Born into darkness

He has never laughed in his life. Not even once. He is almost a year old, he has never had a home. He is a veteran of many operations, his head is shrunken, scarred, elliptical; his black eyes dart back and forth. But she looks at him and smiles. Sarah Cohen, a volunteer with the nongovernmental organization First Hug (Hibuk Rishon), caresses the baby, speaking to him constantly, exploiting every moment. "I come twice a week for three hours, it's very little, because I'm the only one who does it for him," says Cohen apologetically.

She has been here since 11 A.M., on the third floor of the Schneider Children's Medical Center in Petah Tikvah. In no time it is already 3 P.M. and Cohen hugs him and strokes his head. "My emotions have grown a great deal," she says. "Today I can say that I love him. It's very easy for me to establish contact with him, just like with my own baby. Something very intimate. And that doesn't happen all at once; it takes time. It's easy for me to connect, but love is something that develops. Now it's an emotional bond and a sense of longing. It's terribly important to me to know at every moment what's happening with him. I think about him a lot. I imagine him grown up."

When Cohen isn't here, he lives an isolated life, forced to make do with the little time the busy medical staff is able to give him, usually only for tests and treatment. "There's almost no contact, they don't caress him and he needs contact as much as he needs air to breathe," Cohen explains. "I sing to him, kiss him - I do what a grandmother does, what a mother is supposed to do."

Colorful mobiles of birds and fish move slightly above her head. "The nurses here are wonderful, but they have lots of babies on the ward. They can't devote time to him. This is his first year of life and it is full of great suffering. There's a reason why he hasn't smiled even once, not even a smile that's a kind of reflex: He's in pain all the time."

At the very same time, Dvora Nesher is on the fourth floor of Schneider. She comes from Moshav Ein Vered in the Sharon, and is also a volunteer for First Hug. She is sitting on an armchair next to a smiling baby. This is her new charge, and this morning Nesher met her for the first time. She was in such a hurry to get here that she forgot to prepare sandwiches for her son, who is taking the matriculation exam in math today.

"Up until a week ago I took care of an abandoned baby who underwent two heart operations within three weeks," she says. "I met him on the day when he went in for the second operation." She picks up the baby and straightens out her clothes. "I remember that I came to take care of him, and within an hour it turned out that his condition was very serious and they brought him into the operating room. After the operation he was anaesthetized for an entire week. Someone decided to call him A., I preferred to use a pet name. I called him 'Pashosh' (warbler). I don't know why his mother abandoned him, I know that she gave him up even before giving birth to him."

The first baby Nesher took care of was completely healthy, she says. "His mother ran away from the hospital a few hours after the birth. But I'm not getting into that. Today this is a new encounter. This baby won me over the moment I saw her. I don't know how to explain how it happens, but she became part of my family immediately. That's how it is with me. From the moment I leave here, I won't stop talking about her."

Fluorescent lights

Without saying a single word, the two babies from Schneider open a door into another world. This is a world in which babies live under fluorescent lights, alone, as though born into a vacuum. According to the statistics of First Hug, almost every day parents abandon babies in one of Israel's hospitals.

The reasons for abandonment are varied: Usually it happens immediately after birth, when the baby is born with a defect or an illness. There are abandoned babies who were born from an unwanted pregnancy, to a mother who is a minor or a drug addict. Sometimes these are babies who stay alone in the hospital after being victims of abuse by their parents, who are under investigation or arrest. In many cases the babies are not abandoned, but their parents have financial problems and have other children, and find it difficult to visit or to spend a long period of time in the hospital with their baby.

In these many situations, the law distinguishes between a baby who is "abandoned" (natush) and one that is "isolated" (boded) although in effect there are no parents in the picture in either case. Paradoxically, "adoptable" babies, whose parents have signed papers relinquishing their parental rights, are not considered abandoned, but isolated. In terms of the law, abandoned babies are only those whose parents fled from the hospital immediately after the birth, or who abandoned their baby and whose identity is unknown. "But these legal terms simply don't interest us - the legal definition is less relevant, because the baby undergoes an experience of abandonment," says Dr. Tamar Shlezinger, the driving force behind First Hug.

The goal of the NGO, which was founded three years ago, is to reach all abandoned babies in the country and to provide volunteers who will fill their stay in the hospital with warmth. Today the organization has a reservoir of 2,500 volunteers from all over Israel, who have undergone a graphology test and interviews. Last year the NGO was already working with two-thirds of all hospitals (mainly with the Hadassah University Hospital in Jerusalem, Kaplan Hospital in Rehovot, Schneider and the Soroka Medical Center in Be'er Sheva), and took care of 60 abandoned babies. To ensure daily visits, each child is assigned to several volunteers, who work under the supervision of the organization's social worker.

