Twilight Zone / A Doctor Without Borders
May 25, 2006
H a a r e t z . c o m
By Gideon Levy
This is a story about a resident of the Shoafat refugee camp who holds a blue Israeli ID card and has been a Bezeq employee for the past 20 years. He suffered a heart attack and waited more than an hour and a half from the moment he lost consciousness at home until he was brought to the emergency room of Hadassah Hospital on Mt. Scopus, a five-minute drive from his home. The refugee camp, with a population of 40,000, does not have a single ambulance. This is also a story about a Magen David Adom (MDA) team that decided to act with courage and dedication, in defiance of procedure, in an attempt to save the man's life.
What happened during the critical period, from the time the patient fainted at his home until he was declared dead at the hospital? Two MDA ambulances, first an ordinary ambulance and later an intensive care unit as well, arrived within minutes after being called, at the checkpoint that places the Shoafat refugee camp under siege. About another hour went by until the Israel Defense Forces escort arrived. Without such an escort, the ambulance is not permitted to enter this refugee camp, which is a Jerusalem suburb for all intents and purposes.
The intensive care team, headed by Dr. Aviv Tuttnauer, together with paramedic Ihab Elian, did not agree to wait, but decided to exercise their own judgment. After several minutes they entered the camp with their equipment in a private car, contrary to procedure, without an escort and without the ambulance, to try to resuscitate the patient, who was hovering between life and death in the Clalit HMO clinic where he had been taken. They didn't work "by the book," but by the Hippocratic Oath.
Could the patient, Omar Abu Kamel, 42 and a father of seven, who died in the end, have been saved if there had been an intensive care ambulance station in the camp - as there is in almost every kibbutz and in all the settlements? No one can give a definite answer to that question.
On Friday two weeks ago, telephone technician Omar Abu Kamel was not on duty at Bezeq; he remained in the camp. There were morning prayers at the mosque, quality time with the children, and talking with friends at the entrance to the local electrical appliances shop. Toward evening he made his way home, ate supper, spoke on the telephone to his mother in Bethlehem, his home town, and went to take a rest. A quarter of an hour later, his daughter Areej entered the room and noticed that something bad had happened to her father. It was about 6:30 P.M. She called her mother, Nasarin, and the two hurried to pour water on the face of Omar, who was already unconscious. Several relatives were called to the house, and they carried Omar to their car to take him to the medical clinic several hundred meters from the house. They didn't phone MDA because, they say, they preferred to have the doctor see him first, and let him explain the gravity of the situation - believing that the ambulance would thus be sent faster.
At 7:15 they arrived at the clinic. The doctor telephoned MDA at 7:20 and explained, in English, the seriousness of the patient's condition. At 7:21 the MDA ambulance was on its way. The director of the MDA Jerusalem district, Ronen Bashari, reads from the log: The first ambulance arrives at the checkpoint at 7:25; at 7:33 the intensive care unit arrives at the checkpoint as well. The Border Police refuse to allow the ambulance to pass without an escort. According to a new procedure, the escort must be provided by the IDF rather than the Border Police. At the checkpoint, the worried relatives are already waiting, and try to convince the police to allow the ambulance to enter; they are refused. They offer to take responsibility for traveling with the ambulance and escort it in their cars, but to no avail. That's the procedure. The officer, Igor: "We can't let in an ambulance without an escort."
After about 15 minutes, according to the relatives, or after seven minutes according to Bashari and his ambulance team, the MDA people decide to leave the ambulance at the checkpoint, take the necessary resuscitation equipment and drive to the clinic in a private car. This is contrary to procedure, but the Border Police don't prevent entry. From their point of view, there is nothing barring Israelis from entering the camp, located within the jurisdiction of the State of Israel - unless they are in an ambulance. "Situation upon arrival at the incident: critical," according to the MDA log.
In the clinic, the MDA team begins its attempts at resuscitation, including electric shocks. The driver, Ribhi Ibrahim, 22 years in MDA, remains at the checkpoint to guard the ambulance.
