When Sheba Medical Center first received 46 hostages released from Hamas captivity in late 2023 and early 2024, Dr. Noya Shilo, head of the hospital’s Return to Life Center for hostages and their families, acknowledged that there was no established procedure to follow. “There was no protocol and few guidelines in medical literature for how to handle this,” she said at the time.
Now, Times of Israel reports, with another group of freed hostages expected to return, Sheba announced on Thursday that it is “in the midst of final preparations” to receive some of the roughly 20 living captives being released under the latest ceasefire deal.
The Health Ministry confirmed that the healthcare system has now created “specific guidelines” for hospitals designated to treat the returnees. These updated protocols have been adapted to address the expected medical and psychological conditions of individuals who have endured more than 734 days in captivity.
Times of Israel reports that the preparations, overseen by Dr. Hagar Mizrachi, head of the ministry’s Medical Division, draw on “lessons learned from previous releases and rescue operations.”
Alongside Sheba Medical Center, the designated treatment centers include Tel Aviv Sourasky (Ichilov) Medical Center in Tel Aviv and Beilinson Medical Center in Petah Tikva. In cases requiring emergency care, returnees may be transported to Soroka University Medical Center in Beersheba or Barzilai Medical Center in Ashkelon—both closer to Gaza.
The National Center of Forensic Medicine at Abu Kabir has also finalized arrangements to receive and identify the bodies of hostages who did not survive, continuing a process similar to that used in past operations.
The Health Ministry revealed that it contacted the Red Cross several weeks ago, requesting that Hamas not attempt to overfeed captives before their release. The concern, the ministry explained, is that the terror group might do so to disguise signs of long-term starvation.
Medical experts warned that after extended malnutrition, a sudden increase in food consumption can lead to a dangerous condition called refeeding syndrome, which can trigger neurological, respiratory, and cardiac complications.
None of the hostages have been visited by Red Cross representatives throughout their imprisonment in Gaza.
To ensure proper recovery, the Health Ministry instructed hospitals to care for the returnees in separate, secure areas away from other patients, including the emergency department.
Each freed hostage will be placed in a private room, accompanied by family members or trusted companions. The designated area will include both shared spaces for group gatherings and secluded areas for rest and family interaction, according to the ministry.
Given the extended duration of captivity, hospitals were advised to conduct a thorough review of each person’s medical background, paying special attention to untreated conditions that may have worsened during captivity.
A preliminary medical assessment will take place immediately upon arrival “if possible, in the presence of a family member or trusted companion,” the ministry stated.
After family reunification, a second, more detailed evaluation will be performed in coordination with security officials to complete the full medical review.
Each returnee will be examined by a nurse and an emergency medicine specialist, with additional consultations arranged as needed. Hospitals will also receive data on any food or medical care provided immediately upon the hostages’ arrival in Israel. The ministry emphasized that hospitals should consult senior specialists before finalizing treatment decisions.
During the hospitalization period, a multidisciplinary support team will be assembled for each patient. This team will include a primary physician, consulting doctors, a nurse, social worker, psychiatrist, psychologist, dietitian, and forensic doctor.
The team will collaborate closely to develop a personalized, long-term care plan for each returnee.
At Beilinson Hospital, Dr. Michal Steinman, the director of nursing, recalled that preparations to receive nine hostages in February 2024 felt like “detective work.” “We went system by system, ears, eyes, mouth, hair, skin, kidneys, urine, whatever it is, muscles, to think what is happening to a person who is under those conditions of captivity,” Steinman said.
Hospitals will also conduct a psychiatric evaluation within 24 hours of admission. If unusual psychological symptoms are observed, they will be reviewed alongside physical assessments to determine whether they stem from medical causes.
A psychiatrist will lead the overall mental health care plan, guiding medical teams in trauma-sensitive treatment, coordinating with security officials, and providing ongoing support to both the returnee and their family.
A dietitian will evaluate each patient’s nutritional status through physical exams, lab tests, and medical history, with a focus on preventing refeeding syndrome. Families will receive detailed instruction, and each returnee will receive a customized daily meal plan adjusted to their recovery progress.
After completing medical and psychological assessments, staff will decide whether continued hospitalization is necessary or if the patient can safely transition to outpatient care. The ministry recommended that all returnees remain hospitalized for at least four days within the dedicated care unit to ensure stability and close monitoring.
“The return from captivity requires immediate medical evaluation and treatment in hospital, followed by long-term physical, mental, and social care and monitoring after discharge,” the Health Ministry wrote. “The response must be comprehensive, ongoing, and personalized, while maintaining strict privacy.”
{Matzav.com Israel}