The Power of Giving / House of Healing

An Israeli soldier sits outside talking on his cell phone while an Arab boy rests in his wheelchair. A young mother with her newborn baby waits for a taxi and an elderly man is pulled along on a stretcher by paramedics. It's just another day in the life of Rambam Health Care Campus (RHCC ) in Haifa

Daniel Savery
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Daniel Savery

www.rambam.org.il

Known worldwide for its many scientific discoveries, RHCC is much more than a hospital. It is a unique center that houses learning and healing. Not only is it the main academic faculty of medicine and the largest medical center in the north of Israel, RHCC also serves the Northern Command of the IDF. Some 75,000 people are hospitalized at RHCC each year and it acts as a referral center for over two million citizens.

And Rambam is going to get even bigger. Outside the entrance to the campus, situated on the coast at Bat Galim, huge mechanical diggers are carving out the foundations for one of the most ambitious building projects in the country. Four new hospital buildings are planned - one for children and the others for cardiovascular, cancer and emergency care. In addition, there will also be a Biomedical Discovery Tower, which will integrate medicine, science and engineering.

The man overseeing this vision is Dr. Rafael Beyar, CEO and Director General of RHCC. "It's going to be very intense," he says, speaking from his spacious office in the existing Sammy Ofer Tower. "We have never seen such major developments in the history of Rambam."

Indeed, throughout the interview, the murmur of angle grinders can be heard in the background. "We even found a beautiful Byzantine mosaic when we were digging," says Dr. Beyar, displaying the picture on his PC monitor. "There are many civilizations underneath the ground here at Rambam."

War and peace

Evidence of Haifa's medical history can be found in the hospital's reception, where exhibits such as medicine jars from the Hellenistic period are displayed. After the crusades and until the late 19th century, Eretz Israel was considered one of the most unhygienic countries in the Middle East. But during the 20th century, new services, such as Magen David Adom and health funds, raised the standard of healthcare. The Government Hospital of Haifa was inaugurated in 1938 under the British Mandate. After the founding of the State of Israel in 1948, the hospital was transferred to the Ministry of Health and renamed 'Rambam', after the great 12th century physicist and philosopher Rabbi Moshe Ben-Maimon. This year, Rambam Hospital celebrated its 70th anniversary.

Today, like the city of Haifa itself, Rambam is a place where Arabs and Jews coexist. In fact, a Muslim prayer house was opened on campus in April - the first for a government hospital in Israel - and for Sukkot, a sukkah decorated with lulav leaves was built in the canteen.

"We really believe that here we can show to the world that Jews and Arabs can live together," says Dr. Beyar. "Twenty-five percent of our staff and students come from the Arab communities. Even with the intense feelings during the last war, you could see a Muslim physician treating a wounded soldier on one side and on the other side there were Israeli physicians treating Arab casualties. We treated everybody, whoever they were."

Indeed, during the 2006 Second Lebanon War, Rambam was projected into the global media spotlight as it was struck 45 times by missiles. Operating under enormous pressure, the hospital treated 792 injured citizens and soldiers, there were 200 births between the sirens and missile attacks and 4,000 employees never missed a day of work.

Speaking at a fundraising event last May, Captain Tomer Bohadana, whose life was saved at Rambam during the war, praised the hospital staff by saying, "Soldiers have to know that there are people they can depend on. Although you don't go shoulder to shoulder with us on the battlefield, we know that you are with us."

In response to the war, a fortified underground hospital with space for 750 beds is planned. Set on four floors, it will act as a multi-storey car park during peace times, but in times of emergency the lowest floor will be used as a hospital and will be protected against chemical warfare.

"It will take two to three years to complete," says Dr. Beyar, clicking on a CGI graphic of the car park/hospital. "We hope we will not need it."

Philanthropist and global shipping magnate Sammy Ofer, 86, who grew up poor in Haifa, gave a $25 million gift to RHCC for the building of the underground hospital. Furthermore, a new Emergency and Trauma Center, an extension in front of the Sammy Ofer Tower, is currently being built and should be operating by the end of 2009.

