TEL AVIV, Israel — Israel is making arrangements for the anticipated return of hostages from Gaza, bracing for the likelihood that many will face serious and potentially life-threatening health issues after more than a year in captivity.
The exact circumstances of the hostages’ captivity remain uncertain, but the Health Ministry, along with the Hostages Family Forum, which advocates for the families of these individuals, are creating response plans based on insights from former hostages who have already been released or rescued.
On October 7, 2023, Hamas militants captured around 250 individuals during a cross-border offensive that also resulted in approximately 1,200 fatalities. Presently, about 100 hostages are still believed to be in captivity, with Israeli officials estimating that roughly one-third of them may no longer be alive.
The ensuing conflict has drastically impacted the region, leading to over 46,000 Palestinian fatalities, as reported by health authorities in Gaza. These figures do not differentiate between combatants and civilians, although it’s noted that women and children constitute a significant portion of the casualties.
Hagai Levine, head of the health team at the Hostages Families Forum, expressed concerns that the returning hostages will likely suffer from various health issues, including cardiovascular and respiratory problems stemming from inadequate ventilation in the tunnels where they were held. Further complications he anticipates include vitamin deficiencies, severe weight loss, visual impairments from lack of sunlight, cognitive difficulties, and significant psychological trauma.
As a result, medical professionals expect the hostages will require more extensive and intricate medical and psychological care than those who returned after a previous ceasefire in November 2023. Dr. Einat Yehene, a psychologist working with the Hostages Families Forum on rehabilitation efforts, indicated that the care required will be significantly more complex.
Tackling the medical challenges, including the risk of “refeeding syndrome,” becomes crucial, especially as certain dietary choices or excessive food intake could lead to dire health repercussions for those suffering from prolonged nutritional deficiencies. Dr. Hagar Mizrahi, who leads the medical directorate at the Health Ministry, emphasized that strict guidelines would be in place for what hostages can consume during the initial hours following their transfer.
Six hospitals have been designated to receive the hostages, including two facilities in southern Israel that are positioned closer to Gaza, which will provide care for those experiencing acute medical conditions, according to health officials.
Dr. Yehene cautioned that the public should not expect scenes of jubilant reunions, akin to those witnessed after the last ceasefire. The current physical and emotional states of the hostages may result in withdrawal symptoms, exhaustion, and the need for mobility assistance upon their return.
Medical authorities are also bracing for the possibility that some returning hostages may require speech therapy, particularly if they have been isolated for an extended period. Dr. Yehene noted that some might be so traumatized or shocked from the transition that they could struggle to communicate.
To help minimize the trauma for the hostages and ease their adjustment to new settings, officials are making efforts to limit interactions with others and have made changes to the hospital environment to reduce sensory stimulation. These adjustments may include altering room layouts and lighting conditions.
Additionally, Israel’s Ministry of Social Welfare is arranging temporary housing for hostages who might not feel ready to return home directly after their time in the hospital.
Experts have urged both the media and the public to respect the privacy of the hostages and their families. Ofrit Shapira, a psychoanalyst leading a team of health professionals assisting freed hostages and their families, described the initial days of reunion as deeply significant and intimate.
Hospital areas designated for the hostages are expected to be restricted to medical staff and immediate family only, ensuring that the public and journalists are kept at a distance.
Shapira stressed the importance of respecting the hostages’ space, noting that direct questions about their traumatic experiences can be re-traumatizing. It’s essential for them to share their narratives at their own discretion rather than feeling pressured to engage with the curiosity of others.
The support networks formed among previously liberated hostages and their families are proving beneficial, as they volunteer their experiences to assist current hostages undergoing similar challenges. Levine highlighted the strong connections forged among families of hostages and the released individuals, who have become like “psychological families,” actively aiding each other in the healing process.
Many former hostages are reportedly prioritizing the plight of those still missing over their own recovery, indicating a communal fight for solidarity.
Support for families of those hostages confirmed deceased is also a significant aspect of the ongoing efforts. Reports from Israel confirm that at least one-third of the remaining captives have died, while Hamas has yet to acknowledge the status of 33 individuals believed to be freed in the first phase of the ceasefire arrangements.
Dr. Yehene remarked that the moment for releasing hostages poses a significant emotional and psychological trigger, as some families are reminded of loved ones they will never be able to welcome back home due to lengthy delay in negotiations.
