Thursday, January 7, 2010

Learning worldwide: Israel system of support for victims of terror






by T. Katz
The 26th of Nisan 5754 (1994) was a bright, clear day in Afula. Anna Karkovich was certain her future was no less promising. She had good reason to be happy. Although she was a recent immigrant, after only two years in the country she had found a job she liked, working as an English teacher at Nir Ha'emek Primary School.
"I was making my way home from work as usual," Karkovich told Yated Ne'eman. "As I was waiting for a bus I saw a car make a U-turn and drive toward the bus stop. The driver looked completely normal, but then suddenly the car charged forward and blew up right in front of me."
Despite her traumatic injury, Karkovich did not lose consciousness. She saw some of the victims breathe their last breath, while all around her people cried out for help, many bleeding profusely. When she arrived at the hospital the doctors were very pessimistic regarding her prognosis. Seventy percent of her body was covered with severe burns and, as if that was not enough, she had also inhaled gas from the explosives in the car bomb. Anna was worried that she would have to cope with her suffering alone since she had no family in Israel and the person she was closest to, her mother, had stayed in Odessa.
"But I have not spent a single day alone," Anna recalls. "An organization called Assistance for Immigrants in Crisis `adopted' me and didn't let me feel alone. They understood that I had become like a helpless infant once again and made efforts to bring my mother from the Ukraine. Volunteers accompanied me throughout a long year of hospitalization, and after my release they secured an apartment through Amidar and even bought me a refrigerator."
Later, there was a terrorist attack at the house next door. "When I heard about the attack I immediately went to the hospital's plastic surgery ward," recounts Anna [where burn patients are brought]. "I wanted the patients to see me in my pressure suit and to tell them not to give up hope."
Eventually Anna became a volunteer for Immigrants in Crisis. Following the tragedy at the Dolphinarium she had a lot of work on her hands. Like the other volunteers, she sat in the recovery rooms, accompanied patients on their way to the operating room and tried to calm panic-stricken children. "The help I had been given charged me like a battery. I felt compelled to continue to assist the helpless victims."

Extensive Experience in Terrorist Attacks
Immigrants in Crisis set out to fill the critical gaps that state authorities have been unable to handle. Even in the most highly organized country, there still remains plenty of room for citizens to take part. "I cannot expect the State of Israel to sit beside a sick immigrant and hold his hand," says Ruth Brown, the director of Assistance for Immigrants in Crisis, "but as a volunteer organization, we can try to fill in this gap."
Brown recounts the story of a Russian immigrant who lost her husband in a terrorist attack. "When I walked into her home I could see her sadness palpably. She sat all alone with her nine-year-old son in the empty house. They didn't even have a minyan. Nearby was an Israeli family that had lost a son in the attack and in their home was a large, well- organized minyan. Since then we have learned that immigrants find it difficult even to obtain elementary things, such as a minyan, and we have to see to them."
Brown is well aware that in the chareidi sector, volunteering is a way of life. She believes the general public should adopt the chareidi model of chesed. "In all of the shtetls," says Brown, "Jews set up private organizations to provide help and do acts of chesed. Why shouldn't we as well?" she asks.
Many areas of support and assistance are neglected by the State of Israel, which is one of the reasons why chareidi chesed organizations were set up such as Ezra L'marpeh, Hatzoloh, Ezer Mitzion, Zaka and other services. But in the area of victims of enemy activities, the State does go above and beyond the call of duty and dedicates vast resources, thought and even creativity to help and to rehabilitate victims.
The various accounts often heard about the care provided to victims of terrorist activities is both impressive and saddening. Although the authorities have gained expertise and know how to provide for almost every need, it remains difficult to overlook the fact that this rich experience was acquired through years of terrorist attacks and horrifying tragedies.
"We held a comprehensive meeting in the Immigration Committee on injured immigrants," says Committee Chairman Tzvi Handel. "All of the officials involved attended the meeting: officials from the Ministries of Finance, Housing, Welfare, Immigration and from the National Insurance Fund. Seated opposite us was a young man who had volunteered to take care of his family members, one of his sisters and his grandfather, all of whom were wounded in the attack in Netanya. We asked him what he lacked and what he needed. He shocked us with his reply. `You should know,' he said, `I am not shy, by any means. When I need something, I ask for it. And when a door opens a crack I fling it wide open. But in this case, there is nothing left for me to ask for. I got everything I needed without saying a word. I thought a car might be useful, and I was given a car. I thought aloud about a special item I needed and got it right away. Believe me, I've tried to think of everything, but I can't think of anything else to ask for.'
"We were astounded," said Handel, "to hear an Israeli citizen who not only does not have gripes about the State, but who even sings the praises of the services the State provides him. It was really hard to believe."

