Two weeks ago, a small group of people gathered at the cafeteria adjacent to the Rabin Medical Center in Petah Tikva in support of Dr. Ahmed Mahajana, a cardiothoracic resident at Hadassah Hospital in Jerusalem, who was suspended more than two months ago for allegedly expressing support for a Palestinian terrorist being treated in the hospital and even bringing him special food as a treat.

The allegations against Mahajana have been discredited, his colleagues who were present have confirmed his version of events, and the Israel Medical Association stood by him. Even Btsalmo, which had demanded Mahajana’s dismissal, retracted its allegations and apologized. Nonetheless, only seven people gathered in support of Mahajana – and only three were Arabs. The atmosphere among the Israeli public scares them. “I feel very secure in my place, but the Arab doctors a lot less so,” says Dr. Barry Danino, who not only attended the rally but also organized a similar event in Tel Aviv. The Arab doctors who participated asked that we not use their names. Those working in public health fear dismissal, while those working at private clinics fear losing patients. “Most were afraid to come,” Danino adds, “because they were worried that they would be seen as sympathetic to terrorism.”

More than anything else, the public silence from Hadassah Hospital – where there is a large proportion of Arab physicians, including many senior doctors – is deafening. “Around 70 percent of the care staff at Hadassah are Arabs,” says Dr. Lina Qasem-Hassan, chair of the board of Physicians for Human Rights Israel (PHRI). “Have you heard any of them protesting or sending a letter? They’re all afraid to come out in support of Ahmed. And that worries me more than the incident itself because I can already identify the ramifications in other hospitals. A 16-year-old Palestinian has been in intensive care at Schneider [Children’s Medical Center of Israel] for several days, but none of the Arab residents dare get close to him, they’re so afraid of being accused of something.”

Hospitals have become one of the most volatile places where tensions between Jews and Arabs have reached new heights since the suspicions of the Jewish public encounter Arab staff members. “Do you have any idea how many times I’ve been called a ‘stinking Arab’ while on shift in the emergency room?” says one veteran doctor. “On occasion, I’ve had to call the police over such incidents. And what comes of it? I get a letter saying that the case had been closed because of a lack of public interest. In the emergency room, on a daily basis, you’ll hear people telling us we should all go to Gaza. There isn’t a single Arab doctor who has not been told by patients, to his face or behind his back, that they would rather be treated by a Jewish doctor.”

What about the on-duty managers? Can’t they take these people to task and back their doctors? It’s not always an emergency situation. Can’t they say: If you don’t like it, go to a different hospital?

“That actually happened to me at Hadassah when the head of the department took the patient’s file and told him, ‘You’re leaving here right now. We won’t treat you here if you say such things about my physicians,’ but those are rare occasions with people who have years of experience and are not afraid of confrontations.”

In 2016, the cabinet passed a resolution whereby every public hospital in Israel would appoint an anti-racism officer – just like there are people in charge of ensuring that there is no sexual harassment. However, just seven hospitals have appointed an anti-racism officer, and Hadassah is not one of them. The position also exists in six mental health institutions and four geriatric centers, but in none of them is it filled by an Arab. And this is despite the fact that the proportion of Arabs working in the Israeli healthcare system is on a constant upward slope: around half of the new medical, caregiving and dentistry licenses issued in 2020 were given to Arab and Druze citizens of Israel. The need to eliminate racism from hospitals, therefore, is not a marginal problem or something that the state can ignore.

This is especially true in light of the news that the new Israeli government is considering amending the country’s anti-discrimination laws, to allow business owners to refuse service on the basis of religious belief. MK Orit Strock (Religious Zionism) even said in an interview with the state broadcaster that a physician should not be forced to provide treatment that goes against their religious beliefs “as long as there are other doctors who can provide the same service.” She later backtracked, saying that she was only referring to private doctors. “It is inconceivable that the state that this people has established, after 2,000 years of exile and religious dedication, will be a state that calls religious law discriminatory.”