"You have to understand," says Dr. Shlezinger, "that if the baby is healthy, it is quickly adopted. Our problem is with the babies who are in need of medical treatment; they are the ones who remain alone in the hospitals. In principle, the hospital assumes that there are parents around, which is why the hospital can provide for physical and medical needs, but not for the emotional needs of the babies. The nurses will feed and bathe the baby, but they don't have time to hug it, to sing to it - everything a mother does for her child. They rely on the fact that there is a mother and a father who will take care of the baby, and when there aren't any parents, then there's nobody to stand by the crib. That's how it is. Such a baby can live for months in terrible isolation."

The Welfare Ministry takes care of these babies only after their release from the hospital. As long as the baby is hospitalized, the ministry does not intervene. But on the other hand, the hospitals are not organized to provide care for isolated and abandoned babies. That is a problem that is repressed, almost silenced, to which everyone has become accustomed.

"If the Welfare Ministry were to take responsibility for the babies when they're in the hospital, it would provide a solution to this problem. But it doesn't," says Shlezinger carefully, not daring to raise her voice. "This is a situation that is hard to imagine - that during the first months of its life a baby lives without experiencing a hug, without contact. The moment the baby is released from the hospital, the Welfare Ministry will send it to rehabilitative hospitals, foster families or adoptive families. Until then, as hard as it is to believe, the baby is alone."

Can we understand what they experience?

Shlezinger: "These babies live in the present, they have no past because they don't remember, nor do they have a future, because they do not have the cognitive ability to say, 'In another month I'll be adopted and everything will be all right.' And in the present in which they live, everything is black. They cry, nobody approaches them, nobody looks at them. When I feed my baby I look at her, there's eye contact between us, that's very important for her emotional development. But when a nurse feeds a baby, she looks around the room, because she has to keep an eye on the other babies, too. That's a picture I can't get out of my head. The nurse is not to blame for anything, but abandoned babies learn that this is a bad world. They learn to expect bad things, pain. Lack of attention."

You are describing something that is mainly emotional rather than medical neglect.

"Yes, the neglect is emotional, but such neglect also leads to physical deterioration in infants. That is clear. Such a baby will simply be unable to develop. In research, the theory of attachment deals with the process of a baby's attachment to a parental figure during the first year of its life. The main point is that when there is a disruption in that process and the baby does not have even one person with whom to form an attachment, its development cannot be normal. Its cognitive and emotional development will be seriously delayed, and we can only hope that there won't be irreversible damage."

Have you come across such cases? "I saw a baby with Down Syndrome who had irreversible damage in her spine, because she was lying all day long without being picked up. Can you believe it? It was frightening."

Two meters away

This was all a revelation to her, too. Formerly a lecturer in social work at Tel Hai College, Tamar Shlezinger did not think that she would raise the banner on behalf of these babies. She recalls that it all began with a random conversation with a friend, another social worker, who told her that she was treating parents who had abandoned their baby in Ichilov Hospital in Tel Aviv. Shlezinger immediately wanted to run to the baby. That was the first time she was exposed to the phenomenon of abandoned babies; she had never imagined there was such a thing.

"I lived very near to Ichilov at the time and I simply wanted to be with him," she recalls. "I went for the first encounter with the baby with my husband. We were like parents going for a first sonogram for their baby. The thing I remember most is his size: He was twice as big as a newborn, already two months old. His crib was the only one in the room. All the other babies had been taken home by their parents. He didn't even have a name."

Thus it happened that in midlife, while raising her own three children and writing her doctoral dissertation, Shlezinger started to take care of the nameless baby. The entire family helped. "I came in the morning and my husband in the evening. All that time I didn't believe that it could even happen. We took care of him for a month. We saw before our eyes how he changed. He was a two-month-old with Down Syndrome, and immediately, after we had been with him for four days, he began to smile, to turn over. Before that he had no reason to make contact with the world, because the world didn't make contact with him. The Welfare Ministry didn't find a foster family for him, so we raised money from friends, we gave the money to the ministry and they published an ad in the newspapers, and that's how a family was found for him and he left the hospital."

Since then things couldn't be any different: Shlezinger continued to visit abandoned babies and took care of eight of them herself. "I definitely didn't know where it would lead, but I couldn't live with the knowledge that two meters from my house, at Ichilov, there were babies whom nobody loved," she says. "I knew that I could do it. I began to visit other abandoned babies who remained in Ichilov. Each time there was a baby in the hospital, I was there. It happened naturally. I visited one baby after another, and I certainly didn't think that there could ever be an NGO that could reach most of the hospitals in the country."

