Israeli doctors perform life-saving heart
surgery on 4-year-old Syrian refugee from war-torn Homs • As the boy
recovers, his father says: "The man we thought loved us is trying to
kill us and the supposed enemy saves my son's life. I could live here."
Hamoudi with his father and
Dr. Dudi Mishali at Sheba Medical Center, Tel Hashomer
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Photo credit: Liron Almog  |
Four-year-old Mahmoud, or Hamoudi (cute one),
as he is nicknamed, has begun to fit in well in the hallways of the
Pediatric Cardiology Unit at Sheba Medical Center, Tel Hashomer. Wearing
a track suit from an Israeli company, he jumps energetically on the
gymboree and runs up and down the corridor, sometimes stopping for a
snack of apple chips. Children from Petach Tikva, Jerusalem and other
places play with him, though without words, only with the natural
dynamic of children.
None of the children or their parents knows
that Hamoudi, who is busy jumping on the colorful cushions, is a Syrian
refugee. These youngsters were never supposed to meet, but the world has
its own ways of making children laugh together in unexpected places.
Hamoudi's father, barely 30, looks at his son
with a shy smile. If somebody had told him four years ago that Israeli
doctors, of all people, would save the life of his son, who was born
with a rare, life-threatening heart defect, he would not have believed
it.
Hamoudi's father remembers the moment he was
in his small shop in the Syrian city of Homs when the first rumors of
armed conflict between Assad's opponents arrived. At first the rumors
seemed distant and unimportant. He was busy taking care of Hamoudi,
whose right and left ventricles were reversed.
When the British cardiologist in the clinic in
Damascus examined Hamoudi during the first weeks of his life, he said
that not even heart surgery would give him more than a few years of
life. Then his family, who refused to believe that Hamoudi was living on
borrowed time, found themselves dealing with a far graver problem: The
fighting reached Homs, and their city was under artillery fire.
Many of Hamoudi's relatives were killed during
the first weeks of fighting in Homs. The family home was damaged by a
direct hit from a shell fired by Assad's army. In the ensuing chaos,
fear and panic, the family decided to do what tens of thousands of other
Syrians were doing, and fled to one of the borders -- with Jordan,
Lebanon, Turkey or Iraq. When Hamoudi's father and mother crossed the
border (to protect the family's identity, we are not mentioning which
one it was), they settled in a refugee camp, where their situation grew
worse still. The locals regarded them with suspicion, and survival was
impossible. A refugee family receives a grant of $150 per month, which
is not enough for four people (by this time, Hamoudi had a younger
sibling).
But even in the impossible conditions of the
refugee camp, the family kept dreaming about a better future for
Hamoudi. Rumors came from the refugee camps throughout the Middle East,
particularly about what was happening on Israel's Syrian border, on the
Golan Heights, where many people who had been wounded in the fighting
were being given medical treatment in Israel. For the first time,
Hamoudi's family had the option of seeking help from the country they
had been taught to hate and fear most of all.
Hamoudi's father says, "We always heard in the
Arab media how children from the Gaza Strip and the West Bank were
receiving medical treatment in Israel. When the stories began to come
from Syria, I believed with all my heart that Mahmoud would also go for
treatment there. I knew that was what was supposed to happen." But with
the way things were in the refugee camp, a journey to Israel would be
possible only with the right combination of luck and good will.
The good will was provided by a Christian
organization called Shevet Achim, which works from Jerusalem and employs
volunteers from all over the world. When periodic medical examinations
at the refugee camp showed beyond all doubt that Hamoudi's life was in
danger, Shevet Achim's coordinator, Jonathan Miles, made arrangements
for him to undergo surgery in Israel.
It was late in the previous coalition's term,
and the former interior minister, Eli Yishai, unenthusiastic over what
could be a precedent-setting idea, asked for financial guarantees. But
time passed, and about two weeks ago, with fairly good cooperation
between Shevet Achim and the Israeli Interior Ministry, the proper
permits arrived, signed by Interior Minister Gideon Sa'ar.
