with
excellent medical and professional standards, which are
mostly at the level of other large hospitals. What possible
reason, as we have already asked, can cause a chareidi Jew to
turn to a distant hospital when he is able to receive the
same medical expertise at Maayanei Hayeshua?
As expected, the main answer is lack of awareness. "There are
chareidim who do not know that Maayanei Hayeshua is not a
maternity hospital, but a sophisticated, general hospital
which has a maternity wing," Professor Ravid says
sardonically. "There are still lots of people who think you
give birth at Maayanei Hayeshua, but take a sick child to
another hospital."
"I can tell you with conviction that the medical standards at
Maayanei Hayeshua are just the same as the large hospitals.
On the contrary; our service is quicker and more easily
available, and given only by specialists and not residents.
The problem is that we have not put enough resources into
publicity and public relations. Additionally, the kupat
cholim (hmo) doctors who also work in hospitals tend to
refer patients to their own departments whereas most of our
doctors don't work for the kupot cholim."
Professor Yitzchok Versano is chief advisor to the Pediatrics
Department in Maayanei Hayeshua and was, until recently, the
department head. In the past he was Head of Pediatrics in the
Sharon and Beilinson hospitals and presently works also at
the Schneider Children's Medical Center. He says, "From a
medical standpoint the Pediatrics Department at Maayanei
Hayeshua is of the same standard as any respected Pediatrics
Department in the country. We consult with Schneider
Children's Hospital and use their services, for example, for
sub-specialties which are not available at Maayanei Hayeshua.
These facilities are accessible to us exactly as they are to
any other department at Schneider and sometimes we get them
even more quickly.
"The great advantage our department has is that all our
doctors are specialists; most are Schneider graduates. It
means that a child who is admitted to our department, even at
night or on Shabbos or yom tov, will be greeted and
treated by a specialist. The nursing staff is also extremely
professional, devoted and motivated."
The Pediatrics Department, expertly headed by Dr. Channah
Ofir, provides somewhere to turn for all the varied childhood
diseases and problems, with the close cooperation of
Schneider. There is an even greater necessity of being in an
environment which is compatible with someone's way of life
and Torah education for a child, along with the relief of
being geographically close to home and the family.
"I am willing to tell you this, and take full responsibility.
A child receives medical care here which is just as good as
in any other respected hospital. It is without a doubt that a
community hospital like Maayanei Hayeshua has an enormous
advantage in that it enables a chareidi family to be in an
environment suitable to their way of life, close to home and,
as has been mentioned, with a much faster and readily
available service."
The Small Hospital Has the Advantage
Professor Avrohom Weinberger, the Head of the Department of
Internal Medicine at Maayanei Hayeshua and Head of the
Department of Internal Medicine B in Beilinson is well aware
of the shortage of beds in hospitals in Israel. He points out
the great advantage afforded by a small hospital.
"Without a doubt overcrowding reduces the quality of patient
care. Therefore my opinion, based on the facts, is that the
patient would receive more considerate treatment than in a
large hospital where patients are sometimes forced to sleep
in the corridors and be discharged too early!"
"The Department of Internal Medicine at Maayanei Hayeshua,"
adds Professor Weinberger, "offers the entire range of
services needed to treat internal illnesses, with an emphasis
on treatment of the elderly.
"Since we don't have the same facilities as larger hospitals,
if advice or treatment which we can't provide is required, we
receive the services we need from large hospitals with which
we have agreements. What is distinctive about Maayanei
Hayeshua is its subordination to the vaad halocho and
the atmosphere which is suitable for a Torah- observant
patient, which certainly add to his positive feelings and
health."
Cardiac catheterization and bypass operations are not yet
performed at Maayanei Hayeshua. However the modern,
specialized Heart Center which recently opened allows the
Medical Center to provide services which could only be found
elsewhere in the past.
Professor Tzvi Schlesinger, the head of the Heart Center at
Maayanei Hayeshua, who served in the past as head of the
Heart Center at Asaf Harofe Hospital and president of the
Israel Heart Society, explains: "At the Heart Center we have
all the latest equipment together with experienced
technicians and staff. We perform echo-Doppler assessments
and soon we will begin to do Echocardiography Stress Tests,
Stress Tests and Halter monitoring of heart rate and blood
pressure. I believe that the personal attention given and the
special religious atmosphere bring many people to prefer
Maayanei Hayeshua."
