Dei'ah veDibur - Information & Insight

A Window into the Chareidi World

11 Tishrei 5767 - October 3, 2006 | Mordecai Plaut, director Published Weekly








Mayenei Hayeshua Hospital of Bnei Brak: Professionalism Next Door

by N. Katzin

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 . . .

Questions Concerning Halocho and Medicine

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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