Medical Device Daily Contributing Writer

(EDITOR'S NOTE: Medical Device Daily's Israel correspondent, Rae Fishman, lives in the foothills of the Carmel Mountains, “about 20 kilometers out of what was considered the edge of the 50 km firing range of the rocket-propelled bombs, just south of Haifa.” But, as she noted, “that is no longer the case.” She said that the two-part series that will run today and tomorrow were written during the July 12-Aug. 11 period, “between the sirens, in/out of shelters and ducking as needed. One month later, we are still here.”)

ZICHRON YAAKOV, Israel – During the Three Weeks, a traditional period on the Hebrew calendar that has included a disproportionate number of some of the worst tragedies over more than 3,300 years of Jewish history, religious Jews mourn, pray, fast and contemplate the senseless hatred provoking conflict.

Hezbollah upped its usual periodic lobbing of rockets targeted only at Israel's farthest northern border towns to a veritable torrent of 100 to 200 rockets a day across all of northern Israel, a 25-mile-long target between the border with Lebanon and Haifa, Israel's third-largest city, long ago dubbed the city of peace for its highly integrated Moslem-Jewish-Christian population.

To date, more than 2,600 of Hezbollah's Iranian-made rocket-propelled bombs and Syrian-made 302-mm rockets have been dropped on Israel. They have set enormous acreage aflame, caused tremendous structural damage, but miraculously have killed fewer than 100 people. Many more have been wounded and maimed by the weapons, which are packed with thousands of tiny lead balls and/or twisted shrapnel meant to inflict the most non-discriminating damage for a kilometer in every direction from impact.

The Israeli Defense Forces (IDF) has reacted with aerial bombing and land troops to rout out the terrorists and recover the kidnapped soldiers, aiming at Hezbollah operatives hiding under the dense greenery and among the dense citizenry of Lebanon.

During this time, about half of the 1.5 million people living in northern Israel have fled southward from the bombs, the fires and the sirens, about 10 per day in Matam, the high-tech area just south of Haifa, sending whole companies into the shelters.

So the Three Weeks passed, but the conflict with Hezbollah still continues in this latest frenzy of senseless hatred, with rockets now reaching deeper into the center of the country. Sirens punctuate day-to-day life for over one-third of the population of Israel. Everyone listens to radio broadcasts or 24/7 televised “reality shows” of the embattled areas in near real-time, knowing that by the grace of God go I.

The foreign media seems to feed on the gory scenes. This cynical use of the victims of war works well with Hezbollah's (and the Palestinian Arab) longstanding policy and practice regarding field journalists: either report what we say – or be banned from our sources and beware.

Recently, a group of bloggers outed Reuters news journalists who had doctored an electronic image of Beirut to make the damage caused by an Aug. 6 Israel Air Force (IAF) strike on Hezbollah strongholds look significantly more extensive. There has been a multitude of other mock incidents staged for the cameras' benefit, rather than for those seeking truth while yearning for a just resolution.

Why it this important to us in science-based industry?

Journalists in the field are meant to be the trusted extensions of our own eyes and ears, like medical diagnostic and reporting devices. If these professionals are intentionally not reporting accurately, then the data can only become increasingly skewed away from reality.

What if our X-ray or MRI or ultrasound or CT scan data was intentionally skewed? Maybe in order to increase the number of surgeries, or other interventions?

Despite all the threats and attacks — physical and existential, the enormous losses suffered and the high level of anguish, the country and the higher-tech industries manages to carry on somewhat close to normal in typical Israel style: spunky, resolved, imaginative, helpful and on the edge.

The dozen or so medical technology companies contacted by Medical Device Daily in and around the direct target area echoed a chorus of “We are very adaptive. We will manage. We have to.”

But, as time has passed, more are adding, “It is wearying.”

