• The Jerusalem Hills Therapeutic Centers
  • 1 Mitzpe St., Kiryat Yearim, Judean Hills, 9083800
  • 972-77-2023400
  • EN
  • HE
  • The Jerusalem Hills Therapeutic Centers
  • 1 Mitzpe St., Kiryat Yearim, Judean Hills, 9083800
  • 972-77-2023400
  • EN
  • HE

JHTC in the Shadow of Covid-19 Newsletter

Jerusalem Hills Children's Home in the shadow of Covid-19

At Jerusalem Hills, the new covid-19 reality forces us to face new difficulties and resolve conflicts that arise between the children's health needs and their emotional needs. Our unique therapeutic program, "Therapy in Life Space", is centered upon the development of a one-on-one relationship between the child and the care-giver, through consistency, continuity and hard work, along with the integration of the child's family into the healing process. How can we act upon these principles while keeping to health ministry directives? How can you hug a child in crisis when you need to keep a social distance of 2 meters? How can you provide a child with the sense of security when everyone around him is wearing masks and gloves? How can you sustain the child's feeling of stability and consistency when crucial anchors like weekly family visits, extracurricular activities and special therapies are taken away? We are forced to deal with a very complex reality.

In normal days, the Children's Home is like a bubble. It strengthens and builds the children throughout their whole stay at the Children's Home. The new reality fractured that bubble. In accordance with Ministry of Welfare, Health and Education's directives, all home visits were halted (besides Passover vacation). In addition, in an attempt to avoid exposing the children to the virus, all activities that involve contact with people from outside the Home were suspended, including extracurricular sports programs, volunteers, etc., and most importantly parents’ weekly visits.



The Effect on the Children’s Families

The children in our care suffer from primal, complex emotional impairment. There are children whose conception of time is warped and they have trouble grasping the concept of time. Weekly parents' visits are a crucial anchor that helps these children grasp reality and the flow of time. Canceling parents’ visits brought on harsh reactions. There were children who could not grasp when they might see their families again. This caused anxieties and extreme thoughts: will they be all grown up the next time they see their family, or maybe they won’t see them again because the parents will die, or maybe the children will die…. In addition to the children's regular anxieties, they are now concerned that their families will get sick, and maybe they themselves will contract the virus.  For the parents, concern about their children's safety, who they can no longer see on a regular basis, and worry that there will be a covid-19 outbreak in the Home, was also a source of stress. The social workers had to make changes to align with the new circumstances. Contact with the families has become constant to keep them updated on the daily changes. Moreover, since the social services in the community have been cut back, the Home's social workers have been looking out for the immediate welfare of the families. The family situations, which are usually very difficult, have become even more severe in many cases, due to one or both parents being laid off. Therefore the social workers are much more involved in the family situations, ready to deal with extreme cases. The family visits that were halted, are now happening via online video meetings. The weekly meetings between the parents and the social workers have also stopped, as have any special family therapies.



The Moral Dilemma

When the whole world is isolating itself in the safety of their homes, refraining from going to work and protecting at risk populations, the dedicated staff at the Children's Home has continued to work through the initial outbreak and every day since, even over the long Passover vacation. A large percentage of the staff have families, small children at home with no child care available, unable to avail themselves of help from grandparents. They find themselves faced with a serious moral dilemma; do I protect my immediate family, and refrain from going to the Home, or do I put myself and my family at risk by continuing to come to the Home every day, risking being exposed to the virus, or bringing it in to the Home unknowingly. Although concerned with their own health ,older staff members have been putting themselves at risk by coming in to work, as they are crucial to the continued operations and feel they must set an example and provide physical and emotional support to the direct staff. This is despite the fact that they could do their jobs online from the safety of their own homes.

The Ministry of Education's decision to cancel special education studies before Passover affected the Home as well. The teachers, who are crucial to the therapeutic process of the children, suddenly stopped coming. Usually, the children spend the school hours in the special education school that is located on campus in the Home. After school the counselors spend the rest of the day with the children, until they go to sleep. When school was cancelled due to covid-19, the counselors were called to spend all waking hours with the kids. Even though they were sent home by the Ministry of Education, many teachers continued coming in everyday to spend the morning hours with the children, and allow the counselors to take the morning shift off. There were some teachers, who, despite the desire to continue caring for the children, remained at home because they are considered in an at-risk group. Now that the Ministry of Education has re-opened the special education schools, the teachers are faced with this dilemma once again. Most of the teachers returned to work, but unfortunately there are teachers who cannot because they are considered at risk.

