November 17, 2018

Head of Israeli hospital was crucial in aiding quake-ravaged Nepal

On April 25, just hours after the devastating 7.8-magnitude earthquake shook Nepal, Dr. Jonathan Halevy, longtime director general of Jerusalem’s prestigious Shaare Zedek Medical Center, received an urgent call from his deputy director general, Dr. Ofer Merin, a senior cardiothoracic surgeon. Merin, 54, was calling to request time off to organize, transport and lead an Israel Defense Forces (IDF) field hospital in Nepal, as he had done in Haiti after the 2010 quake, in Japan after the quake and tsunami of 2011, and in the Philippines after a devastating 2014 typhoon and flood. Halevy immediately granted Merin leave.  

Eight hours later, Merin phoned Halevy again.

Dr. Ofer Merin (left), who led the Israeli disaster-relief mission to Nepal and brought with him Dr. Jonathan Halevy, who heads the Shaare Zedek Medical Center in Jerusalem.

“At midnight, Ofer called me and said, ‘I’m missing a senior internist,’ ” Halevy told the Journal during a recent visit to L.A. “ ‘Though you’re 67,’ Ofer said to me, ‘and you’re my boss in civil life, are you ready to come?’ ” Halevy — a respected doctor and administrator with 15 grandchildren “and a 16th on the way” — knew that he’d face grueling conditions in Nepal, including the constant risk of aftershocks and tropical diseases, working long hours with few resources and performing difficult operations alongside young army recruits, all while living out of a tent. 

Halevy woke his wife after the call. “I told her, ‘They want me to go to Nepal.’ She said, ‘You shouldn’t miss it.’ ” So seven hours later, early in the morning, Halevy was in Ramle, near Ben-Gurion Airport. He and the other 143 members of the mission were given immunizations and paperwork to fill out. And, because the field hospital is under the aegis of the IDF, they were handed military uniforms.

“I hadn’t worn a uniform in 25 years,” Halevy said, but he donned one with pride and humility, reversing roles with his deputy. “I’m a major. Ofer is a lieutenant colonel, so I was under his command.” Forty-eight hours after the quake, the medical team was in the air. It was a very informal flight,” Halevy said. “The door to the cockpit was open. It took 10 hours instead of seven, because we could not fly over Iran.”

Despite the expertise of the Israeli pilots flying the jumbo jet — carrying all of the team plus 95 tons of equipment — they were concerned. They’d never before landed in Katmandu, the capital of Nepal, and the runway there is notoriously short and surrounded by mountains. Moreover, they didn’t know yet whether the quake had damaged the runway. For an hour, the plane circled above New Delhi, an hour from Nepal, while an advance group checked out the conditions on the ground, then gave the go-ahead to land.

Once in Katmandu, every Israeli had to pitch in to set up the hospital that would save many lives over the next two weeks. 

“We had no Nepalese soldiers or anybody else to help us, so we all unloaded, and there was no exception, even a major, age 67,” said Halevy, pointing to himself. “There was a lot of camaraderie.”

There was also no time to pause before the disaster-relief work began. “In the back of the [earthquake-damaged] Nepalese hospital,” Halevy said, “150 people were waiting for corrective surgery. They had fractures of the limbs, so we took them immediately.”

Because so many of those injured were in mountain villages, the Israelis sent medical outreach groups to treat people where they lived, and, when necessary, bring complicated cases back to Katmandu.

Some found their own way from the villages to the Israeli field hospital. 

This temporary hospital brought by the Israel Defense Forces to Nepal allowed Israelis to treat 1,600 people in the quake-damaged country.

“Look at this couple,” Halevy said, pointing to a photo of a middle-aged couple dressed in traditional Himalayan garb. “She was with a fracture of the ribs and walked for 10 days to come to us, [though] her fractured ribs had injured her lungs. You can see the drain we put in. Within 24 hours, her lungs inflated again and she went back to her village.”

Another photo showed a baby. “This 9-month-old had crush injury,” Halevy said, “with kidney damage. We did not have a dialysis machine there, so we improvised, lavaging his belly,” a pre-dialysis method of irrigating and cleaning the kidney. “There was plenty of room for improvisation there.”

Among the 17 countries that sent teams to help in the immediate aftermath of the quake, the Israelis by far outnumbered all others; the next largest, Taiwan, had a team of 37. The U.S. sent a group of 15, and most countries sent teams numbering fewer than 10. Saying he’d always been a proud Zionist, Halevy stressed that he came back feeling even more so. He was filled with stories of both heroism and compassion.

A group of medical clowns — doctors and nurses with balloons, baggy clothes and bulbous red noses — entertained the Nepalese children while treating them. The men and women from the IDF and from hospitals throughout Israel (10 members of the medical team were from Shaare Zedek) delivered eight babies, treated 1,600 people and performed 130 surgeries on patients with life-threatening conditions. Helping them were Nepalese who’d previously lived and worked in Israel, some of them volunteering as Nepalese/Hebrew interpreters. One Nepalese woman, who’d once been a caregiver in Israel, connected with an Israeli nurse whose grandmother she’d cared for at an Israeli retirement home. After an emotional reunion, the two women developed a close friendship. 

As an internist and leading hospital administrator with more than 40 years of practice, Halevy knew more or less what to expect. 

“During an earthquake, people are buried under rubble, so you see crush injuries with special characteristics,” Halevy said. Muscles, compressed by fallen debris, stop functioning normally, which can cause kidney injuries. “It’s called crush syndrome. Another thing is that people develop severe infections and have nowhere to go, because the hospitals are damaged by the quake. That was the situation in Nepal. So our field hospital was both surgical and medical.” 

There were situations, however, that Halevy did not anticipate.

“One patient came to our emergency room complaining of a half-paralyzed body,” Halevy said. “We did not have an MRI with us. So we referred him to the [Nepalese] hospital, and he came back to us, and he had worms in his brain. I had never seen such a case. These are tropical diseases.” Although the problem was not earthquake-related, the Israelis took him on and successfully treated him with medications. “We had professor Eli Schwartz, who is the Israeli expert on tropical medicine — 10 years earlier, he’d spent two years in Kathmandu on fellowship. He was in my department and gave us a lecture on this disease.” 

After two weeks in Nepal, the Israeli mission flew home. But more will be remembered than just what they accomplished there: They left behind all the medical equipment they’d brought from Israel as a gift to the Nepalese.