Health Min. Plan to Close Burn Unit Riles Rambam Staff

The Health Ministry's decision to close down the only intensive-care unit for burn victims in northern Israel has spurred much opposition, although officials say that the plan is to move the unit to Sheba Medical Center, Tel Hashomer.

The burn unit at Rambam Medical Center in Haifa is the only one of its kind in the northern part of the country. It is staffed by doctors and nurses who have accumulated a great deal of experience in dealing with severe injuries.

A week ago, A., a 27-year-old burn victim, was refused treatment at the existing unit at Sheba because there was no room there, and he was taken to Rambam. Two days ago he underwent the first in a series of skin-transplant operations. Five other seriously burned victims are also currently being treated in the Rambam unit. One of them is a war veteran; another is a blind woman who was burned when boiling water spilled on her.

The plans to close the unit have left many of the staff perplexed and angry.

"It does not make sense," says Dr. Yaron Bar-Lavi, head of the intensive-care unit (ICU) at the hospital. "We are opposed to leaving the entire North without such a unit. This means that any burn victim in the North requiring long-term treatment over many months will need to move, with his family, to central Israel. How two million residents in the North can be left without a burn unit is incomprehensible."

Bar-Lavi warned that the planned unit at Sheba will not be able to deal with a large number of burn victims, if that becomes necessary.

"At Rambam we have gathered much expertise over the years in dealing with burns, and we are organized and have conditions that are not available at Tel Hashomer. On average we treat 25-30 cases of serious burns every year. At Tel Hashomer they lack the capabilities and the space for dealing with the injured," Bar-Lavi says.

Rambam has a burn department with 18 beds and a special bath for victims. During the Second Lebanon War, a large number of injured persons came there for treatment, including those suffering serious burns.

Bar-Lavi notes that it is impossible to separate the ICU from the burn unit because the injuries are interrelated.

"Those who suffer serious burns are ventilated and their injuries require intensive care. We work in a team with plastic surgeons, nurses involved in skin transplants within the ICU, and who are backed up by other ICU staff. It is impossible to separate the two," he says.

"For example, at Tel Hashomer, there are no pressure units for treating those hurt by smoke inhalation. What will they do then - bring them to Rambam for smoke-inhalation treatment and then take them back to Tel Hashomer? That does not make sense."

In response, the Health Ministry says the plan is to establish a national center to treat burn victims at Sheba. Such victims, spokesmen said, are cared for in the ICUs of most hospitals, except at Sheba, where there is an infrastructure specifically tailored for burn victims' needs, which operates independently from ICUs.

Health Ministry statistics, based on data received from the 26 hospitals in the country, show that every six days, there is a new case of a serious burn victim, and every three days there is a case of a person suffering burns of medium severity.