By Aryeh Dayan
Tens of thousands of immigrants underwent radiation against ringworm in the 1940s and `50s. Now, 60 years later, they are still fighting for compensation from the state for illnesses said to be due to the treatment.
On the Israeli national agenda, the ringworm affair is in a class with
the affairs of the Yemenite children (some of whom were allegedly kidnapped
and put up for adoption) and the spraying of new immigrants with DDT. Like
those affairs, it is a symbol of the arrogant and alienated attitude of
the veteran Ashkenazi (Jews of European origin) establishment in the 1950s
toward the new immigrants from the Arab countries. And like those affairs,
this one refuses to die away.
Ten years after the legislation of the law that was designed to eliminate the resentment caused by the ringworm affair, it is apparently about to erupt again, and the victims are once again embarking on a battle, claiming that not only does the state pay absurd compensation, but it prevents even that small sum from reaching a large percentage of the victims. Naturally, at the same time there will be a renewal of the bitter debate about the limits of responsibility of the Israeli government for what was defined about 50 years ago as a medical-humanitarian campaign meant to benefit the olim (new immigrants) from the Arab countries, and turned into a terrible humanitarian tragedy.
The government radiation campaign began in the late 1940s, when a fear arose in the country of an outbreak of a plague of ringworm, a skin disease that grows in the roots of the hair and quickly spreads among children who live in crowded conditions, with poor hygiene. The prejudices of the establishment toward the Mizrahi (Jews of North African and Middle Eastern origin) immigrants contributed both to intensifying this fear and to the means used to solve the problem.
The top echelons of the Ministry of Health and the Medical Corps of the Israel Defense Forces decided to begin a comprehensive treatment and prevention campaign, which was to include radioactive treatments of the heads of all the children up to age 15 who had immigrated from Arab countries. In all, about 100,000 children underwent these treatments.
At a certain stage of the campaign, which lasted until 1960, it was also decided to transfer radiation machines to the Jewish Agency transit camps in Marseilles and other places in Europe and to carry out the treatments there, while the children were still in transit from North Africa to Israel. The medical world at the time, even outside Israel, was as yet unaware of the future damage involved in these radiation treatments; the connection between such treatments and cancer and other illnesses was discovered only years later.
Many people have testified that the radiation campaign caused the children serious emotional harm. Without any explanation, they were brought to clinics where the hair on their heads was shaven, the hair that remained was pulled out with hot wax, and the roots were eliminated with x-rays.
The exact number of Israelis who have suffered from various types of cancer because of radiation against ringworm is not known. However, Prof. Baruch Modan, who researched the subject when he was the head of the Department of Clinical Epidemiology at the Sheba Medical Center in Tel Hashomer, discovered over 30 years ago that their number was more than double that in the general population. The treatments caused many other illnesses: sterility, the loss of teeth and hair, and severe and ugly scars on the scalp and on other parts of the body. According to the most recent estimates, tens of thousands of people contracted cancer or other illnesses as a result of the radiation campaign.
For decades, the government refused to accept any legal or moral responsibility for the radiation campaign. In 1994, the government changed its position for the first time, and passed a law initiated by MK Amir Peretz, to compensate the victims of ringworm treatments. The law determined moderate financial compensation for anyone who had received radiation treatments against ringworm in his childhood, and as an adult fell ill with severe forms of cancer. By passing the law, the government in effect acknowledged the connection between cancer and the radiation treatments administered by the state.
The two government institutions responsible for implementing the law - the Health Ministry and the National Insurance Institute - have submitted contradictory findings regarding the number of victims who have been recognized as eligible for compensation. The Health Ministry, which is responsible both for determining eligibility and for deciding on the percentage of disability that determines the amount of compensation, says that "about 13,500" people are eligible, and about 13,000 have filed claims. The NII, which is actively responsible for making the payments, says that the number of those eligible is "about 11,000." The Health Ministry also says that about 10,000 requests have been denied and that the discussion of 7,500 additional requests has not yet been concluded. The NII spokesman's office says that as of October 2003, "the NII paid the ringworm victims grants and allowances to the tune of NIS 640 million."
