EXCERPTS FROM: “IN THREE WARS: A PERSONAL AND ORTHOPAEDIC PERSPECTIVE” by Cyril J. Kaplan
I graduated from the Medical School of the University of Cape Town, South Africa, in 1940, and after my internship year enlisted in the South African Army Medical Corps in 1942. Serving in military hospitals first in South Africa and then in Egypt, I was finally demobilized from the army in 1946, in London. In September of that year I commenced working at the Liverpool Royal Infirmary, training in the principles of orthopedics. On graduating Master of Surgery in Orthopedics at the end of 1947, I went to London to Guy’s Hospital in London for the FRCS (Fellowship of the Royal College of Surgeons) examination in June 1948. Under different circumstances I might perhaps have considered settling down and making a career in England, but since the end of the war, I and various friends and acquaintances who were ex-Jewish servicemen had been increasingly preoccupied by events in the Middle East.
In November 1947 the United Nations General Assembly had voted 33 to 13 in favor of partition of Palestine. Britain announced that it would withdraw from Palestine in six months’ time, giving the departure day as 15 May 1948. There was widespread rejoicing among Palestine’s Jews, tempered by fear as eighty of them died in Arabs attacks across the country in the days following the UN decision. An undeclared war began, with Palestinian Arab irregulars ambushing buses and attacking Jewish enclaves, while Haganah units tried to defend and supply outlying settlements and to repel mass Arab attacks on a suburb of Tel Aviv and on Jewish quarters of Jerusalem. The armies of the surrounding Arab countries were massed on the borders. From the belligerent statements of Arab governments it was clear that the end of the Mandate and departure of the British promised a concerted military invasion of the as-yet-undeclared Jewish State.
It was during this tense time, while I was busy with my final Royal College of Surgeons examinations that Arthur Helfet, a surgeon I knew from my army service, appeared in London sent by the South African Zionist Federation to recruit surgeons to work in Israel. I immediately volunteered to go as soon as I had completed my examinations. I made my final appearance before the Royal College examiners, whom I satisfied, and was entitled to the letters FRCS after my name. The next day I reported to the office of the British Zionist Federation in Great Russell Street as I’d been instructed, and was told that I would be leaving for Israel in a couple of days’ time. A visa was organized; visa number 12 issued by the consular office in London, so recently founded that the official rubber stamp still read “Jewish Agency for Palestine.” It was provided as a separate document rather than stuck in my passport, because of anticipated problems on leaving Britain. I was told to tell the customs and immigration officials at my point of departure that I was going to France and show them my South African passport, which had no mention of Israel in it. I was also asked to act as a courier to carry important letters to Israel; the postal service from Britain had been suspended. These documents were secret, I was informed, and must not fall into the wrong hands, and I was given the name of the person who would identify himself to me on arrival in Israel and to whom I should give the documents, with a further instruction that if he were not at the airport, I was to take them to a certain address in Tel Aviv in Hakirya, which I had to memorize. Two days later I received a telephone call notifying me to be at a rendezvous at 8 o’clock the following morning, packed and ready for departure.
We arrived at Blackbush Aerodrome from where we would fly to Israel. Our aircraft was a Dakota DC3 (the US designation was the C47) belonging to a South African Company calling itself “Pan-African Airways”; this airline was the precursor of El Al Israel Airlines. The aircrew was all South African and the pilot recognized me from my time as Medical Officer on the Swartkops Air Station. We lined up to go through Customs and Emigration. In answer to the query I told the official that I was going to France, as did everyone else, but I knew he didn’t believe me, or anyone, because all the officials were extremely rude and offhand. At every stop we picked up additional passengers. When we left Rome we were choc-a-bloc full with Englishmen, Frenchmen, Moroccans, Germans, Poles, Italians and about half-a-dozen Hassidic Rabbis with long black coats and streimels (fur-trimmed hats). I do remember that the toilet arrangements were inadequate and the atmosphere was pretty thick. Knowing the pilot, I was allowed to stand behind him in the cockpit and watch our progress over Athens and on over the Greek Islands to Cyprus. There was another DC3 on the tarmac, also full of passengers for Israel, but this, being a British aircraft, was not prepared to fly into Israel, so the arrangement was that ours would fly into Haifa, drop us off and immediately return to Nicosia to pick up the other passengers and bring them in. This was apparently the normal arrangement at the time.
