Subsequent to the war, numerous surveys indicated increasing needs, on the one hand, and decreasing options for meeting those needs, whether the needs were of schoolchildren or adults, and whether the needs were for school councillors, social workers, psychologists or psychiatrists.

With regard to resilience centers, whose purpose is to provide emergency mental health care, their treatment schedules were curtailed, and the continuation of treatment at health funds for individuals in need was and still is limited by a shortage of personnel.

Everything boils down to money: Israel spends relatively little on public mental health care, evidenced by the percentage of the total budget for public health care budgeted and expended on mental health care. For example, during the years 2016-2021, the budget for public mental health services constituted no more than 4% of the expenditures on total  public health care , in 2022 it amounted to 5%, and during the years of the 2023 war, 6%, followed by 7% budgeted for 2025. However, that budget increase (following a war, it should be remembered), is not impressive when compared with the recommended 10% spending on mental health services in high-income OECD countries and with the actual percentage in western European countries, which is much higher — between 12% and 16%.

The present crisis in the treatment of individuals in need of mental health services is first and foremost a crisis of personnel, that is, the difficulty of attracting mental health specialists to the public services, and the shortage of positions in those services, as well as the need to define the number of patients to be treated by professionals in each specialty.

The main recruitment obstacle is the pay, which fails to reflect the investment required with regard to study and training, and is much lower than that in the private sector. It should be pointed out that the majority of public sector mental health workersare women; their inadequate pay contributes to the larger phenomenon of what we havereferred to in other studies as “the treatment deficit.” The shortage of personnel and of positions results in a huge workload, leading to further erosion and leakage of man and woman power from the public services.

The origin of this crisis is inadequate budgeting of the public services over the years, resulting in the inability to provide public mental health services in accordance with demand. Two serious crises that occurred in recent years – the corona epidemic and the October 7, 2023 war – resulted in a sharp increase in needs for such services on the part of the general population as well as of specific social groups – needs that the mental health and welfare services find it hard to meet. This situation is harmful especially to poverty-stricken families and individuals residing in the economic and geographical periphery of the country, where the services are even less accessible, but also to members of the middle class who may find private services beyond their means.

The Ministry of Health introduced a reform that included a budget increase, but its implemention remains partial, due mainly to an ongoing shortage of personnel. Following the 2023 war, mental health services were budgeted at 1.4 billion shekels for the years 2024-25, and in 2025 two labor agreements were signed that significantly increased the salaries of psychiatrists and psychologists employed in the public services. A similar amount was allocated to the Rehabilitation Department of the Defence Ministry, in charge of the treatment of soldiers. However, no solution was provided for the shortage of psychologists, psychiatrists, social workers, educational psychologists and educational counselors.

Raising the salaries of psychiatrists and psychologists is an important step that has the potential to attract personnel to the public services, but it was taken very late, and it will take years to harvest the fruits of that move. Moreover, no decision was taken regarding how many patients were to be treated by each mental health expert, thus failing to deal with the huge burden experienced by each — and the subsequent erosion.

Against the background of mental health problems that arose or worsened due to the 2023 war and the social groups that were highly affected, among them reserve soldiers and residents dislocated from their homes, and the inability of the social services to answer the many calls for help, it is entirely likely that the problems will increase in severity. The steps taken to provide real time care, like crash courses for psychology graduates prior to their specialization and their inclusion in the cadre of treatment personnel, the creation of positions like trainers and supporters of mental fortitude, and chat-bots set up by the health funds, are no substitute for genuine professional treatment.

Mental health services cannot be dependent upon ad hoc solutions or emergency services, which are but poor substitutes for professional help: they need to be part and parcel of ongoing, long-term government services that are properly budgeted; otherwise the burden will remain on individual families and thousands of persons in need will remain without.

Translator’s note: This report was written prior to the Iran war, which has no doubt increased the needs described herein.

The full research in Hebrew is available here.

הפוסט The Serious Crisis of Mental Health Services in Israel הופיע לראשונה ב-Adva Center.

