Helping communities in Israel’s North

Helping communities in Israel’s North

Berrie Foundation’s SPHERE program fights diabetes, works with post-October 7 Galilee evacuees

Dr. Sivan Spitzer and Professor Naim Shehadeh, front row center, with SPHERE administrators and staff.
Dr. Sivan Spitzer and Professor Naim Shehadeh, front row center, with SPHERE administrators and staff.

Israel’s northern Galilee area has, by far, the highest number of new cases of type 2 diabetes annually in the country, the highest morbidity rate from diabetes, and poor diabetes patient management, leading to high rates of complications.

More than half the population in the Galilee are Israeli Arab, whose diet and lifestyle often put them at greater risk of developing diabetes.

This is a story about how a Teaneck-based philanthropy, the Russell Berrie Foundation, is helping to improve this situation, both in normal times and now in the stressful period of the past seven months, when many residents of the Galilee remain evacuated from their homes.

The foundation had given a seed grant that helped Bar-Ilan University open its Azrieli Medical School in 2011. The school is based in the Upper Galilee city of Tzfat, also known as Safed.

“They hoped that some of the graduates would make their homes in the North and that would have an overall impact on the health of the northern communities,” the foundation’s CEO, Idana Goldberg, explained.

In November 2021, responding to a request from the medical school’s dean, the foundation gave a $20 million lead grant to help Bar-Ilan create the Russell Berrie Galilee Diabetes SPHERE. (SPHERE is the foundation’s Social Precision-medicine Health Equity Research Endeavor.)

“We dreamed up SPHERE as our new Faculty of Medicine saw huge healthcare and healthcare outcome disparities in the surrounding communities in the North, compared to the center of country,” SPHERE’s deputy director, Sivan Spitzer, said. “We asked ourselves how could we not only train physicians but also aid the communities we serve.”

This 10-year, $75 million initiative, under the directorship of endocrinologist Dr. Naim Shehadeh, the Israel-Arab president of the Israeli Diabetes Association, is intended to transform diabetes research, prevention, and care in Israel’s socioeconomically disadvantaged northern Galilee region.

“We’ve really been the catalyst for this project, funding a significant planning study that Bar-Ilan used to build out the program, focusing on prevention and not just on research or care,” Dr. Goldberg said. “We’re incredibly excited by what they have done and what we expect them to do.”

From left, Dr. Samir Mahamed, mayor of Umm al-Fahm; Professor Naim Shehadeh, director of the Russell Berrie Galilee Diabetes SPHERE at Bar-Ilan University’s Azrieli Faculty of Medicine; SPHERE’s deputy director, Dr. Sivan Spitzer; Safed Mayor Yossi Kakon, and Azrieli Faculty of Medicine’s Dean Orly Avni. They’re standing in front of the Russell Berrie Galilee Diabetes SPHERE Mobile Testing Unit.

Dr. Spitzer said that social determinants of health — where you were born, grow up, age, and work — account for an estimated 80 percent of individual healthcare outcomes. They’re more determinative than access to care, or the quality of that care.

“Your ZIP code has more impact on health than genetic code,” she said. “Clearly we had to work with our surrounding communities, in partnership with the national healthcare system, faculties affiliated with six hospitals, and municipalities.”

SPHERE healthcare workers — professional teams of secular, religious, and ultra-Orthodox Jews, and Muslim and Christian Arabs — implement programs in 23 municipalities, promoting a healthy lifestyle as well as health education programs targeting high-risk populations and pre-diabetes patients.

The center aims to improve management and mitigate complications of diabetes, transform diabetes care via an integrated, interorganizational model, and research diabetes-causing genetic mutations that are specific to particular populations, with the goal of tailoring treatment and developing new diagnostic and prevention methods.

Angelica Berrie of Englewood, president of the Russell Berrie Foundation, said at the center’s inauguration: “For me, as for millions of people around the world, diabetes is deeply personal. I have experienced firsthand the devastating impact of this disease, which took the life of my late husband, Russell Berrie. SPHERE draws on Israel’s unparalleled expertise in healthcare innovation to change the landscape for future generations.”

Israel’s Ministry of Health is evaluating SPHERE as a model program that could be integrated nationwide, and possibly internationally, to improve coordination of comprehensive, integrated healthcare.

This mission has become more critical since the October 7 Hamas attacks in southwest Israel that precipitated not only a war in Gaza but also missile bombardments in the North from Hezbollah in Lebanon, forcing tens of thousands of northern residents from their homes.

Dr. Spitzer explained that while municipalities have guidelines from the Home Front Command for taking charge of healthcare needs in emergency situations, vital information about residents with complex health needs, as well as data about exactly what medicines and equipment are available and where, are not available consistently or easily.

