In August 1950, many homes in Tel Aviv were fiery with heat and cringing with fear. A year earlier, a number of children, most of them infants, had begun to fall ill with a serious disease and to die in agony. The first report of the outbreak of the disease appeared in Haaretz on July 6, 1949. By the end of that year, 128 infants and young children had become ill, but the health authorities denied that there was an epidemic. On August 6, 1950, my sister, Ofra, who was 2-and-a-half years old, died of the disease. Today I am the only one left who remembers her.
The truth is, I was also meant to forget. Even though Ofra was in my life for over two years, my mother cut her image out from photos of my childhood and stopped talking about her. And maybe I really did forget? Until I saw the lock of hair in an album I wasn’t familiar with. A lock of hair, wrapped in old, yellowing paper, with the word “Ofra” written on it. Now I know the time has come to tell what has not yet been told. The time has come to reveal the shadow that has hovered over me my whole life.
I try to remember her, a little girl, almost my twin: I was 3 and a half. I’ve been trying for years to remember the day when my sister was taken from us. It was at the end of July, 1950. We didn’t have an air conditioner, or even a fan. No one had an air conditioner or fan in those days. It was as if our homes were on fire. To cool off we placed wet towels on ourselves. They dried out quickly and had to be dampened again.
On that particular day, Ofra woke up and Grandma took her temperature and discovered that she had a fever. Ofra’s head hurt. Grandma tried to ease her suffering, to relieve her immediate pain, but she also asked, quietly, “Where does it hurt, tell me, Ofraleh, what hurts exactly?” But she, a mere toddler – how could she articulate all the shades of pain? All she knew, I imagine, is that her head was pounding and that her body, and everything, was boiling hot.
When my mother came home, she could tell from Grandma’s expression that something was “not good.” I try to recall the look of my mother and my grandmother, to imagine Mother’s hand caressing my little sister and the sadness in her green-brown eyes. For decades I’ve tried to imagine that day, which started at home, in the morning, when I wanted to climb into Ofra’s bed, like I did every morning, and didn’t understand why her eyes were closed and why she was saying, “To sleep, to sleep.”
But how do you know, my husband asks me now: How do you know everything you’re relating? The body remembers, I think. When I remember, my body starts to throb, to hurt.
Someone remembered the doctor who sent Ofra for treatment and isolation to the Hospital for Infectious Diseases, in the Pardes Katz section of Bnei Brak. “They called a private doctor,” they recalled. He had a cane, they added. He walked with a limp.
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I’m writing this in the midst of the coronavirus crisis. My consciousness swerves between the polio days of the past, when I belonged to an at-risk group as a baby, and these days, when I’m in the “senior citizen” at-risk group. I think about the isolation and the separation. During the polio epidemic, sick babies were quarantined in special hospitals; during the COVID-19 days, it’s the elderly and the disabled who are being isolated. In both cases, the isolation is liable to kill the patients and ravage the families that have been separated from their loved ones. How fortunate we are now, that the coronavirus is not killing babies.
Until 1948, the occurrences of poliomyelitis in Palestine were rare. In 1949, the number of infants infected with the life-threatening and paralyzing disease leaped to 128. From 1950 to 1954, 4,700 cases of polio were recorded, 760 of whom died. In 1958, the number of polio patients stood at 6,528. The rate of illness only began to subside in 1957, when the vaccine was distributed.
Polio was a worldwide epidemic that knew no political boundaries, as the epidemiologist Tiberiu Swartz noted in his book “The Epidemiology of Polio in Israel.”
Data about the disease is available from Australia, Africa, Switzerland and the U.S. and Canada, among other locales. The outbreak in the United States was worse than all of those, but in Israel the epidemic was 20 times more serious. Whereas in the United States only 5 percent of those infected with polio died from the disease, in Israel 20 percent died.
