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Moment, December 2002, pg 69
THE BEAT GOES ON
Ami Cohen saved kids’ lives around the globe. His recent death on Mount
Kilimanjaro has not stopped his mission
By Lyric Wallwork Winik
On March 27, at he very moment a young Palestinian, carefully wired with
explosives, blew himself up at a seder in Netanya’s Park Hotel, four
Palestinian families were sitting with their children at the Wolfson Medical
Center in Holon, a town just 25 miles to the south. In the sterile confines of
an intensive care surgical floor, the children were recuperating from
life-saving heart operations, provided to them without charge by the Israeli
organization Save A Child’s Heart (SACH).
As news of the bombing, the Passover Massacre, which ultimately killed 29
people, filtered into Wolfson, the Palestinian parents grew increasingly
anxious. Hours passed. Then, nothing - no snide remarks, no glares, no
recriminations. Nothing happened to them or to their children. The staff
continued to check vital signs and administer medication. Doctors and nurses
went about the business of healing. These children were just four of the more
than 50 Palestinian kids who have received care from Save A Child’s Heart since
August 2001; all told, since its founding in 1995m SACH has operated on more
than 800 children from around the world - about one-third of them Palestinians
from the West Bank and Gaza.
But what those four Palestinian families at Wolfson could not have known, nor
for that matter could many of the nearly 80 medical professionals who donate
their time and expertise to SACH, was that this Passover eve concealed a deeper
irony: When Save A Child’s Heart began in 1995, its first two patients were
children from Ethiopia. They flew alone to Israel for surgery and had no place
to stay, so they were housed in a comfortable, donated apartment in a hotel
overlooking the sea. It was the first time either child had seen such a large
body of water. One week after their surgeries, these two children ran down to
the sand and dipped their toes in the Mediterranean as it washed up on the
shore. The place? Netanya, near the Seasons Hotel, which lies about 500 yards
from the Park Hotel.
Perhaps, in another decade, under different circumstances, Save A Child’s Heart
might be firmly ensconced in the global humanitarian lexicon, like Doctors
Without Borders or Operation Smile, which repairs cleft palates. It is, after
all, the largest program in the world providing free pediatric cardiac care -
the $10,000 cost of surgery and an unlimited hospital stay are funded by
private donations, and the medical personnel volunteer their services. (Nothing
in the United States competes or compares.) In addition to children from the
Palestinian territories, SACH has operated on children from Ethiopia, Moldova,
Ukraine, Nigeria, Tanzania, China, Vietnam, and Jordan. SACH also trains
medical personnel from around the world. Of the 800-plus children who have been
operated on by SACH, more than 500 have been flown to Israel for surgery; 97
percent of them have returned to normal lives.
SACH’s story does not easily lend itself to the vernacular of reporting on the
Middle East today. Empty Israeli strollers and small body bags after an attack
at a bus stop are now the norm. In fact, CNN’s cameras did come to the Wolfson
Medical Center and SACH’s offices, but its report focused primarily on the
difficulties Palestinian families have in passing through Israeli checkpoints
en route to medical care. The specialized surgery was presented to the viewers
largely as an afterthought. ABC News has been there, as well, but ultimately
chose to report on Hadassah Hospital in Jerusalem, and the subsurface tensions
there, like the pediatric nurse whose daughter died in a café bomb attack or
the Palestinian mother of a young patient who grew nervous when bombing victims
arrived for treatment, or the young Palestinian boy who drew a picture of
himself shooting his Israeli nurse.
In fact, things are not so magically different at the Wolfson Medical Center.
But the staffers, who come from Russia, Tunisia, Iran, and Poland, as well as
native-born Israelis, Jews and Arabs, shy away from discussing the ethical
complexities of saving a child’s life in a place where babies are dressed up as
suicide bombers, where a toddler and her grandmother can perish in a single
blast, and teenagers, barely beyond childhood themselves, can make video tapes
reveling in their coming "martyrdom."
"We have to make a distinct line between our professional lives and our own
personal morals," explains SACH’s international director of development, Dov
Bet-El. (SACH’s administrative team is composed of a religious Israeli, a
secular kibbutz member who is an officer in the paratroop reserves, a Christian
Arab from the north of Israel, a Londoner, and a woman from Ireland.) Thus,
when the Dolphinarium Disco near Jaffa in Tel Aviv was struck by a suicide
bomber last year, and most of the maimed and wounded teenagers were rushed to
Wolfson, no one moved the Palestinian children who were being treated by SACH
in the children’s intensive care unit. Instead, the surgeons and operating room
staff, nearly all of whom are SACH volunteers, remade the adult ICU to care for
the young Israeli victims.
