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The Lancet Praises Successful Rambam Health Care Campus-Augusta Victoria Hospital Collaboration

Publication Date: 8/5/2018

“The partnership of Israeli and Palestinian physicians from both hospitals demonstrates the great potential of peacemaking in our region through improving treatment of cancer patients.” — Professor Ziv Gil, Director, Department of Otolaryngology Head and Neck Surgery at Rambam HCC.

(L-R): Dr. Salem Billan, Professor Ziv Gil, and Dr. Fadi Atrash, Director, Oncology Department, Augusta Victoria Hospital and graduate from Rambam Health Care Campus. Photo Credit: Erin Friedman(L-R): Dr. Salem Billan, Professor Ziv Gil, and Dr. Fadi Atrash, Director, Oncology Department, Augusta Victoria Hospital and graduate from Rambam Health Care Campus. Photo Credit: Erin Friedman

The July issue of The Lancet Oncology medical journal has published an article describing a successful model of Israeli-Palestinian collaboration between Rambam HCC (in Haifa) with Augusta Victoria Hospital (in East Jerusalem). Professor Ziv Gil coauthored the article.

This joint project between physicians from the two hospitals is already five years old. It aims to promote interpersonal relationships among staff from a variety of disciplines to foster independence of the Palestinian healthcare system by meeting two main goals: formation of an independent Palestinian healthcare system; and assuring continuity of medical care in the Palestinian sector until an independent healthcare system is established.

The project includes a hospital skills enhancement program at Rambam for Palestinian medical staff, Palestinian, and Israeli medical teams working together at Augusta Victoria Hospital, and referral of patients with complicated clinical conditions from Augusta Victoria Hospital to Rambam to be managed by staff from both hospitals.

To date, 23 Augusta Victoria Hospital staff members have participated in the hospital skills enhancement program in various disciplines, including: head and neck surgery, otolaryngology, oncology, neurosurgery, nephrology, and plastic surgery. Graduates of the skills enhancement program have obtained positions in other hospitals and clinics throughout the West Bank. Using their newly obtained skillset they have established medical services previously nonexistent in the Palestine Authority.

The Lancet article presents the growth curve for radiation treatments of oncology patients at Augusta Victoria Hospital since establishment of the program, and draws attention to how quickly the Palestinian physicians gained the necessary knowledge for treating a variety of tumors. The article also discusses the subject of continuity of care for complex tumors in Palestinian patients by staff from both hospitals, at Rambam’s multidisciplinary Department of Otorhinolaryngology-Head and Neck Surgery. Treatments for these patients include specialized surgical procedures not currently available in the West Bank, including robotic surgery, endoscopic surgery, reconstructive surgery, transplants, and surgical removal of skull-based tumors.

Professor Gil explains, “The collaborative Israeli-Palestinian physicians' program and its results over the past five years are evidence that common goals can be deployed as the basis for building cooperation and understanding between our peoples. The model demonstrates the potential of cancer treatment as a tool for building peace in our region of the world.”

“It is clear that successful development of a healthcare system is contingent upon a multiplicity of parameters and we cannot rely upon this program only or on other similar initiatives,” adds Dr. Salem Billan, Head of the Head and Neck Tumor Unit at Rambam and one of the program's developers. “This platform should be adopted by Palestinian and Israeli government agencies or by the international community to be used as a constructive tool for development of a healthcare system in developing countries in areas of tension.”

About four years ago, during Operation Protective Edge, The Lancet published a biting letter of criticism expressing dissatisfaction with Israel. The letter, entitled Open Letter to the People of Gaza, criticized Israel's policies and caused a stir in the world of academia and medicine. Physicians and researchers worldwide called for a boycott of the journal. Some also those who called attention to The Lancet’s overall anti-Israel editorial policy.

At the height of the storm, Professor Rafael Beyar, Director and CEO of Rambam and Professor Karl Skorecki, the hospital’s Director of Medical and Research Development, invited Professor Richard Horton, Editor-in-chief of The Lancet to Israel to see the reality of Israel with his own eyes and learn about its healthcare system. Professor Mark Clarfield of southern Israel's Ben Gurion University also joined the mission.

During Professor Horton's visit, he apologized to some of the physicians, stating, “There is no cause for a BDS-like boycott on Israeli physicians and researchers.” A short time after the visit, he published an article in his journal describing his impressions of the Israel visit, complementing the medical institutions he saw. In addition, transcripts of debates in which Professor Horton participated, as well as Professor Horton’s lecture at Rambam were published in Rambam Maimonides Medical Journal (, an international peer reviewed and PubMed indexed publication sponsored by Rambam.

During that visit, an idea crystallized to devote a special issue of The Lancet to the Israeli healthcare system. It was published in May of 2017 within the framework of a science convention in Tel Aviv attended by medical and academic luminaries, including Professor Arnon Afek, Deputy Director of the Ministry of Health at the time. The special issue of The Lancet was presented at two other scientific conferences held that week in Nazareth and Beersheba, and finally at a formal meeting in the home of the President of Israel, Reuven Rivlin, with Professor Horton, his editorial staff, and authors of the papers in that issue in attendance.