The resuscitation attempts last for about 45 minutes. The MDA ambulance does not arrive. The IDF escort does not arrive. At 7:50 they call the Shalom Clinic in the neighborhood of Shoafat, which is near the camp. This clinic of the Leumit HMO has an ambulance, and they call it. Arrival at destination, according to the Shalom Clinic log: 8 P.M.
Dr. Tuttnauer describes the events: "We left the station at top speed and arrived at the checkpoint without any mishaps. At the checkpoint we didn't meet an escort as required, but we had a sense of urgency, and after a few minutes we decided to enter in a private car that was available. We entered and began to work. MDA on-duty personnel from East Jerusalem arrived there as well. We had the feeling that we were incapable of handling the incident in the field, and we decided to get to a hospital.
"At that point the ambulance of the Shalom Clinic was waiting. We are really grateful to whoever decided to call it, and we went down with the patient. [People in] the street were watchful, but not hostile. We left very quickly. The problem was to get through the traffic. There was a small gathering in the market place, but the residents left it immediately, and at the checkpoint there was also a line of cars. We used the horn, and after a delay of a minute or two we passed the checkpoint. Between seven and eleven minutes from one end to the other, from the moment we left the clinic until we arrived at the Hadassah University Hospital on Mt. Scopus, where we pronounced the death."
The response of the IDF Spokesman: "In the wake of a number of incidents in which Israeli vehicles were attacked in the area of the Shoafat refugee camp near Ramallah, it was decided that MDA ambulances would not be permitted to enter the camp area without an IDF security escort. That same Friday, May 12, when the report about the patient was received, two army vehicles were called in from the nearest sector, in order to escort the ambulance.
"While driving in the area of the camp, the ambulance and the military vehicles were attacked by an angry crowd, in a manner that seriously endangered the occupants of the vehicles. Because of the serious violence, the danger to the lives of the soldiers and the medical team, and the desire to avoid escalation that was liable to endanger Palestinian lives, the vehicles turned back without being able to offer assistance to the patient."
The reply of the IDF Spokesman is very surprising. Ramallah? This refugee camp is an inseparable part of united Jerusalem. The spokesman is trying to present a false situation, as though the ambulance had traveled inside the camp area, was attacked by an "angry crowd" in a manner "that seriously endangered the occupants of the vehicles." This never happened. The MDA ambulances did not cross the checkpoint at any stage.
As for the "danger to the lives of the soldiers and the medical team," as a result of "the serious violence," the MDA physician, Dr. Tuttnauer, testified that people were not hostile. The ambulance driver, who remained with his vehicle on the other side of the checkpoint, testified that although there was stone-throwing, the stones were not aimed at the ambulance and presented absolutely no danger to him.
The IDF Spokesman chose to ignore the one-hour delay in the arrival of the escort force at the checkpoint, the only real reason why the ambulance was prevented from entering the camp.
MDA director Bashari says that this incident "brought to the surface many problems that will now have to be solved." And in fact, the IDF Spokesman said, "The IDF is investigating the event, and is examining ways and alternatives that in future will make it possible to offer medical assistance to Palestinian residents, while at the same time minimizing the risks to all those involved." Shortly before press time, an IDF spokesman added that the head of Central Command, Major General Yair Naveh, had appointed an officer with the rank of colonel to investigate the incident.
In the hospital, Dr. Tuttnauer approached one of the relatives of the deceased and said to him: "We did everything we could, but God loved Omar and He took him." In the Shoafat camp they planned this week to send him and his team a thank-you letter. "They were the only ones who treated us like human beings," said a member of the camp committee, Khadar Dabas.
On Shabbat they buried their loved one near the Al Aqsa mosque, and the Border Police even allowed 70 relatives from Bethlehem to enter and participate in the funeral. That is also mentioned with appreciation in the camp, where nothing humane is self-evident. Tzvi Vitenberg, Bezeq's acting vice president for Jerusalem and the south, and Moti Cohen, chair of the district workers' union, sent letters of condolence, on stationery with the slogan: "Bezeq, in any future you choose."