Between 1949 and 1959, the newly established State of Israel was under an austerity regime. At the beginning of that period, hospitals were still receiving wounded soldiers from battles that continued to rage in the south, as well as new immigrants with illnesses. And on top of all that, the polio virus struck at infants and spread like wildfire. The newspapers noted the symptoms: general malaise, a rise in temperature and headaches. There were also cases of vomiting, constipation and diarrhea, and pains in the legs, as with the flu. Some infected individuals felt fatigue, and had a runny nose and weakness that lasted three or four days. Frequently there was a respite from the symptoms – but then a renewed outburst heralded by headaches, muscle pains, a stiff neck.
The poliomyelitis virus strikes the gray matter of the brain stem and destroys nerve cells. The paralysis usually sets in after two to three weeks, but sometimes within days. Most terrible of all, the newspapers reported, was the suffocation: Death came when the paralysis reached one’s respiratory tract. Yet there were very few “iron lungs” – the ventilators of that era: In the whole country there were about 12, and breathing was difficult in them, too. The machine consisted of a cumbersome cylindrical metal container in which the patient was placed in a prone position. By alternating the air pressure around the body, the iron lung caused the patient to inhale and exhale involuntarily.
In 1950, a record 1,621 new cases of polio were recorded, most of them affecting toddlers under the age of 3. Only 20 percent of the youngsters diagnosed with the disease had a complete recovery. In a press communique, the health authorities denied that there was an epidemic, even though hundreds of patients had been hospitalized in the first two months of the year.
Reporters and physicians alike described heartbreaking cases. In every neighborhood, it seemed, there was some little girl who went to sleep appearing healthy but never woke up. Other children were found with their heads drooping, their bodies all shriveled. Parents were consumed by anxiety. In almost every case of high fever a physician was summoned for a house call, and medical teams had their hands full. The halls at the entrances to HMO clinics were filled with parents, often crying, who were trying to get their children to stand up straight on their legs.
Confusion reigned supreme; physicians had no idea how to treat the virus. The anxiety and uncertainty grew when it was reported that for every case of polio that was diagnosed, there were 500 asymptomatic cases.
Most terrible of all was the suffocation: Death came when the paralysis reached one’s respiratory tract.
Ya’akov Rotem – director of the children’s polio wards at both the Hospital for Infectious Diseases and at Sheba Medical Center, in Ramat Gan – wrote a decade later that “the epidemic that erupted in 1950 found us unprepared, both in terms of the equipment that was required and in terms of knowledge and experience.” Elsewhere Prof. Rotem admitted, “There were mistakes of diagnosis. It’s very easy to overlook minor symptoms and to think it’s not infantile paralysis [another name for polio]. In addition, with very young infants, it’s difficult to differentiate between the inability to move a limb, or a lack of understanding or willingness.”
The sense of helplessness was overwhelming. Rotem reported that he even allowed parents to enter the ward to perform kaparot – a ritual practiced on the eve of Yom Kippur, in which a chicken is swung in the air and then ritually slaughtered, as an act of atonement.
“It’s as effective a method as all the others, with the exception of physiotherapy,” he wrote, adding, “I feel that we are in a tragic episode… I am very miserable. The paralysis is making thousands of families miserable, severing the spark of life of thousands of children, leaving the children crippled. The medical community is making superhuman, desperate efforts to stand in the breach. They possess a great deal of goodwill, along with a great deal of anxiety.”
Most of the children who contracted polio in Israel were put into isolation in special hospitals: Pardes Katz, Rambam in Haifa, Shaare Zedek in Jerusalem. The Pardes Katz facility – a mansion that had been converted into a hospital with 60 beds – took in infants and toddlers from the south of the country up to Hadera. Reports about the hospital’s high mortality rate soon spread. In short order the institution became the terror of many families.
“Children were kidnapped and taken there,” one victim of the disease who had been there told me. This man from Ramat Hasharon, 71, uses a wheelchair as a result of post-polio syndrome, a phenomenon including weakening of muscles in later years, which plagued a large proportion of those who survived the disease. I can only wonder who decided to isolate the sick children and infants – who was capable of a policy of confining suffering babies, most of whom were still breastfeeding, in a strange place where they knew no one?