The turning point began with an Internet forum. "By chance, three years ago, I was reading on a breast-feeding forum and I happened to exchange a few words with Tamar about a breast-feeding pump," recalls Michal Koriat, the chair of First Hug and the owner of Transcom, service providers in the field of clinical research. "And that's not typical of me, because I don't write anything to anyone on these forums. Tamar directed me to a site that she had begun on the subject of abandoned babies. I read it and immediately knew I wanted to help her. There was a very strong connection between us. I don't believe in spiritual things, but I decided that this was my mission. We arranged to meet."

Below the NGO's offices on Yehezkel Street in Tel Aviv, in a cafe, Koriat explains between cigarettes that she understood that she was about to embark on something big. "And it's not that I was looking for volunteer work. Many people like me say, 'All right, I'm the CEO of a company, I also want to give something.' I must admit that I wasn't looking for that. While Tamar was talking I pictured what such an organization should be like, what difficulties it would face. Mainly I understood that the private initiative of several women would not provide a solution to such a complex problem. I knew that it had to be a strong organization, linked to the health-care system, which had the authority to provide the solution to the babies' needs. I asked her if she wanted to take her work another step forward. She was somewhat stunned. She didn't quite grasp what I meant."

'A caressing hand'

In the hospitals they quickly understood the great need for the support offered by the new NGO. "Little babies cannot be alone," agrees Dr. Yoram Ben Yehuda, the director of the Center for the Child at Risk at Hadassah University Hospital, Ein Kerem. "They don't need only food and sleep, they also need attention from human beings, a caressing hand, a loving person. Without these things, deprivation begins from a very young age."

The medical staff, he explains, does not have the time to solve this problem. "We have a ward with 25 infants and three nurses. Can one nurse deal with one child, functioning as his regular mother, and leave the other two nurses with the other 24 infants? The on-duty nurse has a lot of work; she can't devote herself to the individual baby. A nurse can devote an hour or two to such a baby - they make an effort, but the baby needs supervision all the time. A baby can't be without parents, even for a short time."

Hadassah in Ein Kerem has been using the services of First Hug for two years. "I wish I had a solution for every social problem that exists, and I wish the state would provide a solution for all the problems," says Ben Yehuda. "But there are no solutions. The number of work slots in the hospitals, especially for caregiving staff, is very small. And like everything in Israel, when there is no official solution, an NGO arises to provide the solution. This NGO is filling the vacuum. And it's not only that: These volunteers provide a genuine and sensitive, loving touch. In my opinion, this is a truly welcome organization, they do sacred work. They have filled a vacuum that existed for many years. There's a real need for their work."

Fed up donors

Dr. Ofra Aran is the director of social services at Schneider. "I feel that our job is to give the baby the optimal conditions for normal growth and development," she says. "That's why we developed a connection with First Hug. We need them. The First Hug volunteers are part of our staff; they've been active in Schneider for over two years. It's inconceivable that a newborn infant will not have parents at its side. It's our mission to make sure that there is someone at the infant's side. Of course in such situations all the nurses give the baby special treatment, but still, the staff has a lot of work to do, there are limitations, and the isolated baby need someone close by. The volunteers meet that need."

But even after three years of activity, it turns out that First Hug is having difficulty obtaining the institutional recognition that would lead to proper funding of its activities. Already a year and a half ago the NGO asked for assistance from the Health Ministry, the Welfare Ministry and the National Insurance Institute. Nothing has happened since then.

"In an item that was once published on the subject," recalls Koriat angrily, "a spokesman of the Welfare Ministry, Ido Nahum, even replied that there is no such thing as abandoned babies. It's absurd that we have to convince the government ministries that the phenomenon exists, as though we take care of virtual babies who don't really exist. I don't understand their reaction; on the one hand, they use our services, and on the other, they ignore us."

Ministry spokesman Nahum is sticking to his position. "Fortunately, the phenomenon of abandoned children is gradually shrinking, and reaches a maximum of about five children a year," he says in response. "From the moment a mother decides that she is abandoning her baby, the welfare system goes into action and takes responsibility for the child, so parents will be found as soon as possible, either in a foster family or through adoption. It's possible that a child has to stay in the hospital for a long time, and then there's a need for volunteers from the community to accompany it, but as I said, these are very small numbers (almost all the children defined as abandoned are healthy and spend a very short period of time in the hospital)."

Nahum assumes that the members of First Hug are referring to a different problem: "A more common problem, which may exist but is not familiar to us at the Welfare Ministry, is that of sick children who are in need of long-term hospitalization and whose parents cannot visit them enough in the hospital, for personal and family reasons. The social services department of the hospital is supposed to handle such cases. Since these departments are subordinate to the Health Ministry, we have no information on the number of these children and their needs."