Likewise, SACH doctors have maintained that sharp demarcation between the
personal and the professional. Every Tuesday during this latest intifada, they
have staffed a free clinic that cares for Palestinian children from the
territories. Any child is welcome. So far, more than 3,000 have been examined
and 857 treated. This past summer, SACH and Wolfson also cared for a newborn
baby from the Barghouti family. Marwan Barghouti, now in an Israeli jail and on
trial for allegedly committing acts of terror against Israel, helped found the
Tanzim, the paramilitary wing of Yasser Arafat’s Fatah organization. As one
member of SACH put it, "Even at times of their most outrageous savagery, we
continued receiving children from the Palestinian areas."
Perhaps in this climate it is hard to tell a heartwarming story of hope. The
SACH saga certainly qualifies-although it too is punctuated by tragedy.
Today, the story of Save A Child’s Heart remains a story of hope, although that
hope has been punctuated by tragedy. And it begins with one man, Dr. Amram
"Ami" Cohen.
I first met Dr. Cohen for an interview on a cold rainy February day in 2001 in
Washington, D.C., while he was on a whirlwind business trip, and I was
immediately struck by two things: the blunt force of his passion, and a persona
that demolished every stereotype one hears about surgeons. He was honest, warm,
and emotional, tearing up when he told a story, not for effect, but because it
genuinely moved him. Physically, he was a bear of a man. He had a vast torso
and thick arms, a build that seemed more suited to orthopedic surgery, with its
cracking and reinstalling hips and knees, as opposed to the delicate minutia of
repairing tiny hearts, arteries, and veins. But he was very much at home in
that tiny realm.
Born in the U.S., Ami Cohen lived in Israel for seven years as a child. His
parents were ardent Zionists, who had planned to spend their lives in Israel,
but after seven years, they grew lonely and decided to return to Washington,
D.C. They made plans to have their son bar mitzvahed in the U.S. in July. The
year was 1967. Ami Cohen and his sister, Carmi, were sent ahead to the States.
Then, the Six Day War closed in. The elder Cohens stayed and waited out the war
in Israel. In the U.S., as a young teenager and beyond, Ami always planned to
make aliyah and return. He also knew he wanted to be a heart surgeon, and he
knew, too, at age 15 that he had met the girl he wanted to marry. Her name was
Debbie Kamerow. They dated for seven years and then wed soon after college, as
Cohen was about to start medical school. From there, it was education,
training, and residencies, including one with the U.S. Army at Walter Reed
Medical Center in Bethesda, Md. By 1988, Cohen was a fully trained
cardio-thoracic surgeon and the Army sent him to Korea. (By the time the
Cohen’s daughter turned 8, the family had already lived in seven places.)
In Korea, the head of an international charitable organization for children
called Save the Hearts approached Cohen about helping indigent Korean kids in
need of medical care. Cohen not only listened, he volunteered. His superiors
gave him permission to participate, and he performed 35 basic pediatric cardiac
operations while serving in the U.S. Army. It was a chance to do what he
considered simple surgery, but it would give these children a normal lifespan,
"as opposed to a slow death by ages 15 to 20."
After Korea, the Cohen family headed to Toronto, where Ami trained at the
Hospital for Sick Children, formally learning how to operate on pediatric
hearts. Then came the Gulf War. Cohen was sent to Saudi Arabia as a heart
surgeon, but when an army reserve barracks was hit by a missile, Cohen and the
other surgeons took nearly all the cases, from trauma to orthopedics, operating
on the victims for 30 hours straight. But through all his training and his
deployments, Ami Cohen felt the larger pull of his dream of returning to
Israel. Peace and reproachment, Madrid and Oslo were in the air. The time
seemed right. Back in the States, as he packed up to move his family - Debbie
and their son, Nadav and daughter Tali- Cohen received a call from another
doctor asking if he would consider donating his time and surgical expertise to
more children in need. "Call me again in a year," Cohen replied. A year later,
in late 1993, the phone rang, this time in Israel. The caller had not given up.
Would Ami Cohen consider helping children in Ethiopia? This time, Cohen said
yes.
When he finally left for Ethiopia in 1995, Cohen had no plans to start an
international organization. He had no plans to travel the globe like some small
M*A*S*H* unit. He never imagined that he and two other Israeli surgeons would
operate on a 10-month-old infant in China without any of the specialized
instruments required for pediatric heart surgery -and that the child would
survive. He only thought he was going to Ethiopia to help a few sick children.
Cohen quickly discovered that the Ethiopian clinic had no cardiac surgeons, and
he could not even locate a pediatric cardiac surgeon nearby. Operating itself
was precarious; electricity was always on the verge of running out, and the
clinic relied on a clothesline to dry its surgical lines, making it impossible
to operate either during or after rain. Cohen decided to bring two of the
Ethiopian children, Abdul and Helena Khader, back to Israel for surgery.