State Help
How is this help administered? What are victims of terror entitled to receive? All of Am Yisroelhears the bomb when it blows up, but despite the pain, the mourning and the orphans, the victims are left on their own to cope with their crises day by day, hour by hour. During such crisis periods it is difficult for the victim to take the initiative and to ask for what he is entitled to by law, but representatives from the various government authorities search him out to offer their services.
Mr. Shmuel Pinsky, head of the Rehabilitation Department at the National Insurance Fund, explains the basis for the entire assistance and rehabilitation system. The rights to which victims of enemy activities are entitled are identical to the rights of an individual under the care of the Defense Ministry's Department of Rehabilitation. The law regarding care of the victims of enemy activities authorized the National Insurance Fund to act as a statutory extension of the State of Israel in every respect, providing the same level of services as are available through the Defense Ministry to injured soldiers.
A family victimized by terrorism remains under the care of the National Insurance Fund for a period of many years, almost for life. National Insurance officials are currently handling cases of people wounded as long ago as 5708 (1948). Many citizens wounded in an attack thirty years ago or more also remain under the care of the National Insurance Fund.
After having received care and individual assistance for problems that arose at the age of thirty, including assistance in raising their children and the multitude of problems young families face, now at the age of 70 or 75, they are coping with problems associated with aging. Children who lost one of their parents through enemy activities receive massive assistance from the State and are recognized as orphans until the age of thirty. Those who seek higher education are provided with exceptional benefits due to their special circumstances.

The Shock of the First Several Hours
The first few hours are under the "jurisdiction" of the local authorities. "The first twenty-four hours are the province of the local authorities," explains Mr. Pinsky. During this period victims are in a thick fog. They ask vital questions when the information--who is dead, who is wounded, who is missing--has not yet been confirmed.
Sharon Binyamin of the City of Jerusalem's Welfare Department explains her department's initial activities. "From the moment a terrorist attack takes place until the funerals are all over, we are out in the field, at every juncture." A team of social workers and various other professionals arrives at the scene of the incident, evaluates the damage and locates victims, such as sick and horror-stricken people who are prone to panic or to go into shock. They set up an information hotline, combining data from various sources--police, hospitals, or whatever they can, to update those seeking such information.
The Department of Welfare is authorized by law to notify family members, and its field workers are the ones who accompany the families and help them take care of all of their needs, from organizing funerals to notifying the extended family to driving to Abu Kabir [a forensics facility where the dead are identified] and staying with family members tormented with worry until the facts are made known.
Mr. Zeev Friedman, director of social services for the City of Tel Aviv, says that a unique system has been set up by the municipality to care for victims of terror. Since Tel Aviv has known many tragedies over the years, there was no escaping the need to set up a system to take care of the wide range of problems that suddenly arise in the aftermath of terror attacks.
When news of an attack is reported, the unit rushes to the scene, and every member of the staff immediately begins to tend to his assigned task. Some staff members are responsible for accompanying the families and administering psychological and emotional assistance, others begin notifying family members and assist in organizing funerals, transportation, etc. The hospital information unit verifies data from various hospitals and presents it to the families, and notifies other authorities involved in the task of assisting families.
The Life Routine Unit assigns an advisor to every family, who acts as a liaison between the various bureaus and sometimes represents the family vis-a-vis the authorities. The Casualties Headquarters refers the families to the Chevra Kadisha and takes care of all of their needs. The precise system has become an international model which, by dispatching doctors, nurses, educators, psychologists and social workers and by setting up a hotline to allay the fears of the general population, meets the wide range of needs and solves almost all of the problems that arise in the field.
After the first few hours, once the complete picture begins to take shape, clerks from the National Insurance Institute (Bituach Leumi), both claims clerks and rehabilitation workers, step in and begin functioning. Says Pinsky: "All aspects of care are channeled through National Insurance employees. If necessary we contact other government offices and together solutions are found for the entire range of problems."
National Insurance workers visit the victims and their families to offer their assistance. In cases involving death, National Insurance staff workers pay intensive visits during the first three or four days of sitting shiva. They leave a calling card and establish well-maintained ties.
When they finish sitting shiva, mourners are suddenly thrown into normal life. As friends and acquaintances return to their own affairs the bigger problems begin to arise. National Insurance Fund employees help the bereaved cope with life and with the mourning process by talking to them, referring them to community projects organized by support groups and, of course, by providing regular psychological services. Along with the emotional and psychological support, various forms of material assistance are also provided, and National Insurance workers encourage the injured and the survivors to file a claim in order to receive their legal entitlements.