“This was an urgent need, so we built a platform in a week with the help of medical students who volunteered to help the SPHERE team collect the needed information,” she said. “Very quickly, we knew how many first-aid kits were missing, how many generators were needed for safe rooms and clinics in case of power outages, which clinics have safe rooms, which pharmacies are open and have medications on hand,” she said. “The municipalities could then ask the Ministry of Health for what was needed.

SPHERE Deputy Director Dr. Sivan Spitzer, front row in red, with the managers of the health units in the local municipalities that work with SPHERE.

“This is not the bread and butter of SPHERE, but a way to assist our partners at this time.”

SPHERE also produced videos, printed material, and online information, in Hebrew and Arabic, offering diabetes patients culturally sensitive advice on how stress can affect them and what to have on hand in their safe rooms, if they were home, or what to take to evacuation hotels. SPHERE workers have been distributing diabetes supplies, such as glucometers, to evacuees in hotels in the area.

“We also set up a helpline for family physicians to ask leading Israeli endocrinologists for guidance in emergency situations,” Dr. Spitzer said.

SPHERE’s overall team of 30 includes clinicians, researchers, municipal officials, city planners, and economists.

“We have a holistic approach,” Dr. Spitzer said. “We run over 60 research-driven projects — complex, real-world interventions tested with real-world partners — that are constantly assessed to see what works for whom and in what situations. That’s the strength of having an academic faculty leading this effort.”

Orly Avni, dean of the Azrieli Faculty of Medicine of Bar-Ilan University, emphasized the importance of cooperation between all those involved in healthcare for the sake of Galilee residents.

“The role of the university is to produce and instill knowledge, and we at the faculty have taken the challenge of strengthening medicine in the region upon ourselves,” Dr. Avni said. “Our love of the Galilee sharpens our perspective on the difficulties here. The war and evacuation do not bode well for us, but by combining our efforts we can create change.”

At a May 22 conference on diabetes and obesity in Nazareth, about 400 people from the northern healthcare system were on hand as SPHERE debuted a mobile testing van intended as a one-stop shop for diabetes testing and monitoring in the cities and towns it serves.

“The mobile clinic is a great example of integration between SPHERE, municipalities, and the healthcare system,” Dr. Spitzer said. “Many patients aren’t adherent to annual checkups. Now they can come to one place close to home for bloodwork, eye exams, and everything else needed at once, and be done in an hour. That really creates a difference across the North.”

SPHERE is dedicated in November 2021, in mid-pandemic. Angelica Berrie stands in front, on the right, next to the director, Dr. Naim Shehadeh. (Nir Shmul)

The Berrie Foundation’s philanthropy in the North, however, goes beyond diabetes.

For more than 15 years, the foundation has been involved in supporting “efforts to establish economic development clusters, strengthen governance effectiveness in local authorities, address health disparities, and improve people’s quality of life throughout the Galilee,” Dr. Goldberg said.

“We felt that if we can strengthen and support the North, trying to close gaps between the periphery and the center, we could strengthen and support all of Israel.”

For the last five years, the foundation has worked with the Israeli organization Maoz — a diverse network of leaders collaborating on social projects aimed at strengthening socioeconomic resilience — to build a Galilee-focused initiative called Maoz North.

“Having grown its reach and results through multiyear grants, Maoz North was poised to spring into action after October 7 to link and coordinate the problem-solving capacities of experienced leaders who can tackle the specific challenges defining the region’s future,” Dr. Goldberg said.

“Their efforts will be crucial in helping local governments, businesses, and civil society organizations carry out policies and programs that can help restabilize and grow the periphery.”

With Maoz, the Russell Berrie Foundation hosted a Jewish Funders Network meeting soon after the October 7 attacks. This resulted in the formation a new coalition of funders seeking to make a greater impact in the Galilee.

They intend to address specific regional challenges such as violence in Arab towns, a shortage of high-quality and diverse medical personnel, and limited educational opportunities.

“Our aim is to revolutionize the region’s future in ways that make the North the standard-bearer for robust economies, a high quality of life, and thriving, secure communities,” Dr. Goldberg said. “Given our long-term knowledge of the region, our professional team has been proactive in making connections between funders and with grantees.”

The situation in the North unfortunately deteriorated as the government was slow to respond to the needs during this crisis, she continued. Only on May 27 did the government approve the Northern Dawn plan, allocating billions of shekels toward aiding evacuees and rehabilitating and strengthening towns within 9 kilometers of the Lebanese border.

However, Dr. Goldberg pointed out, whole communities have been evacuated for nearly eight months, “and communities that have not been evacuated have no services. There is a severe shortage of teachers, for example, so schoolkids in the North who have remained are getting a minimal education. We’ve been trying to support some grassroots work that is starting to take root to provide that support and we’re also exploring longer-term solutions.”

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