Israel's Discreet Medical Assistants - Saving Children on Minimum Wage

Medical assistance isn’t considered a full-time job and half find themselves taking care of two children in different classrooms without extra pay.

Preschool in Tel Aviv.
Avishag Shaar-Yashuv

For years, N. had owned a small catering business. Then two years ago, she decided to abandon it and become a medical assistant.

“It started by wanting to help a good friend, one of whose children had a rare genetic disease,” says N. “I thought I could contribute something to that child and to his family in general.”

N. works as the boy’s assistant at the local school, in a town in the Sharon. Next month he starts third grade. He has no physical disability – but cannot be left unsupervised at school, not even in class, because if his temperature rises, from playing or running, he convulses, and the attack could be fatal. Without a medical assistant, it would be risky to send him to school, which would bear a social cost, too.

N. rides to school with him and sticks close in all lessons and recesses, accompanying him everywhere except into the boys’ toilets. If he feels ill, she measures his temperature and either takes him home, or to hospital.

She isn’t a regular medical assistant, but a so-called “discreet” one, a term not yet recognized by the health or finance ministries. Neither the other children nor their parents know she’s a medical assistant to the specific boy. They think she’s there for the class.

“Only the teacher knows,” she says. “If I stop being discreet, the boy would be exposed to looks and chatter by the children and teachers, and maybe the parents, too. They’d start pitying him and it would ruin his integration,” says N.

When N. herself falls sick, the boy has to stay home.

For a full-time job, six days a week, N. receives 3,500 shekels a month ($920) from the local authority. Until last year she only received a paycheck ten months a year; the local authority would fire her come every June and rehire her on September 1.

Thanks to the intervention of the Knesset Education Committee, headed by Shas MK Yakov Margi , and Meretz chairwoman Zehava Galon, Israel’s 2,000 medical assistants are supposed to get paid for July and August as well starting this year. However, it isn’t clear if they’ll get the same amount as in other months.

Israel’s medical assistants get little training – exactly two meetings with the child’s general practitioner – which may help explain the lowly status of the profession.

“We need a union to get us professionally and economically ahead, and to solve some other issues that come up,” says N. “For instance, who exactly is your boss during the day? At school I’m not employed by the principal, but I’m subject to her authority. She demands that I do all kinds of things that aren’t my job, such as organizing the library room. It’s exploitation and I have nobody to complain to.”

The law regulates neither the medical assistant profession nor the training for it, says Batya, 60, who worked for many years an administrative manager at a Haifa law firm, which laid her off during cutbacks. She took a medical assistant course and was certified but couldn’t find a job. Neither did a course on assisting autistic children help her land a job. Finally a local authority hired her.

Her job is considered a 70% position, for which she gets 3,300 shekels a month. She’d prefer full-time work but doesn’t think the municipality will allocate resources for that.

Help for medical assistants arrived in the form of Gili Alon, 49, an assistant herself (regular, not medical) at a Be’er Sheva kindergarten. She had battled for the rights of preschool assistants and last year decided to lend a shoulder to medical assistants as well.

With the help of Itach-Ma’achi Women Lawyers for Social Justice and the clerical union, from this year on medical assistants are to get paid 12 months a year, not just ten. During the summer, when schools are out, the local authorities are responsible for giving them other tasks. Now that the schools are out, all that remains is to be seen is which local authorities complied, says Alon.

Pay remains low, however. Medical assistance isn’t considered a full-time job. On top of that, half the assistants find themselves taking care of two children in different classrooms, without extra pay, Alon says. Forget tenure, too. No wonder the turnover rate in the profession is high, she adds.

That 12-month pay deal isn’t automatic, warns Neta Levy, a lawyer with Itach-Ma’achi. The medical assistants have to apply to be utilized elsewhere in summer, which she personally feels simply replaced injury (ten-month pay) with insult (chase the extra work).

Dina, a social worker, has two children that need such supervision. Each year it’s a struggle to find medical assistants, she says, probably because of the lousy pay they get.

“Without an assistant, I can’t bring my children to school, then I have to stay home with them and miss work,” Dina says. “The absence of procedures and the fact that medical assistants aren’t defined [by law], though they are doing life-saving work, hurts their status.”

On top of everything, because of that low status, the teachers expect the medical assistants to do other things like clean, though they aren’t required to.

“There are assistants that the teachers really torment,” says Dina. “The teacher can expel her from the class, or tell her to go get chalk. Since they have no public back, they prefer not to confront the teachers, and the way from there to abandoning the profession is short.”

She thinks that when parents slip the medical assistants extra to stay on the job, which happens, she says, it’s a mistake.

The situation in the Arab sector is dire, Dina adds: “In Taiba and Tira, which are near where I live, there are hardly any medical assistants. Not because they’re not needed: because nobody ever heard they exist.”