The Health Ministry reaction to this article: "With a reduction in the phenomenon of abandonment, awareness has grown regarding babies who stay in the neonatal and pediatric units, whose parents do not remain with them continuously, for various reasons. In the vast majority of cases, the solution is found within the framework of the family. In the rest of the cases, the hospital can seek assistance from the First Hug charity or other charities, or from volunteers who work in the hospital. All of this is in addition to the effort made by all members of the staff, within their ability, to provide optimal care and the necessary stimulation."

The ministry reveals that it does not have "centralized data on the scope of the problem," but at the same time claims that "there are just a few cases per year." An official at one hospital says that they have about 10 abandoned babies per year, but these are only the hardest cases, who are hospitalized for lengthy periods. Babies who are left alone for a week or two, and who constitute a larger number of cases, are not considered part of the same phenomenon.

In addition to the attempt to reduce the problem, a Health Ministry spokesperson confirms that "in the past year, the ministry has been in contact with representatives of First Hug. The ministry welcomes the activity of the organization, which is unique in providing an answer in these cases, and will continue to cooperate with it in order to expand and advance the necessary care provided - even though the issue in question is not considered to be within the realm of support to which the ministry is obligated."

Meanwhile, Koriat and Shlezinger say they are having difficulty raising donations to ensure the ongoing activities of their organization. "It's discouraging, because I thought that by now we would already be past the issue of day-to-day funding," says Koriat. "I come from a private business, and the issue of raising contributions is foreign to me; there's something embarrassing about pleading for money. I speak to people with a lot of money and they click their tongues and tell me, 'Oy, that's terrible,' but in the end they don't open their wallets. Donors are apparently tired of giving money to a niche the government is supposed to fill. We are supported by donations that come from here and there, but there are long periods where there aren't any. Like now."

Just how much money does the organization need?

Koriat: "According to our calculations, it's $1,000 per baby. This amount covers all the care, including the direct cost of the support system (four full-time social workers and three volunteer coordinators) as well as the indirect costs (baby supplies, early childhood developmental consulting, office expenses and more). This is what we need in order to solve the problem of abandoned babies in Israel: $300,000 a year. That's not a lot to solve this horrific problem. But the reality is that the money isn't there. We are not increasing our activity because we can barely get by now with what we have. This whole vast system operates on just two social workers who work two-thirds of a full-time work week. Despite all my cynicism, I now think that I was a little naive. I thought it would be obvious to the institutions that the need here is desperate, that there was no way they wouldn't support us. But it was foolish to think that."

Memories from there

Nadia Landau has been there herself: She was an abandoned baby. A resident of Tel Aviv, Landau is the former director of resource development for the Batsheva Dance Company and a photographer for Maariv newspaper. She has been volunteering in First Hug for over three years.

"I was born in Romania, in Bucharest, to parents who were doctors," she says. "My biological mother died in childbirth and my father couldn't cope with the sorrow. He simply decided to put me into an orphanage. From the age of two days up to the age of a year I was in an orphanage. When my father remarried, his second wife saved me. She's the great light of my life, she took me out of there and raised me."

Do you have memories of that time?

"I don't have any memories of that period as an abandoned baby, but there's a pit, a black abyss that draws in love. My stepmother says that when she saw me I stretched my hands out to her. Years later I returned to that same orphanage and I saw this phenomenon of babies stretching out their hands with hair-raising neediness. As an abandoned baby I know that First Hug is crucial. The care that abandoned babies receive is mainly practical, no more than that, and it has a great influence on the formation of their identity."

Is volunteering to take care of the abandoned babies a type of compensation?

"I had a desire to give something back, this was my way of doing so. I must give something back. In the case of the first baby I took care of as a volunteer for the organization, I was simply drawn in. When I wasn't next to him I thought about him and worried about him. For three months, I was like 80,000 mothers for him. At first when I went home I would feel guilty, I would think to myself how I had abandoned him when I was in my house, in my nest, and he was alone.

"When he returned a smile for the first time it was a moment of happiness. He was three months old at the time, with Down Syndrome. I spoke to him all the time, the way I spoke to my baby. I took him for walks in the baby carriage and I sang to him and taught him how to turn over. I kept asking him to smile, I told him that a smile is what would save him in life. All normal babies are surrounded by a great deal of love and attention, and an isolated baby is isolated to the point of despair. I wrote letters to him, and I photographed him, and I put those things in his adoption file; we left our footprints there for him. I know exactly what these babies feel. I'm proof that abandonment comes with a high price, but even a hug is of tremendous significance."W