Syrian Child
A Syrian child in Haifa, Israel's Rambam hospital with neurosurgeons Dr. Joseph Juilburd (left) and Dr. Sergey Abeshaus (right) Pioter Fliter RHCC

SAFED, Israel -- A gleaming external fixator -- a medical stabilizing device -- screwed into his broken leg, Kareem (as he asked to be identified) is recuperating in the orthopedic ward at Ziv Medical Center in this northern Israel city.

Kareem was heading home to his family on a motorcycle last October to a small town south of Damascus, bringing bread that he had bartered in exchange for milk, when a mortar shell hit the road. Kareem lost his balance and crashed into a car driving in the opposite direction. He suffered multiple fractures in his left leg and in both hands. With only basic medical care available at the local clinic, while other cities were inaccessible because of the conflict, and the border with Jordan closed that day, Kareem had no other option but to turn to the place he had hated all his life, across the Syrian southwestern border: Israel.

“They occupy our land. Israel is our enemy,” he says. “That is true as much as the fact that the Syrian Army is killing us. I needed treatment, and when one is drowning, every stick is good to stay afloat.”

Kareem, 50, shields his face from a video camera with one hand, fearing that he and his family of six would be in danger if someone back home knew that he had sought help from the enemy. Israel and Syria have been at war four times between 1948 and 1982. As a result of the Six Day War in 1967, Israel retained under its control most of the Golan Heights, where about 20,000 Syrians live today. No peace treaty has been signed between the two countries since, and the area is considered to be under occupation according to international law.

All of which makes Kareem’s experience more poignant.

“I received a good treatment here,” Kareem says of Ziv. “Israel is not like what I had heard from the Syrian regime.” Kareem, who is to be repatriated later in the day, is among 700 wounded Syrians rescued by Israel since February 2013. While one-third of them have been treated at the border or at a nearby military field hospital and sent back, the majority have been brought inside Israel for further hospitalization in Haifa, Nahariya, Safed and Tiberias.

“We have many serious cases here, people with complicated trauma to several internal organs or with limbs that we had to amputate,” observes plastic surgeon Shukri Qassis after his routine check on Kareem and the other five patients in the room. As an example, Qassis points to a young man who was hospitalized with large wounds in his chest and back. He needed skin transplants and a special treatment to regenerate soft tissue. But, he concedes, doctors are not always able to put people back on their feet. Five Syrians succumbed to their wounds shortly after their arrival in Safed.

During our stay at Ziv, chatty Israeli physicians and nurses, speaking fluent Arabic, try to cheer up the patients. Social workers offer help and personnel from the International Committee of the Red Cross and the Israeli Army drop by to check on the Syrian patients. Around 75 percent of the 250 Syrians received by the hospital in the past year are adult males, and it would not be unreasonable to assume they weren't all innocent civilian casualties of the Syrian war. Some of the injured men may well have been Syrian government soldiers or fighters in the various rebel groups that oppose President Assad’s regime.

In 2012, in Ramtha, a town at the Jordan-Syria border, combatants from the Free Syrian Army -- one of the main anti-Assad militias in Syria -- were intermingled among civilians to seek medical assistance or simply to rest from the fighting. Since then, the number of Syrian refugees in Jordan has grown to more than half a million, according to the United Nations, and another 2 million are spread among Egypt, Iraq, Lebanon and Turkey.

“The nature of the injuries we treated on Syrian patients indicates that they were hit by bullets, shrapnel, bombing of all kinds, or injured as a result of buildings collapsing or fire, and sometimes a combination of all of those,” says Oscar Embon, director of Ziv Medical Center. “But whether they are soldiers or combatants from one side or the other is not an issue for us. Here, they wear no uniform.”

According to Embon, after treatment that costs an average of $15,000 and a three-week stay during which -- for security reasons -- they are not allowed to leave the hospital, Syrian patients are discharged and escorted by the Israeli Army back to the border.

The security issues often mentioned by doctors at Ziv Hospital relate to the personal safety of the Syrian patients. As most of the ethnic Syrians living in the Golan Heights are pro-Assad, the fear is that someone may come to hurt or identify and later report on the Syrian patients to the Syrian regime. Therefore, the hospital policy about visits is very strict. “I tried to visit with some friends, but the patients don’t like to talk to us,” Salman Fakherideen tells IBTimes over the phone from Majdal Shams, a Syrian town under Israeli rule in the Golan Heights. “I believe everyone has the right to be helped, even by Satan. But I think also that Israel should not just take credit for its medical help and then send those people back to Syria. It is not safe there.”

The Israeli government acknowledged its assistance to Syrian victims at the end of last year, and Prime Minister Benjamin Netanyahu toured the field hospital in the Golan Heights only few weeks ago.

“It is important that the world sees the pictures from this place, which divides the good from the bad,” Netanyahu said at a press briefing after visiting the Israeli field hospital at the border with Syria. “The good part is that Israel is saving the lives of those who have been wounded in Syria. The bad part is that Iran is arming those who are carrying out the slaughter.”

One of the reasons behind such a delay before going public was the need to build some trust, according to Col. Tarif Bader, head of the Israeli Northern Medical Command. “At the beginning, when we treated the first seven cases in February 2013, that was for us the first humanitarian mission at our border -- a hostile border, even. And for the Syrians, it is probably not easy to face a physician wearing an Israeli military uniform,” he tells IBTimes at Mount Bental, the site of a famous tank battle during the Yom Kippur War and today a tourist overlook in the Golan Heights. “Over time Syrians have realized that their lives can be saved here. I hope that trust-building between Syria and Israel, and perhaps a future peace deal, may be started by the 80 to 100 wounded Syrians that we treat every month.”

All of which raises the question: Could Israel grant further protection to Syrians being treated there? The first obstacle would probably be Israel’s own security concerns, so far minimal because of the low number of emergency cases Israel has dealt with. “A security screening is always performed by UNDOF personnel [the United Nations Disengagement Observer Force deployed since 1974 on the Israeli-Syrian ceasefire line agreed to at the end of the Yom Kippur war] who are first to be approached by someone who comes from the Syrian side of the border,” explains Mordecai Kader, director of the soon-to-be-opened Center for Islam and Middle East studies at Bar-Ilan university in Ramat Gan, Tel Aviv. “Only then Syrians are handed to the Israeli Army. But this remains a humanitarian mission for Israel. As for the claim circulated in the media that we try to turn those people into intelligence assets, I can say that this is not the way we recruit people. That process takes years,” added Kader, a former Israeli military intelligence officer.

Another obstacle is a legal one. “Israel is a signatory to the international conventions on refugees,” notes Yuval Shani, professor of International Law at Hebrew University in Jerusalem. “If those Syrians fear persecution and they can individually substantiate this claim, they can make the case to obtain refugee status. Syrians may also have another option. They could stay in Israel under ‘group protection’ until the situation in their country calms down. But this needs a political green light first, a decision that the Israeli government hasn’t made so far.

“Of course, the most important precondition is that a Syrian treated here is willing to establish a case against deportation back to Syria,” Shani, who is also a member of the United Nations Committee on Human Rights, adds.

So far, none of the Syrians who have been treated at Ziv has asked to stay in Israel. And it is likely that the seven to 10 Syrians who arrive every week in Safed won’t make that request, either.

As Kareem puts it, “Everyone wants to go back to his wife, kids and land.”

Before leaving the hospital, he expresses the hope that Syria and Israel will one day make peace. But for now, the two countries remain officially hostile, and the Syrian civil war has meanwhile claimed 140,000 lives in almost three years.