Small-Town Dreams

In a small room in a small clinic in a small Middle Eastern town, a small woman speaks to a small group of visitors. The thoughts she expresses, in small, clipped bursts of Hebrew, aren't small. They are large and weighty, and translated into English, they hold her listeners--tough, seasoned veterans of American emergency services--rapt.

   She's talking about fear. The fear of missiles crashing through roofs and into streets. The fear of fathers who can't protect their families. The fear of children who dare not play outside. A fear so constant and conditioning, for some it can ultimately trigger incontinence when the sirens come. Of a community so battered by fear and death and war--the grotesque asymmetrical kind that finds children legitimate targets--that acute stress reactions can be triggered, at last, by something as mundane as the call of a strolling street vendor.

   The Americans have seen a lot. They haven't seen this.

Rocket City

   They call Sderot Rocket City. It's a small town in central Israel, less than a mile from the Gaza Strip. That's where the rockets have been coming from, now, for more than a decade.

   From 2001-09, according to the Sderot Media Center, which works to publicize the town's plight, more than 10,000 rockets were launched from Gaza toward Sderot and the western Negev Desert. Primarily Qassams, simple steel artillery rockets developed by Hamas, the U.S.- and E.U.-designated terrorist organization that governs Gaza, they grew over the decade in range and payload. By 2009 they'd killed 28 people, nine in Sderot, including three children, and injured hundreds more. Israel cracked down after that, but even in the "quiet days" since Operation Cast Lead, Sderot has taken, by the estimate of one town elder, around 700 rockets.

   The woman is a psychiatrist. Originally from Europe, Dr. Adriana Katz is now the lone mental health professional on this weary front line of long, intractable conflict. She says she's assisted roughly a quarter of Sderot's residents in her time here--around half of those for stress and anxiety problems. It's not PTSD, Katz is careful to distinguish, because "there is no post-."

   Sderot is just one stop on a full itinerary for the Americans, but for nearly all of them it's the most memorable. These Americans alleviate suffering--they are doctors, nurses, paramedics, leaders of emergency care systems. They've come to Israel as guests of its government to exchange ideas on mass-casualty incidents and nonconventional threats. If a rocket were to land in Sderot that day, they'd know how to treat the injuries. Against the emotional wreckage wrought by years of random shelling of civilians, their skills seem less useful.

   They worry about her. "Who's helping you?" is the first question when Katz finishes speaking. Her response is nebulous.

   Dr. Katz says she was a liberal even by European standards--a pacifist and a Jew who came home to help her people. She's seen their fear for more than 15 years now. She's experienced it too; fluent in English, she speaks to the Americans in Hebrew because, she says, it's "the language in which she knows fear." The fear is also conditioning her--Dr. Katz says she feels herself changing. As the years have passed and the bombs kept coming and the town around her changed--some dying, some fleeing, homes and businesses destroyed and rebuilt--she feels herself hardening, growing dark. She knows, of course, that the fear and suffering associated with Gaza and the Middle East and their conflicts aren't confined to Israel's side of the fence. The Gazans suffer too. She sees all this, recognizes it, regrets it, but what can she do? The bombs keep coming.

   When you go to Sderot, they tell you at each stop where the shelters are located. When the siren comes, you have 15 seconds, move quickly but calmly. Katz's clinic has one. The 2,000-square-meter covered indoor playground for Sderot's children has two. The schools have been rebuilt to serve as them. So have the bus stops. Good thing, because the rockets are getting better. By the time of Operation Cast Lead, the Qassams' range had increased from 3-4 km to 10-20, and their explosive payload from 0.5 kg to 10-20. Longer-range rockets have also been used to target more distant cities like Ashkelon and Ashdod. And just before the Americans' arrival, a laser-guided Kornet antitank missile fired into a school bus killed a 16-year-old.

   The local police are matter-of-fact when they show the Americans the piles of rockets. The retired school principal is more passionate. In the fortified underground municipal operations center, from which the mayor, police and army ran things during Cast Lead, he ticks through the faces and names and videos of the victims, and damns early government half-measures to protect Sderot. He calls his city "Shelterstan." Like Katz, his frustration is apparent. A parade of U.S. politicians have come and posed and spoken, Rick Perry and Mike Huckabee and then-candidate Barack Obama, but not much has changed. The projectiles keep coming, and to the people of Sderot, the world remains coldly ambivalent. Sometimes it blames them.

The Bright Side of Red

   When the sirens come, they call it a red alert. The street vendor mentioned by Katz had fresh red watermelons for sale. He'd call that out as he pushed his cart down the street. Ultimately, the mere shouting of the word red, as the fruit man hawked his wares, was enough to trigger anxiety reactions and send people to Katz. Officials had to ask him to stop.

   While the body count in Sderot hasn't been huge, what happens to people who endure such torment for years on end is. "I think," said one of the Americans, Mike Spencer, a retired paramedic who once commanded EMS over half the city of Chicago, "if there had been a loud car backfire while we were there that day, we'd have all been working."

   If there's a bright side, however, it's this: Being under attack, traditionally and nonconventionally, for years on end can help a nation develop a pretty good emergency response system.