A Tale of Two NICUs

One of the most heartbreaking outcomes of the ongoing fighting in Gaza is Israel’s use of starvation as a weapon, which has already caused hundreds of deaths from hunger – first and foremost among the most vulnerable, the children. It’s unimaginable. Where has the basic instinct gone, that we, adults in a functioning society, have, to take a wounded, hurt, weak child in our arms and help them? Who among us stops to check a child’s ID before caring for them? How did this happen to us, and why aren’t we noticing it and recalculating our path? Mushon Zer-Aviv calls on us to imagine a different reality – and then make it happen.

Ayala Shalev, Editor, That’s About Us

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A Tale of Two NICUs / Mushon Zer-Aviv

Of all the horrifying images coming from Gaza, the one that finally broke me was an Instagram video of Dr. Ali Alhaj Salem, a specialist in the neonatal intensive care unit, or NICU, at Al-Helou Hospital. In it Dr. Salem explains that the premature babies in his care have been born early largely because of their mothers’ malnutrition and that, for the same reason, the hospital is experiencing a shortage of breast milk. The mothers are simply too malnourished to produce it, he says. His voice is unemotional, his language professional. He doesn’t cast blame. He doesn’t even mention the blockade of humanitarian aid that kept food, water and fuel from reaching those dependent on it in Gaza. As incubators beep in the background, the doctor explains that the infant formula they need is “not available in our market now.”

He also looks sickly thin.

The sound of beeping incubators is not foreign to me. My son Yotam was born in the 28th week of his mother’s pregnancy, three months too early. Happy pictures of a newborn on his exhausted mother’s chest were not a part of our family album. Instead, facing an emergency cesarean section and the lives of both mom and baby in danger, I was left waiting in the hallway outside the operating room, afraid that I would be the only one of us three returning home from the hospital.

All through that first long and terrifying night I watched other new parents pushing strollers back and forth, until finally the door to the operating theater opened. A doctor emerged, pushing a plastic box on wheels. He signaled me to follow him. We entered a room with rows of identical plastic boxes. The nurses plugged the new one in. They wrote the mother’s last name on the new box and asked me if I was the father. It was only then that I could fully see inside the box. There I found a tiny humanlike creature wrapped in tubes, weighing less than two pounds, unable to breathe on his own.

From that point on it seemed my life’s entire mission was simply to protect this new life. But in reality, as I stood outside that box, I could not save him on my own. When his mother woke from her ordeal, and for weeks after, she tried to pump breast milk to feed him. But her wounded body and her overwhelmed spirit couldn’t respond, no matter how hard she tried. The nurses finally, gently, suggested she stop. We, his parents, could not save him on our own. We needed help.

The cliché is it takes a village to raise a child, but to save preemies like my son and those in Dr. Salem’s NICU takes much more than a village; it takes a society committed to protecting its weakest members, and it takes a functioning public health system. And that requires a free society, free from war and occupation, fully capable of protecting its own.

Human evolution may have hard-wired most new parents to adopt their own children, to protect them and to prioritize the well-being of their own bloodlines over others. But preemies of any species rarely survive in the wild, and their mothers often die with them. The natural world never expected parents, villages or societies to save premature babies. And yet, in this era, we can, and we do. If there’s a single measure of humanity’s progress against the cruelty of nature, it has to be the significant decline in early infant mortality since the late 19th century.

Intensive care units for newborns are therefore extremely unnatural. None of the babies there are loved or cared for above the rest. Every preemie is equally “adopted” by a cadre of stand-in parents. Until they’re healthy enough to go home and be loved and cared for by their parents, the only thing that dictates extra attention for one baby over another is the tempo of incubator beeps.

From the moment my son was born, Israeli citizens, who may never know he exists, imagined him as an inseparable part of their community. They asserted their national solidarity and invested their taxpayer money to save his life. From the moment the preemies in Gaza were born, many Israeli citizens, who may never know they ever existed, imagined them as an inseparable part of their enemy. We have denied the fate of my son to those fragile bodies unluckily born an hour and a half south from my child’s NICU, in Tel Aviv.

NICUs are built, not born — just like health systems, just like wars, just like apartheid. We imagine them into being by drawing imaginary boundaries of belonging and solidarity — lines that persuade us to save some babies and allow others to starve to death.

The lives in Dr. Salem’s incubators are no less precious than my son’s. It has been 14 years since Israel’s national health system saved my son’s life; and in four more years the state of Israel will demand that my son and his friends be ready to give their lives — and possibly take others — as soldiers. Neither Palestinian nor Israeli children deserve to grow up in the shadow of endless wars, sentenced to violence simply because their societies failed to imagine themselves otherwise.

The preemies in Gaza have no sovereign state to save them, only the rest of us. Whatever we and our governments choose to do next, whether local or global protests, cease-fire and hostage release talks, recognizing Palestinian statehood, international sanctions, arms embargoes, humanitarian airdrops or anything else, would have to somehow lead to electricity flowing into these incubators and baby formula flowing into these tubes. And it has to happen fast.

Imagination allowed humanity to overcome some of the cruelties of nature. What we need now is for humanity to overcome the cruelties of its own imagination.

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Mushon Zer-Aviv, a board member of A Land for All, a joint Israeli-Palestinian political initiative, works at the intersection of design, technology, society and political imagination.

The essay was originally published in the New York Times on August 4^th.

The translated text was published in “Ha’aretz” newspaper on August 10^th.