RESPONSIBILITY AND COMMUNICATION
We take very seriously our responsibility for student health and welfare. We’ve had many years of experience in providing high quality health care and supervision for students far away from home. We know how important this is both to the student and to the parent who is thousands of miles away. It’s not unusual, during a residential program, for every student to have a number of days when they don’t feel well. We have a sophisticated and thoughtful health care system in place. While parents will generally not be informed regarding fairly typical and minor ailments (head colds, stomach upset, etc) parents are consulted and are involved in helping determine the most appropriate treatment when more serious illnesses or injuries are involved. Parents are given prior to the semester, a list of emergency contact phone numbers and email addresses so that parents are aware of who to contact if ever there is a concern or a question. It is critical that parents and students be very honest with EIE as to their child’s medical and emotional history, medications, hospitalization or other treatments the students has received. As EIE takes its responsibility for student welfare very seriously, having full and complete information about each child entrusted to our care is tremendously important. Only when we have the full history of each student, can we provide the quality of care that every student deserves and that parents expect.

MEDICAL FORMS
Parents and the student’s physician complete a medical form and questionnaire as part of the application process in North America. The day following the students’ arrival to Tzuba they are given a kibbutz medical questionnaire to complete. These two forms are then amalgamated. During orientation, EIE Registered Nurse, Director of Health Services, meets with all the students individually who take any type of medication on a daily basis. EIE policy is to keep the bulk of these medicines in a safe and to allow the students to have only two weeks supply at a time. Every two weeks, the EIE RN meets with this group of students and gives them a further supply of their medications. EIE students are responsible for holding onto and dispensing their own daily medication.

IMMUNIZATIONS
Consistent with our camps and Israel program policies, EIE students must have a host of immunizations in order to participate. Please refer to the NFTY-EIE Student & Parent Handbook for a complete list.

TAKING CARE OF THOSE NOT FEELING WELL
If a student is not feeling well he or she must contact a madrich (counselor) during the morning wake up call. The student and counselor go to the Kibbutz Tzuba Clinic with the student’s medical file in hand. The kibbutz nurse sees the student, makes a diagnosis, gives the appropriate treatment and advises on activities, diet etc., for the remainder of the day. If the kibbutz nurse believes that the student requires a referral to a medical practitioner, the counselor will notify the EIE nurse and the necessary arrangements will be made. The EIE nurse holds additional clinics three times a week, on varying days, depending upon the weekly schedule. Only the nurses are qualified to grant students sick leave from class and activities.

The student’s medical file accompanies him or her to all medical appointments. Following visits with either nurses or doctors, the school nurse is updated. If a student received sick leave from the day’s activities he or she will have an early curfew at 9 pm. If the student is not fully recovered by the next day, he or she should return to the kibbutz clinic or see the school nurse.

STUDENTS ACCOMPANIED BY EIE STAFF
For any medical treatment, a male counselor accompanies male students, and a female counselor accompanies female students. All conversations at points of medical assistance take place only in English so that the student understands everything being said. The counselor must present the nurse or doctor with the student’s complete up to date medical file and point out any pre-existing conditions or medications currently being used. The student brings all medications that are currently being taken with him or her to the appointment. Again, anytime a student is seen by a physician, or is taken to a clinic or hospital, he or she is always accompanied by an EIE staff member.

No ‘invasive’ procedure is conducted without explicit permission from the nurse, assistant principal or the principal. If an IV is needed, it is started and then the counselor immediately notifies one of the above. A clear explanation of how to use any medications prescribed must be given to the student in the presence of the staff member and repeated aloud to double check the instructions, use and dosage. The counselor must verify in the presence of the student what the instructions for care, diet and rest are for the same day and for the next 48 hours. A clear legible written doctor's report, test results and any x-rays that were taken are brought back to Tzuba.

Parents will be informed as promptly as possible if there is any significant medical problem so that parents can be informed and involved in the recommended treatment of their child.

MEDICAL FACILITIES
The Kibbutz Tzuba Clinic has two nurses on duty everyday. Additionally, 3 times a week there is an English speaking family physician at the clinic.

If a student requires a referral or further treatment, we use the following facilities:

• The Jerusalem Medical Center - They are an excellent staff of six English speaking family practitioners. The facility also has a competent nursing staff, full laboratory and x-ray capabilities. One floor below the medical center is a pharmacy, should there be prescriptions that need to be filled.
• Terem Jerusalem - A 24 hour emergency room, full service, walk in clinic.
• Hadassah Hospital is less than a 10 minute ride from Kibbutz Tzuba. The Emergency rooms at Hadassah Hospital and specialists at Hadassah are available if need be. When EIE is away from the Kibbutz, we have access to hospital emergency rooms throughout Israel.
• Specialists in all fields have contracts with our health insurance provider.

