A Life Saved Only to Be Lost

Israeli doctor Akiva Tamir still speaks of his young Palestinian patient as though the boy had lived.

Tamir and a team of cardiologists, surgeons and other specialists worked repeatedly in recent years to cure the illness that weakened Mohammed abu Hilal’s heart. In May, the most successful operation yet restored Mohammed’s vitality. He gained weight, grew and was playing soccer with new energy.

On Oct. 17, Israeli soldiers shot Mohammed dead. It was a day when half a dozen Palestinian civilians were killed by Israeli troops who patrol the edge of this wretched refugee camp in southernmost Gaza; it started as a firefight with Palestinian gunmen but ended with Israeli tanks firing several rounds into the densely populated warren of concrete-and-tin shacks.

Mohammed, the first to die, was killed as he walked home from his uncle’s house. He was 15.

The story of Mohammed and his doctors illustrates how closely Palestinians and Israelis cooperated before their societies were driven apart -- perhaps irreparably -- by the destruction and hatred of the deadliest fighting in a generation. Israelis and Palestinians today are more likely to kill than to heal each other; both sides have been hardened, their societies devastated. Any common ground has been soaked in blood.

The news of Mohammed’s death hit Tamir and his partner, Zion Houri, hard.

“Stupid, stupid, stupid,” Houri said. Such a waste, agreed Tamir.

Tamir and Houri work out of the Wolfson Medical Center in the Tel Aviv suburb of Holon. Mohammed was ferried 55 miles from Rafah to Holon dozens of times for treatments and for three operations in three years. Each trip was an ordeal: acquiring hard-to-get permits, crossing checkpoints and transferring from one (Palestinian) ambulance to another (Israeli).

Leafing through Mohammed’s file, Tamir reviewed his handwritten notes and remembered the first time he treated the boy. Progressive heart failure. Huffing and puffing. Unable to walk easily. A heartbeat nearly twice the normal rate.

He described Mohammed’s condition in the present tense -- until reminded that the boy was dead. He seemed truly distraught.

“All our lives what we do is try to make people feel better and give them a future,” Tamir said, shaking his head. “I cannot imagine this.”

*

When Mohammed came home the last time from Israel, he seemed so much better.

“His health was such that I never used to think he would get any taller,” recalled his mother, Inshirah. “But he was getting fatter and taller. He was becoming a man.”

His father, Sami, began contemplating a marriage for him. After losing four of their nine children to disease, they finally came to believe that Mohammed, their eldest, would make it.

From his sickly years, Mohammed was a homebody. He loved to make decorations from plastic flowers and fiddle with the family aquarium and draw pictures. Now he was playing a little soccer and volunteering to help his uncle build a house. He wanted a computer.

“It was a big change,” his father said. “We had always thought he would die at any moment.”

The Abu Hilals live in a rented four-room house at the end of a network of narrow, winding alleyways in the so-called Block O of the Rafah refugee camp. They had to sell the home they owned, plus their small textile factory, to pay medical bills.

Rafah has long been one of the deadliest and most miserable corners of the Palestinian-Israeli conflict. It has been transformed into a nightmarish urban battlefield, where Palestinian guerrillas routinely fire grenades and guns at Israeli troops patrolling the border with Egypt, and troops routinely demolish Palestinian homes, raze orchards and shell neighborhoods.

In October, Mohammed’s mother traveled to Saudi Arabia in a religious pilgrimage that she had promised God to make if her son survived.

She never saw him again. He was killed while she was away and buried before she could return. She had always thought that if something happened to one of her children, it would be 13-year-old Ahmed. He loved to go out and taunt the troops. Not Mohammed.

It was about 2:30 in the afternoon that day, and Mohammed, a lanky boy with the first trace of an adolescent mustache, had finished school. He was walking home the 100 yards or so from his uncle’s house when the shooting started.

Mohammed was shot by a large-caliber round from a tank-mounted machine gun, witnesses said. In the next couple of hours, tank shells hit the pavement in front of a boys school and a corner grocery store, killing the shopkeeper and his customer. The dead also included 8-year-old Shamya abu Shamalah, who had stayed home from the mosque that day because her parents thought that the streets might be dangerous. She was killed fleeing her bed as shrapnel pierced the thin walls of her home.

The Israeli army does not dispute the details of what happened in Rafah and said it regretted the loss of civilian life, but it insisted that its forces -- including a 60-ton Merkava tank and an armored bulldozer -- had come under fire. October was a month in which Israeli forces killed about 30 civilians, many of them children, according to Israeli human rights organizations, during an open-ended reoccupation of most of the West Bank and parts of Gaza.