While we’d been en route a ceasefire was being organized by the United Nations mediator Count Folke Bernadotte of Sweden, which came into effect on 11 June. We landed at Haifa because the airport at Lydda was still in the hands of the Arab Legion. No sooner had we got into the terminal building when the air-raid sirens sounded and some anti-aircraft guns nearby started popping off. But everyone said “Ein davar” – It’s nothing. This was my first experience of one of the mock air raids for the benefit of the United Nations observers in Haifa Port; the planes would unload quickly, turn around and fly out, while Israel would explain to the UN that an Egyptian air-raid had been driven off. Inside the airport building a young man called out the name I had been given in London, identified himself, said he was expecting me and asked for my courier’s bag. I was only too happy to hand over to him my “letters of introduction”. He asked my name and gave me the greeting I was to hear so many times over the next fifty years: “Shalom, Doctor”.
Early on during the period of the second truce we visited Jerusalem. It was by a route new to me, although I had heard about it; the famous Burma Road, built at night in early June across hills and valleys in order to bypass the Latrun area, which was held by Arab Legion troops. The water pipeline to Jerusalem was still cut by the Arab Legion, which controlled the pumping station at Latrun, so the city had to depend on its own more or less biblical resources – wells and cisterns, the Spring of Gichon – and was severely rationed to one kerosene-tin per person per day for all purposes. The beautiful Hadassah Hospital which I had visited previously was now encircled and isolated on Mount Scopus, and treatment was being carried out in what was known as “Hadassah A” and “Hadassah B” which were some buildings deeper inside Jewish Jerusalem that had been taken over as makeshift hospitals. They were crowded out both with wounded and with illness, and the medical staffs had a pretty tough job. This was only a short visit to Jerusalem in order to assess medical needs and to see whether we could help with supplies, although these were now arriving in considerable quantity from the USA.
It was decided that our group should move from Tel Aviv to the old Government Hospital at Bat Galim in Haifa, where we would start operating as an orthopedic unit. Arthur Helfet was chief and I was his first assistant, with Dr. Berelowitz as our anesthetist. Accordingly, we went around Tel Litwinsky Hospital choosing orthopedic patients who were packed into ambulances and sent on convoy to Haifa, where we met them and got them settled down. During the war the British army in Haifa had taken over the Italian Hospital in the German Colony as a British military hospital, evacuated it when they left Palestine in May 1948. Now designated Israel Military Hospital No. 10 – Beit Cholim Mispar Esser in Hebrew – the majority of the patients were accommodated here, and the military cases brought over to the main Bat Galim army hospital for surgery and returned to No. 10 a few days later as soon as their conditions permitted. The Bat Galim Hospital was a very modern, imposing structure that had been built by the mandatory government on the sea-shore at Bat Galim. It was however poorly equipped because the British, before leaving, had allowed destruction of many of the hospital beds and fittings. Most of the instruments seemed to have disappeared, although after several weeks a couple of young men came into the hospital in bathing costumes with handfuls of surgical instruments which they said they had found on the sea bed near the hospital. They asked whether we wanted them. We needed them desperately so a diving squad of young men was formed who dredged the bottom and found most of the surgical armamentarium which had been dumped there before the previous occupants had left.