After the coronavirus pandemic, food security in unrecognized villages worsened. Societal infrastructures had to reassess their capacity under large-scale emergency stress. In the unrecognized villages of the Negev, exploratory research conducted in the first year and published in September 2023 highlighted how the lack of infrastructure, particularly water and electricity, directly affects residents’ food security (in Hebrew). The war that began on October 7th, 2023, and the exploratory research findings prompted us to continue using qualitative methods for this study. The subsequent findings resulted from 21 semi-structured interviews conducted in seven villages deprived of recognition. Based on these findings, we recommend developing an emergency plan for situations when the movement of Bedouin people is restricted to their villages; otherwise, future emergencies could lead to starvation.

Chapter one examines the consequences of the October 2023 war on food security in unrecognized villages. First, a traditional food rationing system in these villages, used in times of crisis, tends to promote isolationism. Second, at the war’s onset, tourism-related jobs and employment along the Gaza border ceased, which were the primary sources of income for women in the villages. Third, the war drove up the cost of living, reducing the variety of products available, mainly fresh fruits, vegetables, and meat. The loss of income, rising cost of living, and increased socioeconomic isolation has severely impacted the regular food supply in households. These three effects of the ongoing war are expected to undermine food security and compound into worsening long-term health issues.

Chapter two addresses the measuring of food security in unrecognized villages. The interviewees noted that discussing food insecurity is considered shameful in Bedouin society. Shame complicates access to accurate quantitative measurements of Bedouin food insecurity. Additionally, the approach to identifying food insecurity differs from that of most people in Israel. Some interviewees described reliance on the land and living modestly as a healthy Bedouin tradition. For instance, in response to a standard food security questionnaire, “Did you skip a meal in the last two weeks?” the answers are likely to be negative, as olive oil in pita bread is regarded as a meal. Food security questionnaires must be tailored to local contexts, or else connotative discrepancies can lead to inaccurate results.

Chapter three examines the gendered division of labor concerning food security within the household. Traditionally, women leave their homes to move into a home within the men’s community. It is important to note that the Bedouin household is traditionally organized as a network instead of a nuclear unit. Dependents frequently experience flexibility within their family structure. As a result, the husband’s extended family dependents may live in the husband’s household. Gender-based power dynamics within the home are typically dictated by conservative patriarchal norms that enforce gender roles in the context of food security. Women are expected to perform domestic and reproductive labor, while men are expected to be the breadwinners. Both gendered labors attribute to food security in the household.

The conclusion emphasizes the need for comprehensive research and locally focused policy. Regarding research, conducting studies that resonate with the culture and challenges of daily life in each village is recommended instead of relying on standard food security questionnaires. Furthermore, it is essential to adapt measurements and responses to reflect the perceptions of Bedouin villagers and ensure that all questions are tailored with gender sensitivity. Regarding policy, protocols must be established to protect Bedouin villagers from starvation in emergencies and non-emergencies. A consistent and storable source of fresh food must be developed to promote self-sufficiency. During non-emergency periods, it is advisable to adopt a flexible definition of the household, ensuring it includes everyone who may share a meal. Lastly, we strongly advocate for integrating women into stable employment that aligns with their customs and raising awareness of food security in high schools as teenagers start taking active roles in their households.

הפוסט Food Insecurity in Bedouin Villages Deprived of Recognition in the Negev Region of Israel הופיע לראשונה ב-Adva Center.

In the following, we will differentiate between the financing and the supply of healthcare, and between the effects of what appears to be an increase in private provision of healthcare services on patients, physicians, health maintenance organizations (HMOs) and hospitals.

Firstly, in contrast to Sweden, Canada and Germany, where public and private health services constitute two distinct systems, in Israel there has been a blurring of boundaries between the public and the private sectors. Public Health Maintenance Organizations (HMOs) market their own, private insurance to members (the so-called supplementary insurance – supplementary, that is, to the universal basket of health services that every resident is eligible to receive), HMOs own private hospitals — Maccabi Healthcare Services owns a chain of 8 Assuta medical centers (4 hospitals and 4 clinics), Meuhedet Health Services owns three private medical centers; and Clalit Health Services owns 51% of Herziliya Medical Center, a private hospital. In addition, public hospitals sell private services; and private hospitals sell public services to the HMOs via a commitment to cover the cost of the service (Form 17).

