MEDIA | PROJECT ROZANA AUSTRALIA

MEDIA

Interesting online stories relating to Project Rozana, its mission and its work.

By Judy Siegel-Itzkovich 5 September, 2017
Israeli hospital removes male testicles from teenage girl in surgery

The 14-year-old patient, who was born without a uterus, is reported to be in good condition.
Pediatric urologists have surgically removed testicles found inside a 14-year-old girl who was born without a uterus.

The very rare case, treated at Hadassah-University Medical Center in Jerusalem’s Ein Kerem, involved a girl with a female appearance and perception.

A few months ago, the girl’s parents identified male traits in their daughter that were getting stronger – as the girl entered adolescence, the testicles began to grow, and sex hormones they produced made hair grow on her body and her voice to become lower.

She was referred for testing to Prof. David Zangen, director of the pediatric endocrinology and juvenile diabetes unit, who immediately suspected the syndrome included in a rare group of diseases involving sexual development.

Specific hormonal tests and ultrasound confirmed the suspicion of a specific syndrome and therefore a thorough genetic investigation was also carried out. The diagnosis shocked the girl and her family when it became clear that there were testicles in her abdominal cavity, even though her external genitalia were female.

“In our tests it turned out that she had a vagina, but in the internal structure of the body she had no uterus,” explained Zangen. “She was born with the testes that functioned only partially in terms of hormonality, which is very rare, but she has female gender identity. In such cases, a multidisciplinary team at Hadassah have taken her case.

The team, headed by Zangen and senior pediatric urologist Dr. Guy Hidash, includes a psychologist, a geneticist and a social worker to discuss the girl’s gender. “The case of the girl presents us with a situation of relative deficiency in the enzyme, which causes the non-development of male sexual organs in the newborn – but increases the signs during adolescence in adolescence,” Zangen said.

Hidash, who performed the procedure to remove the testes from the abdominal cavity, explained: “The gender of human beings consists of four distinct parameters – genetics (whether it is XY or XX chromosome), the appearance of the genitals, the hormonal state (testosterone or estrogen) and sexual identity (how he or she perceives himself/herself as male or female).

“But if there is a contradiction among the parameters, we must analyze what is the right treatment for the specific patient. In terms of health, testicular removal was an important step once it was decided that she is a girl.”

The teen will need further surgery to complete the anatomy accurately.

Since the establishment of the multidisciplinary team at Hadassah three years ago, 18 cases of gender disorders have been treated surgically, and all have been successful,” Hidash continued, “both in terms of the success of the operation and the patients’ coping with their decision.”

The girl’s family was afraid of the case becoming known in the community in which they live and debated how to raise the funding for the complex treatment. They were finally helped by Project Rozana, an initiative of Hadassah Australia, which covered the shortfall cost of the surgery.

(Note, the last sentence was factually inaccurate, and has been amended by us. Ed.)

By Judy Siegel-Itzkovich 14 August, 2017
Gaza boy able to walk after Jerusalem doctors remove tumor
Picture: Four-year-old Sliman takes first steps after successful surgery

Four-year-old breathes easier after surgical removal of chest growth undetected in Gaza hospitals.

A four-year-old boy from Gaza is able to walk after undergoing complex surgery at Hadassah-University Medical Center, in Jerusalem’s Ein Kerem, to remove a tumor from his chest.

Born with a number of birth defects in his spine and chest, Sliman was taken during his short life to several hospitals in Gaza where unsuccessful attempts were made to diagnose his condition. He had been operated on in the past to reduce congestion on the cervical spine due to the lack of development of the vertebrae, but his clinical condition did not improve due to the lack of proper treatment for the other problems he suffered.

After years of sitting in a wheelchair, unable to stand or stand on his feet and in severe respiratory distress, Sliman was taken a few weeks ago by a Red Crescent ambulance to Hadassah for surgery.

