Friends of Schneider Children's Magazine of the Association of Friends of Schneider Children's Medical Center of Israel Volume 2 • November 2007 The Pin – and the Safety Catheterization obviates Surgery Page 3 Checking Kidneys With Heart Quality of Life for children with kidney failure Pages 8-9 Thank You! Friends of Schneider Children’s pays tribute to its many donors Page 14 Opening Lines SCHNEIDER CHILDREN’S MEDICAL CENTER OF ISRAEL is the only comprehensive, tertiary care hospital of its kind in the country and indeed in the entire Middle East, dedicated exclusively to the well-being of all children from the time of birth and beyond. Offering the full range of pediatric specialties, Schneider Children’s also receives patients from the Palestinian Authority and Jordan, and from as far away as Africa, Asia and Eastern Europe, thus fulfilling its mandate to serve as a “bridge to peace” in the region. Since its establishment in 1992, Schneider Children’s has become recognized for its medical and academic excellence, and today it is considered one of the leading pediatric care centers in the world. The medical center owes its establishment and name to its founders and major benefactors, Irving and Helen Schneider of New York, USA. Dear Friends, During the past year, Schneider Children’s initiated several major projects and advanced others, all of which have one objective - improving the health and well-being of sick children: reconstruction of the Cardiac Intensive Care Unit within the Department of Cardiothoracic Surgery; relocation of the Day Care Hospitalization Department which will vacate space for the expansion of the Emergency Room; construction of a second catheterization lab; and installation of an advanced gamma camera for Nuclear Medicine. In addition, more than 53,000 children and adolescents from all over the country were treated in the Emergency Room (ER), 18 organ transplantations took place including liver, kidney and heart, and 24 bone marrow transplantations were conducted. It is with much warmth and admiration that we express our appreciation to the staff of the hospital for their outstanding achievements as well as to our generous donors for their welcome support. There is no substitute for your efforts and dedication! With appreciation, The Editorial Board Five-Star Rating Schneider Children’s was recently voted the most beautiful hospital in Israel by the Council for a Beautiful Israel. Current Concern: Supporting Special Needs Frequently, the diagnosis of a severe disease in a child is accompanied by difficult consequences that complicate the family’s ability to cope with the situation. The Association of Friends has undertaken – in addition to the development and advancement of the hospital – to support the humanitarian needs of sick children and their families such as out-of-basket medications, special dietary needs for children on dialysis, or dental care for organ transplant recipients who commonly suffer from caries. “Sometimes, assistance involves simple matters such as transport to the hospital for treatment,” says Dr. Aviva Ron, Chair of the Association’s Executive Committee. “An organ transplant recipient cannot travel on public transport for fear of contracting an infection, and not every parent has a car. If parents cannot afford a taxi, based upon the recommendation of the hospital’s Social Services, we provide the necessary means so that the child can continue treatment critical to his health.” At the same time, the Association of Friends advocates children’s needs. “Our aim is to ensure that not one child will be without the required medication because his parents do not have the money,” concludes Dr. Ron. Friends of Schneider Children's The Association of Friends, a registered Israeli non-profit, accords socially-conscious individuals and organizations in Israel and abroad with an opportunity to connect to the heart of great accomplishment. Giving to Schneider Children's is an emotional partnership that grants the donor immeasurable satisfaction – both in the spirit of giving and in the knowledge that every shekel will reach its objective. A contribution to Friends of Schneider Children's is aimed towards one sole objective - saving lives and improving the quality of life of sick children (see page 16). Cover photo: Dr. Miriam Davidovits and patient, Dialysis Unit FRIENDS OF SCHNEIDER CHILDREN'S Magazine of the Association of Friends of Schneider Children's (Reg. 580168987) Volume 2 November 2007 Tishrei 5769 Editor-in-Chief: Ziva Caspi; English Editor: Cynthia Barmor; Editorial Board: Dr. Aviva Ron (Chair of the Executive Committee), Riva Shacked, Ronit Singer; Writing, Graphics and Production: Sarig Ra'ayonot; Contact: [email protected]; Association Offices: 14 Kaplan Street, Petach Tikvah 49202; Tel: 03-9221748, 03-9253481; Fax: 03-9210784; www.schneider.org.il/eng Gifts Of Life The Pin – and the Safety First in the world: Open safety pin removed from child’s lung using the technique of catheterization obviates surgery and excision of part of the lung Even after the successful removal of hundreds of foreign objects from airway passages, this was a first for Schneider Children’s specialists: a child of four arrived at the hospital with an open safety pin lodged in his lung which had been there for about a month. “The open safety pin caused a high fever and represented an immediate danger to the child’s health,” said Dr. Tommy Schonfeld, Director of the Pediatric Intensive Care Unit. Imbedded deep in the lung, the pin could have punctured the airway passages at any time resulting in hemorrhaging and other complications. The bronchoscope, the instrument normally used to remove foreign bodies, was unable to reach the pin due to its depth in