Tili Fisher Yosef ’04

“If there’s one place that consistently preserves optimism and hope for coexistence, it’s the health clinics and hospitals.”

There was an urgent need to identify bodies, and many went to volunteer at Shura base to help with the effort. Then my colleagues and I received a morbid task from the Ministry of Health: we got a list of missing people, which we then divided among us, and had to go into their medical records and look for identifying marks—like whether they’d had their appendix or gallbladder removed, or a tooth extracted. We started looking for scars or other identifiable details. There was one person who’d had a mole removed, so we took note of where it was, thinking there was likely a scar. It was hours and hours of work. I remember sitting at home with my kids, glancing at them while reading about missing children, and diving into the most intimate details, hoping that all the work I was doing would be in vain. I felt an intimate connection with these people. It was a sacred task, and a scarring one.

Women and Women’s Health on the Frontlines
One of the places where I feel my role has been most meaningful is at the Briah Foundation, where I frequently receive questions related to women’s issues. We have women serving at the front, beyond enemy lines—combatants, paramedics, doctors—often for long stretches of time. And suddenly, I’ve found myself receiving questions we had never encountered before. For example, a young female fighter about to deploy was concerned about getting her period while in Gaza, where there was no running water, but was hesitant about using hormonal interventions. Or a young doctor who was breastfeeding and called to the battlefield, asking what she should do about engorgement. I had to connect her with a lactation specialist. She literally dried up her milk to go to the battlefield. That was the level of sacrifice. Men leave their families as well, of course, but we need to understand that for women, the health implications are entirely different.

Preparing for the Hostages’ Return
One of the things that has stayed with me the most throughout this year is that the daughter of a dear friend and colleague of mine was among the hostages taken from the Nahal Oz surveillance base on October 7. Naama Levi is probably one of the most recognized hostages because of the horrifying footage of her being dragged into the van with bloodstained pants. That image has stayed with me throughout this whole time. It’s such a relief to be writing these words now that—after 477 days in captivity—she has finally made it home.

Among the many preparations for the hostages’ return, one of the most urgent concerns is addressing their malnourished state after being starved in captivity. Medical teams, along with clinical dietitians, are planning in advance how to safely refeed them. Reports indicate that before their release, hostages are given the chance to shower, receive clothes, and eat. We don’t know how this is done in Gaza, but when they arrive at the helicopters and camps, they receive small portions—like crackers with spread and tea, similar to breaking a fast. Once in the hospital, they are questioned about their recent food intake, and blood tests are done. Based on this, a gradual reintroduction to regular food is planned. A study from Schneider Hospital published after the release of the children hostages revealed that most suffered from skin and hair infections, untreated skin wounds, malnutrition, vision problems (especially from lack of daylight exposure), and vitamin D deficiency. Many also had chronic conditions without access to their medication.

The Struggles of Rehabilitation After Trauma
The effects of rehabilitation are immeasurably difficult. I personally haven’t accompanied any hostages through rehabilitation, but I have a patient, for example, who’s a survivor from the Nova festival. She fled with her partner, moving from trench to trench, and was shot in the knee and back. The bullet stopped on her spine without entering it, causing excruciating pain but no paralysis. It’s in a dangerous spot, so removing it is too risky. So, she now walks around with a bullet in her back and in constant pain. Imagine trying to move on with your life, dealing not only with post-trauma, but with pain that never lets up. This leads to a dilemma: Do we give painkillers? What kind? Opioids are the most effective, but do we just swap one ailment for another? These are the kind of challenges I face daily in my work.

Invisible Victims & The Ripple Effects of War
There are so many circles affected, beyond just the hostages and combatants. These are the ‘invisible’ ones—the spouses and families of combatants. For example, a woman who hasn’t seen a doctor throughout her entire pregnancy because she has three children at home, her husband is away in the reserves, and she has no one to help her. Or a woman whose exposure to content related to sexual violence has resurfaced childhood trauma, resulting in severe, complex post-trauma. There are mothers who haven’t slept in over a year because their children are at war, struggling with anxiety, eating disorders, or substance use. There’s been a massive increase in the purchase of sedatives and sleep medications, meaning this population is becoming very, very ill. The saddest thing is that we’re seeing a significant rise in domestic violence. Here, I think everyone is truly a victim. For example, someone returning with post-trauma often experiences irritability and hyperarousal, losing control at the smallest triggers. I see these issues regularly in the clinic. 

And then there are also the terribly trivial things—people whose chronic conditions are becoming unbalanced. In the chaos of the war, there are no medications available—antibiotics, medications for blood pressure or diabetes—none of it can be found.

Healthcare in Israel: An Island of Coexistence
The healthcare system in Israel is an island of coexistence. Furthermore, I think this is the only place where we sometimes see a reversal of roles in the power structure. A Jewish patient in serious condition may be treated by an Arab doctor. So, not only is there equality here, but sometimes we see these role reversals. But it is a very complex situation. The war, as always, brings out extremes, and we sometimes have to deal with racist reactions. A patient might say, ‘I won’t let an Arab doctor treat me,’ which is shocking. Where it’s up to me, there’s zero tolerance—if you refuse care from an Arab, you won’t get care from a Jew either. That’s the rule. 

Living and working in coexistence during a war inevitably evokes complex emotions. In one of our staff meetings, a doctor bravely shared that her family is in Gaza, and that she feared for their lives. In Israel, the media doesn’t show what’s happening there; it’s mostly left out of the conversation. This was early in the war, and I felt that, at that point, the Jewish side had a hard time holding space for her experience. Yet, she felt she could share it. And that speaks volumes. In that group of doctors, she felt safe enough to say, ‘I have family in Gaza, and it’s hard to see them suffer.’ It may seem trivial, but after everything we experienced on October 7th, it’s not.

If there’s one place that consistently preserves optimism and hope for coexistence, it’s the health clinics and hospitals. It’s clear—we’re all here for the same purpose.