Those who are granted between 5 percent and 39 percent disability are eligible for a one-time grant of NIS 1,218 for each percentage of disability. Those who have over 40 percent disability will receive a monthly allowance in addition to the one-time grant. The grant will be NIS 50,000 if the committee has determined between 40 percent and 74 percent disability, and NIS 100,000 for higher disability. The monthly allowance for those who have been granted 100 percent disability will be 25 percent of the average national salary, i.e. about NIS 1,800; the sum of the allowance will decline with a decline in the percentage of disability.
"That's really minimal compensation, I would even say that it's adding insult to injury," says attorney Yadin Yaron, who represents many ringworm victims. "Anyone with less than 40 percent disability, which includes the vast majority of those receiving compensation, received an almost absurd one-time payment. Only someone who suffers from a brain tumor or from multiple tumors receives over 40 percent." The NII statistics indicate that only 27 percent of those eligible - 3,000 out of 11,000 - have received a regular allowance.
And why were such absurd sums determined? Apparently the state knew how to exploit the fact that the victims of the radiation treatments didn't have much of a chance of winning lawsuits. "Fifteen years ago, before the law was passed, a large group of radiation victims turned to me and asked me to investigate the possibility of filing a suit against the state for medical negligence," says Yaron. "After I checked into the matter, I reached the conclusion that the radiation treatments were carried out according to what was common in the medical world at the time, and that there was no chance of winning a lawsuit based on the claim of negligence. Since I believed that the state nevertheless has a very large moral obligation towards these people, I suggested that they file the lawsuit, and litigate against the state on a moral basis." The legislative process began immediately after the filing of this lawsuit. Its conclusion, in which the low compensation sums were set, put an end to discussion of the lawsuit.
The purpose of the law was to put an end to the resentment caused by the ringworm affair. But judging by a long series of indicators, which have been multiplying in recent months, that didn't happen. An association of the radiation victims is about to embark on a public battle, claiming that the Finance Ministry has for several years been making every effort to reduce the allowances, which are low in any case, and to empty the law of content. Lawyers who are handling the lawsuits of the victims claim that the Health Ministry has given in to the treasury, is causing a significant slowdown in the work of the medical committees discussing the compensation claims, and is placing endless legal and bureaucratic obstacles in the path of the plaintiffs. In labor courts all over the country, which are authorized by law to discuss appeals of the decisions of the medical committees, there has been an increase in the number of those appealing the denial of their claims or the tiny sum allocated to them for compensation.
"During the first years, the law was implemented in a more or less acceptable manner, but since 2000 or 2001, everything has changed for the worse," says Malka Cohen-Gilboa, the lawyer for the Association of Ringworm Radiation Victims. According to the law, those who request compensation must first appear before an "experts' committee" that determines whether there is a direct connection between the person's disease and the radiation treatments he received. "In recent years," says Cohen-Gilboa, "the experts' committees have greatly increased their demands for proof of this connection. In the past they believed those who turned to them. Now they ask them to bring documents and witnesses to prove that they received radiation treatments. The problem is that none of them has documents, and the only witnesses were their parents, who in most cases are no longer alive."
Someone whose eligibility for compensation is acknowledged by the experts' committee is sent to another committee, a "medical committee," whose job it is to decide on the percentage of disability, which determines the amount of compensation. "Up until three years ago, the percentages of disability were granted very generously, and with greater consideration," says Yaron. "The treasury seems to be applying great pressure on this issue." If in the past about three or four months on the average passed between the time the lawsuit was filed and the time it came up for discussion, complains Yaron, today the process takes about a year and a half.