Neither had ever been on a plane before, had seen more than one or two white
faces, or had ridden on an elevator. But they left their family and all that
they knew and headed to Ben Gurion Airport and then to the operating room at
Wolfson.
Cohen had no housing for them other than at the hospital, so he improvised and
put them up in his parent's apartment in Netanya, overlooking the sea, the same
sea that the kids would frolic in a week after surgery. (When Cohen returned to
Ethiopia a year later for a follow-up clinic, Helena ran up to him from a
soccer game, smiled and said simply the Hebrew word for "sea.")
Inside Ethiopia, almost overnight, the initial waiting list of 9 to 10 surgical
candidates for Save A Child's Heart grew to 900. Cohen had no plans to build an
organization; he wasn't interested in developing an infrastructure. "At first,
it was just Ami and his secretary," Debbie Cohen recalls. "Then he asked
different doctors and nurses to volunteer." (In Israel, there is no waiting
list for pediatric cardiac surgery. If anything, there is excess medical and
hospital capacity there.) Another doctor at Wolfson who came from Moldova in
the former Soviet union said that there were plenty of kids in need there.
Barely a year after the first surgery on the two Ethiopian children, a SACH
team was traveling to Moldova. And there were other children who were arriving
at Wolfson, Palestinian children who came from the disputed territories.
Some were sent by an American Christian named Jonathan Miles, a former New York
City television reporter and director of an organization called "Light Unto the
Nations." Miles, his wife, and four children moved to Israel in 1990 to "live a
Christian life of study and piety." He began by helping Russian emigres to
Israel and then moved to the Gaza Strip to help coordinate medical assistance
for locals. (Until recently, he was living in a Palestinian refugee camp, and,
after overstaying his Israel visa, is now in Jordan, and is still sending
patients to SACH.) He has arranged for more than 100 SACH operations on
Palestinian children.
The first Palestinian child whom Cohen operated on was a girl named Aziza. She
spent 10 days in the hospital. "The family was very formal, and the father said
very little to us the entire time," Dr. Cohen recalled. On their way home, the
family was stopped at an Israeli checkpoint. An Israeli radio reporter asked
the father how he felt about being stopped, and he replied that 10 days ago, he
would have answered differently. Up till then, he had known only the young
soldiers. But then he went on with great warmth to praise the Israeli medical
team that had saved his daughter's life. "Now," the Palestinian man said, "we
have to make peace."
Ami Cohen was driving home when he heard the father on the radio. "I was so
shocked, I almost drove off the road."
Another Palestinian family even took out and advertisement in the local paper
in English and Arabic, thanking "all the doctors and nurses for their
remarkable efforts to give back the smile to the faces of our children." Cohen
himself liked to show a slide of an Arab mother who was a third-grade teacher
with the Palestinian Authority. She insisted that the staff at Wolfson take a
picture of her and her son in his Israeli pajamas in an Israeli hospital on the
same day that other Palestinians had attacked an Israeli school bus. "She
wanted him to know where he was on the day that those other children were
killed," said Cohen.
However, not all Palestinian beneficiaries of SACH have been able to express
their thanks for fear of being labeled collaborators. "Some are nervous," says
Barbara Zakheim, the director of development for SACH's Washington, D.C.,
business office. " Some of the Palestinians don't want their names known."
Although SACH -which was conceived of as an international organization- was
growing rapidly, it operated on a shoestring budget for years. "In the
beginning, sometimes the kids stayed in our house," Debbie Cohen adds. "I would
be making dinner and our daughter would bathe them and then take them up to her
room. Everybody pitched in."
But the hope that SACH offered was so strong that a mother in Moldova, who was
told her 2-month-old son was too young and sick to fly to Israel for surgery,
nevertheless sold her farm to get enough money to buy a plane ticket to Israel
for herself and her son. "She came to the airport with the child half-dead in
her arms, gambling that we would help," Ami Cohen recalled. The child, Vassily
Pahomi, had his first surgery at Wolfson in 1996 and then returned at age 2 for
a final operation to correct the defect.
By 1998, SACH had expanded further into Africa, and made its first trip east to
China. Debbie Cohen remembers that expedition, where the team found the
surgical linens so dirty that they swiped sheets from the tourist hotel where
they were staying. The doctors performed many surgeries in China-even during a
power outage, while a local man cranked a hand-operated generator.
After operating on one young boy, who had spent his entire life in the
hospital, the boy's whole village turned out to say thank you. As the mayor was
congratulating the team, standing in the hospital corridor, he mentioned how
grateful he was that "such a small country of 60 million would send a team of
doctors." Ami Cohen interrupted him to say that Israel was a country of only 6
million. And the mayor replied, "I saw that, but I thought it must be a
mistake."