the lung. In order to obviate surgery that would have involved partial excision of the lung, Dr. Schonfeld consulted with Dr. Einat Birk, Director of the Cardiology Institute, Dr. Elchanan Bruckheimer, Director of the Cardiac Catheterization Laboratory and Dr. Yoram Stern, senior ENT physician. The team devised a novel approach: to try and remove the pin via catheterization, a technique mainly used for precise invasion of blood vessels. The creative idea became a reality through impressive teamwork that pooled the cumulative experience and knowledge of Schneider’s experts. Doctors Dr. Elhanan Bruckheimer (l) and Dr. Tommy Schonfeld (r) with the patient imitated the catheterization technique and applied it to the airways, successfully reaching deep into the lung. With the help of a catheter, which has a much smaller circumference than the bronchoscope, cardiologists successfully closed the safety pin and then, assisted by the ENT specialist, gradually removed it from the child’s body. As far as is known, this is the first time in the world that the removal of a foreign object has been performed via catheterization. Rare Operation: Liver Transplant in an Infant After reducing 20 kgs, the mother donated a liver lobe, the doctors donated knowledge and skill – and the 15-month-old infant was reborn at Schneider Children’s In a rare circumstance at Schneider Children’s, a mother’s dieting helped to save the life of her daughter of 15 months who needed an urgent liver transplant due to congenital liver disease. Once she was found to be compatible, the mother volunteered immediately to donate a liver lobe to her daughter and lost about 20kgs in weight so that the lobe would suit the size of the child. There was also an additional complication that provided an exceptional challenge for the medical team: the infant was born with displaced organs. This was the first time that surgeons at Schneider Children’s transplanted an organ under such unusual conditions. Thanks to their wide experience and thorough preparation, the operation was completed successfully. The surgery and related developments was filmed and documented in a movie called “I Gave You My Life” and screened on Israel TV’s Health Channel. New Endeavors Skiing with New Organs Thanks to the generosity of a donor, six children who underwent organ transplantation at Schneider Children’s attended a special ski camp in Switzerland for pediatric organ recipients, and returned with the sense that anything is possible The successful transplantation of a liver or kidney is only the beginning of a long road towards a healthy and normal life. Six children, who underwent transplantation surgery at Schneider Children’s, vacationed this past winter at a special ski camp for pediatric organ recipients that takes place every year in Davos, Switzerland. This is the third consecutive year that a delegation from the hospital has attended the camp. Their participation was made possible due to an anonymous contribution to the Association of Friends. The children were accompanied by family members and Nurse Rachel Beregin, Transplant Coordinator at Schneider Children’s, and were also honored by a visit from the Israeli Ambassador to Switzerland. The group returned full of excitement and awed by the challenging and enjoyable experience of being with 70 other children like themselves from all over the world. Most importantly, they proved that through courage, motivation and the proper support, they could ski safely towards a normal life and be like other children. Summer Camp for Burn Survivors For the fourth consecutive year, Camp Susquehanna invited burn survivors treated at Schneider Children’s to join their peers in the USA About 35 campers – all burn survivors, and including youngsters who had been treated at Schneider Children’s – participated in Camp Susquehanna for three days of nonstop fun in Millersville, PA, USA. Typical summer activities, from ball games to canoe trips and rope-challenge courses, were enjoyed by the participants who came from all over the world. Some campers had visible scars, while others had scars that were easily concealed under clothing; but all shared the common horror of burns resulting from explosions, fires or car accidents. A unique experience of being together with like others was celebrated, and the happy campers left Susquehanna with a renewed sense of comfort and peace. Bridge to Peace Delegation from Bethlehem’s Caritas Baby Hospital promotes ties Under the aegis of the Austrian Embassy in Tel Aviv, a delegation of senior hospital personnel from the Palestinian Authority’s Caritas Baby Hospital in Bethlehem visited Schneider Children’s recently. The objective of the visit was to explore mutual programs and ties together with possible advanced training of Arab medical personnel at Schneider Children’s. A similar delegation from Schneider Children’s will reciprocate the visit and arrange for about 25 selected staff members from Caritas Baby Hospital (doctors and nurses in the main) to each spend periods of two weeks training at Schneider Children’s. Second Catheterization Lab Needed Catheterizations in children are very different and far more complicated than those performed on adults. Each procedure can take several hours and only a maximum of 2 - 3 children can be treated per day. The number of procedures performed at Schneider Children’s has shown a significant increase of some 20% every year. This steady trend is due both to continued referrals as well as to the introduction of new techniques that obviate open-heart surgery for the treatment of Congenital Heart Defects. The Pediatric Cardiac Catheterization Laboratory at Schneider Children’s - the largest such center in Israel - was established 14 years