Allowances
Victims of enemy activities are entitled to monthly allowances. This includes the immediate family, bereaved parents, orphans and widows, who are entitled to an allowance averaging approximately NIS 5,000 ($1,200) per month. The handicapped are entitled to compensation during the period of their hospitalization and, after the extent of their incapacitation has been assessed, they are provided with a regular monthly allowance. Minors under the age of 18 are also eligible to receive a monthly allowance based on the extent of their incapacitation. In cases of lost income, an assessment is made of the previous income and the minimum allowance is no less than the amount of monthly income earned immediately before the injury was sustained.
The most notable problem is associated with self-employed workers. Unlike government workers, for example, whose income level can be determined simply by looking over pay slips, earnings generated by farmers or store owners may be difficult to assess accurately. In many cases, although the business is in debt, because of the large cash flow and turnover, people manage to maintain high levels of consumption.
"When the claims officials arrive," says Mr. Tzvi Handel, "they examine all of the books and prove according to the balance of losses and profits that the man was in debt. Although they set his income at minimum wage, of course this does not allow him to lead the same kind of life he used to lead."
Mr. Handel claims that a logical and fair solution must be found to deal with this problem through proper legislative channels. The problems are numerous, he says, and while the victims' needs should be taken care of immediately, openings cannot be created for acts of fraud.
From this point on, specific types of assistance are given to the entire family. Families that have little possibility of being able to afford to buy an apartment are given large rental subsidies (e.g. if average rental costs in Tel Aviv are $600 per month, National Insurance provides $500 per month), while other families may receive large housing loans. The Ministry of Housing also participates in providing solutions to the problem and in many cases purchases Amidar apartments for the family.
The rental subsidies and housing loans do not always solve the problem. Often families that own apartments face problems due to unsuitable housing. "What is a family with a crippled girl supposed to do if they live three floors up?" asks Pinsky, explaining that on numerous occasions the possibility of helping families to exchange their apartment for another one has been under consideration. Many families are assisted in car purchasing, professional training or retraining for a professional suitable for workers whose capacities have been reduced.
The various government ministries cooperate to a large extent. Although there are some complaints about overlapping and discrepancies regarding who does what, in general all parties involved do their best to alleviate the heavy burden that falls on the victims. Issues concerning welfare, such as taking care of children who have lost their parents, are transferred to local welfare authorities, while various other government ministries may step into the picture to assist with other matters. Yet in many cases uncertainties regarding distribution of responsibilities and the authority held by various entities still remain.
The great diversity within the population and the tremendous problems the victims often face spur National Insurance employees to find creative solutions. Although they must work within the framework of the regulations, National Insurance workers have synthesized the policies and are trained to find solutions by taking advantage of flexibility within the system. Many families are entitled to transportation costs or reimbursements for cab fares to visit victims in hospitals or other care facilities. Often a family member may need to stay in a hotel located near the hospital.
"After the Sbarro tragedy, we covered hotel costs for Shabbos- observant family members staying at a hotel near the hospital," says Mr. Pinsky. "We understood that they had to have somewhere to sleep at night and they could not go home." Chava Keren, head of the region of Samaria east of Petach Tikva, explains that National Insurance employees make great efforts to meet specific, personal needs: from flying family members in from abroad, to providing full room and board to family members who sit beside hospital beds day and night, all the way to dental care and driving lessons.
Says Keren: "Three days before Pesach there was a major attack in Samaria. We realized that the families would find it difficult to prepare for the holiday and we paid to provide them cooked meals throughout the holiday." In one tragic case children were orphaned and went to live with one of the grandmothers, but had to stay with the other grandmother as well. The two grandmothers lived far away from one another, and special funds and an escort were provided to transport the children using a private van service.
Furthermore, each injury is unlike the next. In many cases a relatively light injury may have been sustained, but because the victim is a mother, the repercussions can be much more serious for the family. Sometimes shock victims recuperate more slowly than those who sustained more serious injuries. Often the trauma takes root and turns into nightmares that constantly haunt the family, and the victim's unstable psychological condition affects his ability to function at work, his level of concentration and his general state of happiness.
In short, no two cases are alike. Each one is evaluated on an individual basis and every victim is entitled to personalized attention and care.
Sometimes victims may not even be officially listed, but their injuries continue for years. "Following the Sbarro bombing we set up talk groups," explains Mr. Pinsky. "We gathered together the eyewitnesses and asked them about their feelings. People sat and recounted horrifying eyewitness stories. Many of them spoke candidly and admitted that they were in a state of distress, saying, `I can't fall asleep at night,' or `I've become really irritable,' or `I have nightmares and sometimes I am suddenly overcome with fear.' These groups provided people with an opportunity to listen to one another, to internalize the solution to their problem and to receive professional help."
National Insurance Institute (NII) workers dedicate considerable effort and thought to ways of helping injury victims and bereaved families, and indeed the immediate assistance the various authorities provide is comprehensive and wide-ranging. Nevertheless, many problems remain to be solved, and many new ones emerge after a certain period of time. "The State of Israel is not thorough enough in handling problems in the long term," claims Deputy Minister Yuri Stern.
Take, for example, Yuri Abramov, who was injured in the bombing at the mall in Netanya. He appeared before the members of the Absorption Committee and nearly passed out while he was speaking to them. With downcast eyes and a voice choked by tears, he revealed his medical condition. "I am a cardiac patient and I need to take expensive medication. My allowance does not even cover all of the medicine I very badly need."
Galina Palin, whose daughter Katya was injured at the attack on the Dolphinarium, explained the complexity of her problem. "Our thoughts are all tied up in taking care of our daughter, but I was fired the week before the bombing and my husband is also unemployed. We spend all day at our daughter's bedside. I am afraid of the future. I worry that eventually they will forget about us."
The impressive range of assistance and support provided to victims of enemy activities by the authorities, government ministries and the National Insurance Fund is touching on one hand, but it is sad to think that only in times of tragedy does Am Yisroel's good side come to light.


