BGU | MY PATH, Haim Doron, MD

CHAPTER 2

First Steps in the Health System in Israel

First Years in the Negev- at Kibbutz Gvar'am We arrived for a meeting at Clalit’s Judea District offices on Benyamin Street 3 in the heart of the city of Rechovot. We were greeted by the district physician Dr. Tzvi Canani and the administrative director of the district, Moshe Edelbaum. At the time Clalit’s management structure was split into two directorates. This structure is discussed further on. When they met us, Dr. Canani and Mr. Edelbaum were astonished -- two very young people, a new immigrant doctor and a nurse, fluent in Hebrew, who wanted to go to the Negev! They said that on the first day of May, I would begin work in the Kibbutz Gvar’am area. But first I must undergo two weeks of in-service training under a veteran physician in another kibbutz within the Judea District, Kvutzat Yavne near Gedera. Furthermore, for Neomi to become a nurse with the Tipat Halav (‘Drop of Milk’) healthcare network for infants and their mothers, she needed to undergo several weeks of in-service training in preventive medicine, and work at one of the temporary housing transit camps (ma’abarot) and immigrant villages. I believe that a set date and time have to be met to the letter. Thus, when the appointed date arrived, I managed somehow to get to Ashkelon city, only to discover that, since it was the 1st of May, International Worker’s Day or Labor Day, public transportation was at a standstill. Consequently, I began to hoof it, along the Ashkelon-Gaza Road to Gvar’am. I had walked quite a distance when a small vehicle suddenly appeared, driven by the head of the regional council. He asked: “Are you the young doctor for us, arriving today?” Then he took me into his car and drove me to my destination. A number of days later, Neomi joined me. I received a small room as living quarters that was way too small to contain all the baggage we had brought with us from Argentina. Neomi made us dinner on a kerosene burner found in a closet on the porch. We got settled in Gvar’am and I began working as a doctor. It was there that my outlook crystallized as to the work of the doctor in a kibbutz. The bottom line was: a kibbutz doctor does not need to be a kibbutz member. The doctor and nurse in the kibbutz clinic make important decisions regarding the lives of the members in the kibbutz (sometimes the nurse even more than the doctor, since the nurse heads the kibbutz’s Health Committee). The doctor and nurse decide the diet this or that member requires, the individual’s work hours and work conditions, i.e., workload and schedule. In order to make such decisions, it is inadvisable that the doctor and nurse be members in the community. Rather, they should be professionals who come from outside the kibbutz, in order to deal objectively with the health issues of its members. 4 At the time, I was working day and night as a doctor in the Gvar’am area while Neomi worked in the Ashkelon ma’abara 26 as a nurse. These were times of insecurity in the area -- marked by border incursions by armed guerrillas from Gaza against Israeli civilians in the Negev. For my work, I received a jeep from Clalit that would no doubt make you laugh today at the sight of it. I used it to travel to the various points of settlement. 5 One rainy night, I was driving my 4 Ideally, decisions would be made on medical grounds only, free of group pressure, conflicting priorities, vested interests, status gaps between individuals, or conflict between individual needs and the ‘good of the group.’ For example, in times of food scarcity or rationing, a medical decision on diet could determine whether a particular kibbutznik got half an egg or a full egg per day, or ‘enjoyed’ a piece of chicken at the main noontime meal vs. only half a watermelon to stave off his or her hunger. 5 No doubt an open canvas-top jeep. Due to the precarious security situation at the time, civilian travel throughout the Negev and parts of the southern coastal plain was by car convoys.

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