HEALTH INSURANCE
NFTY-EIE students are covered through Harel health insurance during their entire EIE experience in Israel. Preexisting conditions are not covered by the NFTY-EIE policy. The health insurance company issues an insurance card for each student. During field trips and activities off of the EIE campus on Kibbutz Tzuba the following policies are in place:

• Students must carry their medical insurance card with them wherever they go.
• EIE issues a list of emergency numbers for Israeli families who host EIE students for a free weekend off campus.
• Counselors carry the students medical files with them whenever they go on a trip in the event that a student needs to visit a clinic or hospital
• A counselor accompanies each student to the doctor, clinic or hospital if a visit is necessary
• Medical personnel who accompany the EIE group on field trips additionally carry the students’ medical files and are in touch with the Harel insurance hotline
• The EIE nurse is on 24 hour call for consultation while the group is off campus

Important note: while students are covered by health insurance in Israel, it is essential that students remain covered by the medical insurance they have at home. Please do not allow for any gaps in medical insurance coverage as pre-existing conditions are not covered by our policy in Israel. Visits to mental health providers are not covered by our insurance in Israel.

PRE-EXISTING CONDITIONS
It’s very common for students to come to EIE with a range of pre-existing conditions. If a student needs to see a doctor to treat a pre-existing condition, the EIE staff will make the appropriate appointment and parents are usually informed. EIE has a wide range of specialists available to treat almost any condition. Since pre-existing conditions are not covered by our medical insurance, either students pay for this visit themselves or EIE pays for the doctor’s visit and then bills the parents accordingly. If need be, documentation form the treating physician can be sent to parents so that parents may claim the charge on their child’s medical insurance at home.

REPORTING
The student’s name is written on a board in the main NFTY-EIE Kibbutz Tzbua office, so the entire staff is aware of who is ill. The nurse's treatment sheet is copied and one copy is given to the EIE nurse. The original is attached to the students' medical file, in chronological order so that there is an up to date and complete medical history of all students, at all times. The person who accompanied the student to the clinic is responsible for creating an electronic file of the incident.

VISITS & FOLLOW UP
Students who are not participating in activities and are left to rest in their rooms are checked on every 90 minutes, unless they have a temperature, are vomiting, have diarrhea or stomach pain in which case they will be checked at least every hour. Checks will be made of their temperature and pulse, their bodily functions, what they’ve had to eat or drink and how they are feeling. Stomach problems of any kind accompanied by vomiting or diarrhea are treated with the BRAT (Bananas, Rice, Applesauce, Toast) diet. This diet is gradually introduced after the student had clear liquids and feels that he/she is able to eat something. The BRAT diet should be continued for 24-48 hours until normal stomach and bowel function returns. All observations are recorded in the student's medical file and the school nurse is notified of any changes. Personal hygiene is also emphasized.

AFTER HOURS
If a student feels ill in the evening, after curfew, the students initially seek advice from the counselors. If the counselors require further assistance or advice they may contact the EIE nurse. If she is unavailable the Kibbutz Tzuba 'on call' nurse will assist. If it is determined that the student needs to be transported for medical attention off the kibbutz after hours to a hospital emergency room, arrangements will be made with our EIE driver and the EIE administration is informed. If the driver is unavailable a taxi will take the student and a counselor. As always, the student's medical file with all updated attachments together with the Harel insurance card will be taken to the appointment.

MEDICAL EMERGENCIES
The NFTY-EIE counseling staff all trained in basic first aid. An Israeli medic travels with each group on challenging camping trips and hikes. There are counselors present with the students at all times. If a medical emergency arises, they initially asses the situation and administer first aid if necessary. The counselor then immediately contacts the EIE RN to give her details regarding the situation. The nurse and counseling staff decide together what the next steps are for appropriate treatment. If the student must be transported to a medical center, he/she is always accompanied by a counselor.

PREVENTION AND FIRST AID
NFTY-EIE has three large and three mini first aid kits. These kits accompany the group on outings. For each bus there is always a large and a mini first aid kit on board. Counselors and teachers instruct students the night before activities as to how to dress (including appropriate footwear and hats), what to bring (including water and sunscreen). Staff is present to do an 'inspection' as the students board the bus and send students back to their rooms if necessary to get the appropriate gear for the weather and day's activities.

PRESCRIPTIONS
If a student is treated at Terem, the clinic, he/she is typically given enough medication to cover the first dose or two until the prescription can be filled. Alternatively, the Terem staff provides the counselor with details of the 'on duty' pharmacy that is open after hours where prescriptions can be filled. The school nurse is updated regarding the meeting. She receives a copy of the doctor’s report and prescription and the original is attached to the student’s file. The person who accompanied the student to the clinic is responsible for creating an electronic file of the incident.