Prof. Uzi Yizhar, head of the chest surgery unit, said that a significant congenital tumor had developed, causing pressure on the spinal cord and lung that led to recurrent pulmonary infections and chronic lung damage. “When he arrived at the hospital, there was evidence of acute pneumonia in the entire right lung.”

After his admission to the hospital, the boy was hospitalized in a pediatric ward, where he was treated by specialists in pulmonary medicine. He underwent a number of diagnostic tests prior to the decision on chest surgery. “Over the past two years, Suleiman had stopped moving his legs,” said Yizhar. “He had no feeling in his lower limbs and could not stand on them; his parents had to transport him in a wheelchair.”

After his respiratory condition improved, “we decided to operate it in order to perform an excision of the unusual and large tumor from the chest.” In the successful operation, the entire tumor was removed.

The child’s rapid recovery surprised even his doctors. “After the tumor was removed, Sliman was moved from pediatric intensive care to the pediatric surgery department, where his respiratory condition improved greatly,” recalled Yizhar. “The next stage was inevitable, so I said to him: ‘Come on, kid, we start walking,’”

The doctors believe that the removal of the tumor in his chest, ostensibly a location unrelated directly to walking, has reduced the pressure on the spinal cord, improved his breathing and nutritional status and helped him start walking.

“He took my request seriously and put his feet on the floor, making a great effort to move one leg and then another,” continued Yizhar. “He really wanted to go, and he had great determination. He himself pushed his wheelchair around the ward.”

He has been transferred to Alyn Hospital Pediatric and Adolescent Rehabilitation Center where he will continue his healing and undergo rehabilitation.

By Simon Tatz, AMA Director, Public Health, 14 August, 2017
INSIGHT

To escape the cold of Canberra, my wife and I headed off to the Middle-East – Israel, including the West Bank, and to Petra in Jordan.

When I first visited Israel more than a decade ago, the on-going conflict between Syria and Israel was an ever-present threat. These two bordering nations have been in a formal state of war since 1948. They have fought three wars and countless skirmishes. Syria still does not recognise Israel and if you have an Israeli passport (or even a visa stamp) you are denied entry into Syria.

On my previous trip I travelled up to the Golan Heights. This is a disputed region, two-thirds under Israeli control with the remainder under Syrian rule. A buffer zone is designed to maintain peace.  I looked (with trepidation and from a safe distance) from one warring country into another.

The Syrian civil war has, however, drastically reshaped the relationship between the Syrian and Israeli peoples, a realignment that has come about mostly through medical and humanitarian aid.

Over the past year, media reports have surfaced about the extent of medical aid and treatment being provided to Syrian refugees fleeing the horrific and barbaric civil war that has destroyed a once beautiful country. My wife travelled to Syria just before the war erupted and described a magnificent and mostly peaceful nation, steeped in a rich history, and one that warmly embraced visitors.

Recently, the New York Times reported on the extent of Israel’s Operation Good Neighbor which operates (literally) along the Israeli-Syrian boundary in the Golan Heights. The Times detailed how Syrian doctors (surely the bravest of people) coordinate the care refugees need, which is then provided by Israeli medical teams. Working with the Free Syrian Army, patients (and their families) are transferred across the military lines to Israeli hospitals or medical centres via military ambulance.  Some wounded go directly to hospitals in northern Israeli towns.

It is reported that Israel has treated more than 4,000 Syrians injured in the civil war. The costs of treating Syrian refugees is split between the Israeli Ministry of Defense, the Ministry of Health, and by the treating hospitals. The cost runs into the millions.

Israeli officials estimate that their aid is reaching about 200,000 Syrians, including displaced families housed in tent cities on the international border. They are also funding and equipping medical clinics.

One of the inspirational people behind the medical relief efforts is Georgette Bennett, founder of the Multifaith Alliance and a daughter of Holocaust survivors. The Alliance’s mission is to “raise funds to provide humanitarian relief to Syrian war victims, heighten awareness of the growing dangers of inadequate responses to the Syrian humanitarian crisis, and plant the seeds for future stability in the region by fostering people-to-people engagement”.