The institute was not established
In the past, says Yaron, percentages of disability were also granted for scars caused by the radiation treatments, and for spots and other damage to the scalp. Today these things are not taken into consideration. Article 7 of the law determines that the Health Ministry, "will establish a national institute for the study of the subject of ringworm and how to treat it," whose tasks will include "locating, registering and documenting those who suffered from ringworm and received radiation treatments," and "the establishment of a system for early diagnosis of illnesses to which radiation patients are exposed."
The research by the institute, it was explained when the law was passed, would also deal with discovering the connection between the radiation treatments and other illnesses (aside from cancer), in order to make it possible to add these illnesses to the list of illnesses which entitle people to compensation.
Ten years after the legislation of the law, the institute has yet to be established, and the list of illnesses has never bee expanded. "Several years ago, Nissim Dahan, who was the health minister at the time, signed an order that added benign growths in the thyroid gland to the list of illnesses," says Yaron. "The treasury didn't approve the order."
Cohen-Gilboa: "In 1974, Professor Modan proved the connection between the radiation treatments and breast cancer, but breast cancer has still not been placed on the list. In the past, percentages of disability were also granted for emotional distress; now that is no longer the case. For years we have been demanding a payment for wigs, which many of us have been forced to use for 50 years. Nothing has been done."
Attorney Zvi Regev, whose Hadera law firm represents dozens of the radiation victims, claims that the plaintiffs are required to appear before the experts' committee without being represented by a lawyer, and are asked tricky questions, for example, whether the radiation treatments hurt. "If the plaintiff gives a positive answer, his request is denied. This question is tricky because the treatments really didn't hurt, but pulling out hair with wax hurt a great deal." He says, "It's not clear how they expect a 60-year-old man who underwent radiation treatments 50 years ago, when he was a child, to make this precise differentiation."
The Health Ministry refused to submit a formal reply regarding the claims, saying that the subject has now been sent to the Supreme Court. A senior official in the ministry, who requested anonymity, said that the ministry and its committees are operating in accordance with the law.
No right to know?
"Had the Health Ministry informed me 15 or 20 years ago that I underwent radiation treatments against ringworm," says Batsheva Gadassi, "maybe I could have saved my life." Gadassi, 54, who recently fell ill with a severe form of cancer, blamed the Health Ministry for not informing her in time of the fact that her name is included in what is called the "Modan file" - a list that was prepared 35 years ago, and includes the names of 12,000 of the approximately 100,000 children who received radiation treatments.
Since the list was compiled, the ministry has refused to warn those whose names are included on it. Gadassi appealed to the Supreme Court with a request to require the ministry to do so. "It won't help me any more," she says, "but I want to save the lives of others."
Gadassi was born in 1950 in Moshav Shtulim, to parents who had come to Israel a year earlier from Yemen. She says that in the summer of 1957 all the children of the moshav were taken to Haifa, on the pretext that they were going to a summer camp. "A large truck picked us up. On the way to Haifa we sang and played happily, but the moment we arrived at the Sha'ar Ha'aliyah camp, near Haifa, the abuse began. They took us into the clinic, smeared some substance on our heads, pulled out all our hair and gave us radiation treatments. We returned home bald and bruised, both physically and emotionally."
This incident was so traumatic for her, that for decades she erased it from her memory entirely. She remembered it down to the last detail a few months ago, when she went to receive radiation treatments against the cancer that has developed in her throat and that threatens her life. When she filed a lawsuit in the Health Ministry, she discovered for the first time that her name is included in the Modan list.
All the health ministers and all the directors general of the ministry who have served since the list was compiled have opposed the demand to send warnings. Among the opponents was Prof. Baruch Modan himself, who prepared the list and afterwards served as director general in the 1980s. The Health Ministry explains that the Modan file is "a research file only," and there is no certainty that everyone included in it did in fact receive radiation treatments. Sending warnings to all of them is liable "to sow unnecessary panic" without being medically efficacious, because it is doubtful whether anyone will succeed in stopping the development of the cancer. But the ministry insists that the list is not classified: Anyone who asks to know whether his name is included on it, will receive an immediate reply. (A.D.)