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May 11, 2010

Israel’s Haitian Tent Hospital Boosts IDF Image

http://www.jewishjournal.com/community/article/israels_haitian_tent_hospital_boosts_idf_image_20100511

Dr. Ofer Merin in Haiti
Photo Joe Shalmoni (C) 2010, All Rights Reserved.

Dr. Ofer Merin in Haiti
Photo Joe Shalmoni (C) 2010, All Rights Reserved.

Within three days of the massive earthquake that struck Port-Au-Prince last Jan. 12, Dr. Ofer Merin and his 230-member crew comprised of army officers and medical personnel from major hospitals throughout Israel arrived in the battered Haitian city on an Israel Defense Forces (IDF) medical mission.

They brought with them 30 tons of cargo and within 24 hours had set up a highly sophisticated, fully equipped tent hospital capable of treating 60 patients at a time. The portable facility was staffed by 40 doctors, 25 nurses and numerous paramedics; it included a pharmacy, an intensive care unit, a radiology wing, a children’s ward and a maternity ward; and the Israelis brought a computerized registration system that allowed them to track each patient and his or her medical profile by simply scanning a barcode.

The world took notice of Israel’s problem-solving presence at the disaster — 6,000 miles and a 16-hour flight from Israel — commending the immediacy of the Israeli response and an almost unbelievable preparedness for such an emergency. Many countries around the world sent relief workers and physicians, but the Israelis were the first with state-of-the-art technology to create a fully functioning hospital.
Merin, a soft-spoken cardiac surgeon from Shaare Zedek hospital in Jerusalem, led the charge, and said that he was proud that for once, the world could see his country as he sees it — deeply empathetic and highly skilled.

“It was important for us that people understand that the same soldiers that are wearing these IDF uniforms seen in the Gaza Strip are the same people that are now assisting other people in need,” Merin said last week in an interview at the Beverly Wilshire Hotel. Merin was in Los Angeles to receive a Medal of Valor award from the Simon Wiesenthal Center’s Museum of Tolerance.

“There are no two faces of this army,” he insisted. “It’s one face.”

By chance, one month before Merin and his reservist team were dispatched to Haiti, they had been called out for a practice drill setting up a field hospital — Merin has served in the reserves as commander of the Israel field hospital for the past seven years. But despite this up-to-the-minute preparation for the technical side of administering emergency medical care, the Israelis found themselves facing an unimaginable demand on the ground: 300,000 wounded Haitians were seeking medical treatment.

“We were really overwhelmed by the numbers,” Merin said. “This is something that we did not expect. We did not know that the situation, a few days after the quake, would be that medical assistance was really scarce. There were no other big facilities to assist people, so the issue was that after a few hours the hospital was full. So, what are you going to do?”

Merin decided to squeeze more beds into the facility. And even then, even at absolute maximum capacity, the Israelis couldn’t come close to meeting the need. Merin and his crew — ranging from their early 30s to late 50s — soon found themselves in the unfathomable position of having to turn people away.

The psychological burden was hard to bear: “You have to stand there — and cars are coming in with four, five, 10 patients — and you have to make this unbearable decision, which one you think you should treat and which one you think unfortunately you’re not going to treat,” said Merin, who, as acting director of the hospital, oversaw the entire triage operation. “And I don’t want to speak about what it means that you’re not going to treat [someone], because mentally that was difficult even to think. What does it mean to say that I’m not accepting this patient for treatment?” 

Sometimes the language barrier between the Israelis and their Haitian patients was a blessing. Hearing their personal stories — how one man who had lost his wife and seven of his eight children brought his only surviving son for treatment — was too emotionally taxing. “It’s totally different to treat a kid when you know that all of his brothers and his mother died, and his father is standing there, begging you to save his life,” Merin said.

Emotional detachment was often the only way to be effective. Merin formed three-person ad hoc committees that met each night to share the burden of deliberating over complicated medical decisions — the premature infant who needed a ventilator, the elderly man with a severe head injury.

Merin recorded each challenging case in his journal, which he updated every few hours, five times a day. Each morning, Merin said, after an hour-long jog “to clean my brains,” he would gather his staff for a meeting to discuss the pressing issues of the day.

Those morning meetings soon evolved into pseudo-therapy sessions, in which the team would focus on coping strategies. “We were dealing with issues that have no textbook answer,” Merin said. With tragedy unraveling all around, it was crucial to have space to express their feelings. “None of us slept a lot,” he said.

The experience also had its rewards. For Merin, his moment of pride came while driving around Port-Au-Prince surveying the disaster, an Israeli flag flapping in the humid wind above his car. The Haitians lining the streets began clapping and waving at the sight of the Israeli flag. “People in Haiti had no idea what are Israelis, what are Jewish people [when we arrived], but after three days, they knew exactly what is Israel.”

Before they returned home, Merin told his staff they needed to prepare themselves for a radical psychological shift. “I was afraid that coming back to Israel, the usual problems we encounter every day would seem so small — that we would have a problem adapting back to our life.”

Indeed, Merin’s life has undoubtedly changed over the past four months. He has been asked by several medical publications, including the prestigious New England Journal of Medicine, to write about the ethical dilemmas he encountered in Haiti. He is also traveling frequently, lecturing about his experience and receiving numerous honors on behalf of Israel.

“It’s a crazy change in my life,” Merin said, sipping a frothy latte. “I was working as a physician, and now I’m going around the world with a tie, sleeping in fancy hotels.”

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