Immigrants in the Eye of the StormThe Dolphinarium tragedy illustrated how some sectors face even greater challenges in coping with terrorist attacks. New immigrants from the former Soviet Union had numerous problems that amplified the effects of the bombing. "Immigrants from Russia do not have an infrastructure of community support," says Deputy Minister Yuri Stern. "When tragedy strikes chas vesholom hundreds of friends and family members come to visit Israelis, while immigrants from Russia are left all alone." At Abu Kabir the Israeli family stands with the whole tribe on hand, whereas the Russians stand on their own, waiting for the terrible news.
"We have been handling the case of a child who lost both of his parents in the bombing of Line 18 in Jerusalem," recalls Ruth Brown, of Assistance for Immigrants in Crisis. "The organization adopted him and we have been doing everything in our power to be like a family to him." Brown describes support groups the organization has set up for grandmothers and grandfathers who are raising their orphaned grandchildren. People in such situations do not have an extended family to lend a hand and to help raise the children. In addition to the loneliness and the vacuum the immigrants must confront, in most cases their financial situation is dismal. "When you lead a normal life," says Yuri Stern, "people enlist all their coping powers, but when troubles comes, every challenge takes on tremendous dimensions and becomes unsolvable."
Russian families are small. Several families lost their only child at the Dolphinarium tragedy. "Why should I work so hard to pay the rent?" the miserable immigrants ask themselves. "I have no one to work hard for. I have no motivation."
The psychological difficulties alone are an involved topic. Immigrants from the former Soviet Union who suffered from open displays of antisemitism hoped to come to a country where they would not be a despised minority. Says Stern: "When they finally arrive in Israel full of hope and here they encounter hatred as well, they feel displaced and frightened."
Immigrants from Russia are unaccustomed to make use of psychological care and when the psychologist arrives he does not speak their language and is not familiar with the nuances of the Russian mentality. And above all, says an activist for Russian aliya, these immigrants feel that the State does not provide adequate protection. Many of them have right-wing leanings and simply cannot comprehend why the State does not take more aggressive steps to crush the Palestinian Authority.
The Dolphinarium tragedy revealed the vulnerability of immigrants from the former Soviet Union, who lack the resources to cope with such situations, and all of the authorities had to extend their limits in order to provide assistance. Immigrants who were the victims of other terrorist attacks feel that they did not receive the kind of comprehensive assistance made available to the victims of the Dolphinarium tragedy, and have risen up against the unjust treatment they received. "Maybe I have no choice other than to apply pressure through a committee chairman or a Knesset member in order to receive the same rights granted to the victims of the Dolphinarium," says one immigrant, who was injured in the Hadera bombing.