But grateful families couldn't provide medical supplies or pay bills. SACH
needed an infrastructure, bigger donations, and a staff. So, in the middle of
1998, Cohen persuaded Dov Bet-El, an engineer who had worked in high-tech
start-ups before partially retiring to join SACH and help create an
administration for the organization. Like almost everyone else who met Cohen,
Bet-El was swayed by Cohen's enveloping passion.
Now, instead of a hotel or Cohen's own home, SACH set up a small apartment for
visiting families and children. (The visitors' quarters have grown since then,
and now occupy a large house, often with 25 to 30 people staying in its rooms.)
And, in addition to performing surgeries, it began to train medical personnel
from Africa and China who could then take their new skills back to the children
of their own countries.
As SACH gained notoriety and prestige, more medical supplies and financial
donations arrived. There was even a fundraising event in Washington D.C., for
the University of Tel Aviv (a portion of the monies went to SACH), where Cohen
shared a podium with Leah Rabin, Jehan Sadat (Anwar Sadat's widow), and Empress
Farah Pahlavi, widow of the late Shah of Iran. SACH began treating pediatric
patients from Ghana, Zanzibar, and Nigeria, and prepared to hold special
five-day clinics in both Congo and Tanzania. Even the start of the Al-Aqsa
Intifada in September 2000 did not slow the stream of patients. Almost daily,
SACH received pleas, by letter and email, from desperate parents who wanted
help for their children. One message from China was headlined simply, "Subject:
Save My Baby's Life." SACH's success had exceeded all expectations. But then in
August 2001, tragedy struck.
While on a medical mission in Tanzania, Ami Cohen had made plans to climb Mount
Kilimanjaro, the snow-covered peak that Ernest Hemingway, for one, had
lionized. It was in keeping with his personality. If there was a mountain, he
wanted to conquer it. This however, was not a metaphorical mountain, but a real
one. And force, will, and passion were not enough to sustain him there. At age
47, he developed altitude sickness and then cardiac complications. And there
was no high-tech Wolfson Medical Center to intervene. Cohen died on the
mountain.
"I remember going into the children's intensive care ward at Wolfson shortly
after Ami's death," Debbie Cohen says. "There was an Israeli family there whose
son was still recovering from surgery. He had been very sick, so even though he
was several months old, he had not had a brit milah yet. And the parents, when
they heard that Ami was gone, cried and said that Ami had promised that he was
going to come dance at the baby's bris."
Ami Cohen's funeral was packed. School-age friends of Cohen's son, Nadav, left
a special European trip, for which they had saved for months, to fly back for
the burial. Jonathan Miles and a Palestinian couple with their daughter crossed
over from the West Bank. Letters arrived from around the world.
But the story of Save A Child's Heart does not end with Ami Cohen. In the year
ending in August 2002, SACH had operated on more than 225 children, more than
in any other year. "We've got to keep on doing what Ami Cohen started," says
Dov Bet-El. " It gives meaning to his life."
In early 2002, a SACH team traveled to Congo and brought back six children for
surgery, and another team returned to China in mid-June. Among the 50-plus
Palestinian children SACH has operated on in the past year is a young girl from
Ramallah with Down's Syndrome, who was brought to SACH right after the spring
siege on Yasser Arafat's compound ended.
Whether SACH has been able to make even a dent in the hostility between
Israelis and Palestinians is an open question. The Israeli doctors routinely
have been prevented by the Palestinian Authority from speaking directly to
Palestinian doctors about follow-up care; communications go through
intermediaries. But, says Bet-El, "there are 237 families you can't con about
the compassion of Israelis-237 Palestinian families who, since 1996, have had
their children saved by SACH."
Meanwhile, Debbie Cohen and her children are also surviving. Nadav is in the
army, and Tali is completing her high school exams. Debbie's first day back at
work in 2001 was on Sept. 11. She says she's been sustained by seeing what
wonderful friends her children have, by frequent family visits, and even by the
friendship of a group of women who knew Ami Cohen back in Silver Spring. They
were all part of Habonim, a Zionist youth organization. She likes to remember,
too, the words that Ami Cohen wrote in 2001 for the Society of Thoracic
Surgeons: "I am convinced that for the vast majority of people who choose
cardiothoracic surgery as a profession, idealism was initially a strong
factor... For those who are searching, join us and let's make the network to
help children with heart disease around the globe. There is work for everybody.
There are no dollars and cents in it, but it is worth a fortune."
And Debbie adds her own postscript: "I can't even imagine the leap of faith
that lets you put your child on an airplane when you don't know if they're ever
coming back, but you have no other options, so you just say 'take my child.'"
And SACH does. Every day, the children still keep coming.
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