H a a r e t z . c o m
By Gideon Levy
This is a story about a resident of the Shoafat refugee camp who holds a blue Israeli ID card and has been a Bezeq employee for the past 20 years. He suffered a heart attack and waited more than an hour and a half from the moment he lost consciousness at home until he was brought to the emergency room of Hadassah Hospital on Mt. Scopus, a five-minute drive from his home. The refugee camp, with a population of 40,000, does not have a single ambulance. This is also a story about a Magen David Adom (MDA) team that decided to act with courage and dedication, in defiance of procedure, in an attempt to save the man's life.
What happened during the critical period, from the time the patient fainted at his home until he was declared dead at the hospital? Two MDA ambulances, first an ordinary ambulance and later an intensive care unit as well, arrived within minutes after being called, at the checkpoint that places the Shoafat refugee camp under siege. About another hour went by until the Israel Defense Forces escort arrived. Without such an escort, the ambulance is not permitted to enter this refugee camp, which is a Jerusalem suburb for all intents and purposes.
The intensive care team, headed by Dr. Aviv Tuttnauer, together with paramedic Ihab Elian, did not agree to wait, but decided to exercise their own judgment. After several minutes they entered the camp with their equipment in a private car, contrary to procedure, without an escort and without the ambulance, to try to resuscitate the patient, who was hovering between life and death in the Clalit HMO clinic where he had been taken. They didn't work "by the book," but by the Hippocratic Oath.
Could the patient, Omar Abu Kamel, 42 and a father of seven, who died in the end, have been saved if there had been an intensive care ambulance station in the camp - as there is in almost every kibbutz and in all the settlements? No one can give a definite answer to that question.
On Friday two weeks ago, telephone technician Omar Abu Kamel was not on duty at Bezeq; he remained in the camp. There were morning prayers at the mosque, quality time with the children, and talking with friends at the entrance to the local electrical appliances shop. Toward evening he made his way home, ate supper, spoke on the telephone to his mother in Bethlehem, his home town, and went to take a rest. A quarter of an hour later, his daughter Areej entered the room and noticed that something bad had happened to her father. It was about 6:30 P.M. She called her mother, Nasarin, and the two hurried to pour water on the face of Omar, who was already unconscious. Several relatives were called to the house, and they carried Omar to their car to take him to the medical clinic several hundred meters from the house. They didn't phone MDA because, they say, they preferred to have the doctor see him first, and let him explain the gravity of the situation - believing that the ambulance would thus be sent faster.
At 7:15 they arrived at the clinic. The doctor telephoned MDA at 7:20 and explained, in English, the seriousness of the patient's condition. At 7:21 the MDA ambulance was on its way. The director of the MDA Jerusalem district, Ronen Bashari, reads from the log: The first ambulance arrives at the checkpoint at 7:25; at 7:33 the intensive care unit arrives at the checkpoint as well. The Border Police refuse to allow the ambulance to pass without an escort. According to a new procedure, the escort must be provided by the IDF rather than the Border Police. At the checkpoint, the worried relatives are already waiting, and try to convince the police to allow the ambulance to enter; they are refused. They offer to take responsibility for traveling with the ambulance and escort it in their cars, but to no avail. That's the procedure. The officer, Igor: "We can't let in an ambulance without an escort."
After about 15 minutes, according to the relatives, or after seven minutes according to Bashari and his ambulance team, the MDA people decide to leave the ambulance at the checkpoint, take the necessary resuscitation equipment and drive to the clinic in a private car. This is contrary to procedure, but the Border Police don't prevent entry. From their point of view, there is nothing barring Israelis from entering the camp, located within the jurisdiction of the State of Israel - unless they are in an ambulance. "Situation upon arrival at the incident: critical," according to the MDA log.
In the clinic, the MDA team begins its attempts at resuscitation, including electric shocks. The driver, Ribhi Ibrahim, 22 years in MDA, remains at the checkpoint to guard the ambulance.