MK Simcha Rothman, a leader of the Religious Zionism party, took to Twitter to say that “freedom means that people can do things that I don’t like. Freedom of expression means people can say unkind things about religious people, Arabs, or gay people. Freedom of occupation means that a person can act however they want toward their customers, they can boycott them or not, and the consumers will punish that person – or not. That’s freedom. Shocking, no?”

Prime Minister Benjamin Netanyahu was quick to distance himself from the Religious Zionism MKs’ comments, saying that “in the country I lead, there will not be any situation whereby someone – whether they are gay, Arab, ultra-Orthodox or anything else… will visit a doctor and not be given service.” The chairman of the Israel Medical Association, Prof. Zion Hagay, also stated that “The Hippocratic Oath obligates Israeli physicians and nobody and no law can change that fact. We will not allow anyone to bring alien or political considerations into the relationship between doctors and patients. The healthcare system will always be an island of sanity, a symbol of coexistence, a place where Jews and Arabs work shoulder to shoulder, where the value of equality is paramount.”

And still, despite all the promises to maintain solidarity and sanity between Jews and Arabs, the situation on the ground is far from ideal, to put it mildly.

Shomrim, in a special project that is also being published as a cover article in the Calcalist supplement, went into the field with physicians and academics, Jews and Arabs, and returned with a worrying impression.

‘We’re Seen as Partners as Long as We Are Good Children’

During the coronavirus pandemic, it might have appeared that coexistence between Jews and Arabs had been achieved, when the media filled with moving articles about the heroism and compassion displayed by Arab caregivers and doctors. But even then, there were those who understood that public support of the Arabs working in healthcare was conditional. “The terminology was militaristic. People were talking about the war against the pandemic and how hospitals were the front line – but, unlike previous wars, this time we’re all on the same side, fighting the same enemy,” says Dr. Guy Shalev, executive director of PHRI. “And still, the legitimacy of the Palestinian teams is conditioned on them wearing a white coat. During the election campaign that was taking place at the time, politicians continued to argue that it was not legitimate to rely on Arab votes to form a government, and a petition was sent by medical professionals saying that the value of an Arab vote in the election should be the same as the value of an Arab surgeon in the operating theater.”

The small amount of optimism generated during the pandemic quickly disappeared during Operation Guardians of the Wall in May 2021, which all those interviewed for this article refer to as a traumatic moment. “When there were riots on the streets of mixed cities, I was afraid to go to work, but I didn’t feel like I was understood,” Qasem-Hassan recalls. “The healthcare system sees us as partners as long as we are well-behaved children, but you cannot just delete everything that you’ve experienced along the way, you can’t just turn up at the clinic as if nothing is happening. I teach family medicine residents, and I decided we would discuss the situation rather than study as normal. One doctor from the Misgav Region said that she sent a WhatsApp message to the residents’ group, hoping that one of the Arab students would help her leave her community, and didn’t understand why no one responded. In the class, they explained that they were in the same situation and that it didn’t work like that. They can’t just talk to the demonstrators and persuade them to let them through. That was an important conversation. People cried and talked. But the system doesn’t encourage open dialog or expressions of solidarity because, as far as they are concerned, that’s a threat.”

Can you give me an example?

“One friend of mine was forced to leave her clinic because patients shared in a local WhatsApp group a post she had written on Facebook, in which she expressed anger over the killing of children in Gaza. She was a family doctor who had taken care of them with dedication for years and she suddenly became a terrorist sympathizer in their eyes. She received death threats and was forced to move to a different region.”

While it may have seemed to some that the tensions had blown over, the case of Hadassah’s Dr. Mahajana, which hit the headlines in October 2022, made it abundantly clear just how far the situation in Israeli hospitals is from being calm. Mahajana and another resident brought food to the department to celebrate successfully passing their exams – and the leftovers were distributed by a medical assistant to the patients, including the 16-year-old detainee, who had been shot in the chest after allegedly stabbing a passerby.