ago. Although the equipment is still in excellent condition, it is unable to support the latest technologies such as reduced radiation, enhanced 3-D imaging and speedier procedures. Since Schneider Children’s caters to children, there are corners that cannot be compromised. In order to meet all requirements, a new state-of-the-art laboratory has been Last year, Schneider Children’s conducted 516 pediatric cardiac catheterizations, marking the 8th consecutive year showing an increase in the numbers of patients; despite intensive efforts, there is still a 4-month waiting list; the addition of a second catheterization room is pressing; the estimated cost is over $2 million planned to adjoin the existing catheterization lab. The new lab will be equipped with the most advanced biplane imaging equipment for both pediatric cardiac and peripheral interventional radiology. The coordinated service will accommodate the increasing demand for interventions that are currently performed at the neighboring adult medical center. The total number of procedures in both labs will reach 1,300-1,500 a year. The cost of the new laboratory is estimated at over US$2 million. Only about half that amount has been raised from private donations. The Association of Friends of Schneider Children’s has undertaken to help raise the balance. Mobilizing for the new Cath Lab Schneider Children’s has been fortunate to obtain funding from donors in the United States, through Medical Development for Israel, Inc., towards the acquisition of new equipment for the multimillion dollar cath lab. However, further funding of some $1 million is still needed to support construction costs and complementary apparatus such as a multipurpose ultrasound ($175,000) and a hemodynamic recorder system ($100,000). 5 Connecting With Children Supernatural Visit, Regular Size Para-normalist Uri Geller bends spoons with hospitalized children urging them to “think positive” Brainstorming about Brain Tumors The Hemato-Oncology Department’s Research Week hosted Prof. Eric Bouffet from Toronto, one of the leading experts in the world on brain tumors in children Uri Geller – a regular visitor to Schneider Children’s encouraged children in the Oncology Department to “think positive thoughts and believe that you will get better!” Geller bent spoons with the children, chatted with them at eye level, and delighted not only the youngsters but also families and staff members alike. The Friends Association is deeply indebted to Mr. Geller for contributing his honorarium while in Israel to Schneider Children’s. About 25% of malignancies in children are brain tumors – a complex field, where medical achievements still do not match those of other cancerous diseases. The Oncology Department is trying to advance the outcome of therapies for brain tumors by integrating cutting-edge neurosurgery with chemotherapy treatments, supportive care and rehabilitation, while simultaneously promoting understanding through research. “The objective is to open therapeutic avenues that will ultimately bring about recovery for many more children by minimizing the chronic side effects of treatment,” said Dr. Isaac Yaniv, Director of the Hemato-Oncology Department. The prolonged effort recently found expression during Research Week which included lectures and the 2nd Pediatric Brain Tumor Symposium. The event attracted a large audience from the Pediatric Oncology, Neurology, and Neurosurgery communities in Israel mainly due to the keynote speaker, Prof. Eric Bouffet. Prof. Bouffet, an expert in pediatric brain tumors, visited Schneider Children’s within the framework of the Schwartz-Reisman Visiting Sick Kids Scholarship Program sponsored by the Hospital for Sick Children in Toronto, Canada. Cardiac Surgeon Becomes Part of the Family Prof. Vidne, a cardiac surgeon who has seen it all, was surprised to discover that a period of over 20 years differentiated between his operating on a (future) grandfather and his infant granddaughter. It was a happy reunion… from the depths of the heart During his career, Prof. Bernardo Vidne has conducted over 40,000 cardiothoracic surgeries – so surprising him is no easy matter. Nonetheless, the Director of the Cardiothoracic Surgery Department at Schneider Children’s was very excited to discover that the lovely baby that he operated on, Roni Attar, was the granddaughter of Assaf Attar, on whom he had performed surgery more than 20 years ago. Prof. Vidne conducted an open-heart operation on baby Roni due to a congenital heart defect that obstructed the flow of blood to her lungs. Her grandfather, Assaf, had a valve repaired – “a procedure that was thought dangerous at the time,” recalled Prof. Vidne during the emotional meeting with grandfather and granddaughter. Now, we can add another title to Israel’s leading cardiac surgeon: “Family Surgeon”. On The Cutting Edge Of Medicine From Scans to Cure The new gamma camera that was acquired through a generous contribution from Germany of more than $200,000 (plus additional assistance from Clalit Health Services), has upgraded activities in the Nuclear Medicine Institute at Schneider Children’s. We spoke with Dr. Zvi Bar-Sever, Director of the Institute What is nuclear medicine? “It involves scanning with radioactive compounds to diagnose early-stage disease. Certain substances injected into the body localize selectively in organs and tissues thus indicating levels of disease. The gamma camera absorbs tiny amounts of radiation emitted from the body and translates Dr. Zvi Bar-Sever it into a computerized image. The way in which these materials are absorbed by the body shows the physiological and biochemical function of the organ. Sometimes this is the only evidence of disease in the body.” What is the