With no passports or visa, Hamoudi was taken
to Israel for examination, treatment and rapid surgery at Sheba Medical
Center, Tel Hashomer. Dr. Dudi Mishali, director of pediatric cardiac
surgery at the hospital, and Dr. Shai Tejman-Yarden, who heads its
pediatric arrhythmia clinic, were updated on Hamoudi's condition before
he arrived.
"We had two options," Mishali said. "The first
was to go with an easier operation, which would have given him another
15 to 20 years of life. If he had been 60 years old, for example, that
would have been the best option, and we would have said we had done him a
great favor. But we felt that for a 4-year-old, that option would be
cruel and unfair to him and his family."
So Mishali and his team chose to perform the
most complicated surgery available for Hamoudi's condition. This option
was fraught with danger, an all-or-nothing proposition.
"The operation is called a double switch,"
says Dr. Mishali, "because we use a highly complex procedure to change
the direction of the ventricles and the arteries."
Before the operation, the doctors prepared
Hamoudi's father for all possible outcomes, including the worst. His
mother, who remained in the refugee camp with their younger son,
received updates by telephone. All they could do was pray. Hamoudi,
supported by Shevet Achim volunteers from Denmark and the United States
and by the hospital staff, did not understand why everyone was fussing
over him.
The eight-hour operation was a success. A
state-of-the-art pacemaker made by the Medtronic medical devices company
-- whose vision also includes working across borders -- was implanted
in Hamoudi's heart. The pacemaker contains a battery that will enable it
to last for many years, much longer than other pacemakers, since no one
knows when Hamoudi will next be able to receive thorough medical
treatment or regular follow-up.
'I would like to live here'
Mishali, the nurses and the entire staff of
the unit still get excited when they see Hamoudi running around and
smiling so soon after the operation. Hamoudi is more mature than most
children his age, perhaps because of the constraints of a wartime
childhood in a refugee camp and the tragedy that has befallen his
country.
Hamoudi was supposed to stay under observation
for two weeks in the intensive-care unit. But just two days afterward,
he amazed everyone by jumping out of bed, running among the hospital
units, gorging himself on sweets and asking for his mother.
"Now that the operation is over, he is a child like any other. His life expectancy is exactly like yours or mine," Mishali said.
Mishali wears the skullcap of a religiously
observant Jew and a plaid shirt beneath his scrubs. He is particularly
short of time this week, since he came back from performing 10 heart
operations on teenagers in Nigeria to a backlog of work at the hospital.
A volunteer wherever he is needed, Mishali
comes back to the unit at Tel Hashomer, where children not only from
Israel but from the entire Middle East await him. "These are the moments
in my work that give me the drive to get up for work every morning," he
says, smiling. "I see this as my mission."
The children in the Pediatric Cardiology Unit
have already seen every possible response: Some parents have knelt to
kiss the physicians' feet, others have broken into song and dance in the
hospital corridors, and still others have fallen weeping on the
surgeons' necks, refusing to let go. But Hamoudi's father holds back,
mostly from shyness and fear. He does not know Israel, and if he ever
thought he did, he is learning about it anew.
"Israel is a very good place," he says, first
making sure that we will not give his name or publish his photograph. "I
would like to live here. But I know it will be difficult. Nobody knows
when the war in Syria will end, and in the meantime we live in
uncertainty."
Every day he is here, he is surprised by the treatment he and his son receive.
"All our lives, we were taught to love one
person and hate another," he says. "Now the one we learned to love is
trying to kill us, and the one that is supposed to be my enemy has saved
my son's life. The people on the Syrian street do not hate Israel, and
I'm sure that is how the Israeli people feel about Syria."
Soccer in Jerusalem
Hamoudi's father speaks about the extremely
harsh conditions in the refugee camp. Shevet Achim's volunteers, who
visit the many refugee camps, say, "The world is looking away once more.