After Mahajana had left the room and the police officers guarding the patients realized that the food was not from the hospital’s kitchen, one of them located Mahajana and demanded his details. “My name is on the tag on my coat,” Mahajana told the officer, “And you can also ask the department director about me.” Another officer chastised Mahajana, saying, “I am in charge here and you will show me your identification card,” while recording what Mahajana was typing. “It’s really stupid that you’re filming,” Mahajana responded.

Mahajana could not have imagined to what extremes this incident would lead. The officers claimed Mahajana had “bought cakes for the terrorist,” taken a selfie with him, and congratulated and blessed him in Arabic. Police even claimed that he had told one of the nurses that the patient was a martyr – a strange thing to have said, given that he was wounded and not dead. Hadassah rushed to suspend Mahajana, even though colleagues who had been present at the time denied that the allegations were true. Now, more than two months later, Mahajana is still suspended.

In a letter to Hadassah, attorney Leah Wapner, the secretary general of the Israeli Medical Association, wrote that “it is unclear on what grounds Hadassah believes that the physician in question acted in the way that he is accused. A hospital does not have the authority to dismiss a doctor because of an allegation that he refused to identify himself to a police officer. This is an interaction between the doctor and the police and has no relevance to his work at Hadassah.”

“Around 70 percent of the care staff at Hadassah are Arabs,” says Dr. Lina Qasem-Hassan, chair of the board of Physicians for Human Rights Israel (PHRI). “Have you heard any of them protesting or sending a letter? They’re all afraid to come out in support of Ahmed"

Should a well-regarded physician be dismissed simply because he told a police officer that filming him was a stupid thing to do? Is that not the kind of behavior that warrants, at most, a reprimand? And what would have happened to a Jewish doctor under similar circumstances? Asked what disciplinary violations Mahajana had committed and why those violations justified his dismissal, Hadassah responded: “The mediation process that the hospital’s management decided on is ongoing and we will respect the privacy of all the involved parties.”

“You should also ask why the version provided by a police officer who is a guest in the hospital is considered more dependable than that of an exemplary physician who has worked at Hadassah for more than four years,” says Qasem-Hassan. “The very fact that he was asked to produce his ID card by the ‘authorities’ – when he, as a doctor, is the professional authority in the department – is twisted.”

“It’s not going to be easy for Hadassah to get out of the corner it’s painted itself into and like every medical organization, it does not like to admit its mistakes,” says Hadas Ziv, 

head of activities and ethics for PHRI. “Here, however, the price will be the crushing of solidarity between teams and indirectly legitimizing Jewish patients who act inequitably toward Arab doctors because if the management is doing it, then they are also allowed to.”

Has the Mahajana case opened Pandora’s box in terms of how people view the treatment of Arab doctors in the healthcare system?

“Yes, I hear about cases that really hurt my soul. One doctor came to me with a particularly painful case. He was so scared that he did not even want us to deal with it, just for us to know that there are other cases like Mahajana’s.”

Mahajana understands those doctors who have not come to his defense publicly. “They are afraid of being fired and stigmatized in public,” he tells Shomrim. I was afraid when I read the comments on the online article, saying, ‘We’ll hang you,’ ‘Go to Gaza’ and ‘Ben-Gvir should get involved here.’ The responses in the street were also frightening. I went to buy shawarma in Jerusalem, and people in line said, ‘Here’s that terrorist doctor.’ I’m lucky the owner knows me and came to my aid, otherwise, who knows how it could have ended. At the entrance to the police station, when I was called in for questioning, people shouted, ‘Here’s the terrorist who hands out knafeh,’ when my best friend is a doctor in the army. Two weeks after the incident, I was interviewed under caution for four hours. They asked me where my father and brothers work; they are both lawyers who represented some of the security prisoners who escaped from Gilboa Prison.”

It's still not a crime to be the son of a defense lawyer, even one whom defense security prisoners, but that connection may provide another explanation for the treatment that Mahajana was given. According to Prof. Michael Elkin, who was present at the meeting, “in my experience, when the Shin Bet comes to a hospital’s administrative director and says something about one of the employees, it’s taken as fact. When the hospital comes up against a security organization, the security organization calls the shots.”

