Deadly fire shines light on societal ill

Violence against health workers in Israel is hardly new or unique. It seems every week brings another sordid story of a patient or relative of a patient pushing a nurse or threatening a doctor. While health professionals often try to bring attention to the phenomenon, it rarely rises above a blip on the Israeli news media radar.

And then something terrible happens. Something like a patient burning a nurse to death in a health clinic near Tel Aviv, as occurred on Tuesday morning. Coverage of the event is deep and wide, delving not only into the personal tragedy of Tova Kararo and her family, but also shedding rare light on the plight of Israel’s health workers.

Focusing on the victim, Yedioth Ahronoth reports that Kararo worked at the clinic for 30 years where she was known simply as “Nurse Tova,” her name also meaning “good” in Hebrew.

“They didn’t just give her the name ‘the good nurse’ for nothing. When I heard that she’s the one who was burned in the clinic I couldn’t stop crying,” a resident of the working-class Holon neighborhood in which the clinic is located is quoted saying.

Bringing a bit more of the victim to life, patient Isabelle Siton tells of how Kararo would need to prick her twice a day when she was pregnant, even on Shabbat, and Kararo invited her to her home to do so.

“When my kids were sick, they only wanted Tova. Shots, bandages, everything. My son Amit played soccer and would often get injured during games, and he would only let Tova bandage him. Blood tests? Just Tova. The kids wouldn’t be afraid when they went to her, and they didn’t need a lolly. To Tova they would go without fear.”

As for the prick who killed Kararo, Haaretz reports that he became disgruntled at the clinic after he reacted to a flu shot and didn’t accept the staff’s reassurances. The paper cites those close to the investigation saying that the man, a 78-year-old Holocaust survivor, says he had only meant to burn the clinic, not hurt anybody, and that relatives had alerted social services that he was mentally unwell but claimed he was not a violent person.

“He wanted to cause damage to alert about the suffering he was going through and get help from authorities,” the paper quotes his lawyer saying.

The main headline in Israel Hayom — “And then someone screamed ‘Tova’s inside, on fire!’” — plays up the drama, and an accompanying article plays up the sadness, with family members, neighbors and others recalling the nurse as “the heart of the clinic.”

“She was an angel. She took care of every patient in a pleasant and professional manner,” a friend and colleague is quoted saying.
Despite the fact that the suspect was apparently unwell in the head, the incident still became inexorably linked with the wider story of violence against health professionals.

Yedioth, running pictures of doctors and nurses holding signs in solidarity, plays up statistics that count some 3,000 violent incidents in each of the last two years (though Haaretz reports 3,000 in total in the two years).

“We are shocked and saddened by the murder of a nurse while she was carrying out her duty and join in solidarity protesting to stop any type of violence against health staffs,” the entire nursing staff of Ziv Hospital in Safed is quoted saying.

Yet while everyone is against the violence, there is some discussion over its root causes.

In Haaretz, Idfo Efrati writes that long waiting times and other ills plaguing the health system are at least partially to blame for the violence.

“The health system, especially in its current form characterized by heavy overcrowding, is ripe for violent outbreaks,” he writes. “Sick people in physical and mental crisis and unsure circumstances are accompanied by worried relatives, are stuck continuously waiting and plucking at straws for tests or care. Opposite them stand medical staffs who are constantly overworked and dealing with manpower shortages, needing to make complicated medical decisions and at the same time ease the patients’ sense of crisis. Their suffering isn’t always seen by the patients or their relatives, and they themselves sometimes feel helpless and humiliated.”

In a column in Israel Hayom, Doctors Union head Leonid Edelman — who has an interest in linking the violence to a lack of resources in the constant battle for more state money and resources — mentions the long lines, but doesn’t cotton to the reasoning. Referring to Health Minister Yaakov Litzman who termed Tuesday’s killing the crossing of a red line, Leonid rebuffs that as well.

“This is a line that’s crossed every day when health workers become a practical target for verbal and physical violence while they are working,” he says. “When the time a patient has with a doctor or nurse is very limited, when lines for surgeries or tests are long and when there are not enough beds and overcrowding in the emergency room, it creates amazing pressure that sometimes explodes into violence against us. That being said, there’s no justification for violence. We must work to eradicate it immediately. Violence is a plague in Israeli society. When it occurs in the health system it hurts us doubly — not just on the attacked victim, but also on all other patients.