Surrounded by kin, Mahmoud Abu Danash, 45, managed a half-hearted smile of acknowledgement as this reporter turned the corner into the children’s ward of Wolfson Medical Center in Holon on Christmas Day. The ghosts of surgeries past were still evidently casting dark shadows over Abu Danash; right now, doctors were operating on his 4-year-old son’s heart.

Lubna Umm Muath, the boy’s stepmother, paced the hall nervously, her robes as dark as her countenance. Muath had been sedated and taken down to the subterranean operating room just an hour earlier.

The hospital’s chief cardiologist Dr. Akiva Tamir explained that Muath — who was brought to the Israeli hospital from the West Bank town of Hebron earlier this week (as detailed in Part I of this story, here) — has a congenital anomaly of the pulmonary veins, the channels bringing oxygenated blood from the lungs back to the heart. One of the veins “is misplaced and has to be directed appropriately to the left atrium,” Tamir said.

“This is a complex surgery, it’s not simple,” he added. “If you leave him like that, he will be very sick at a young age… and could not survive beyond 40 or 50. With this surgery he’ll live a normal life.” Other children the hospital treats would die before the age of 10 if left unoperated, he said.

Muath was diagnosed at six months by Palestinian Dr. Rula Awwad, a pediatric cardiologist trained through Save A Child’s Heart (SACH) at Wolfson, who now works in Bethlehem. Doctors monitored his development for the past two years and waited until now to operate, as Muath’s condition would be easier to treat at his age.

Down in the operating theater, Muath’s tiny body lay splayed out on the gurney for two hours as cardiac surgeon Dr. Lior Sasson and Dr. Ejigu Yayehyirad Mekonnen, an Ethiopian trainee with SACH, performed the delicate procedure beneath bright white lights. “Que Será Será” played in the background, a soundtrack to Muath’s blood pumping metronomically through clear tubes into an artificial heart and lung as the doctors operated and his vital signs pinged on an overhead display.

Doctors operate on 4-year-old Muath Abu Danash's heart at Holon's Wolfson Medical Center on Wednesday, December 25, 2013. (photo credit: Ilan Ben Zion/Times of Israel staff)

Doctors operate on 4-year-old Muath Abu Danash’s heart at Holon’s Wolfson Medical Center on Wednesday, December 25, 2013. (photo credit: Ilan Ben Zion/Times of Israel staff)

Saving young hearts and building a better Middle East

When SACH started training heart doctors like Awwad, there were none working in the West Bank whatsoever, Tamir said. Now there are several who are experienced pediatric cardiologists, and there’s reportedly one German-educated cardiac surgeon working in the West Bank and two more being trained at Wolfson. But even so, said Abu Danash, the West Bank’s hospitals couldn’t provide the care Muath needed.

To help diagnose and prevent infant cardiac disease, Tamir set up a weekly free clinic in 1995 for Palestinian children whose physicians refer them for evaluation. “It has been going on every Tuesday, in times of peace and in times of war” for 18 years, he said. “We decided that saving lives is not related to political issues.”

In total, the project has provided a three-to-five year training program for over 100 physicians and nurses from around the world, including dozens of Palestinians.

“What happens in practice today is that beyond the fact that we’re giving them fish,” said Wolfson’s director, Dr. Yitzhak Berlowitz, “we’re also teaching them how to fish.” He explained that now that Israel is self-sufficient in treating infant heart disease, and has minimized it through prevention and detection, it was putting its expertise to use by helping its neighbors and those in the developing world. He lauded SACH as “a humanitarian project of the first rate.”

“A child with a serious heart defect who isn’t treated is sentenced to death,” Berlowitz said, beaming with pride when he mentioned that, to date, SACH has treated and saved the lives of 3,300 children from 48 countries.

Of those, roughly half were Palestinians from the West Bank and Gaza Strip, SACH Executive Director Simon Fisher said. He said the organization’s operations, including the Heart of the Matter project with the Palestinian Authority, has had a beneficial influence on Israel’s image among the Palestinians by facilitating day-to-day positive interactions.

Abu Danash told this reporter that his neighbors and family raised no objections when they heard his child was to receive treatment in Israel, because they knew medical care was better there and that the Israelis — the Jews — were helping them. He said that there were two different stories of Israeli-Palestinian interaction — one of intifada and violence, and the other of cooperation. He gave a strong indication he favored the latter. 

Fisher stressed that the organization made no distinction based on a child’s family’s political affiliation.

“We bring children because of their medical condition, not because of their family connection,” Fisher said. “Whether it’s Hamas, Fatah or Islamic Jihad, it really doesn’t matter. That’s part of the message we hope to send back with the families.”

“That’s our contribution toward preparing the grounds for a better Middle East one of these days,” he said.

The Heart of the Matter, which is funded in large part by the EU’s Partnership for Peace program, received especial praise from the head of the EU Delegation to Israel. Ambassador-designate Lars Faaborg-Andersen said that Muath’s surgery is “just one example of the wonderful work being carried out by the dedicated staff at the Wolfson Medical Centre in Holon, in collaboration with Palestinian doctors,” and that “all Israelis can be proud of their efforts.”

Closing up

Not long after the surgeons stitched up Muath’s tiny chest, his anxious stepmom stood facing the intensive care unit’s window, gazing in trying to espy her stepson. Bunked in the six-bed room alongside Muath were five other children: one from Gaza, one from Hebron, one from Ghana, one from Tanzania and one from Israel. Inside, surrounded by a nonstop chorus of electronic beeps and pings, nurses cleaned the boy up. Umm Muath fretted, holding her hands as if in prayer before her mouth.

Lubna Umm Muath stands outside the ICU at Holon's Wolfson Medical Center on Wednesday, December 25, 2013, looking at her stepson Muath. (photo credit: Ilan Ben Zion/Times of Israel staff)

Lubna Umm Muath stands outside the ICU at Holon’s Wolfson Medical Center on Wednesday, December 25, 2013, looking at her stepson Muath. (photo credit: Ilan Ben Zion/Times of Israel staff)

Inshallahs from the day before transformed into hamdulillah – praise God — as the nurses informed Muath’s parents that the operation was successful. Umm Muath welled up and broke into tears while talking with family over the phone.

Dr. Lior Sasson, the surgeon who operated on Muath, said the procedure went successfully and that the little boy was now sedated. “In a few days he can come out of the ICU,” he said.

“It seems to me that the genetic factor is very strong here; maybe it was related to intermarriage in the family and that caused the whole problem,” Sasson speculated. “When [Muath] will become a father, there’s a chance that he will pass it down.”

By Monday or Tuesday, Sasson said, Muath can go back home to Hebron. After speaking to Abu Danash, he added simply, “I hope that this time he will get his son for a normal life expectancy. That’s the expectation.”