This, too, is being felt in the field, as Mahajana testifies. “One senior nurse said, ‘Over my dead body will Ahmad return here. He and his family are terrorists.’ Another nurse sent the first article published about me to a WhatsApp group for nurses from Hadassah, underneath which she wrote, ‘I never knew Ahmad is a terrorist.’”

Hadassah is very proud that it was considered for a Nobel Peace Prize, but relations within the departments sound complex.

“That’s true – and now they’ve appointed an organizational consultant to mediate between Jewish and Arab teams.”

Mahajana understands those doctors who have not come to his defense publicly. “They are afraid of being fired and stigmatized in public,” he tells Shomrim. I was afraid when I read the comments on the online article, saying, ‘We’ll hang you,’ ‘Go to Gaza’ and ‘Ben-Gvir should get involved here.’

‘The Arabs Suffer More, But They Report Less’

The suspension of Dr. Mahajana is an extreme manifestation of the racism that, on a day-to-day basis, expresses itself in small incidents which do not attract much attention. According to a recent survey of 951 workers in the wards and emergency rooms of four major hospitals in central Israel, 42 percent of Arab medical and healthcare workers say that they have been racially harassed – almost double the number of Jewish workers (24 percent). The survey was conducted by Prof. Nihaya Daoud from Ben-Gurion University of the Negev’s School of Public Health, who also serves as head of the National Health Council of the Arab Councils’ Monitoring Committee. “The healthcare system is in dire straits regarding positions and personnel,” she tells Shomrim. “And there’s a lot of frustration over long waiting times or treatment that the family disagrees with, and that comes to the surface quicker with employees from with a weakened identity. The same thing happens with Black healthcare workers in the United States.”

42 percent of Arab medical and healthcare workers say that they have been racially harassed – almost double the number of Jewish workers (24 percent). The survey was conducted by Prof. Nihaya Daoud from Ben-Gurion University of the Negev’s School of Public Health

There are plenty of examples. One doctor told Shomrim that “the daughter of one patient wanted us to conduct a certain test and we told her that wouldn’t be necessary. Then she said, ‘If it were one of your people, you’d give her the test.’ I asked her what she meant and she said, ‘Arabs, of course.’”

Dr. Danino also says, “I had one Palestinian resident with me in the ER and it did happen that people asked for a different doctor to treat them.”

And what do you tell them?

“There are some places that will agree and there are those who will say that they don’t do that kind of thing. It depends on who happens to be there at that moment.”

In other words, it depends on how busy the ER is?

“And whether you have the courage to say no. And if you do give in, you need to mediate that with the staff member who has been hurt. I remember one Arab midwife who was replaced at the family’s request and she left the room crushed. No one explained anything to her. They just replaced her. On the other hand, when I go with a Palestinian doctor to the territories in one of PHRI’s mobile clinics, many times, people ask for the Jewish doctor. Racism exists on both sides, the Palestinian doctor is problematic – partly because of us and partly because of them – so I can understand where the generalization comes from. And, by the way, when it comes to choosing between an Israeli or an American surgeon, many Jews will choose the American one because ‘maybe they know more overseas.’”

What happens overseas, however, is not always a guarantee of excellence. Some universities have a good reputation, others less so. Perhaps people just want a doctor who studied in a prestigious institution and because the vast majority of medical graduates in Israel and Jews, they make these calculated gambles? Shalev does not buy into this theory. “Anyone who studied overseas undergoes rigorous examinations here. The Arab residents, even those who studied here in Israel, will always have to go that extra mile. They will have to show excellence to get somewhere standard for a Jewish resident. A Jewish resident who studied overseas will not be held to the same high standards.”

Dr. Qasem-Hassan recalls , “when I worked at an emergency center in Jerusalem, one family didn’t want me to touch their child. We took an oath to treat everyone, and when it’s an emergency situation, you don’t ask questions, you treat the patient. But in other cases, it depends on the situation. When people reach the end of their lives, they soften up. I’ve yet to encounter any untoward behavior in hospices, but maybe I just haven’t been in that position enough time.”

