PETAH TIKVA, Israel โ Three-and-a-half-year-old Rafael of Jerusalem had spent nine months confined to a hospital room, dependent on an artificial heart device to stay alive and preparing to travel to the United States for a transplant that his physicians feared might not come in time.
Then, less than two hours before his scheduled departure, everything changed.
A heart had become available.
That heart belonged to six-and-a-half-year-old Saba Badir of Kafr Qasim, whose family, in the midst of unimaginable grief, made the decision to donate her organs after she suffered catastrophic brain hemorrhaging and was declared dead.
The transplant, performed at Clalit Health Services’ Schneider Children’s Medical Center, has given Rafael a second chance at life and highlighted the extraordinary cooperation between medical teams at Schneider and Soroka Medical Center, as well as the profound impact of organ donation.
For Rafael and his family, the journey to transplantation had been long and uncertain.
Born with a complex congenital heart defect, Rafael underwent his first heart surgery at just three-and-a-half months old. Years of hospitalizations and treatments followed.
Despite repeated interventions, his heart continued to deteriorate.
Dr. Amichay Rotstein, a senior pediatric cardiologist at Schneider Children’s Medical Center who has treated Rafael since infancy, said physicians eventually concluded that transplantation represented the only realistic option.
“We went through many hardships,” Rotstein recalled. “I had to tell the family that we were not moving in the right direction, that his heart was failing, and that he would most likely need a transplant.”
When Rafael’s heart failed during surgery, physicians initially placed him on extracorporeal membrane oxygenation, commonly known as ECMO, before transitioning him to a Berlin Heart ventricular assist device.
The machine, roughly the size of a small refrigerator, became Rafael’s constant companion.
“Suddenly, we saw a different child,” Rotstein said. “A child who had barely been functioning began eating again, gaining weight, and smiling.”
“There is something remarkable about children,” he added. “They adapt to this reality. Rafael learned to live with the device and to protect the tubes as though they were part of him.”
Rafael’s mother said her son fully understood the importance of the machine.
“He knew the Berlin Heart was protecting him,” she said. “Whenever the machine beeped, he would immediately check that the tubes weren’t bent. At night, he would remind me to connect it. He embraced the device with love because he knew it gave him strength.”
As months passed without a suitable donor, physicians made the difficult decision to transfer Rafael to the United States, where pediatric heart transplant waiting times are often shorter.
His father had already traveled to New York to prepare for the family’s arrival.
The remainder of the medical team, including Rafael’s mother, nurses, physicians, and technical staff, stood ready to leave for the airport.
Then came the unexpected call.
“When I entered the room, there were far more doctors than usual,” Rafael’s mother recalled. “I thought they were talking about the flight. Then the doctor told me, ‘We’ve found a heart for Rafael.’ I almost fainted. I was in complete shock.”
At the same time, tragedy had struck another family.
Saba Badir, the youngest of four sisters from Kafr Qasim, had accompanied family members on a trip to Eilat.
Her father, Mahren Badir, described her as “the spirit of our home.”
“She was the most playful one. Daddy’s girl,” he said.
The day before her death, Saba had spent time at the beach and promenade with her family.
The following morning, she could not be awakened.
After initially receiving treatment at Yoseftal Hospital, Saba was airlifted to Soroka Medical Center in Beersheva, where physicians discovered that a congenital weakness in a blood vessel in her brain had ruptured, causing catastrophic bleeding.
Two days later, she was declared dead.
When physicians approached the family about organ donation, the decision was immediate.
“My daughter is gone,” Mahren Badir said. “What am I going to do with her heart? What am I going to do with her kidneys? The body is buried, but the organs can give life. At least let them save other children.”
Before saying goodbye to his daughter for the final time, he whispered, “Don’t forget us from above. We will meet again. And if I ever did anything wrong, forgive me.”
As Saba’s organs were recovered at Soroka Medical Center, a race against time began in Petah Tikva.
Dr. Gabriel Amir, Director of Neonatal Cardiac Surgery Services at Schneider, led the complex transplant procedure.
“Everything is timed down to the minute,” Amir explained. “The goal is to have the child ready at the exact moment the donor heart arrives. The shorter the waiting time, the better the chances for the new heart.”
The operation was lengthy and technically demanding.
Ultimately, the transplant succeeded.
“The heart started beating,” Rotstein said. “It was the beginning of a new life. It was everything we had hoped for.”
For Rotstein, the moment carried profound personal significance.
Last year, his son, Sgt. Tom Rotstein was killed while serving in the Israel Defense Forces during combat operations in Khan Younis, Gaza.
“There are mornings when all you want to do is stay under the blanket,” Rotstein said.
“Then you receive the news that there is a heart for a child waiting for a transplant, and you throw off the blanket and get up. This work sustains me. It gives me a reason to get up in the morning and continue living.”
Today, weeks after the surgery, Rafael is recovering, growing stronger, and beginning to experience life outside hospital walls.
His first request following the transplant was simple.
He wanted to visit the zoo and feed a giraffe.
That wish has already come true.
Looking at photographs of Rafael, Saba’s father said, “My daughter’s heart is alive. It is a gift from God. Thank you.”
Rotstein said the experience serves as a powerful reminder of the importance of organ donation.
“It is not something we take for granted that we reached this moment,” he said. “There were times when hope seemed to be fading. But organ donation gives life, literally. Whoever saves one life, saves an entire world.”
Today, inside Rafael’s chest beats the heart of a little girl whose family, in their darkest moment, chose hope.