For decades, I collected documents of various kinds. I read daily papers from the years 1949 to 1952, I pored over medical articles summarizing the treatment of polio, and about fascinating epidemiological monitoring. I interviewed everyone I could get hold of: physicians, nurses, students in nursing schools who treated the sick children in real time; physicians who were involved later in victims’ rehabilitation; patients who had survived; and relatives of both survivors of those who died of polio.
I interviewed members of my own family – my parents and the aunts and uncles who had been by my parents’ side during the 10 days that Ofra was hospitalized, until her death. I spoke to former neighbors, who told me about the fear that gripped the community and about attempts to keep the children at home, about the obsession with hygiene and the spraying of areas around our house with Flit, which contained DDT, after Ofra’s hospitalization. I also interviewed ambulance drivers who took sick children to the hospitals.
What I had already learned from material about the Yemenite children affair – involving the disappearance of large numbers of infants and children of new immigrants during the state’s early years – which I collected for 20 years, as part of a larger research project about the Israeli National Institute of Forensic Medicine, greatly facilitated my understanding of how information about the polio-stricken youngsters in Pardes Katz was also concealed from the public. I received reports from people who were hospitalized there – one of them, astonishingly, for an entire year, from age 6 to 7, with his parents forbidden to visit him.
I collected material from various centers that treated children suffering from polio. For example, Anat Rotem, the daughter of the late Ya’akov Rotem, sent me invaluable information. In the course of collecting the documents and conducting conversations, I decided to write the hushed-up story of the polio epidemic through the prism of one family, my own, that had tied its fate to the Hospital for Infectious Diseases in Pardes Katz.
I am reflecting now on the power of the medical establishment. For decades after Ofra’s death, my family refused to tell me the truth about the circumstances surrounding it. Beginning in 2002, I tried to figure out where Ofra’s medical file from Pardes Katz was. Following a sleuth-like effort, I was informed that it was in the archive of Sheba Medical Center. Now, the real journey began.
The anxiety and uncertainty grew when it was reported that for every case of polio that was diagnosed, there were 500 asymptomatic cases.
From 2009 until 2017, I exchanged countless emails and phone calls with Hanna, then-director of admissions at Sheba. She informed me of the disappearance of Ofra’s file in a fire, and other such tales. Not until 2017, in the wake of a personal request to the secretary of the hospital’s CEO and to Hanna’s successor, accompanied by a threat to take legal action, did I receive a photocopy of what they called a medical file. Its meager contents left me reeling.
The atmosphere at a hospital encourages confessions. My father and I sat on a bench near the room in the intensive care unit where my mother had been hospitalized following a serious heart attack. And then I asked about Ofra.
“Ofra was hospitalized for 10 days,” he related in a subdued voice. “Mother and I wandered back and forth outside the hospital but were not allowed in. We begged, but nothing helped. We were absolutely out of our minds. When I couldn’t take it anymore, I broke in by force and I saw her, Ofra, alone and sad. Then she saw me. Immediately she smiled and tried to sit up in bed. You could see that she was in pain, because her smile was crooked. But after a few minutes some brute attacked me and threw me out of the room. As he was removing me, I managed to get a look at her. I didn’t take my eyes off her. When Ofra saw that I was leaving the room, she looked at me with a face that seemed to say she knew she was losing me forever. I will never forget that look. There isn’t a day when I don’t remember it.”
That was the first time my father told me about his final encounter with Ofra. I was now 46, and it was than 40 years after the event.
Unlike most other countries, Israel isolated the infants who fell ill with polio and prevented their families from having contact with them. Nevertheless, the mortality rate here was one of the highest in the world. Are these two facts connected?
Prof. Ronni Gamzu, the director of Ichilov Hospital in Tel Aviv and currently the national coordinator of the struggle against the coronavirus pandemic, has decided to allow the controlled entry of family members to visit the sick, the elderly and the disabled, despite fears of infection by COVID-19. Similarly, later in life, Ben Zion Werbin, director of the pediatrics department in Hadassah Hospital Tel Aviv during the polio epidemic, recanted his support for isolating the children. I interviewed Prof. Werbin at length a few years before his death in 2009.