Prof. Sarab Abu-Rabia-Queder documented several similar racist incidents in her book ‘The Emergence of a Class Identity: Naqab Palestinian Professional Women’ (Magnes Press, 2017), in which she interviewed Arab women working in healthcare professions. One of them emotionally told her that “a soldier came from treatment with a high fever, he was shaking all over. I gave him two blankets and covered him up like a baby – and the moment he recovered, he said, ‘I don’t want that Arab taking care of me.’” Another nurse told how a Jewish patient insinuated that a Bedouin nurse had stolen her wallet and the shame she felt when accused of something just because of her race.

“One sentence that all of them repeated was, ‘I need to prove that I am professional even though I am an Arab,” Abu-Rabia-Queder tells Shomrim. They challenge the system and the familiar balance of power. One nurse I interviewed said many patients said, 'You’re Arab? I can’t believe it, how you’ve advanced, you went to university.’ It’s alien to them.”

The figures from Daoud's survey are surprising when it comes to violence against medical teams, something that was in the headlines in 2022. “A quarter of Jewish staff reported physical violence against them, compared to 15 percent of the Arabs.”

How do you explain that?

“The Arabs suffer more, but they report less. Minority groups are afraid to report violence against them, in case the management starts to view them as problematic and decides to fire them. It’s also possible that Arabs have different concepts of violence to Jews. One Arab nurse in the ER told me that, ‘if a patient were to throw a folder at them, a Jewish nurse or doctor would say that’s violence. If someone throws a folder at me, I’d just shrug it off.’ In any case, the handling of violent cases isn’t serious. And it seems that Arab team members are more likely to say there’s no point even reporting the incident.”

“One sentence that all of them repeated was, ‘I need to prove that I am professional even though I am an Arab,” Abu-Rabia-Queder tells Shomrim. They challenge the system and the familiar balance of power. One nurse I interviewed said many patients said, 'You’re Arab? I can’t believe it, how you’ve advanced, you went to university.’ It’s alien to them.”

‘As a Jew, You’re Not Aware of How Prevalent It Is’

Most of the charged encounters occur in emergency rooms – and that’s no coincidence. The inter-ministerial committee on racism, discrimination, and exclusion in the health system noticed this, too, and recommended that waiting areas in ‘potentially charged areas,’ such as emergency rooms and maternity wards, be redesigned to minimize friction. Shomrim asked the Health Ministry where this recommendation has been implemented, but a spokesperson responded that the ministry had not been informed of any such development. Asked what anti-racism training staff in the field are given, the ministry replied that it is currently in the process of implementing a directive issued by the ministry’s director general on the issue. It added that in early 2023 the training program would be launched.

Dr. Shalev warns, however, against focusing on racism from the patients. “It’s very convenient for the health establishment to present racism as something external. It’s not us, it’s the patients who bring these opinions from home. This way, it absolves itself of racism, which is its responsibility. It’s a more sophisticated and transparent racism, which primarily expresses itself through silencing. Which part of your identity you need to keep under wraps and what is seen as legitimate. A softer religious identity will be more acceptable and people will wish you ‘Ramadan Kareem,’ but a national identity is beyond the pale.”

There are plenty of workplaces that try to minimize political disagreements. Is it that critical?

“As a Jew, you’re unaware of how prevalent it is. Hospitals send public relations videos to potential donors showing helicopters landing on the roof to show how they helped in military operations, and that does not undermine the perception that they are neutral. But if a doctor writes in support of the people of Gaza who are under attack or cries over the children killed? That’s not allowed. And a nurse who, in her free time, attends a perfectly legal demonstration will be fired for bringing politics into medicine.”

Is there also racism between peers? At the water cooler?

“Of course. One Arab doctor told me about an argument between a Meretz voter and a right-winger in the physicians' lounge. I asked him, ‘And what did you say?’ He replied: ‘Are you crazy? I can’t get involved in that kind of conversation, I’ll get into trouble immediately.’ And that was a well-respected doctor in the department. The atmosphere whereby some people can say what they want while others feel that they have to censor themselves is highly problematic; nobody complains about it to the anti-racism officer, but it affects daily life.”