We worked very hard and got through a lot of cases and eventually, after about 3 months, Arthur Helfet returned to South Africa leaving me in charge of the unit. By then it was running very well, with the invaluable help of mainly volunteer doctors and nurses from outside the country. In the meantime we’d cleaned up the wards at Beit Cholim Mispar Esser and moved in our patients. Someone who dropped in now and then was David Rosenberg, the South African doctor to the 79th Armored Brigade. We were designated the military hospital for the Northern Command which was the sector covering the Upper Galilee, where the 7th Brigade faced Kaukji’s irregular Arab Liberation Army. The 7th Brigade and particularly its 72nd Infantry Battalion were a Machal unit composed largely of English-speaking volunteers – referred to by the Israelis as Anglo-Saxim – who naturally felt at home in our English-speaking hospital. Our other source of patients was, of course, the navy whose base was in Haifa, but whose operations carried them down the coast as far as Gaza and beyond where they attacked the flank of the Egyptians, and every now and again we had a wounded man back from one of these raids. The air force had a squadron at Ramat David – known as “RD” or Rosh Daled – and as this group was wholly English-speaking from South Africa, the USA and Britain, they often popped in to speak to us, or rather to our English-speaking nursing staff, who enjoyed the attention.
The second truce had commenced on 19 July with the ALA, Lebanese and Syrian forces holding villages in the northern Galilee up to the Lebanese border, threatening kibbutzim on the headwaters of the Jordan. Egyptian forces occupied the Mediterranean coast to within 20 miles south of Tel Aviv with a large force entrenched around Faluja, and in control of Gaza and Beersheba and astride the communication links to the Negev kibbutzim. Such a precarious situation was unsustainable and it seemed highly likely that fighting would resume in the near future, in which case No. 10 Military Hospital had to be prepared to receive casualties.
We considered the establishment of an adequate blood transfusion service our first priority and set about organizing one. After rejecting Assis orange juice bottles because the neck was too narrow, we decided to use plasma bottles, of which we had hundreds. Jews in America had given blood which had been made into dried plasma, and we had far more of this than we would ever require. Each bottle came with a screw-on, pre-sterilized giving set and what we did was to wash out and re-sterilize a hundred of these bottles, charge them with the proper amount of sterilized sodium citrate solution and take blood directly into the bottles from our donors. The first ones were members of the hospital staff and also some of the patients. We subsequently spread our net to include various army units around and about and, having advance information regarding possible military activity, stepped up our blood-taking prior to such an action so that ten or twelve days later we could give back to the Army its own blood. The scheme worked admirably, providing a first-class blood transfusion service comparable in every way to that run by the British army in the Middle East during the War.
Among our other problems was the shortage of surgical instruments. Hal Gershoni told me one day that a big box had arrived in the harbour addressed to the Magen David Adom, which, on opening, had been found to contain a large hospital sterilizer of the size used for sterilizing bowls and other containers. The interesting thing was that it was packed full with surgical instruments. Magen David Adom is the equivalent of the Red Cross Association in other countries and runs ambulances, trains people in first-aid and civil defense and, in Israel, operated the blood transfusion service. It had no hospitals, did not have to equip hospitals, and really had no need for surgical instruments. These had obviously been sent over by some philanthropist in the USA in the hope that they would reach the right place and do the most good. Desiring to bring this hope to fruition, I went down to the harbor with the hospital ambulance, loaded the box in and took it up to No. 10 hospital, where I handed it over to the Commanding Officer. There was a lot of fuss because it hadn’t come through the proper channels, but I am afraid that Jack Wilton and I were very rude about proper channels and merely took the instruments and sterilizer up to the operating theatre where the instruments were put into use immediately, and the sterilizer as soon as we could get the plumber to connect it up to the steam source. I am sure this was a highly illegal act but, not being for personal gain, I hope it will be condoned.
The type of work we did in the orthopedic department of the hospital was standard military orthopedics. When the acute injuries and casualties came in our first job, of course, was resuscitation, and I do feel that our methods were somewhat in advance of those practiced at that time by the Israeli doctors, although their practice in subsequent wars improved until during the Yom Kippur War it was probably the best I have seen anywhere in the world. In 1948 and 1949 we were leaving our wounds open where possible and treating them by delayed primary suture or even late skin graft. This is a lesson that is re-learned in every war.