Among analysts of healthcare systems, the conclusion appears to be that privatization, whether of medical insurance or actual healthcare provision (physicians, hospitals and clinics, HMOs), has a number of negative consequences on both equity in healthcare and on the viability of the public system. Privatization affects equity because not everyone can afford private insurance and private services; privatization affects the viability of the public system, because a private sector that develops parallel to the public sector “reduces the number of staff available to work in the public sector“. Moreover, with reference to the UK’s National Health Service, but relevant to other public health systems as well, “the public sector is progressively destabilized as private providers offer higher pay and select easier cases but contribute little to training [as training is done in public hospitals B.S.]”. Moreover, the private sector tends to recruit stars that serve as magnets for patients as well as for other doctors.

Obviously, the purpose of the healthcare system is first and foremost to provide services to persons in need of preventive and curative care. Just as obvious, the higher the public financing of healthcare services, the higher the potential for equity of access among those persons in need. But if the matter of financing is obvious, the matter of provision is not. If the public services are inadequate to satisfy demand, there is a logic and a praxis that says, whynot develop private services so that there are more opportunities for healthcare? This is true, of course. However, lest we forget, the private healthcare market, like other markets, is profit-driven rather than service-driven. It supplies not just services, but also business opportunities. Of necessity, then, private health services usually cost more than public services. In Israel, public health services involve national health insurance fees and copays for medications and physician visits, but not the full cost of the services, and certainly not profits.

If public services (physician visits, diagnostic tests, surgery) are not available in real time, that is, in time of need, the needy turn to private services, if they can afford them. (If they cannot afford private services, they may forego treatment). But if too many persons turn to private services, these, too, can become inaccessible. The infamous queue for public health services may be reproduced in the arena of private services, because supply is always finite and demand is not. Thus, despite the fact that many persons in need will not be able to afford private healthcare services and are not in competition for the same, the presence of two parallel systems – the public and the private – may very well sow the seeds of their own inadequacy, so to speak.

הפוסט Wanted: Reduction of the Private in Privatized Healthcare Services in Israel הופיע לראשונה ב-Adva Center.

Why did the government choose to exclusively increase funding for centers in the West Bank instead of implementing a comprehensive cross-border increase or reinforcing centers in the Gaza Envelope and the north? The government did not present any data, and there were no assertions made about the distinct needs of resilience centers in the West Bank in both the 2021 State Comptroller report and discussions within Knesset committees on national resilience. Aside from discussions about the overall shortage in public mental health services, the report and discussions emphasized the challenges of traumatic stress victims in the communities of the Gaza Envelope and the northern regions.

Data on the number of treatments provided to traumatic stress victims in various resilience centers from 2017 to 2020 highlight the disproportionate funding allocated to the West Bank centers in comparison to those in the southern regions. This discrepancy existed even prior to the exclusive increase in funding for these centers as outlined in the coalition agreements.

Either way, in light of the horrific attack of October 7^th on the southern communities and the current attacks on the northern localities, the government should rethink its decision to prioritize the West Bank centers.

The report received significant media attention. Dr. Yuval Livnat, who wrote the report said in one of the interviews: “the government must make sure that mental health services are provided to traumatic stress victims, wherever they are. It is imperative that the government explains its decision to increase allotment exclusively to the centers in West Bank. The budgets for treatment of trauma victims, must be allocated professionally and in a just manner without any political or sectorial considerations“.

הפוסט Budgeting Resilience Centers: Professional Decisions or Political Pressures? הופיע לראשונה ב-Adva Center.

The percentage of Arab Israeli physicians in Israel has been on the increase. By the end of 2021, Arab physicians constituted 24% of Israeli doctors aged 67 and younger. That same year, 43% of new licenses for physicians were awarded to Arab and Druze doctors. The share of Arab citizens in other healthcare professions is also considerable.

In times of war, as in other crisis periods such as the COVID-19 pandemic Arab Israeli medical professionals serve as a vital resource in service of the state. During their work, these professionals ignore the political exclusion of Arabs (they are not currently represented in the government), as well as their exposure to the crossfire of members of organized crime operating in their communities.