most common scan that you do? “Bone scans for the identification of infection or trauma to the skeleton, kidney scans and oncological follow-up for tumor remains. The high sensitivity of scans is the only way to track disease processes in bones and organs at these early stages. Many decisions regarding treatment and surgery are based upon the results of scans.” What is so special about the new camera? “This camera is a ‘hybrid’ that also includes a CT, and enables a connection between the two examinations. The CT emits very low radiation and is not an alternative to a standard CT – although it provides the precise location of pathological concentrations demonstrated in the scan. We recently conducted a scan in a child with neuroblastoma. The nuclear scan showed a suspicious concentration of pharmaceuticals in the left side of the abdomen. Merging a CT image with the scan showed that the dramatic concentration which seemingly indicated a recurrence of the disease, was a rare variation of the physiological absorption in the brown fatty tissue. Only through the CT, which provided us with a precise location in the abdominal cavity, did we know for certain that this was not a tumor and thus prevented a biopsy and chemotherapy. This is an excellent example of diagnostic precision that combines two imaging techniques in one examination.” Shortly: LCD ceiling “to hold” children A TV set and DVD are only allowed in the Nuclear Medicine Institute for therapeutic purposes: with them, young children are able to remain still until the completion of the examination. As if to underscore this point, Dr. Bar-Sever initiated the establishment of an impressive LCD ceiling comprised of several adjacent screens. Friends of Schneider Children’s has already received a generous contribution towards this objective, but $10,000 are needed to complete the project. “We are hoping that another contribution will make it possible ‘to raise’ the ceiling,” said Dr. Bar-Sever. Checking Kidneys – With Heart The multidisciplinary staff in the Nephrology Department includes many doctors, nurses and paramedical professionals, and treats the child suffering from chronic kidney failure along the long road to survival and quality of life. From the moment of diagnosis in the Nephrology Clinic, through dialysis treatments, to a kidney transplant and prolonged follow-up care spanning years – these are the pediatric nephrology experts who integrate medical excellence, outstanding empathy for their young patients and an ability to give with their heart and soul Shahar was 18 months old when she was brought to Schneider Children’s with kidney dysfunction. Her condition quickly deteriorated into terminal renal failure and her father offered to donate a kidney. Attached immediately to a dialysis machine in the Nephrology Department, doctors feared that the child might be carrying a genetic mutation which would necessitate excision of both her kidneys. The results of her blood tests, which were sent from the Genetic Analysis Center in England, confirmed suspicions. Soon thereafter, Shahar underwent transplant surgery: while the first surgical team removed her kidneys and one kidney from her father, another team transplanted the organ into the infant’s body. Despite a rare infection which necessitated intense and precise treatment after the transplant, she was discharged with a perfectly functioning kidney that has since been performing well now for more than two years. This drama is one of many: over 70 children have undergone kidney transplants in the hospital – each child with his own story, and each one a world unto himself. The long road back to a normal life begins in the Nephrology Department, moves to the Dialysis Unit and reaches a peak with transplantation and continuing care spanning years and sometimes involving a second transplant. “A close connection is created with many of our patients,” says Dr. Miriam Davidovits, Director of the Department. As a national pediatric referral center, Schneider Children’s conducts about 95% of kidney transplants in children in Israel. Numerically speaking, this amounts to about 20 transplants a year. The percentage of success is high and on a par with leading centers in the world. Dr. Natan Bar-Natan, Director of the Pediatric Kidney Transplantation Service, knows every patient and family personally. “Sometimes, the need for a transplant results from an acquired and debilitating disease, but other times the child suddenly becomes ill – and from a completely healthy child, parents must face a transplant in a matter of days. This is definitely a shock, as is the long wait for a kidney and when it finally arrives, parents’ joy is mixed with foreboding and uncertainty.” The Dialysis Unit at Schneider Children’s, the largest in the country for children, enables young patients to survive until a suitable kidney is found. “Dialysis is a critical interim stage - especially during the long wait for a donor kidney – without which it is doubtful if the child would arrive at a transplant at all,” notes Dr. Davidovits. Although only a transplant can dramatically improve quality of life, this does not transform a sick child into a healthy child. Transplantation involves a “Catholic marriage” with the hospital, requiring prolonged medications and close follow-up. Prof. Eytan Mor, Director of the Transplantation Unit at Schneider Children’s, explains: “A transplanted kidney has an average life span of 10-15 years so that in most cases, our patients are ‘returning customers’. A transplant can only be deemed a success about 6 years after the operation.” Transplantation is a complex process: Together with Dr. BarNatan, departmental staff is actively involved in immediate post-surgical care alongside