From Crisis to Care: A Multidisciplinary Care Framework for Repatriated Civilian Hostages: Development,...

Objective: On 7 October 2023, Hamas-led militants attacked Israeli communities bordering the Gaza Strip, abducting 251 people, including 201 civilians. Wolfson Medical Center was chosen by Israel's Ministry of Health to care for repatriated civilians following a hostage release deal. We describe the development and implementation of a multidisciplinary care framework and report the clinical characteristics and short-term hospital outcomes of the repatriated civilians treated within it. Methods: A multidisciplinary framework was developed and implemented to address acute and chronic medical conditions, physical trauma, sexual assault, psychosocial support, and nutritional rehabilitation. Clinical characteristics and short-term hospital outcomes were retrospectively extracted from the electronic medical records. Results: Between 24 November and 1 December 2023, we treated 10 repatriated female hostages (median age 67 years, range 29-85 years) held captive for 48-55 days. They suffered physical trauma and loss of family members during the 7 October events. Captivity was associated with inadequate nutrition, poor hygiene, physical injuries, psychological distress, and insufficient management of chronic medical conditions. Acute conditions on arrival included rapid atrial fibrillation, heart failure, deep vein thrombosis, endocrine abnormalities, gastrointestinal symptoms and dermatologic conditions. Care required individualized planning, flexibility, and close coordination with national authorities, community health providers, and social services. Conclusions: Our experience highlights the need for comprehensive, coordinated care frameworks that not only address the medical, psychological, and social complexities of early recovery and reintegration but also ensure effective oversight and training of the medical teams involved.