They fulfill their roles in accordance with their Hippocratic oath, which requires them to care for every human being, regardless of religion or ethnic origin. They are now working around the clock, often filling in for Jewish physicians called up to serve in the reserves.

These professionals are rarely thanked by the government of Israel and their chances of becoming citizens with equal civil rights once the war ends are negligible. Thus, following the November 2022 national elections, the coalition agreement between the Likud and its right-wing and religious partners included a statement that “affirmative action” in acceptance to medical schools would be instituted for IDF veterans (most of them Jewish) – an absurd reaction to the high percentage of Arab physicians in Israel.

Arab Israelis’ contribution to the health sector is essential

Thus, to give just one more updated example of the inequality of their civil rights, the Finance Ministry has been withholding budgets that were supposed to be transferred from the Interior Ministry to Arab municipalities.

The need for Arab Israeli healthcare professionals is not temporary and will not cease with the end of the present war. In 2020, Israel had 3.31 active physicians per 1,000 residents, lower than the OECD average of 3.64. Up until a few weeks ago, one could hear many Jewish physicians expressing their intent to relocate abroad, in reaction to the judicial overhaul. If such intents were realized, the situation in Israel with regard to healthcare professionals would be expected to worsen and the dependence on Arab professionals to deepen.

Arab Israeli healthcare professionals, “soldiers in white” in the words of Arab Israeli journalist Furat Nassar, provide Arab Israeli patients in public hospitals with the experience of a respectful and equitable relationship aling with a feeling of security.

That experience serves as a pillar of strength for the Arab population of Israel in a country where this population is still neglected or excluded in many areas. At the end of every working day, Arab Israeli healthcare professionals return to their homes in localities that have ceased to be safe havens: It should be remembered that in the last 11 years, from June 2012 to the end of June 2023, no fewer than 856 Arab Israeli men and 143 Arab Israeli women were murdered in their own communities by other Arab Israelis.

Hospitals, the places in which so many individuals experience pain and illness, are also the places of cooperation between Jewish and Arab physicians. It is incumbent upon us to remember that and to strengthen that cooperation in ordinary times as well as in emergencies.

It is an important element of a democratic state.

// The English version of this article was originally published in the Jerusalem Post.

הפוסט In war as in peace, Arab Israeli physicians’ contribution to Israel is essential הופיע לראשונה ב-Adva Center.

The nature of socio-economic data is that they become known with the passage of time – some after a few months and others after a year or two or more. In the meantime, the latest socioeconomic data for Israel published by state institutions – the Bank of Israel, the Central Bureau of Statistics (CBS) and the National Insurance Institute (NII) – are, at best, for 2021, while some are for 2020 and others for 2019.

And during those years, we were subject to another worldwide crisis with socio-economic implications – the Corona epidemic. That epidemic, which has yet to run its course, though it was shunted to the margins of the news by the sights and sounds of the Russian war against the Ukraine, caused the death of millions, the closure of numerous businesses, unemployment rates unknown since the 1929 crash, as well as huge government outlays for aid to individuals and businesses and, of course, on health.

At the same time there were individuals who not only were not adversely affected during the Corona crisis, but actually profited.

This was the case of the ten richest persons in the world, whose combined worth prior to the epidemic stood at 700 billion dollars, a sum that had doubled by 2022 to 1.5 trillion dollars.

Israel’s wealthy partake of the same phenomenon: according to the financial newspaper “The Marker,” the wealth of the 500 richest persons in Israel quadrupled over the last four years and grew by 32% between 2020 and 2021.

The figures presented below reflect the first chapters of the story of the epidemic, which is also a story of the widening of inequality in Israel and elsewhere. This, in hope that the war currently raging in eastern Europe ends quickly and will not become the main story of Israel: A Social Report next year.

הפוסט Israel – A Social Report 2022: The Inequality Epidemic Still Rages הופיע לראשונה ב-Adva Center.

I beg to differ with the Alternative Prime Minister and with all others sounding the hi-tech jive: what Israel needs more than more hi-tech is more help-tech.

