Israel’s North Star: A Small Medical Center Making a Big Difference

Israel is a small country that receives a disproportionate amount of news coverage.  However, it’s often the stories about places you don’t hear about that showcase the authentic Israel, along with its challenges and promise.   Often these places are not necessarily in the country’s center but rather in its periphery, the part of Israel that is in most need of attention.  Behind the headlines of conflict and crisis, they quietly represent the secret success of Israel.

One such institution is the Tzafon Medical Center, located near Tiberias. TMC is a small hospital that will double its size in the next few years and serves diverse segments of the population in Northern Israel from the Galilee to the Golan Heights and the Jordan Velley.  As the largest employer in the region, it has become a robust hospital with a range of services providing quality health care to 300,000 residents of Israel’s North.

The story of TMC’s ongoing growth and development is a quintessential Israel story, with implications for humanity as a whole. It’s a story of bridging gaps of inequality in health care delivery, of entrepreneurial innovation in the service of social justice, and of the vastly underreported story of multiculturalism and co-existence in Israel.

Let’s start with the issue of equal access to health care.   Israel has what is referred to as the “center” and the “periphery” –geographic distinctions, with socio-economic implications. The vast majority of Israelis live in the center, i.e., the Tel Aviv area, considered most desirable area with the greatest number of economic opportunities.  Generally speaking, the residents of northern and southern Israel live in the periphery and are disadvantaged.  This has certainly been the case with respect to health care, and it is the number one challenge of TMC.  The good news is that they are tackling it with energy, idealism and innovation.

In addition, it’s important to understand the hospital’s ethnic diversity.   Staff and patients alike represent a mosaic of Israelis:  Christian and Muslim Arabs, Bedouin, Druze, Circassians, Ashkenazi and Mizrachi Jews.   No one is turned away for treatment at TMC.

Even during times of upheaval between Arabs and Jews, as occurred during the riots of May 2021, when stones were being thrown and fires set all over Israel, relations at the hospital between Arabs and Jews were unaffected.  Dr. Dalit Porat, Head of the Oral Medicine Unit, sent a message to her staff urging them not be influenced by external events since “we are family. Although the country was on fire, my unit kept working in such an authentic way.  I was proud to be a part of it.”  Dr. Porat herself is a great example of the Israeli story:  on her mother’s side, she is 6^th generation from Tiberias, and on her father’s side, the daughter of a Hungarian Holocaust survivor.  She is staunchly loyal to her roots in the Tiberias region and dedicated to serving her community.

Like Dr. Porat, many of the physicians have trained in the larger more prestigious hospitals in Israel:  Sheba-Tel Hashomer, Ichilov and Rambam are a few that come to mind.  They could easily have remained at those more established institutions and had a very nice life.  Instead, they chose to work at TMC.  Why?  Many are originally from the region and are committed to giving back and building a strong medical center to answer the needs of the underserved communities of the North.   In the words of Professor Avi Peretz, Head of the Innovation and Research Division,  “I know some of our employees who have received exceptional offers to work elsewhere, yet chose to remain here out of their strong sense of Zionism and commitment to serving the community.”

Everyone I spoke to about the hospital stressed its “family atmosphere.” The locals think of it as “our hospital.”  Dr. Porat told me that one of her elderly patients had been her kindergarten teacher whom she referred to as “Haganenet Rachel” (the kindergarten teacher Rachel).  Because she was a frequent patient, even staff from all sectors referred to her this intimate way.

But the hospital is not just a warm, homey place.  Cutting edge developments are happening there.  As part of a collaboration with the Azrieli Faculty of Medicine of Bar Ilan University, TMC houses a nationally acclaimed Innovation and Research Division developing bio-medical research in the Galilee. According to its director Professor Peretz: “Studies have shown that medical centers actively engaged in innovation and research tend to offer better medical services and have higher quality medical teams.”

Indeed, innovation also happens organically.  Dr. Porat was haunted by the death of one of her patients due to a delay in his treatment of oral cancer.  The loss impelled her to create an app to detect oral cancer at an early stage.  This innovation may prove to be lifesaving for future patients.  Another example of an innovative center of excellence  is provided by surgical experts who have started performing minimally invasive belly lymph nodes  transplantation: super-microsurgical procedures using a designated advanced microscope for the first time in the entire country and the Middle East—a specialty still unique to TMC.

Israel has been rightly labelled “Start-Up Nation.”  Israeli entrepreneurship is so often employed to make the world a better, and in this case, a healthier place.  Medical research and innovation are often driven by practitioners in the field who encounter real world problems and seek solutions that will benefit not just the residents of northern Israel, but hopefully all of humankind.

There’s another aspect of working in a small but growing hospital that provides great satisfaction to physicians. Since it is a work in progress, new protocols are constantly being created.    Dr. Nizar Horani, who heads the Stroke and Neurology Department, recently developed a new life-saving protocol that applies to victims of   “wake-up stroke” He also takes pride in his development of three new clinics to offer preventative care and follow-up to victims of stroke, Parkinson’s disease and general neurology.  While Dr. Horani did his residency for many years at a larger hospital, he appreciates the latitude he now has to build a department with better approaches to patient care.  In contrast to a large busy hospital, at TMC he finds he actually has more time for research.

Dr. Horani’s background could not be more different from that of Dr. Porat.  He hails from the small Arab village of Deir Hanna with a population of 30 % Christians and 70% Muslims.  Yet, like Dr. Porat, he has chosen to give back to his home community despite more lucrative opportunities elsewhere in Israel.  They share the same idealism and make up the rich mosaic of the hospital.

Perhaps the most exciting new development at TMC is its Rehabilitation Center.  Currently there are only three such facilities in all of Israel, all located in the central part of the country. Residents of the North have been forced until now to forgo high quality treatment due to lack of accessibility. With plans to open in 2024, this will change the landscape of care dramatically.

Health disparities are not unique to Israel—they are a critical issue here at home as well.  A recent study commissioned by the Blue Cross Blue Shield of Massachusetts Foundation found that communities of color are the most heavily impacted by health inequities.  In addition, the vast majority of rural communities in the U.S. likewise lack access to quality health care.  Both America and Israel share common challenges in this regard.   There’s no doubt we could learn a lot from each other.

There is a dedicated nursing assistant at TMC named Zina Swud, a Bedouin woman raised in Eilabun, a small Arab village in the Lower Galilee.  Her family were innocent victims of war by Israeli troops in 1948.  She believes in the maxim: “Remember but forgive.”  Zina’s brothers all served in the Israel Defense Forces  and one of them fell in the line of duty.  Zina and so many others like her remind us that there is still great promise for a bright future in Israel.  Unfortunately, the media does not highlight these rays of light, but they are there and call out to be nurtured and amplified.

The title of this article is “Israel’s North Star.”  Many cultures throughout history have looked to the North Star as a symbol of hope and direction.  Tzafon Medical Center—the “little engine that could”—serves as a symbol of optimism in our small but highly scrutinized Jewish homeland that remains a work in progress after 75 years.  There are unsung heroes and heroines in Israel’s periphery performing acts of Tikkun Olam every day if we just bother to look.  And they are an inspiration.

For more information about TMZ go to https://www.youtube.com/watch?v=a8pOsSL_0y8

For more information about the new Helmsley Rehabilitation Center go to https://fb.watch/laDGL57CNt/?mibextid=lYQMGx