By Allison Warren, Staff Writer
Over this past month, we have witnessed the return of many Israeli hostages from Hamas captivity, as well as the release of five Thai nationals. Israel underwent preparations for their arrival to best treat their medical conditions, with the expectation that many hostages underwent severe, life threatening complications after spending over a year held captive in Gaza. The Health Ministry and the Hostages and Missing Families Forum planned for an array of potential scenarios based on the reports from prior released or rescued hostages. Six hospitals have prepared to receive hostages, two of which are closer to Gaza and plan to treat those with acute medical issues.
Once returned, the hostages undergo an extensive medical evaluation including, “infectious disease screening, thorough nutritional assessment including vitamin levels, potassium, zinc, and vitamin B12, pregnancy testing for women of reproductive age, blood clot screening – a condition previously observed in hostages due to prolonged immobility, and detailed examinations of neurological, respiratory and cardiac functions,” Israel Hayom reports. A multidisciplinary team of ophthalmologists, gynecologists, geriatric specialists to evaluate prolonged immobility effects, dentists and mental health professionals were assembled. The Health Ministry recommended a minimum four day hospitalization period.
Due to the lack of ventilation in the tunnels, Hagai Levine, the head of the health team at the Hostages Forum, predicts that the returning hostages will suffer from cardiovascular and respiratory health issues. Additionally, they may face vitamin deficiencies, starvation, significant weight loss, vision problems due to prolonged darkness, broken bones, cognitive impairments and mental health trauma. Sunglasses have been prepared to help ease their adjustment to light, as they may be unaccustomed to it. Starvation leads to severe muscle and fat loss, protein depletion and metabolic breakdown, as the body uses muscle tissue for energy.
The hostages are also more susceptible to infections due to weakened immune systems from malnutrition. Severe deficiencies in important minerals such as potassium and magnesium can result in cardiac arrhythmias and organ failure. Long-term nutritional deficits can also impair brain function, leading to memory loss, poor decision-making and mood instability due to a lack of essential B vitamins. Recovery for the hostages will involve a diet rich in protein, vitamins, and minerals, alongside regular blood tests to monitor and prevent dangerous side effects.
There are several challenges facing the doctors as they treat the surviving hostages. One such challenge is the “refeeding syndrome,” explains Dr. Hagar Mizrahi, head of the Ministry of Health’s medical directorate. This occurs when one who underwent prolonged vitamin and nutritional deficiencies is exposed to certain foods or too much food, leading to profound health complications and even death. The sudden electrolyte imbalances from rapid refeeding may lead to brain swelling, heart failure, and digestive issues. As a result of this concern, the Red Cross and the Israeli military medical team have received strict instructions for what food the hostages may eat in their first few hours home.
Dr. Einat Yehene, a psychologist at the Hostages Families Forum who oversees the captives’ rehabilitation, suspects that some returning hostages may need speech therapy, especially those kept in isolation. She also describes how some may be potentially unable to speak from the trauma or due to shock from their transfer to Israel.
Accommodations have been made to help those returning acclimate to their new reality, such as stripping down the hospital rooms, changing the lighting, and limiting the number of people who may interact with them. Temporary housing solutions have been provided for by the Ministry of Social Welfare in case the hostages do not feel able to go directly from the hospital to their home. The hospitals have been “sterilized,” primarily closing off access to the media. Experts say it is best to allow the former hostages to share their experiences at their own pace rather than to ask direct questions.
Hormones have played a unique role in the health and appearance of the returning hostages. Our adrenal glands produce adrenaline, which prepares the body for action by “raising heart rate, increasing blood pressure, and improving blood flow to muscles.” This adrenaline surge will create temporary strength, alertness and energy.
Dopamine is a neurotransmitter that is responsible for generating feelings of satisfaction and pleasure during joyous occasions. As hostages return, they may experience a dopamine rush, creating a brief euphoria and happy appearance. Yet once dopamine levels drop, fatigue and depression can set in.
Similarly, serotonin is a hormone which regulates mood, sleep and appetite. The hostages have undergone months of low serotonin due to stress, yet upon release the sudden spike may provide the hostages with a temporary sense of calm and confidence.
While in captivity, hostages likely had high levels of cortisol, a hormone that is produced in response to long-term distress and may affect immune function, blood pressure, blood sugar and metabolism. Yet upon release, the cortisol levels drop sharply, and one may experience extreme fatigue and immune system complications.
Dr. Danny Brom, Founding Director of Metiv, The Israel Psychotrauma Center, offers an inspiring reminder from the field of trauma recovery. “Even after immense suffering, human beings have the remarkable ability to bounce back.” Despite the hardships they’ve endured, many of the returned hostages have shown extraordinary resilience, putting aside their own recovery to contribute to the mission of bringing others home. Their strength and determination reflect a deep, unwavering hope that recovery is not only possible but a testament to the resilience of the human spirit.
Photo Caption: Hostage posters hung in the Beren campus
Photo Credit: Emily Goldberg / the YU Observer