Once the country with the highest number of physicians per 1,000 people –  4 per 1,000 people, Israel now boasts 3.13 (compared with the average of 3.6 in OECD countries). According to TheMarker (March 3, 2022), the future looks dim: the prediction is that 30% (583) of an estimated 1,932 medical school graduates to be licensed to practice in 2022 received their degrees from medical schools abroad whose diplomas will soon lose their recognition, due to the unacceptably low level of the medical education and the paucity of the clinical experience they offer.

Israel needs more doctors now, and the needs will grow with the population. And nurses? Anyone who has ever been in hospital knows that nurses are the professionals who actually take care of you. But they are few and far between: Israel has only 5 practising nurses per 1,000 people, compared with an average of about 9  per thousand – almost double — in OECD countries. Unlike physicians, some 40% of whom are women, nurses do not make news (84% are women).

Doctors and nurses are not the only help-tech (and other public service) professions we read and hear about day in and day out: there is a shortage of some 10,000 teachers and some 10,000 psychologists, as well as 20,000 care workers for the elderly.

In the public services, there is a dearth of positions for social workers — sorely felt during the corona crisis of the last two years. And other help-tech workers, like physical therapists, dieticians, speech therapists and occupational therapists, are also in short supply in the public services.

One of the reasons for the shortage of help-tech workers is that salaries are low, especially relative to hi-tech workers. And the majority of nurses, teachers, psychologists, social workers and physical, speech, and occupational therapists are women.

It is no secret that women’s salaries do not equal those of men, among others, because the majority of women work in occupations that underpay them; that is, there is no connection between their pay and their social worth.

No, what Israel needs more than more hi-tech workers is more help-tech workers, more positions for help-tech workers in the public services, and higher salaries that will not discourage women (as well as men) from entering and remaining in the help-tech professions. In the long as well as the short run, our quality of life depends more on help-tech than on hi-tech.

הפוסט More Hi-Tech ? What Israel Really Needs is More Help-Tech הופיע לראשונה ב-Adva Center.

Israel’s top one percent received the most expeditious state protection and benefits. The Bank of Israel supported big corporations by purchasing 15 billion NIS worth of corporate bonds. This aid contributed to the fact that while the real economy shrunk, the Tel Aviv 90 Index increased by some 18% in value during the first year of the corona epidemic.

The government exempted the wealthy from the burden of participation in financing the costs of the corona crisis. Israel expended an estimated NIS 137.3 million on aid to businesses and citizens. As this sum was not budgeted, it increased the budgetary deficit and the national debt. The Netanyahu-Gantz coalition did not consider raising taxes, despite Bank of Israel declarations that tax increases were unavoidable.

If tax increases are not imposed on the wealthy, such increases will either fall to the lot of the middle class or, alternatively, result in the privatization or reduction of public services – moves that will hurt middle and low-income families. In light of these possibilities, the report recommends imposing a wealth tax.

Hi Tech in Times of Corona: Like its ultra-rich, Israel’s hi tech sector has not been adversely affected by the corona epidemic. In fact, the hi tech sector continued to grow despite the corona crisis. For example, the financial newspaper The Marker reported in January 2021 that “the 13,500 hi tech workers employed in the ten largest technology companies listed on the stock exchange gained no less than 2.5 million dollars in income.”

Small Businesses in Times of Corona: Small businesses are the main reason for the increase in employment in the Israeli economy that occurred over the past two decades and the concomitant decrease in unemployment. While the businesses in question are small, together they constitute the largest employer in the Israeli economy. In 2018, small and medium sized businesses accounted for 1.92 million employee posts, or 60% of the 3.17 million posts in the private sector.

Small businesses were the main losers in the corona crisis, primarily service providers, many of whom had become upwardly mobile due to increased consumption in the decades preceding the crisis. In 2020, private per capita consumption in Israel decreased by 11.1%, more than the average in OECD countries – 6.3%.

Dun and Bradstreet estimated that in the first half of 2020, 37,600 Israeli businesses shut down, among them 1,550 restaurants, bars and coffee shops; more than 1,000 construction and renovation firms; some 600 transportation companies; and 450 clothing shops. Their estimate was that by the end of the year, 80-85 thousand businesses would close down – an increase of 85% over 2019.