For the people of Syria, it is inconceivable that after so much time,
the whole world is not interested in what is happening there, and people
have already begun dealing with other things."
According to Hamoudi's father and the
volunteers, life in the camps is bleak. At first, the Jordanians and the
Lebanese opened their doors to Syria's war refugees, but now their
patience is wearing thin. On the one hand, there is the human desire to
help people whose homes were destroyed and whose families were murdered.
But on the other, the Arab countries fear the far-reaching economic
repercussions of taking in so many refugees.
Survival in the camps is very difficult,
Hamoudi's father says. Everybody is looking for jobs, and willing to
work in subpar conditions to provide for their families. The Syrian
families live in tiny apartments, for which they are asked to pay a
higher rent than the local population, and the fact that they have no
legal status that would allow them to work or plan for their future
makes their struggle harder still.
They also miss their country as it used to be, and the family members they left behind.
"This week, we saw photographs of the snow in
Homs on Facebook," Hamoudi's father says. "That was rare, but I do not
know whether we will ever go back, or what will happen to us in the
future."
Before leaving Syria, Hamoudi's father was a
devoted soccer fan, even taking Hamoudi to games played by the local
team, which often won championships. Hamoudi is already a discerning
soccer fan who, like his father, admires the well-known Portuguese
player Cristiano Ronaldo. The Shevet Achim volunteers say that on the
long evenings at the convalescent home in Jerusalem where they stay,
Hamoudi's father sometimes gathers the children for a game of soccer,
and the volunteers join in as well.
Who is your friend?
Hamoudi is the first Syrian refugee to have a
planned operation in Israel (others refugees have been treated for
war-related injuries). But of course, not every story like his has a
happy ending. Just this week, an Iraqi baby died after waiting 40 days
for a heart operation that was to have been performed in Israel. A delay
in the issue of his entry permits sealed his fate, and his heart
stopped 15 hours before he was to enter the operating room.
"Unfortunately, there are such cases. In an
attempt to find consolation, I tell myself that these are the slaps God
gives us to remind us, the doctors, that we are not God and we should
not get too far above ourselves," Mishali said.
He chooses to concentrate on the cases where
he succeeded in saving the child's life "without it making any
difference to us who he is or where he is from."
"There have already been situations where,
during one day of a military operation, we operated on a child from the
Gaza Strip, and the next day we operated on the son of a pilot from
Ramat Hasharon. That is when I think, as a doctor, that when I see this
father's tears of happiness or that one's, does it really matter to me
which is which?" he said.
"The happiness of a mother and father is
happiness in any language. It needs no translation. Our real mission is
here. There is no feeling like this one, that we saved the life of a
child, whoever he may be and wherever he may be from."
Even though Hamoudi's condition is good,
Shevet Achim's volunteers know of more work to be done. A Syrian
17-year-old needs urgent cardiac surgery, but the wheels of bureaucracy
turn slowly.
"This is the essence of 'You shall love your
neighbor as yourself,'" says coordinator Miles. "Together with the staff
of the Israeli hospital, we define who 'your neighbor' is, and our goal
is that everyone realize that people are people, certainly when it
comes to children. For the members of Shevet Achim, the answer is clear,
though for the State of Israel, it is more complex."
In the small physicians' room at Tel Hashomer
sits a surgeon in a skullcap, a group of devout Christians and a
bleary-eyed and battle-weary Muslim father. On the warm floor between
them sits a little boy, drawing with colored marker pens on stationery
with the Sheba Medical Center's letterhead at the top.
Before we part, I ask Hamoudi if he knows a bit of
Hebrew. The only Hebrew Hamoudi knows is "Shabbat shalom." His favorite
moment of the week, which he chose during the short time he has been in
Israel, is the Friday night service welcoming the Sabbath. In the
hospital, he murmurs the word "Shabbat" to himself, a shy blush rising
in his cheeks.
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