the transplant team and personnel from the operating theater, anesthesiology, intensive care and other departments, as well as social workers, dieticians, psychologists, physical therapists and paramedical teams. The majority of recipients are hospitalized in Pediatrics C, where the nursing staff bears the responsibility of the critical post-surgery period requiring medications and preparation for continuing care upon discharge. A significant role is played by the transplant coordinator, Rachel Beregin, who, over and above technicalities, accompanies the parents providing guidance and support. The prolonged followup, sometimes 10 years or more, is managed by the Nephrology Department. “We are blessed with a highly professional, wonderful and caring multidisciplinary team,” says Dr. Davidovits. “Schneider Children’s has an excellent cadre of specialists from different disciplines. Our work is so complex and emotionally-charged that it would be impossible to accomplish without the support of one another. This is our strength.” Dr. Davidovits has a professional aspiration of establishing a research facility and nephrology laboratory as expected of a national center. The Nephrology Research Laboratory would be dedicated, inter alia, towards tissue engineering and the use of stem cells for renal tissue replacement in cases of acute and chronic renal injury. Findings will constitute a breakthrough and promote the care of children with end-stage renal failure. “But dreams come true here as a matter of course,” she says, recalling the story of a girl, who underwent successful kidney transplantation a few years ago following years of dialysis treatments, and recently visited the medical center with her two children. “Our best reward however is to see children with a new lease on life,” she concludes. “When we can help a child to hold on until a transplant, and then see them return to normal life afterwards, sometimes volunteering in the Israel Defense Forces or starting a family – this is the greatest satisfaction for any doctor.” The Art: Hemodialysis in an Infant Almost 20% of patients in the Dialysis Institute at Schneider Children’s are babies and infants who weigh less than 15 kgs (33lbs). “Performing hemodialysis in an infant is a true art due to the size of the blood vessels, unstable blood pressure, and the difficulty of holding a baby still during the four hours he is connected to a machine and monitor,” says Dr. Davidovits. The medical team is assisted by an art therapist, a social worker and volunteers who distract the babies and children during their 12-15 hours of weekly treatments, which are “erased” from their lives. Research First of its Kind Vaccination Against Colon Infection Research data collected by Prof. Shai Ashkenazi has found that the rotavirus leads to at least 4,000 hospitalizations every year and some 15,000 hospitalization days. The good news: now there is a vaccine already approved in Israel Summertime is characterized by a seasonal rise in the incidence of infections of the digestive tract, especially those caused by bacteria such as shigella (dysentery germs) and salmonella (an important cause of food poisoning). Infections are expressed by recurring diarrhea, which sometimes can consist of blood or mucus, and accompanied by vomiting and fever. The main reason for hospitalization is dehydration. While the summer season represents a time for increased colon infections, the most common virus that causes diarrhea in children is in fact gaining ground during winter. This is the rotavirus that - while prevalent throughout the year - shows a rise in incidence mainly in the cold months. In a research study headed by Prof. Shai Ashkenazi that took place in 6 Israeli hospitals, it was found that the rotavirus causes at least 4,000 hospitalizations each year and about 15,000 hospitalization days. Some of the children also developed complications such as convulsions and blood infections that required hospitalization in the intensive care unit. Prof. Ashkenazi noted that recently, a vaccine was approved for use in Israel against the rotavirus that represents the first vaccine of its kind against colon infections. The vaccine is administered orally three times to an infant from the age of 6 weeks until 32 weeks. Inoculation Against Flu Nasal spray more effective than injections! International research headed by Prof. Ashkenazi Pioneering international research headed by Prof. Shai Ashkenazi of Schneider Children’s has found that flu vaccination via nasal spray is 53% more effective than vaccination via injection. Prof. Shai Ashkenazi The study involved 114 medical centers around the world and included 2,187 children between the ages of six months to six years, who suffered from chronic infections of the airways and were therefore at higher risk of a contracting severe influenza. The children were divided arbitrarily into two groups, one of which received vaccinations via injection and the other via nasal spray. Findings revealed that the nasal spray was markedly more effective in preventing flu and reduced the number of doctor visits as well as kindergarten and school absenteeism. The spray vaccine was approved by the Food and Drug Administration (FDA) in the United States for ages 5-50, but has not yet been registered in Israel. As a result of the new findings, the FDA is discussing the possibility of approving the vaccine also for smaller children. The research findings were published in the prestigious Journal of Pediatric Infectious Diseases. Prof. Ashkenazi, an expert in infectious diseases, is the Director of General Pediatrics A and the head of the Research Unit at Schneider Children’s. New Gene Discovered that Causes Fatal Degenerative Disease in Children