One afternoon a call came in to the hospital asking me to go to Kfar Giladi in the northern tip of the Upper Galilee, as they required orthopedic assistance. I packed a surgical kit and other requirements into an ambulance and off we went. The driver said that they had to get through in a hurry and for this reason they were not going to take the Nazareth-Tiberias road – which was safe – but were going to try the quicker west-east route via Acre-Safed-Rosh Pina; they had come down that way and had been fired on by Arab irregulars in the valley near Shezor. Security levels in the region tended to fluctuate constantly, but apparently Israeli scouts now reported back that the risk might be reasonably low for the next couple of hours. So I agreed to this plan and off we went, though when we got into the valley they made me get into the back of the ambulance and lie down on the floor, which I accepted gladly as a very wise precaution. Luckily, there were no shots and we got through to Kfar Giladi in record time.
When we arrived there I found the kibbutz hospital fairly full of casualties and Dr Ragolski in charge. Without any special training in orthopedics he had done a wonderful job. His main concern was the treatment of the fractured femurs but he had managed to reduce all of these satisfactorily and immobilize them in Plaster of Paris spicas (a cast that wrapped around the body and extended down the affected leg) which, although heavy and uncomfortable, did the job beautifully. There was very little I could do except help him because he was getting on very well indeed. I stayed with him for a day and then took the worse of the wounded back to Haifa with me in the ambulance. I’d been greatly impressed by Dr Ragolski’s abilities and on my return put in a very good report about his work, making a request that he be posted to my unit as I needed an assistant surgeon.
As October advanced it was becoming very cold at night in the Galilee and our troops there were suffering, dressed as they were in khaki cotton drill with no adequate winter clothing. At the end of Operation Ten Plagues the Israeli Army had became the owners of a tremendous amount of Egyptian military stores. I was doing the rounds in one of the wards at the bottom of the hospital grounds which adjoin the main road in Haifa, when we heard the rumble of armoured vehicles. All of us rushed out to see what had happened, because this was a new sound to us. There, racing along the road, were a lot of light Egyptian tanks and Bren gun carriers, their Egyptian numbers painted out and a big white Tzadik along the front and sides, showing that they had been taken over by the Israeli Army. They dashed right through the city and went into action against Kaukji’s forces that same day, and at the same time the Israeli Army in the North was re-equipped with warm British battle dress, British greatcoats and British Army blankets. These at least of our basic military requirement were obtained without the payment of money.
On 24 February 1949 the UN mediator Dr Ralph Bunche oversaw the signing of an armistice between Egypt and Israel, intended to “facilitate the transition to permanent peace”, and the last defenders of the Faluja pocket marched across the Egyptian border with full military honours. Peace negotiations were opened with Lebanon and signed on March 23, and Israeli forces withdrew from the positions along the Litani River that they had reached during the Upper Galilee offensive. Discussions with the Transjordanians became stuck on the frontier line through the Hebron Hills, which were still occupied by Iraqi troops. Ben-Gurion determined that before any agreement was reached, Israel would claim its full territorial entitlement under the borders of the original Palestine Mandate and the 1947 UN Partition Plan, and occupy the whole of the Negev down to the Gulf of Aqaba. Military columns were sent south, the Transjordanian Arab Legion units in their path withdrawing across the Transjordanian border. On March 11 the Israeli flag was raised on the Red Sea beach that would become Eilat. Armistice agreements were signed with Transjordan on 3 April 1949. Israel’s War of Independence was over.
Source: “In Three Wars: A Personal and Orthopaedic Perspective” by Cyril J. Kaplan, Published USA, Xlibris Corporation 2008, (www.xlibris.com or www.amazon.com)
Copyright (c) 2008 Dr. Cyril J. Kaplan. All rights reserved. Permission has been given to use these excerpts for reading purposes only. Permission must be obtained from the author to use any of this material in any way whatsoever, other than for reading purposes.