Where is the Money?More than one million shekels for the victims of the Dolphinarium tragedy have accumulated in the Tel Aviv Development Fund, yet despite the months that have gone by since the bombing and to the great surprise of many expectant recipients, the money has yet to arrive at its destination. One television channel broadcast an investigative story on the subject that claimed the chairman of the fund is Mayor Ron Chuldai and the members of the fund have not yet found the time to meet to decide how to transfer the money and who will be entitled to receive it. For now, the money is sitting in a general-purpose account, mixed in with other monies. The televised report accused the Mayor and claimed that the fund is used, among other things, to finance Chuldai's many trips abroad.
In Tel Aviv construction goes on. The Mayor lays sidewalks and sewage lines, and renovates nonstop in a city that never stops. Meanwhile the victims of the bombing still face problems for which solutions have not been found, and for which funds have not been located. Despite the fact that she has been discharged from the hospital a girl in a wheelchair cannot go home because her wheelchair is too wide to fit through the doorway. Other families are coping with acute problems associated with hospitalization, treatment and more.
What does the City of Tel Aviv have to say?
"The report in question is maligning and false," said the city spokesman. "The reporter failed to verify the facts with us and she called on Friday when there were no personnel authorized to comment, yet she asked her questions anyway. She also behaved deceptively, posing as a donor in order to get answers." The spokesman explains that this is a public fund in which public monies accumulated, requiring full disclosure and extreme prudence in distributing the funds. "Since we are unable to decide which of the victims of the Dolphinarium should be entitled to greater amounts of assistance, for no two victims are alike, we have set up a committee headed by a judge that will set appropriate parameters for distribution."
The judge who has been deemed fit to head the committee is Judge Badimus Aloni, who is expected to return from a trip abroad in the near future. When asked whether there was any connection between the money in the fund and the Mayor's travels abroad, even the mild-mannered spokesman grew angry. First of all, he claims the Mayor and the municipality were the ones who encouraged the fund and initiated a banquet to benefit the victims. Furthermore, the spokesman emphasizes that Chuldai uses the fund to pay for trips abroad only when the trips are organized for the sake of the fund itself.
Who knows? But in the meantime the children impatiently waiting for the money to arrive can expect to wait for a long time.




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