The chief economist of the Israel Ministry of Finance estimated in May 2020 that 54% of workers furloughed were employed in small businesses.

Food Insecurity in Times of Corona: The highest proportion of persons reporting food insecurity during the corona epidemic was found among Arab citizens of Israel. In April 2020, 23.5% of Arabs reported that they or members of their family had reduced the amount of food or the number of meals during the previous week, compared with 14.1 % among persons in the general population of Israel aged 21 and over.

Inequality in Health in Times of Corona: Israelis of low socio-economic status sickened more than Israelis of high socio-economic status, among other things due to the higher incidence of health risk factors like high blood pressure and diabetes among them.

The corona epidemic threatens everyone, but the threat is especially acute for persons whose living conditions promote contagion. Housing density and household size are larger among Haredi Jews and Arab citizens of Israel than among others, resulting in greater susceptibility to infection from the virus.

Another factor influencing the rate of illness from the corona virus is the sense of alienation of these same two population groups from the central government of Israel and its institutions, resulting in indifference or non-compliance with official instructions issued as to how to keep safe from contagion.

The result: the death rate of Arab citizens of Israel aged 60 and older from the corona virus was three times that of non-Haredi Jews; and the death rate of Haredi Jews four times that of non-Haredi Jews.

Mental Health in Times of Corona: The corona epidemic has had an adverse effect on the mental health of Israelis. During the first lockdown, about one-third (34%) of persons aged 21 years and over suffered from tension and anxiety. That proportion rose to 42% when the lockdown was lifted in July 2020. In November 2020 the proportion decreased to 37% — still quite high. Those reporting the greatest suffering from tension and anxiety were women and Arab citizens.

Feelings of loneliness and depression were revealed by the Citizen Resilience Survey conducted by the Israel Central Bureau of Statistics, which showed that in April 2020, 30% of interviewees aged 65 and over reported loneliness and 19% reported depression, compared with 24% and 16%, respectively in the general population.

Housing in Times of Corona: Before the outbreak of the epidemic (2018), Israeli households from the bottom income decile living in rental housing expended 54% of their disposable income on rent and related outlays. For households in the second lowest income decile, that expenditure constituted 34% of their disposable income; in both cases, housing expenditure was higher than the 30% considered the maximum households should have to pay for housing. The economic hardships of the epidemic for households residing in rented housing led to an increase in requests for rent assistance, along with an increase in the number of eligible households waiting for public housing units.

While the economic crisis accompanying the corona epidemic had an adverse effect on renters as well as on home owners with mortgage payments to meet, the benefits given by the government in the area of housing were directed not to them but rather to persons purchasing housing units as investments. With the expressed purpose of stimulating business in the real estate sector by incentivizing investors,  in July 2020 the purchase tax for investors was reduced, thus abrogating the increase made in 2015 to discourage real estate investments in favor of the purchase of own homes.

The full report is available in Hebrew here

// The report was produced in cooperation with the Friedrich Ebert Stiftung, with support from MAZON: A Jewish Response to Hunger and The New Israel Fund

הפוסט Social Report 2021 – Corona: Epidemic of Inequality הופיע לראשונה ב-Adva Center.

The number of acute care hospital beds in Israel remains low even when it is age-adjusted: that is, if Israel’s younger age distribution is taken into account. This is reflected in a Taub Center publication from 2019 written by Dov Chernichovsky and Roi Kfir about the number of acute care hospital beds in Israel compared with other countries in the OECD:

In 2016, there were about 2.2 acute care hospital beds per 1,000 persons in Israel. Even after adjusting for the younger age structure of the population relative to other countries, the number of acute care hospital beds rises to 2.5 per 1,000 persons, but is still lower than the OECD average of 3.6 and much lower than the ratio in countries with public healthcare systems similar to the Israeli model (Belgium, Germany, the Netherlands, and Switzerland, and to a lesser extent also France). In these countries, the average is 4.4 beds per 1,000 persons.

