The Medical Health Handbook for Your Gap Year in Israel
This guest post was written exclusively for Pack for Israel by Adina Berkowitz RN BSN. Adina has been a nurse for over 15 years. Since making aliyah 5 years ago, she has been working with GAP year students in yeshivas and seminaries, providing health care to adolescents and young adults.
Hello Parents of future GAP year students!
As you are preparing for your teen’s year in Israel you undoubtedly have a million things to think about and prepare. You’re excited, yet worried; there is so much to think about and organize! Your teen is about to leave home and travel far away from your supportive cocoon for an intensely transformative year. It's important to be prepared, and part of this preparation process includes planning for medical issues. Here is a little crash course and some medical tips from a local school nurse.
First and foremost, I’d like to stress the importance of being completely transparent and honest with the school about your teen’s medical/psychological/emotional history before they arrive. When the school knows the whole history, they will be better prepared and, therefore, more supportive to your teen. They may be able to offer resources and/or suggestions of ways to facilitate their time in Israel.
In addition to the school knowing in advance about any medical issues, it is important to prepare your teen and review with them what medical/psychological/emotional issues they’ve dealt with and to make them aware that medical care will likely be very different from what they’re used to. Up until now you have likely been handling all of their medical related issues, such as making doctor appointments, speaking with providers, buying medications, reminding them to take their medications, advising them when they get sick with viruses etc . Now they will be responsible for themselves and should absolutely know their medical history, allergies, and medications. This will make them more independent, and also will help guide medical providers in making decisions if they ever do need medical attention.
Your teen will need medical insurance. Most Yeshivot/Seminaries offer a medical insurance plan to their students. They are either private or affiliated with the kuppot (HMO that all Israelis are entitled to). The recent acceptance of GAP year students by the kuppot has been extremely positive. It gives students more convenient access to care and allows them to go to the respective clinics all over the country.
This is especially exciting for Yeshivot/Seminaries that aren’t located in Jerusalem. Instead of having to schlep there for most specialist appointments, now they can be seen by local kupah doctors and specialists. Private insurance companies offer the same care but only with certain providers, which can sometimes be limiting. Either way, medical insurance ensures the safety of your teen and allows them to see Israeli providers, whether it be in urgent or non-urgent care settings.
Some schools even provide English speaking medical providers that come to the schools weekly to provide on-site primary care clinics as well as telemedicine. This is what I do, by the way!
American prescriptions are not honored in Israeli pharmacies. If your teen needs a prescription medication it should either be brought to Israel, sent, or will need to be prescribed by an Israeli licensed doctor. It is important to keep in mind that medications required for pre-existing conditions may not be covered by insurance.
Also take note that not all medications that are available in America are available in Israel. Sometimes the medication is available, but in a different dose, under a different name or perhaps the long acting version of the medication isn’t available but the regular one is.
In order to find out in advance, one could ask the school if they know about the specific medication from previous students taking the same medication, look up the medication in the Misrad HaBriut (Ministry of Health) Israel Drug Registry (https://israeldrugs.health.gov.il), or call a pharmacy and ask a pharmacist.
There is no lack of OTC medications available in Israeli pharmacies; that being said I would strongly encourage parents to send a basic mediation kit including Advil, Tylenol, Neosporin, Hydrocortisone cream or Benadryl anti-itch cream, Benadryl, allergy medication, cold and flu medication (for example DayQuil, NyQuil), inhalers for those who have one. Even if your teen only uses the inhaler a few times yearly: bring it! GAP year students often complain that their allergies/asthma/viral illnesses have never been so severe than when they are in Israel.
The change in environment, close living conditions with other students, increased stress, decreased sleep, change in diet, and exposure to new bacteria/viruses/allergens can cause GAP year students’ immune systems to be more susceptible, and, therefore, tend to more easily and frequently become ill.
What happens if my teen gets sick in Israel?
Before anything else, the Em/Av Bayit or other program staff should be told about any medical problem. It could possibly be something he or she can deal with directly, or at least provide guidance and support.
If your teen needs to be seen by a medical professional, the following options exist: Primary care doctors, specialists, visiting PA/Nurse/Doctor or telemedicine, urgent care centers and, of course, the ER. Some clinics even offer walk-in hours, such as Wolfson Medical Center. The process of making an appointment to see a doctor depends on the insurance and the school policy. It is important to note that scheduling specialist appointments can sometimes take a long time.
If an issue needs to be addressed quickly and no appointments are available in the near future, going privately (paying full price) is always an option. In this case, getting an appointment is much more rapid.
In case of emergency
Students who have a serious medical issue are able to go to urgent care centers and receive treatment. Terem, Yad Sarah, Bikur Rofeh and the kupah urgent care centers (for those who have a kupah). Of course, the Emergency departments (ER) are available to anyone who, G-d forbid, needs. Typically, the Em/Av Bayit (or someone from the school who has proficient Hebrew skills) will accompany your teen to the urgent care or ER. They will keep them company, reduce their stress and, more importantly, be their advocate.
An advocate is especially important to help navigate the language barrier and act as a liaison between your teen and the medical providers. Moreover, an advocate will ensure the proper care of your teen, which can require a bit of extra assertiveness, and even pushiness at times. It is overwhelming to be in the ER or urgent care especially for a young, foreign student without their family.
ER vs urgent care
Sometimes it’s not so clear whether to go to the urgent care center or the Emergency department. Your child’s school can help guide your teen, but in general if the issue is something for which you would go see your primary care doctor but want to have it addressed immediately, an urgent care or a walk-in clinic is the place to go. Examples: vomiting and diarrhea, muscle sprains, simple fracture, minor cuts/abrasions, pain with urination, mild asthma exacerbation, skin lesion/rash, ear pain, eye infection.
Going to the ER involves a life-threatening problem! Examples: seizure, loss of consciousness, major burns, difficulty breathing, eye or head injury, facial laceration, severe abdominal pain, very high persistent fevers, severe anaphylactic allergic reaction. Ultimately, if your teen goes to an urgent care or walk-in clinic and it is determined that a higher acuity of care is needed, they will be referred and sent to the ER.
Emergency phone numbers
In Israel, there is no central dispatch number like 911 in the US. Here are some important emergency numbers to keep handy:
- 100 - Police
- 101 - Magen David Adom Ambulance
- 1221 - Hatzalah Ambulance
- 102 - Fire and Rescue
About the author - Adina Berkowitz RN BSN
I have been a nurse for over 15 years, initially working in the hospital setting in various specialties, namely at Children’s Hospital of Pittsburgh and Boston Children’s Hospital. Since making aliyah 5 years ago, I have become integrated in the Yeshiva/Seminary and Summer Camp settings, thereby providing health care to adolescents and young adults. It has been a pleasure to provide medical guidance to these young, talented, and ambitious teens, whom I often see making an impact both in Israel and in summer camp. Please feel free to email me with any questions. (firstname.lastname@example.org)