“We should not have taken the infants out of their homes,” he told me. “In any case, there was no treatment in the hospitals. All that we had to offer a sick infant was chicken soup, a smile from his family and quiet. We should have left them at home.” He reiterated this view several times during the interview.
It was Werbin who sent Ofra from home to the hospital in Pardes Katz. I said nothing to him about this.
In 1950, a woman we’ll call Rina was a first-year student in the Mandatory school for nurses housed in Hayarkon Hospital in Tel Aviv. Like her classmates, she too was assigned to the Pardes Katz hospital in order to help treat the infants suffering from polio.
“I see those babies to this day, only the head peering out,” she told me. “And I remember their gaping mouth and the lips that wanted air. The babies wanted to breathe, but the iron lung couldn’t help them,” she added, her voice breaking. “The infants were placed in an iron cylinder, which was worthless. Just imagine – they took the babies, whose respiratory muscles were already damaged by the disease, and placed them in an iron lung suited for adults. Did you ever see a person who wants to breathe and can’t? A child who couldn’t breathe?”
A decade ago, I went to her apartment in Holon to interview her. Moving about with the lightness of a child, though over 80, she placed sandwiches, cake, lemonade and coffee on the table.
We shouldn't have taken the infants out of their homes. In any case, there was no treatment in the hospitals. All that we had to offer a sick infant was chicken soup.Ben Zion Werbin
“I was a nurse for decades, and I saw everything, everything,” she told me. “But I will never forget those paralyzed babies. They still come back to me at night. I was 18 at the time – what did I know? I remember one child, whom I checked on all the time, because I somehow grew attached to him, and I cried when he passed away, I really did. I remember him. He cried all the time, ‘Help me to breathe, help me to breathe.’ I told him it would be all right, but he didn’t believe me anymore.
“And then he stopped crying. Fell silent. First his legs were silent, then his hands were silent, then his breathing went quiet, and in the end all of him was quiet. Silence. Paralysis. Have you ever thought of the connection? They took him out of the iron lung quickly, in order to put another boy in, also with serious respiratory problems, who also died. The iron lung didn’t help anyone.”
Every person I interviewed told me about a child that he or she was unable to forget. For Werbin, it was “a boy of 4 who fell ill with fever. The attending physician suspected infantile paralysis; the diagnosis was confirmed and the child was placed in quarantine. His parents were by his side. At the end of the first week, signs of paralysis in the limbs and the respiratory muscles surfaced. ‘We had to place him in an iron lung,’ the doctor told me. Only his head stuck out. He received food while supine, his mother was with him.
“His condition continued to deteriorate, and became critical on the third day in the iron lung. His ability to breathe was severely damaged. Every so often he said to his mother, ‘Mommy, I can’t breathe, help me.’ After a few hours, he looked at her and said, ‘Mommy, enough, it’s the end.’ And he died.”
The chronological proximity and the physical presence in the same hospitals of the Yemenite children and the polio children might explain the hushing up and official denial of both the epidemic and its victims, on the one hand, and of the affair of the new immigrant youngsters, on the other. Indeed, many of the physicians, ambulance drivers and nurses who were involved in treating the stricken youngsters had also been questioned by one of the state commissions of inquiry that investigated the case of the Yemenite children. This made it very difficult for me to persuade some people to talk about the polio epidemic, as they feared they would be accused of involvement in the disappearance of the Yemenite children.
Thus, Prof. Rotem testified in a session of the commission of inquiry, held on January 29, 1997: “It was something awful, because it was only iron lungs, and they didn’t meet the requirements… If the child had moisture in the throat, then the lungs pulled the moisture into the lungs, and we saw that this was very bad. I was actually the expert – excuse my modesty for the moment – on infantile paralysis, a very tragic expertise. Because there was no cure, there was only treatment with love and hope for a miracle… One morning, I decide that I myself would enter an iron lung. The nurse was against it, ‘No way…’ She was going to put a department director into an iron lung? But I said… ‘I am ordering you... I can’t close the door by myself.’ So they put me into it. I wanted to know how a child feels in the grave while he’s still alive.”