Medical breakthroughs

Another major project is the Ruth Rappaport Children's Hospital, which is scheduled for completion in three years. Designed by internationally accomplished Tel Aviv-based architect Arad Sharon, it will encompass eight floors and 250 beds. According to Sharon, the building is intended to be playful but not infantile, to appeal to children's intuition and spontaneity. Each hospital floor will be color coded and decorated to express a theme from nature, such as the blue "Ocean Floor" and green "Forest Floor" - evoking fairy tales where children make brave journeys. The ground floor of the atrium will contain a lobby, science museum, cinema, Internet cafe and shops. The upper atrium's piazza will be paved in large red and white squares like a game board.

"My sincere hope for the hospital bearing my name is that it will care for all the children of the State of Israel without religious, ethnic or gender bias," says Ruth Rappaport, originally from Haifa, whose family also donated the current Faculty of Medicine (Technion).

The "Legacy Discovery Project at Rambam," is a donation from the Legacy Heritage Fund from New York and Jerusalem. Sometimes referred to as the Biomedical Discovery Tower, it will work with biomedical technological companies to invent and develop advanced remedies. Biomedical research is any form of experimental medicine that aims to create new treatments, devices or drugs to be used for specific diseases.

Dr. Beyar has been involved in biomedical research throughout his career. After completing a Ph.D in Biomedical Engineering, he became a cardiologist and was the Dean of the Faculty of Medicine, before becoming the CEO of RHCC.

"Many of the major discoveries in medicine are made by physicians, not scientists, who are working with real patients during the day and really thinking about how to improve the treatment," he says. "These are the ones who come up with the best ideas. They know the practice and they know the theory."

One example of a recent breakthrough at Rambam is electro-magnetic navigation of the heart, which was invented by Dr. Shlomo Ben-Haim. "He developed a new method to map the dimensions of the electro activity of the heart," Dr. Beyar explains. "It allows you to see exactly how to inject these patients with very precise ablation." In short, ablation is a procedure that destroys damaged tissue and is fast becoming the major treatment for heart disease.

"Another example is developing new imaging facilities, what we call PET/CT," Dr. Beyar adds. "It is molecular imaging and can be used to show parts of the anatomy that are related to cancer. This new invention is a real breakthrough."

"Even with the intense feelings during the last war, you could see a Muslim physician treating a wounded soldier on one side and on the other side there were Jewish physicians treating Arab casualties."

Personalized medicine

Despite all the achievements and additional knowledge, the mortality rate from cancer still remains high worldwide. "Although we have made many achievements in specific areas, such as leukemia, we didn't yet conquer the disease of cancer," says Dr. Beyar. "This is maybe because the age of the population has increased. In our centers, we put a lot of emphasis on cancer research. One of our major goals is to use genetics to be able to predict a response to therapy. This is what we call 'personalized medicine'."

Dr. Beyar believes that bio-informatics (using computers and genetics to predict diseases) will have a huge impact on the future of oncology - the branch of medicine that studies the growth of tumors. "I have no doubt that in the future we will have to screen a patient for genetics and be able to prevent cancer based on their genetic pattern," he says. In a commitment to combating cancer, a new Oncology Hospital is planned for development. There will also be a new Cardiovascular Hospital, which will be located in the future Arc Building and will encompass 24,000 square meters of space at a cost of around $35 million.

Much of the funding for these projects comes from Israeli philanthropists and Dr. Beyar thinks that this is something to be proud of. "We have many reasons to be proud of what is happening here in Israel," he says.

"Rambam creates around it a circle of hitech and medical industry that contributes to the economy, employment and pride of the people."

However, running through the heart of this ultra-modern hospital is the ancient philosophy of Maimonides. "The Rambam called for excellent medical ethics and attitudes towards the patient," says Dr. Beyar. "It is very important to keep communication with the patient at a personal level. Don't forget, with all our devices and new machines, the personal touch between the physicians, the nurses and the doctors is sometimes the most important aspect in managing diseases."

www.rambam.org.il

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