According to Professor Ravid, a patient who has is suspected
of having had a heart attack or other heart problem can come
to Maayanei Hayeshua to get a diagnosis and treatment. If
someone needs a cardiac catheterization they will immediately
be transferred to a hospital with a catheterization unit.
"International studies show that the survival rates for
patients who came to a hospital with no catheterization unit
are identical, since the transferal time is negligible. In
fact, it is an open secret that a patient arriving at a
cardiac catheterization unit from Maayanei Hayeshua will be
treated just as quickly as one arriving there from another
ward in the same hospital."
Almost Everything Which We Shouldn't Need,
Be'ezras Hashem
The lack of knowledge in the chareidi community about the
wide range of services provided by Maayanei Hayeshua, may
have been due to the lack of reliable information as to when
one shouldn't head for Maayanei Hayeshua. It was Dr.
Rothschild who said after the opening of the Pediatrics Ward,
"We know exactly what we are capable of and what not. We can
treat the majority of patients and if we can't we transfer
them to Schneider. Here no one is ashamed to say that they
know more somewhere else."
G. slipped, badly bruising his foot which swelled up
dreadfully. Does Maayanei Hayeshua have anything to offer? E.
was rushed to hospital by ambulance in serious condition with
symptoms of a heart attack. The Mobile Intensive Care Unit
refused to take him to Maayanei Hayeshua. M. who suffered
from a gallstone was surprised to hear from the medical
askan with whom he consulted that the preferred expert
was close at hand in Maayanei Hayeshua.
We asked Professor Ravid to give us guidelines about this.
"First, we don't yet deal with trauma and we don't have an
Orthopedic Department. Someone injured in a major accident
should turn to the Emergency Room in a big hospital. If the
problem is a minor injury or a suspected broken bone we can
do an X-ray and diagnosis and treat simple cases.
"On the other hand with regard to sick children, internal
illnesses, intensive care and cardiac intensive care, heart-
lung problems such as heart failure or irregular heartbeat,
geriatrics and, of course, gynecology — don't hesitate!
General surgery, including various operations (gall bladder,
hemorrhoids, the large intestine, and appendix) has a
tremendous advantage at our hospital — the surgeon is
an expert, there are no waiting lists, there is an excellent
anesthetist and we use only the very best and up-to-date
equipment."
And here are some more of Maayanei Hayeshua's plans for the
near future. Immediately after yom tov a full
neurological service is due to open. A dialysis unit is set
to be opened within a year. Within a year or two there will
be an oncology department, expansion of surgery and other
fields. The number of delivery rooms will double and a
neonatal intensive care unit will be built.
To return to our original point, we pray that we won't need
any of these services except for the Maternity Unit . . .
When we say that a hospital keeps halocho, we usually mean
Shabbos, kashrus, tznius and the like. Maayanei
Hayeshua is much more than that says Rav Hoffner, hospital
rabbi. What is unique is that even the smallest things are
done according to halocho, and the entire staff is
subject to the Vaad Hahalochoh.
Rav Hoffner notes that Maayanei Hayeshua has become the world
center for questions concerning halocho and medicine.
Topics include the treatment of terminally ill and dying
patients, Shabbos and medicine, gynecology and others.
Dr. Menachem Breyer, the deputy medical director who is known
for his public battles against euthanasia of the terminally
ill, adds: "Maayanei Hayeshua is the only place where so much
value is put into the kedushoh of life. Not one week
goes by without such a case; for example, a hospital refusing
to resuscitate a terminally-ill patient or to "waste"
expensive treatments on the elderly."
Families who find themselves in fierce battles over the right
of an elderly family member to receive appropriate treatment,
soon discover where to turn. "Old people leave other
hospitals and are admitted here. Both because of the way we
value the kedushoh of life and also because of the way
we act towards the elderly. This attitude also manifests
itself in the way we treat babies with deformities and birth
disorders.
"Sometimes the halocho decides that not doing anything
actively is preferential, even if the doctor thinks
otherwise. Each case is decided individually by poskei
halocho and the facts with which we provide them. This is
the greatness of Maayanei Hayeshua."
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