A Tale of Two NICUs

New York Times

4 days ago

Of all the horrifying images coming from Gaza, the one that finally broke me was an Instagram video of Dr. Ali Alhaj Salem, a specialist in the neonatal intensive care unit, or NICU, at Al-Helou Hospital. In it Dr. Salem explains that the premature babies in his care have been born early largely because of their mothers' malnutrition and that, for the same reason, the hospital is experiencing a shortage of breast milk. The mothers are simply too malnourished to produce it, he says. His voice is unemotional, his language professional. He doesn't cast blame. He doesn't even mention the blockade of humanitarian aid that kept food, water and fuel from reaching those dependent on it in Gaza. As incubators beep in the background, the doctor explains that the infant formula they need is 'not available in our market now.'
He also looks sickly thin.
The sound of beeping incubators is not foreign to me. My son Yotam was born in the 28th week of his mother's pregnancy, three months too early. Happy pictures of a newborn on his exhausted mother's chest were not a part of our family album. Instead, facing an emergency cesarean section and the lives of both mom and baby in danger, I was left waiting in the hallway outside the operating room, afraid that I would be the only one of us three returning home from the hospital.
All through that first long and terrifying night I watched other new parents pushing strollers back and forth, until finally the door to the operating theater opened. A doctor emerged, pushing a plastic box on wheels. He signaled me to follow him. We entered a room with rows of identical plastic boxes. The nurses plugged the new one in. They wrote the mother's last name on the new box and asked me if I was the father. It was only then that I could fully see inside the box. There I found a tiny humanlike creature wrapped in tubes, weighing less than two pounds, unable to breathe on his own.
From that point on it seemed my life's entire mission was simply to protect this new life. But in reality, as I stood outside that box, I could not save him on my own. When his mother woke from her ordeal, and for weeks after, she tried to pump breast milk to feed him. But her wounded body and her overwhelmed spirit couldn't respond, no matter how hard she tried. The nurses finally, gently, suggested she stop. We, his parents, could not save him on our own. We needed help.
The cliché is it takes a village to raise a child, but to save preemies like my son and those in Dr. Salem's NICU takes much more than a village; it takes a society committed to protecting its weakest members, and it takes a functioning public health system. And that requires a free society, free from war and occupation, fully capable of protecting its own.
Human evolution may have hard-wired most new parents to adopt their own children, to protect them and to prioritize the well-being of their own bloodlines over others. But preemies of any species rarely survive in the wild, and their mothers often die with them. The natural world never expected parents, villages or societies to save premature babies. And yet, in this era, we can, and we do. If there's a single measure of humanity's progress against the cruelty of nature, it has to be the significant decline in early infant mortality since the late 19th century.
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