Through the efforts of Georgette Bennett, the Multifaith Alliance is helping the most desperate people flee one of the cruellest conflicts the modern world has witnessed. Ms Bennett told media that the cooperation between Israel and Syria is “a great glimmer of hope coming out of this tragedy”.

What is most inspiring is how medical aid and treatment is breaking down decade old animosities and hatreds. On the Multifaith Alliance website are stories from Syrian refugees.

“It was a very big shock to me. Syrians were brought up to fear Israelis as the devil who wants to kill us and take our land,” said a Syrian humanitarian worker.

One refugees summed the situation up this way:

“Israel is doing exactly what it must do. It is not taking part in the war, but is helping wounded Syrians who need help. And it’s not only the government. Israelis are helping Syrian refugees in Jordan, in Greece, Serbia, North America. No one would have blamed the Jews and the Israelis if they had said it was not their problem. That is, by the way, what many Arabs and Arab countries did. The Gulf States, for example, shut their doors to Syrians – and these are the countries that call themselves friends of Syria.”

Another said: “It has struck a chord with a lot of Syrians. This is supposed to be our enemy.”

I can only hope that the bloody Syrian conflict ends soon and the plight of Syrian refugees is recognised world-wide. I also hope that other Middle-East countries take Israel’s approach and provide medical and humanitarian aid to those injured and affected by this war.

By Nathan Jeffay, 10 August, 2017
Aid for Syria beyond Ziv
Picture: An Israeli medic helping a Syrian child.

THE Israeli military has released new information that gives a sense of the scale of aid it is providing to Syrians – and spoken to The AJN about how the operation extends far beyond children getting treatment in the Galilee.

More than 4000 people have been brought from Syria to Israel to receive medical aid according to the IDF, which has now revealed that it has sent vehicles – including two ambulances – and even six donkeys which are used by medical professionals in Syria.

It has transferred seven generators, water pipes to rebuild Syrian infrastructure and equipment for a temporary school, as well as 120,000 gallons of fuel for operating wells and heating homes and bakery ovens.

Other items moved across the border by Israeli officers include 40 tons of flour, 225 tons of food, 12 tons of shoes and 55 tons of winter clothing.

These details give the clearest picture so far about the work that Israel does for citizens of Syria – a country that is still at war with the Jewish State. Until now, officers have been reticent to go into details. Even last month when The AJN covered a ceremony where Australia-based charity Project Rozana gave $25,000 to Tzfat’s Ziv Hospital for the treatment of Syrians, very limited information was available on the overall scale of aid efforts.

The IDF has now stated that a year ago, its Northern Command established the headquarters of Operation Good Neighbour, to formalise and expand the help provided. “Very quickly, we understood that everything related to routine healthcare was very problematic on the other side,” the project’s medical director Sergey Kotikov told The AJN.

As medical systems have “collapsed,” the IDF has been trying to cater for some of the most urgent needs. Diabetics, for example, struggle to get their hands on insulin so Israel has dispatched insulin along with 90 pallets of pain killers and anaesthetics. Israel also gives diabetics the know-how for managing their condition in areas where clinics with specialists have long since disappeared. “For diabetics the situation is a real problem,” said Dr Kotikov. “We tell them how to manage their diabetes.”

Israeli doctors are in constant communication with Syrian counterparts, who aren’t only assessing patients on their side of the border and getting them ready for transfer to Israel, but are also ensuring follow-up care in Syria. Doctors who treat Syrians in Israel often say that they worry for their patients’ welfare when they get back home, but the latest IDF information suggests that many are being well cared for.

The ongoing conversation with doctors on the Syrian side of the border is so good that 50 Syrians have been treated in Israel and then returned to Israel for follow-up treatment.

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