The resuscitation attempts last for about 45 minutes. The MDA ambulance does not arrive. The IDF escort does not arrive. At 7:50 they call the Shalom Clinic in the neighborhood of Shoafat, which is near the camp. This clinic of the Leumit HMO has an ambulance, and they call it. Arrival at destination, according to the Shalom Clinic log: 8 P.M.
Dr. Tuttnauer describes the events: "We left the station at top speed and arrived at the checkpoint without any mishaps. At the checkpoint we didn't meet an escort as required, but we had a sense of urgency, and after a few minutes we decided to enter in a private car that was available. We entered and began to work. MDA on-duty personnel from East Jerusalem arrived there as well. We had the feeling that we were incapable of handling the incident in the field, and we decided to get to a hospital.
"At that point the ambulance of the Shalom Clinic was waiting. We are really grateful to whoever decided to call it, and we went down with the patient. [People in] the street were watchful, but not hostile. We left very quickly. The problem was to get through the traffic. There was a small gathering in the market place, but the residents left it immediately, and at the checkpoint there was also a line of cars. We used the horn, and after a delay of a minute or two we passed the checkpoint. Between seven and eleven minutes from one end to the other, from the moment we left the clinic until we arrived at the Hadassah University Hospital on Mt. Scopus, where we pronounced the death."
The response of the IDF Spokesman: "In the wake of a number of incidents in which Israeli vehicles were attacked in the area of the Shoafat refugee camp near Ramallah, it was decided that MDA ambulances would not be permitted to enter the camp area without an IDF security escort. That same Friday, May 12, when the report about the patient was received, two army vehicles were called in from the nearest sector, in order to escort the ambulance.
"While driving in the area of the camp, the ambulance and the military vehicles were attacked by an angry crowd, in a manner that seriously endangered the occupants of the vehicles. Because of the serious violence, the danger to the lives of the soldiers and the medical team, and the desire to avoid escalation that was liable to endanger Palestinian lives, the vehicles turned back without being able to offer assistance to the patient."
The reply of the IDF Spokesman is very surprising. Ramallah? This refugee camp is an inseparable part of united Jerusalem. The spokesman is trying to present a false situation, as though the ambulance had traveled inside the camp area, was attacked by an "angry crowd" in a manner "that seriously endangered the occupants of the vehicles." This never happened. The MDA ambulances did not cross the checkpoint at any stage.
As for the "danger to the lives of the soldiers and the medical team," as a result of "the serious violence," the MDA physician, Dr. Tuttnauer, testified that people were not hostile. The ambulance driver, who remained with his vehicle on the other side of the checkpoint, testified that although there was stone-throwing, the stones were not aimed at the ambulance and presented absolutely no danger to him.
The IDF Spokesman chose to ignore the one-hour delay in the arrival of the escort force at the checkpoint, the only real reason why the ambulance was prevented from entering the camp.
MDA director Bashari says that this incident "brought to the surface many problems that will now have to be solved." And in fact, the IDF Spokesman said, "The IDF is investigating the event, and is examining ways and alternatives that in future will make it possible to offer medical assistance to Palestinian residents, while at the same time minimizing the risks to all those involved." Shortly before press time, an IDF spokesman added that the head of Central Command, Major General Yair Naveh, had appointed an officer with the rank of colonel to investigate the incident.
In the hospital, Dr. Tuttnauer approached one of the relatives of the deceased and said to him: "We did everything we could, but God loved Omar and He took him." In the Shoafat camp they planned this week to send him and his team a thank-you letter. "They were the only ones who treated us like human beings," said a member of the camp committee, Khadar Dabas.
On Shabbat they buried their loved one near the Al Aqsa mosque, and the Border Police even allowed 70 relatives from Bethlehem to enter and participate in the funeral. That is also mentioned with appreciation in the camp, where nothing humane is self-evident. Tzvi Vitenberg, Bezeq's acting vice president for Jerusalem and the south, and Moti Cohen, chair of the district workers' union, sent letters of condolence, on stationery with the slogan: "Bezeq, in any future you choose."
posted by HRM Deborah of Israel and the Messenger of Peace at 8:25 PM
0 Comments:
Post a Comment
<< Home