Over all these years I didn’t visit the hospital in Pardes Katz. At first it was due to lack of information, which my parents had refused to provide me. When I finally got the name of the hospital, I didn’t dare. I went to visit only when the place was already in ruins, having shut down in 1999, and been demolished six years later.
What was I searching for? What did I hope to find? Would I have been able to understand what happened to my sister in the 10 days during which she was here by herself? I wanted to find the room she was in, to understand, for example, whether all the children were placed in one room, as was the custom then, or whether they were separated in small rooms. Perhaps I wanted to find out whether there was a toilet in the room or only outside it, in the corridor. Maybe the color of the beds, whether there were curtains. I hoped the structure would remember, that the spaces would reveal to me who caressed her. How the paralysis developed in her. Whether they placed her in an iron lung?
The information was denied me for decades.The medical literature refers to a high mortality rate in Pardes Katz as compared to other places. It also maintains that Dr. Eliachim Marberg, director of that facility, made more use than others of the iron lung, which afterward turned out to be deadly for babies. In the great epidemic of 1950, the mortality rate of children who were placed in iron lungs was quite high: 80 percent mortality in the Pardes Katz hospital, 69 percent at Rambam, in Haifa. Rotem, for his part, concluded that the machine was unusable for infants and that in many cases an iron lung caused a worsening of the situation, including pulmonary complications and death.
So now I am going to the Hospital for Infectious Diseases in Pardes Katz. Going to the place where my sister was alone, without Mommy and Daddy, without anyone she knew, endured ten long days there unable to breathe, alone. And I am going there, finally. After these years.
My back hurts; that’s where I feel pain at times of high emotion. I try to envision this baby, a tiny girl, lying there alone, alone, exactly when she needs her parents, her sister, her grandmother; precisely then she is alone. How is it possible, I wonder. Maybe I’ll find the answers. Why, why did they agree to send her alone, how did they agree not to go in? How did that outrage come about? And how did she disappear afterward, too, as though she had never been? But she was, she very much was, and I have no one I can ask now. All the people who knew Ofra have died, at least almost all, and the others don’t understand why it’s important to ask about her. But, I think: Little girl, tiny girl, you were born, you breathed, you lived, you were. It is impossible to die just like that.
I am following the stones and the houses, looking for the genealogy, the traces of people who lived there, the traces of the lost children. The traces of Ofra, my beloved little sister. Why did Grandma allow her to go? Why did all the people I believed in all my life fail here?
I go to Pardes Katz as if a little girl, 3 years old, who has lost half of herself, it evaporated, and she’s looking for traces, archaeological relics, remnants. And I know, even if I find the building, the void will remain, a void I have felt all my life, which I tried to fill up with research about death and bereavement: A void that remained empty, a black hole that always reappeared and demanded more, because everything was so close and yet so far away. I wanted Ofra, to know what happened to her, to place my hand on her soft hand, to be there with her, my almost-twin. Like a pathologist, an archaeologist, someone reconstructing a family tree, I am going to Pardes Katz.
Seventy years have passed since the polio epidemic, and the world of medicine has taken gigantic strides, so we are told, based on scientific advances related to DNA, imaging, medication. But has all that progress manifested itself in the confrontation with the coronavirus? Have we succeeded in understanding better the etiology (cause) and the epidemiology (how the disease is spread)? In the past decades the Patient’s Rights Law was enacted, and awareness of human rights and of gender equality has developed. But has it? Has much changed between the isolated sick infants stricken with polio and the elderly and the isolated of the coronavirus pandemic? Are we really better able now to talk about what frightens us, about what medicine knows and doesn’t know, and about what is important to us as a community, as a society?