Moreover, according to the head of the Israeli Association of Intensive Care Medicine, the number of intensive care beds in Israel – even prior to the COVID 19 crisis – was half the number needed. Namely, while 600 intensive care beds are needed, in actuality there are only 300 beds.

Not surprisingly, the shortage in hospital beds results in high occupancy rates (average of 94%) which are significantly higher than average occupancy rates in the OECD — 75%.

Another negative consequence of the insufficient number of acute care beds is that the average

length of hospital stay in Israel is short: an average of 5.2 days vs. 6.7 days in OECD countries and 6.2 days in the countries with similar healthcare systems.

We all know how these figures impact the patients´ experiences – many lay in the corridors instead of in rooms, with no shred of privacy, and they are often discharged from the hospital while they are still in need of care.

What about the medical teams?

A recent survey commissioned by the Ministry of Health about burnout among medical teams found that hospital staff persons suffered higher rates of burnout than other medical teams.

The survey ranked burnout levels on a scale of 7 and defined results of over 3 as high. Nurses reported a burnout level of 3.5, specialists – 3.5, interns – 3.9, and residents – 4.3, significantly above the desired threshold. Despite random news reports about the plight of medical residents, they reported the highest burnout levels, and their working conditions have yet to improve: they work 24-26 hour shifts, juggling numerous responsibilities.

Hospitalization conditions of patients and the working conditions of medical staff must change.

The Ministry of Health has been asking for an addition of NIS 3-5 billion for public hospitals for a long time. If funds are not granted, then medical staff will continue to burn out and patients will continue to receive care that is under par.

The data presented here are but the tip of the iceberg. Other examples include the sharp decline in the ratio of physicians to population, which was once one of the highest in the world, to second from the bottom among OECD countries. This is also the case for nursing school graduates, indicating that the current shortage in nurses will grow in the coming years. Furthermore, about a half of Israeli doctors are over 55 years of age (compared with an average of 34% in OECD countries).

The future of medicine in Israel seems grim. The healthcare system needs more than cheers and a mass outpouring of gratitude. It needs public pressure for a cure – in terms of funding and with regard to the organization of the public hospitals array in Israel. It also requires a change in the higher education system, so that young Israelis who wish to pursue careers in medicine have an opportunity to study in Israel and so that more young men and women go on to study nursing.

הפוסט Coronavirus Crisis: Cheers are not enough! הופיע לראשונה ב-Adva Center.

Arab citizens of Israel, totaling some 20% of the population, are here and there. Here – in pharmacies and in the hospitals located in the center of the country, places receiving a great deal of media attention. There – in the Arab and mixed localities – parts of the same Israel that are nowhere to be seen in primetime.

The health of Arab citizens over there – in the Arab and mixed localities – is not as good as that of Jews. There the Infant mortality rate is double the rate among the Jewish population: 6.0 cases per 1,000 births versus 2.3 among Jews. Life expectancy at birth for Arab citizens is lower than that of Jews: 82.3 for Arab women compared with 85.1 for Jewish women, and 78.0 and 81.7 for Arab and Jewish men, respectively. Arab citizens smoke more than their Jewish counterparts, are they are more prone to obesity, diabetes, stroke, asthma and depression.

Both ¨here¨ and ¨there¨ you can see Arab men and women in the healthcare professions: the most recent data published by the Health Ministry (2015) indicated that 15% of the 25,331 physicians employed in the healthcare field were Arab. The ratio is similar among nurses. The estimate is that 20% of the medical staff in hospitals consists of Arab citizens. Pharmacy has become a field often associated with the Arab population: in 2014, the Health Ministry reported that 42% of pharmacists were Arab, and it is only logical to assume that this figure has increased. In other words, Arab healthcare professionals are on the frontlines of the war against the corona virus.

Since the Arab population is less healthy than the Jewish one, and since Arab healthcare professionals are playing a significant role in the public health system´s fight against corona, one would expect a better coverage of the impact of the disease on Palestinian Arab citizens of Israel. Arab society is part and parcel of Israeli society and it should be represented and discussed in the daily media reports about the virus that all Israelis follow so closely.

הפוסט What Happened to 20% of Israel’s Citizens? הופיע לראשונה ב-Adva Center.