Yehiel Tal, CEO and co-founder of Regentis Biomaterials (Haifa), said that sirens go off five to 10 times a day in MATAM, which is the Matam high-tech zone. It has had a handful of the hundreds of hits daily in Haifa, but “everyone files down to the bomb shelter. We are getting used to it, and now more people bring in laptops — since more people take work home — or have something ready to read.

“Lately, those employees who stayed away are also coming in, but the managers have been working regularly from the beginning. More people now are being called up for reserve army duty, and it is also summer, the usual vacation time,” Tal said.

Regentis' R&D has been more affected than business development because the animal care facility at the Technion School of Medicine was shut down when the entire Rambam Medical Center campus came under multiple rocket attacks, driving 90% of the hospital into makeshift basement facilities, as has Phillips Medical Systems and others.

“Our physician research collaborators have other priorities,” Tal said. Rambam is the main hospital in the north, handing hundreds of the wounded as well as its usual patient load. “I am deeply impressed that everyone is dealing with this situation so well, including mothers with children who use the common childcare facilities set up. It is just what we do now,” he said.

Similar sentiments were expressed by Avi Levy, CEO of Stryker GI Israel (Haifa), formerly Sightline Technologies, who said, “It is impressive that workers are so devoted. Not that we are not worried, but we have our sights set on meeting our milestones, which actually helps us keep our priorities intact.”

The firm organized its first video conference to facilitate stay-in-place meetings with the U.S., but Levy said, “we would have done this anyway, eventually.”

Uzia Galil, the octogenarian veteran founder of Elron Electronic Industries whose 1962 start-up seeded the electronics industry in Israel, was still at work as usual late in the evening in the Haifa offices of Uzia Initiatives and Management , dedicated to med-tech solutions to prevent hospital errors.

He told MDD, “We are now more on the alert. I was born here and we are here for the next generations. We have to defend what we have. My grandson is in the army, and we all hope his children will be able to live in peace. To make sure, we have to be strong and hold fast to the small country we have.”

Bob Buckwald, CEO and co-founder of the electro-optics company CI Systems (Migdal Haemek), said, “We are not at the frontline, but many of our employees come from further north, so we outfitted a gan yeladim [kindergarten] in our very large miklat [bomb shelter] because most summer camps and childcare are shut down, and many are concerned about leaving their children.

“We talk about the tactics of war at lunch, but during the day we are concentrated on the work. Naturally, we worry about Israel's future, especially when we see what is happening with Hezbollah in Lebanon, with Syria and Iran, but our focus is on ensuring the long-term development of our companies' health.

“This has been mainly a daytime war, unlike the Gulf War when most of the missiles were fired at night. Buckwald added that his son is getting married this month and the venue of the wedding had to be moved because the hall had been bombed. “Many people who were planning to come cancelled, even though we found another hall farther south.”

Given Imaging (Yokneam) which is located south of Haifa, also is allowing its staff to bring its children to the office — something that is now more systematic, but not unheard-of in Israel. The maker of the revolutionary PillCam reported that 80% of its work force has been showing up so operations have been largely unaffected.

To be sure, the Nasdaq-traded company said that it would transfer inventory of PillCam capsule endoscopes and Given Diagnostic Systems to the U.S. and Europe, and is ready to activate a backup manufacturing facility it set up in Ireland during the Gulf War.

This is not a sign of flight, but a “strategic reconstruction,” the company said.

At the beginning of this month, Given Imaging — along with Lumenis (Yokneam), Medigus (Omer), and Bio-Light Life Sciences Investments (Ramat-Gan), and academic institutions including Ben Gurion University of the Negev (Beersheva), Hadassah Medical Organization (Jerusalem), Sheba Medical Center (Tel Hashomer) and Tel Aviv University — reported the formation of a medical imaging consortium with an estimated budget of $10 million a year over five years.

The Ministry of Industry, Trade and Labor will finance two-thirds of the venture, and the consortium's medical device companies will finance one-third. The aim is to create a joint foundation able to make diagnostic imaging-based monitoring, and non-invasive treatment advances, not possible by any single member alone.