Another achievement for Schneider Children’s Genetics Institute A team of researchers from the Genetics Institute at Schneider Children’s, led by Prof. Motti Shohat, Dr. Lina Basel and neurologist Dr. Rachel Straussberg, have identified a genetic mutation causing the debilitating disease called Infantile Bilateral Striatal Necrosis (IBSN). Symptoms of the rare disease appear only after the age of one year, and are characterized by difficulties in swallowing, weight loss, impaired development and severe movement disorders. ISBN can lead to death before the age of 10 and is common mainly among the Bedouin population in Israel. The gene causing ISBN was unknown until now. According to Dr. Lina Basel, “identification of the disease-causing gene will enable early and accurate diagnosis of patients, including prenatal women from high risk families. Study of the mechanisms of IBSN will promote better Dr. Lina Basel understanding of the degenerative processes in the brain and lead to the development of new medications in the future for improved treatment of debilitating diseases for which a cure has not been found.” 10 Highlights Huge Advances in Microscopic Surgery Dr. Dragan Kravarusic Laparoscopy at Schneider Children’s has gained speed – due in large measure to Dr. Dragan Kravarusic, who recently returned from advanced training in Canada Over the past decade, more and more operations are being performed by minimal invasive surgery (laparoscopy) – a method that prevents an open incision of the abdomen and promotes rapid recovery without scarring, reduced pain and hospitalization. Schneider Children’s recently introduced these procedures in children with very low body weight. For the first time in Israel, the Department of Surgery, headed by Prof. Naftali Freud, utilized this technique to repair a congenital condition known as Bochdaleck’s hernia, and reduction of a prolapsed bowel (intussusception). In addition, laparoscopy has also been introduced to repair obstruction of the stomach valve (pyloric stenosis). Success is due in no small measure to Dr. Dragan Kravarusic, who returned to Schneider Children’s following a two-year fellowship at Calgary Children’s Hospital in Alberta, Canada, where he advanced his knowledge and skills in pediatric laparoscopic surgery. “In Calgary, more than half the general surgeries in children are performed by minimal invasive surgery, including infants weighing less than 5kgs (11 lbs),” says Dr. Kravarusic. “Experience has shown that this is the preferred method of surgery by both medical teams and parents for all types of operations in children.” Multiple Organ Donation It is extremely rare to receive organ donation from a child or adolescent, yet the family of a child who was fatally wounded gave four children a new lease on life. The multiple surgeries took place simultaneously by transplant teams at Schneider Children’s. The heart was given to a 12-year-old girl who suffered from a disease of her heart muscle. The liver was given to a five and-a-half-year old girl, who had been waiting 7 months for a liver transplant. The two kidneys were transplanted in two boys aged 4 and 6. Liver recipient and her father 11 The Journey From Silence To Sound Cochlear Implants “Today, a deaf child is already a thing of the past” When a profoundly deaf child becomes a hearing child and learns to speak, this is a medical, technological and rehabilitative triumph of the first order. In 2006 alone, 34 hearing-impaired children underwent Cochlear Implantation (CI) at Schneider Children’s – and began to hear. “A cochlear implant is one of the most impressive developments in the field of Otology and Audiology,” says Dr. Eyal Raveh, Head of the ENT Unit. “Today a deaf child is already a phenomenon of the past. This is not hocuspocus, but rather a combination of superb technology and two great teams.” On average, 5 out of every 1,000 children suffer from some deafness while one or two are born profoundly deaf. The Audiology Institute, headed by Prof. Joseph Attias, sees about 6,000 children annually, most of whom suffer from intermittent hearing problems with about 1,000 diagnosed as hearing impaired requiring intervention. The earlier the hearing impairment is diagnosed, the greater the chances of success. Consequently, Schneider Children’s conducts hearing tests in newborns and rehabilitation already starts at birth. “The window of opportunity is open until the age of three years,” explains Prof. Attias, “otherwise difficulties in balance and understanding develop. The cochlear implant is currently performed at the age of a year, which allows the brain to quickly learn how to detour imprecise sounds. We teach the deaf child to differentiate between the electronic impulse and the significance of the stimulation. In a normal person, there are 1,500 hairs, each one of which is an auditory channel. A child with a cochlear implant has 20 auditory channels. In fact, he only hears peripheral sounds and great emphasis is placed on rehabilitation in order to train the brain to complete the sounds. In this way, we are eliminating the deaf-mute from this world: when a child learns to hear, he also learns to speak.” About 160 cochlear implants have been performed thus far at Schneider Children’s. Despite very safe and reliable technology, each implant is a project and constitutes a ‘Catholic marriage’ with the clinic, involving prolonged rehabilitation and follow-up. Technology is advancing rapidly with the future in miniaturization of the implant, i.e. insertion of the entire implant without any exterior device. “Eventually, we will be able to improve programming so that a deaf person will hear with the quality of a CD” says Prof. Attias. “Afterwards, we will need to ‘train’ the nerve