The Israeli commander overseeing operations in Rafah, Brig. Gen. Yisrael Ziv, this week acknowledged that the army used “exaggerated force” on Oct. 17. “The tank fired four shells, when one was enough,” he said.

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Cooperation in the medical field was once one of the hallmarks of a slowly normalizing relationship between Israel and the Palestinians. From 1994, when the self-rule Palestinian Authority was established, until 1998, an estimated 4,000 people were involved in 148 cooperative health projects, and new projects were being launched every year.

Little of that is left. All official contact between the Palestinian and Israeli health ministries has ceased. And though the occasional incident in which Israeli medics treat Palestinian terrorists gets wide attention, the reality is that only a handful of private, virtually underground shared efforts continue.

Grim health statistics reflect that reality: Nearly three-quarters of Palestinian children now suffer from some form of malnutrition or anemia; kidney dialysis patients are dying because of lack of treatment; diseases such as hepatitis, meningitis and tuberculosis are reported to be on the rise.

Tamir and Houri are part of a program called Save a Child’s Heart. In six years they and their associates have cared for 800 children, most of them non-Israelis. A quarter of them have been Palestinians. On any given day, the intensive care ward might include children from as far away as Tanzania and Eritrea.

Although they still treat some Palestinian children, the doctors have found it easier in the last two years to find partners to work with in distant Congo or Mauritania. Palestinian doctors have become reluctant to seek their assistance, Tamir and Houri said. Somehow it’s seen as consorting with the enemy.

Gray-haired, bespectacled Tamir, 51, is a quintessential Israeli, a “sabra” -- Israeli-born with Israeli parents. His dark-haired partner Houri, 48, is a Tunisian-born Jew who immigrated to Israel at the age of 16. Both completed military service and did reserve duty. Both, like most Israelis, have felt their political leanings shoved decidedly to the right in the last two years of conflict.

Houri, especially, was a regular supporter of the leftist Meretz Party. But last year he voted for right-wing hawk Ariel Sharon. So did Tamir.

“I don’t like Sharon,” Tamir said of the prime minister. He believed that Sharon’s predecessor, Ehud Barak, was sincere in attempting to end the conflict. Once Barak failed, Tamir decided that the Palestinians were not serious about making peace and the conflict became a “war for the homeland” best led by Sharon, Tamir said.

Houri, who completed some of his studies at UCLA, can use the remnants of his native Arabic to speak to his Palestinian patients, although it is a Tunisian dialect peppered with French and the jargon of his Tunisian Jewish community.

Mothers trail him, asking when their child will be well, when will he sit up or stand.

“We believe that helping children is the sane thing to do,” Houri said. “Maybe it brings a little sanity, an island of sanity, to an insane situation.”

Houri says they try to keep politics out of the hospital, but that is next to impossible. On one level, everyone maintains an informal professionalism that is typical for Israel. But tension festers just below the surface, expressed primarily in comments made by nurses or parents in the corridors.

Houri remembers a suicide bomber’s attack on a crowded Tel Aviv cafe five years ago. A father of one of his Palestinian patients applauded the news as it came over TV sets in the hospital waiting room. The mother of one of the Jewish victims worked in radiology.

“We gain our power from curing people,” said Tamir, whose office walls are decorated with the photos of patients. “Some people gain power from sending their children to bomb other children. There’s a lot of hatred out there. We try to go in the other direction and gain power from curing people.”

Both Houri and Tamir support what they see as their government’s war on terrorism, in defense of Jewish lives and well-being, to make Israeli streets safe again. But their views are sculpted by nuance.

Tamir is anguished that his son, a soldier, has pulled Palestinians out of their homes in the middle of the night for interrogation and arrest. There has to be a “cleaner” way to fight this battle, he says. But his family, including his soldier-son, says he’s being unrealistic, “a dreamer.”

*

Days after his son’s death, Sami abu Hilal and some of his other boys, male relatives and neighbors are seated in plastic chairs outside the home.

When he is asked about the Israeli doctors, Abu Hilal touches his heart in a gesture of respect. He remembers that they always treated him well.

But then, bitterness takes over. The question on his mind is whether the same doctors who saved his son would also take up guns against Palestinians as part of their military service. He is sure that they would.

He recalled the moments after the most recent surgery ended in success. The doctor placed his hand on Abu Hilal’s shoulder. “Tell your son that a Jew did this,” the doctor said.

A grateful Abu Hilal, somewhat hyperbolically, told the doctor: “If my son ever throws stones at your people, I will cut off his hands.”

That sentiment evaporated with the smoke, thuds and crackle of the tank fire that claimed Mohammed’s life.

Abu Hilal says he’d rather send his other children to “the worst doctor in Palestine” than return to the Jews, if this is how things end. “I want revenge.”