The new reality destabilizes the consistency and stability that are so important to the therapeutic process of these children, since every few days new directives are laid out forcing us to constantly make adjustments and changes, usually in a short time frame. The moral dilemma, together with the ongoing concern for providing the children with the best care, the fear of getting sick and the general feeling of uncertainty are directly affecting the staff's stress levels. The staff's stress level in turn has an immediate effect on the children's stress level.



Changes in the Home's Routine in the Shadow of Covid-19

The new daily routine at the Home is dictated by the adjustments that we are constantly forced to make due to the new covid-19 reality. When we were limited to gatherings of no more than 100 people, we were forced to shut down the dining hall and all meals moved to each unit's cottage. And then we were cut down to only 10 people. The immediate questions were: How do you split a group of 10-15 children? What will be the emotional damage to children who are already in a fragile state because they can't go home, they don't have family visits and can't eat in the dining hall with all the other children? To refrain from adding additional stress and anxiety, it was decided to keep each unit intact, since each unit operates as a familial unit. All the activities in the Home were confined to each unit's cottage. Food consumption has gone up substantially, due to the fact that more food is needed for 8 groups eating separately and due to the emotional eating that we are encountering as the children's stress and anxiety levels rise.

In preparation for the recent Passover vacation, we were forced to deal with some difficult dilemmas: How do we let those children who normally go home do so for such a long vacation, knowing that many of them are going to harsh family situations which will not be beneficial for them and may harm their individual therapeutic processes? How can you monitor each child and make sure he is safe throughout the whole vacation? How will the children go home, when many parents usually come pick them up on public transportation, which currently is limited and problematic and could endanger the children and parents? How will "Vacation Group" happen, when the children are confined to the Home only, without the possibility of outings or special activities? How do we receive the children back at the Home at the end of the vacation? How do we verify that the children who return aren't carrying the virus?

The children were sent home for Passover vacation in a few stages, allowing for the children with more difficult home situations to remain at the Home longer. When the parents could not come pick up the children, staff members drove the children Home, and brought them back at the end of the vacation. "Vacation Group" was quarantined to the Home, with caring staff taking care of the children the whole time. The social workers, psychologists and counselors were in constant contact with all the children, those at the Home and those home for vacation. They were in touch with the families, and made sure the children didn't suffer any lapses in their emotional states, compiling a weekly report on each child. The children returned to the Home over a 3 day period, so that the staff could receive each child separately, checking their temperature and physical condition. Once all the children had returned each group went into 2 weeks solitary confinement as a precaution. Although our special education school has re-opened, the directives required that there are no more than 3 children in a group with a teacher. Therefore the children have been divided into groups of 3, studying mostly in the unit cottages, but occasionally in the school building. Here too the dedication of the staff to the children has been awe-inspiring.

At this point any sign of Illness among the children suddenly gets them all on edge. A sneeze, which once would be ignored, gets scared looks from the other children. The others fear that this child may have the virus and want to keep their distance. The latest health directives which require that all staff and children wear masks don’t improve the situation. Wearing a mask for a normative person can cause a sense of distancing, seclusion, withdrawal from the surrounding people. All this is much more drastic in children who suffer from severe emotional abuse. One of the main elements in our therapeutic treatment is the personal connection between the child and his care giver. Wearing a mask creates the exact opposite atmosphere from the one that we are trying to create. The mask can cause the children to feel more withdrawn and secluded. The mask barricades the basic emotions that are transmitted though facial expressions. The staff is doing its best to explain to the children the importance of wearing a mask, and the importance of cleanliness and hygiene. We are doing our best to make the children feel comfortable with the masks, and each child has received a reusable cloth mask. Covid-19 has become a pressing topic among the children and the staff is there to regulate their worries and calm their nerves. The staff provides the children with as much information about the current situation in the shadow of covid-19, in order to help them calm down and feel in control, but without overwhelming them or creating new anxieties. 



The Financial Ramifications

In this time of uncertainty, it is difficult for us to evaluate the financial damage to JHTC. In accordance with the changing guidelines from the different ministries, we have had many unexpected expenses that are directly affecting our 2020 budget. We already see a drastic rise in expenses for cleaning products, food and technological equipment to allow for studying in small groups, as well as salary increases for the maintenance staff and the care givers.

Now, more than ever we must rely on you, our JHTC friends and longtime partners, to help us through this difficult time and enable us to continue providing the children with the care they so desperately need.