Thousands of Disabled Israelis Enduring Arduous Wait for Prosthetics

Many have to wait for months to see a specialist.

Rami Shlush

G. is waiting for a new leg brace. The 19-year-old national service volunteer from central Israel, who was struck with polio at age 3, needs the brace so she can walk without falling.

About a month ago, her brace broke. Her mother called one of the hospitals in the center of the country for an appointment with a rehabilitation physician to have her fitted with a new brace. She was given an appointment in May.

“I cried, I begged for a closer appointment. This is a 19-year-old girl. She can’t stop her life all of a sudden. The secretary said there was nothing she could do and hung up on me,” the mother said.

G. is meanwhile using an old brace, which is too small for her and is damaging her spine, she added.

Even when the long-awaited appointment comes, that may not be the end of it. “Because it hasn’t been three years since the last brace, to receive a new one an exceptions committee has to approve it. I don’t know what will happen,” the mother said.

G.’s story is not unusual. An exhausting wait is the lot of thousands of disabled people in Israel who need state-funded walking aids or prostheses. There are 11,000 such disabled people in Israel, under the care of the Health Ministry’s Lewis rehabilitation institute. The process consists of several stages: submitting an application for state assistance, recognition of eligibility and level of eligibility, meeting with an approved specialist who determines the type of equipment needed, selecting a manufacturer, taking measurements, transferring the plan to the Lewis Institute for approval, and meeting with the specialist to check the finished product before it is given to the patient.

Keren, a non-profit organization representing amputees, sent a letter recently to Health Ministry Director General Prof. Arnon Afek and to the prime minister’s bureau, warning that the situation has become intolerable.

“These delays, between two and six months long, happen again and again and cause great suffering to a large group of people who need the equipment, both children and adults,” the organization wrote through its attorneys.

Keren’s chairman, Haim Reisler, says things are only getting worse. The bottleneck, he says, is the long waiting period for an appointment with an approved rehabilitation physician. There are only 34 approved by the Health Ministry and they see patients for this purpose in addition to their full-time jobs in rehabilitation departments in various hospitals.

“On one hand I understand the doctors. They have no incentive or remuneration for this and prefer to be in their departments rather than approve prostheses for the disabled. The feeling is that there’s no regulator, that the Health Ministry is not in the picture and the hospital directors set the pace.”

Not everyone goes through the same long, arduous process. People who can afford it buy the equipment privately, at a cost of between 8,000 shekels and 200,000 shekels (about $51,000). For the disabled of the Israel Defense Forces the process is much shorter, as it is for victims of traffic accidents.

S., 79, from central Israel, is an amputee above the knee. “We wanted a more advanced piece of equipment instead of the old prosthesis that he had,” his daughter said. S. finally received an advanced prosthesis with a vacuum silicone seal. But he soon developed an allergy to the material. Then began the long process of applying to the specialist for an appointment (a three-month wait), the dermatologist (to approve that there is indeed an allergy requiring replacement of the equipment), and another wait for the rehabilitation specialist and exceptions committee.

“It’s shameful that in 2015, the disabled should have to wait so long for walking aids. The Health Ministry should be dealing with this. If the situation does not change, we intend to petition the High Court of Justice to determine that the wait for an approved physician not exceed 14 days,” Reisler said.

The Health Ministry responded that a rehabilitation department has been established in the ministry to improve service. The ministry said that of the 11,000 applications to the Lewis Institute annually, half were for orthopedic shoes and it was focusing on streamlining this element.

“Beginning on April 1 a new directive has been formulated [initially as a pilot program]: People with permanent disability who need [special] shoes [about a third of this group] and who have been dealt with twice in the past by the same supplier and treated by the same authorized doctor, will not have to apply to the authorized doctor for six years from the last visit.”

The ministry said this year it would be hiring more physiotherapists who would be authorized to issue orders for braces. The ministry also said it is checking into authorizing community orthopedic physicians to approve the equipment.