RAMAT GAN, Israel (JTA) — In December, Nechemia, a combat engineer, was serving in Gaza alongside his close friend when a rocket-propelled grenade exploded next to them.
Nechemia suffered severe shrapnel injuries on one side of his body, one of four soldiers injured in the incident. His friend, just feet away from him, was dead.
Now, Nechemia is recovering in Sheba Medical Center, a massive hospital complex in the Tel Aviv suburb of Ramat Gan, in a ward for seriously wounded soldiers. He appreciates the camaraderie of his fellow injured troops and feels grateful to have come out with life and limb.
But the hardest part, he said, has been survivor’s guilt. He was unable to leave the hospital for his friend’s funeral, and the bereaved family came to visit him.
“At some point when I was in the hospital, his family and his girlfriend came to meet me and it was tough for me,” said Nehemia, who did not give his last name per Israeli military policy. “My mentality after coming out alive, after getting hit by an RPG used against tanks, a meter from me, and not losing any limbs, and no mental damage, and just just being alive is absolutely a miracle.”
He added, “And suddenly, my friend who died, his family came and it just all went down. And it was like, f—, like, they’d lost their son. And I was talking to them and explaining to them what happened, and it was very, very tough.”
Nechemia’s challenges encapsulate those faced by the almost 6,000 Israeli security personnel who have been injured since the launch of the Israel-Hamas war on Oct. 7. Now, the Defense Ministry estimates that in addition to the hundreds of Israeli soldiers who have been killed in action, the number of wounded soldiers could rise to as many as 20,000 by the end of 2024. If that number bears out, it would be the highest number of Israeli soldiers wounded in any war in the country’s 75 years of existence — topping the 1948 War of Independence’s count of 15,000 wounded and 1973 Yom Kippur War total of 9,000.
Israel’s Health and Defense Ministries say their system is equipped to tend to the needs of so many injured soldiers, and several of the wounded told JTA that they are confident in their recovery. But in the long term, the prognosis is unclear: How will Israel deal with the high number of injuries in the coming years? And how will the thousands of wounded soldiers cope with the physical and mental trauma they experienced?
“Rehabilitation will be the biggest national challenge in the State of Israel in the coming decades, and the journey of the injured and their families has only just begun,” said Amitai Ziv, who is director of the Sheba Integrated Rehabilitation Hospital in the Tel Aviv suburb of Ramat Gan.
Since Oct. 7, Ziv’s facility has provided both physical and psychological care for about 70% of the seriously wounded in-patient soldiers after they leave emergency care, including Nechemia. Many are amputees. During that time, the rehabilitation center has grown from 140 beds to 262. Ziv sees no end in sight to the increased capacity — especially as war threatens to erupt on Israel’s northern border with Lebanon.
“It was and still is a huge challenge, but we went through it and we continue to do it as we speak,” he said. With an air of calm, he added, “The healthcare system in Israel at large and the Sheba Medical Centre in particular is well prepared for any scenario from the north, including the extreme scenarios.”
More than 4,000 soldiers have already gained fast-track membership to the country’s official IDF Disabled Soldiers Organization, which has provided treatment and social opportunities for injured soldiers and their families since 1949. That number is more than 10 times the organization’s typical growth of about 300 wounded soldiers per year.
About 20% of the newly wounded soldiers are being treated for mental injuries, but it is still too early for them to be formally diagnosed with Post-Traumatic Stress Disorder, or PTSD, per the Defense Ministry’s guidelines. The ministry typically waits one year following the injury to make a PTSD diagnosis.
But there are informal ways the soldiers are working to maintain their mental health. One of the benefits of treating so many wounded soldiers in just a few locations — with rooms containing as many as six beds — is the camaraderie that forms among wounded soldiers.
“I’m here with all the injured soldiers together,” said Nechemia. “We are all going through this together with other guys who went through similar stuff. We all have nerve damage, and we are all screwed up, so going through it together for sure makes the process a lot easier.”
A few doors down from Nechemia rests Aaron, an infantry reservist who was shot in both of his legs in Gaza and caught shrapnel on his right side and back. He sustained the injuries after unsuccessfully trying to extricate his commander, who was shot while in a school run by UNRWA, the aid agency for Palestinians.
“I thought that he was dying and if I could run over fast enough to save him, or to get to him and bring him into the house, I could save his life,” he said. “I went on a spiritual journey where I saw my life a bit blurred and there was definitely a higher presence there and of course the classic image of sky. I remember basically saying thank you for a beautiful life up until now that I lived.”
Aaron’s hospital room is frequently filled with visitors and adorned with a “wall of communal support and love” that includes many handwritten notes from schoolchildren. He says that his injury has caused him to reconsider his professional future as a tech worker.
“I want to do something that has a greater direct impact on the people of Israel, not just on the high tech sector in Tel Aviv,” he said. “It’s made me think a lot about what I’ll do next and maybe I won’t leave tech, but I certainly will value my time differently and spend it helping the people of Israel and the country at large.”
Some of the soldiers are working toward recovery by aiming to reach a milestone they had achieved before their injury. Orr Sheizaf, a long-distance runner who was wounded by a booby-trapped tunnel in the central Gaza city of Khan Younis, will be the official ambassador of the Jerusalem Winner Marathon on March 8, which is sponsored by the footwear brand Saucony.
Sheizaf completed his first marathon in Jerusalem in 2020 but knows even running several kilometers this year will be a struggle: He’s run in the pool at Soroka Medical Center, in Beersheva, but cannot yet run on the ground. Not long ago, he had several pieces of metal removed from his foot.
Even as they face a long road ahead, however, Sheizaf says the vast majority of wounded soldiers he has met are feeling grateful. “I would say 90% of people are happy about being alive, feeling that they’re in a good place and going in a good direction,” he said. He added that he feels a sense of identification with the soldiers who were wounded in some of Israel’s past, mythologized wars, in 1967 and 1973.
“It’s going to take time, you need to be patient and you won’t be able to go back to what you used to do as soon as you want to,” he said. “But [you] might be able to go absolutely back, eventually.”
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