to grow over the implant so that in fact it becomes part of the body. At the same time, we hope to reach the optimal combination of an implant together with medication to revive the remains of hearing or to preserve them. If we find that it is not possible to repair the nerve, the implant will be placed directly on the brain stem and bypass the nerve. Perhaps this will take time, but the vision will be realized.” Beyond the Implant The journey from silence to sound involves a long and difficult road for both parents and child; the older the child, the more complex the rehabilitation process. Adolescents in particular must deal with a challenging array of conflicts alongside pubertal development. Common to all is the need for emotional support throughout the intensive and prolonged aural rehabilitation. In order to promote ultimate success, Schneider Children’s would like to create support groups – unique in Israel – where CI youngsters can voice their hopes and fears among same-age peers in the their situation. The only problem is lack of funding resources. A contribution of $3,000 will sponsor one support group of 12 two-hour sessions. 12 International Visitors Ambassadors Galore… From Japan… A delegation of leading Japanese sumo wrestlers replete in traditional garb was conducted under the banner of "brotherhood and peace". From Khatimansisk, Siberia… A delegation of 9 officials from Khatimansisk in Siberia were particularly impressed with Schneider Children’s computerized system of medical folders. Four Ambassadors to Israel visited Schneider Children’s and joined the growing list of previous Goodwill Ambassadors. From Egypt…Charismatic Ambassador Mohammed Issaem Ibrahim declared “what I have seen has exceeded my expectations”; from Austria… Dr. Kurt Hengl; from Angola… Mr. José João Manuel; and from Australia… Mr. James Larson. From Angola… A delegation of three Angolan physicians discussed cooperation through the advanced training of physicians and patient referrals for treatment. From Brazil… Luiz André dos Santos Gomez summed up his visit of Schneider Children’s as “un hospital extraordinario”! From Australia… A 20-member group under the auspices of Manna International from Adelaide, Australia, arrived for their annual visit led by the indefatigable Colin Stock. From Singapore… From Moscow… The Victoria Children’s Foundation sent three representatives to learn about psychosocial rehabilitation for children. From Africa… A special mission came to Israel to study the country’s health system and the treatment of AIDS from the Ivory Coast and Ruwanda. From Tomsk, Siberia… The objective of the Tomsk delegation was to establish a fellowship exchange program in Pediatric Hematology-Oncology. Mrs. Jennifer Yeo, wife of Singapore’s Foreign Minister, George Yeo, who was in Israel heading a delegation of their country’s leading business people, is an attorney and a champion of social causes including children with cancer. From Chile… The Mayor of Padre Las Casas and his party of two visited Schneider Children’s as part of a study tour of the health network in Israel at the recommendation of the Israeli Ambassador in Chile. 13 Friends With Heart Across The Oceans Support of Schneider Children's crosses borders and continents, connecting institutions, organizations, businesses and individuals from all corners of the globe, in a united display from the heart – and within From the UK From Italy Life-Saving Marathon Sailing with the Torino Community 900 athletes participated in the 30th Tiberias Marathon, but only for one of them, this was a race to save a life. Daniel Rose ran in the international event in January in order to raise funds for the Hematology-Oncology Department at Schneider Children’s, where his 18-month-old nephew was hospitalized. The child had contracted Ewing’s Sarcoma, a rare type of tumor that attacks the bone and soft At the initiative of Nora Bengio, long-time friend of Dr. Aviva Ron, Executive Chair of Friends of Schneider Children’s, a group of 50 enthusiastic supporters of the hospital gathered together in Torino, Italy, at a unique fundraising event. Under the auspices of Friends, Mrs. Bengio arranged for a special dinner party aboard a boatrestaurant on the River Po. As it was the Festival of Purim, guests donned original masks which were all handmade by children hospitalized at Schneider Children’s and watched the premier of a new movie about the medical center. Maestro’s Visit: Bravo! Daniel Rose and Dr. Yaniv, Director of the Hematology-Oncology Department at Schneider Children’s tissue. “I feel helpless and I love sport,” said Daniel, “so running in the marathon was my way of doing something positive.” Contributions from his circle of family and friends were donated through Friends of Schneider Children’s to the Oncology Department. Israel at 60 Expo The Association of Friends of Schneider Children’s participated in the Zionist Federation of Great Britain’s “Israel at 60” Expo that took place at Wembley on November 11th. Friends was represented by Coordinator, Ziva Caspi. A musical visit such as this does not happen every day: the acclaimed Italian conductor, Riccardo Muti, visited the HematologyOncology Department at Schneider Children’s and was the recipient of a short percussion recital performed by hospitalized patients in his honor. Maestro Muti, who was in Israel to conduct the Israel Philharmonic Orchestra in celebration of the orchestra’s 70th anniversary, was accompanied by his wife and the Contessa Emanuela di Castelbarco, granddaughter of Conductor Arturo Toscanini. The Maestro donated his honorarium from the gala concert to the Hematology-Oncology Department towards an Arabic-speaking social worker within the framework of the hospital’s “bridge to peace” efforts. Thank You! The Spirit of Giving To our many wonderful donors in Israel and abroad, Friends of Schneider Children’s would like to express its heartfelt appreciation for your unstinting support and generous contributions that you have made during the past year. Together, your donations have surpassed the highest totals reached in all previous years, helping to fulfill our objectives. We are proud to mention some of the many projects that have resulted from your generosity which continue to make the difference between “have” and “have not”. May you be continually blessed. Thank you!! Would you like to be part of the world of medical excellence? • $240,000 towards a Neurosurgical Microscope • France - $170,000 towards the Emergency Room Expansion • Mexico - $100,000 towards the Cardiac Intensive Care Unit • Photography exhibition • Art Exhibition • Children’s annual artwork exhibition supported by Bank Discount for the past four years • $60,000 towards an ultrasound for the Surgical Suite • United Kingdom - $20,000 towards research 14 Would you like to support the future of the children of Israel? You can do so by contacting Friends of Schneider Children's at [email protected] Contributions made in Israel, the United Kingdom and the United States are all tax-deductible. "We make a living by what we get; We make a life by what we give" (Anon) From Australia Dear Friends, Fundraising throughout the year has been directed to the expansion of the Emergency Room with lifesaving gifts made to the Cystic Fibrosis Unit and Pulmonology, Oncology and the Social Services Department. My thanks to our many new friends in Victoria, New South Wales and Queensland, as well as to the students at Bialik College, Beth Rivkah Ladies College and Leibler Yavneh College in Melbourne and Moriah College in Sydney. Mazeltov to Bnei Mitzvot: Nechama Pilcer, Dalia Lederberger, Sophie Teperman, Keren Schneeweis, Rachel Elbaum and Adrian Rich, who all requested donations to the hospital in lieu of gifts. This year we look forward to fundraising cooperation with United Israel Appeal Victoria in order to support sick immigrant children from Ethiopia and Russia. Wishing you all good health, Sincerely, Annie Silver Chair, Melbourne Friends of Schneider Children’s Batmitzvah Joy Rachel Elbaum jumps for joy wearing her Schneider Children’s t-shirt in celebration of her batmitzvah. In lieu of gifts, Rachel asked her guests to make donations to benefit sick children at Schneider Children’s. Mazaltov and many thanks! “This is Not Only a Gift for You, But Also for Me” Einat, 15, from Petach Tikvah met Esther from Australia who saved her life. Those there will never forget This was one of those moments which one can never forget. Einat Zinger, a 15-year-old girl from Petach Tikvah, whose life was saved by a bone marrow transplant, met the donor for the first time - Esther Ciechanowski, from Australia, who was on a visit to Israel. Einat had been waiting for three years for a bone marrow transplant since she became ill with cancer. Following a search in the world registry of potential donors, a suitable donor was found in Australia about a year ago. “I heard about an Israeli girl who needed a transplant and I did not hesitate,” said Esther. “I believe that those who can help others cannot choose not to do so.” Einat underwent the transplant in the Bone Marrow Transplantation Unit headed by Dr. Jerry Stein. Her life was saved by the donation and today she is in follow-up care at Schneider Children’s. “I am glad that I could help you, Einat – this is a gift not only for you but also for me,” said Esther to an emotional Einat. Dr. Stein too had difficulty hiding his feelings. “I am honored to be at this extraordinary meeting and pay tribute to Esther’s willingness to respond. I hope that this act will raise awareness and readiness in many others to join the world registry of bone marrow donors.” Bialik College Primary School On a cold and wintry day, primary school students participated in Pyjama Day (why bother putting on your school uniform when you can just hop out of bed and come to school in your favourite pyjamas?), a fun-filled event that served as a fundraiser for Schneider Children’s. Bialik College’s Primary School has supported the hospital for the past few years raising both awareness and funds for the Clowns Program and Emergency Room expansion. 15 Story Sounds… The Education Center at Schneider Children’s works under the auspices of the Ministry of Education and comprises a team of 20 Jewish and Arab special education teachers and therapists. Within the framework of their annual project, they selected to introduce children to literature, through which children embarked upon a wonderful and magical voyage on the wings of words, drawings and imagination. At the start of their journey, children read or listened to stories. An array of books was selected for the project from Hebrew bestsellers to universal classics and popular legends. The resulting imagery prompted the children to search for both apparent and hidden meanings as well as within themselves, to struggle with moral dilemmas, to become acquainted with styles of coping and different perspectives, to discover existing and new figures, to feel different emotions and to express aspirations and hopes. Children were then asked to present tangible and creative perceptions of their personal dialogue through various means: writing, drawing, sculpture, music and computer. During an era where computers and technology somewhat relegate the world of books to the corner, we chose to emphasize their importance while wandering along magical paths and listening together to the sounds of words.
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