Just speaking Arabic can be a cause for tension. “We cannot speak Arabic, even when it’s just small talk, nothing to do with work,” says one doctor from a hospital in northern Israel. “The Nation-State law was a turning point in that respect because the argument that Arabic is also an official language in Israel was no longer valid. Senior doctors shouted at us to stop talking ‘that Arabic’ or told us not to speak Arabic in their presence, even if it was a private conversation in the doctors’ lounge. A doctor once said, ‘I’m liable to commit a nationalistic terror attack here’ because we were talking Arabic.

“Obviously, we will talk Hebrew when necessary, but why persecute people talking Arabic during their breaktime? Some units put up a sign saying, ‘Only talk Hebrew here,’ and the word ‘Hebrew’ was written in other languages, so there’d be no confusion.”

Maybe the problem isn’t with Arabic but with foreign languages in general. People who don’t understand them feel left out or worry they are being gossiped about?

“Russian staff members talk Russian between themselves and no one says anything about it. And the signs are posted in units where there is a majority of Arabs.”

According to Prof. Abu-Rabia-Queder, “the Arabic language has been stigmatized as a hostile language in the Jewish-public sphere, which leads to the dehumanization of anyone speaking it; they are identified as other and hostile.”

“People in the health establishment are terribly offended when you accuse them of racism,” says Prof. Nadav Davidovitch, chair of the Department of Health Systems Management at Ben-Gurion University’s School of Public Health and a member of the anti-racism committee. “But you cannot keep burying your head in the sand. You can also see the trend when it comes to promoting Arab managers and researchers. The committee also addressed the need for education, starting as soon as possible. It’s not being discussed enough in medical schools and healthcare colleges, which is evident in what is happening in the field.”

One Arab doctor who taught at Tel Avi University recalls: “We do not arrive at university mature. Children aged 19 or 20, straight from school. This is their first time interacting daily with Jews, and the Jews don’t really know us, so everyone arrives with a lot of preconceived ideas, and there are comments made daily – sometimes not intentionally, sometimes more aggressively. I’ll never forget how one student told me, ‘Don’t take this personally, but I believe you all should be deported.’”

Another doctor says how, “I was assigned as a student to a senior endocrinologist, who didn’t know that I am Arab, during the fighting that was going on in Gaza. He told me that all Arabs needed to be driven into the sea. I replied, ‘I don’t know what kind of solution that would be.’ And he still didn’t understand. I told my head of department about it and he said, ‘The nerve of that guy, I’ll have a word with him,’ but nothing happened.”

According to Prof. Daoud, “you cannot assume that, because of the nature of the work or the Hippocratic Oath, that everyone treats everybody else with respect and that there is no discrimination or glass ceiling. There are almost no Arabs in top managerial positions. Not in the Health Ministry, the Health Maintenance Organizations, and the small number of hospital directors that exist are in the north of the country, not in the big hospitals in the center. Not to mention that the moment an Arab is appointed to a senior position, he becomes very statesmanlike and identifies with the establishment.”

This is the moment to point out that the most senior Arab doctors in Israel refused to be interviewed for this article, even though they were not asked to talk about the charged case of Dr. Mahajana, but, rather, about the treatment of Arab healthcare workers in Israel by the establishment and by patients – as people who manage teams in hospitals and who have been through many challenges themselves.

Three Arab doctors who have reached the highest managerial positions – Prof. Salman Zarka, director of Ziv Medical Center in Safed and, as of July 2021, Israel's coronavirus czar; Prof. Masad Barhoum, director of the Galilee Medical Center; and Dr. Morshid Farhat, CEO of Assuta Hospital in Haifa – all declined to be interviewed. A statement from the office of Zarka, a retired IDF colonel, added, “this issue is less relevant for us. We have employees of different religions and a variety of cultural backgrounds and we are proud of this. The criteria for us are professionalism and humane values.”