Israel must be prepared to take care of the wounded from the war with Hamas - editorial

The numbers coming out are terrifying.

According to the Defense Ministry, more than 6,000 members of Israel’s security establishment, including the IDF and the Israel Police, have been wounded since October 7 in attacks on that gruesome day and in the ensuing war in Gaza with Hamas and in the North with Hezbollah.

Of that number, more than 2,000 have been recognized as permanently disabled in some way.

Fortunately, or unfortunately, Israel has more experience than most other countries with rehabilitative services, and the country’s centers for treatment are among the best in the world. However, nothing prepared the medical establishment for the onslaught of injuries resulting from the war over the last three months.

The number of physically and emotionally wounded will undoubtedly grow as the war continues, with many, if not most, requiring long-term rehabilitation. Many will need in-patient or out-patient services for both physical injuries and post-traumatic stress disorder (PTSD).

Only a month into the war, the Health Ministry told the Knesset that Israel was not prepared to handle the massive number of people, both military and civilian, wounded in the war, along with the usual number of patients moving through the medical system.

“I have never seen a scope like this and an intensity like this,” Edan Kleiman, who heads the nonprofit Disabled Veterans Organization, which advocates for more than 50,000 soldiers wounded in this and earlier conflicts, told AP recently. “We must rehabilitate these people,” he said.

Wounded assisted by the Defense Ministry at "full capacity"

The Defense Ministry said it was working at “full capacity” to assist the wounded and that it was cutting red tape and hiring employees to deal with the influx. Kleiman said that his organization is tripling its manpower, adding therapists and employees to help wounded veterans navigate bureaucracy and upgrade rehab centers.

But that will not be enough, according to researchers at Jerusalem’s Taub Center for Social Policy Studies. In the chapter on health care in the recently released Center’s 2023 State of the Nation Report, they recommended that Israel’s health system adjust immediately to the wartime reality while continuing to plan for the long term in order to deal optimally with any future challenges.

Moreover, the chronic shortage in the healthcare workforce is worsening, and the number of hospital beds per population continues to be low.

Even before the war, Israel received poor marks for being ranked in the lower third of the OECD countries in national healthcare expenditure. In 2022, the national expenditure on health care at current prices was NIS 132.6 billion. In fixed terms, this is an increase of 0.8% relative to 2021, although per-capita expenditure decreased by 1.1%. The expenditure in 2022 was 7.3% of GDP, as compared to the OECD average of 9.3% and the US expenditure of 16.6%.

This figure puts Israel in the bottom third of the OECD countries. Israel also ranks low in terms of public expenditure on healthcare out of national expenditure, with only Portugal, South Korea, and Chile ranking lower.

The per-capita rate of physicians in Israel is lower than the OECD average, although, in the past decade, it has risen from 3 to 3.3 physicians per 1,000 population.

The number of hospital beds in Israel is significantly lower than the OECD average, particularly in the periphery. In 2022, the rate of general hospital beds in Israel (excluding psychiatric hospitalization beds) was 1.77 per 1,000 population, which is slightly higher than in 2021, when it was 1.75 – still significantly lower than the OECD average (3.4 per 1,000 population in 2021).

Those numbers are even more alarming when considering Kleiman’s estimate that the number of wounded is likely to stretch close to 20,000 once those diagnosed with PTSD are included.

Late last month, Prime Minister Benjamin Netanyahu visited wounded IDF soldiers at Sheba Medical Center, which provides exemplary rehabilitative services. “You are genuine heroes,” he told the soldiers.

One of Israel’s greatest challenges, when this war ends, will be to remember their heroism and to take the necessary financial, emotional, and bureaucratic steps to ensure that they can remain as such in the years to come.