Sitting in his clinic in the original stone buildings of Haifa’s Rambam Medical Center, Dr. Eric Amster converses effortlessly with colleagues in both Hebrew and English.Amster, an epidemiologist and physician specializing in environmental and occupational medicine, arrived in Israel two-and-a-half years ago on a Fulbright scholarship, enticed by exciting opportunities in his field – and decided to stay in Haifa. He and his young family have already settled in the city and learned Hebrew.“Haifa is great,” he enthuses. “It offers the best of California; it’s one of the only places in Israel that has incredible nature, stunning beaches and an active urban life.”Amster’s field, occupational and environmental medicine, is an unusual one for an emerging doctor to choose. It is a multidisciplinary field that focuses on the interactions between human health and the surrounding environment.Not only do these physicians treat occupational and environmental illness and injury, they also contribute widely to preventing ill health caused by harmful environments.His journey in occupational and environmental medicine has taken him around the world from his hometown of San Diego. But it was in the Negev desert that he originally found his calling.“My parents had long instilled a love of the environment, of Israel and of tikkun olam, healing the world,” he says. “I studied for a semester at the Arava Institute, an environmental research program based in the Negev, and it was here that I realized my passion for environmental health and research.”THE ARAVA Institute is considered the premier environmental education and research program in the Middle East. Students arrive from across the globe, and the institute serves as a place where Israelis, Palestinians, Jordanians and others can put aside political differences and cooperate on initiatives dealing with environmental concerns and challenges.Amster spent a semester studying a range of subjects there, from sustainable agriculture to environmental ethics.The exposure to the intense impact of the environment and the experience of living in such a culturally diverse community reinforced his desire not only to study environmental medicine, but also to return to Israel one day.Having completed his undergraduate studies in biology and music, he began working in medical research. He then traveled to Mexico, where he worked as a freelance writer for British publication The Economist, writing about environmental concerns in Mexico City, one of the most polluted cities in the world.From his time in Mexico City, through his medical training at the University of California, to his residency at Harvard University, he has witnessed the detrimental effects of the working environment.“Be it a quesadilla vendor in the streets of Mexico City, an immigrant farmer in the fields of California’s Central Valley, or a factory worker in Israel, the health effects of hazards in the work environment are equally devastating,” he explains.Having reinforced his chosen specialty by specializing in toxicology and health during medical school, he was accepted to study for a master’s in public health and complete his residency at Harvard (where he continues his affiliation as a visiting scientist).WHEN HE received a prestigious Fulbright grant to take part in a research program in Haifa, it reignited fond memories – of the Arava Institute, of a summer Young Judea program and of a year spent studying in yeshiva in Jerusalem – and he jumped at the chance to return to the land that had originally fueled his passion in environmental medicine.Shortly after landing in Israel, though, he was propelled into national disaster relief efforts as Haifa became engulfed in forest fires in late 2010.“I saw the flames from my window at Haifa University, and we evacuated the building,” he recalls.“Later that night, I was contacted by the Health Ministry to produce guidelines on who should be hospitalized and how long-term health damage could be prevented in those exposed to the fires.”The fire raged for four days and killed 44 people. It was the deadliest fire in the country’s history.In response to the disaster, Amster initiated the “Carmel Cohort Study,” which has been following firefighters exposed to smoke and other hazardous materials in the course of their duty. A quarter of firefighters suffered from acute stress-related symptoms following the fire, and more reported that in the months following the fire they continued to experience symptoms of physical ill health.The study is still in progress, and researchers are analyzing data from the second annual follow-up of firefighters’ health.BUT AMSTER’S efforts to contribute to Israeli health did not cease when the Fulbright grant concluded.He and his family decided to stay in Israel, and this year he accepted positions at the Institute for Occupational and Environmental Medicine at the Rambam Healthcare Campus, and at the Technion – Israel Institute of Technology, where he teaches at the American Medical School (TeAMs Program). He also holds a post at the University of Haifa’s School of Public Health.“The field of environmental health in Israel is in the very early stages of development,” he notes. This means that physicians need to have a broad knowledge base, be open to interdisciplinary collaboration and vary their research interests. One moment, Amster may be identifying a chemical exposure hazardous to a pregnant patient, potentially saving the fetus, and the next he may be working on management of air pollution.“In Harvard, I learned a great deal, but the field was very specialized,” he says. “Here in Israel, given its infancy, there are endless opportunities!” And that’s no understatement. As Amster reels off the list of projects and studies he is conducting, one is liable to forget that he has only been practicing medicine for a little over five years. In addition to his busy clinic at Rambam, he travels around the country as part of a delegation of Rambam doctors who investigate occupational health and workplace safety in dangerous industrial environments.“I was at a factory where six people had already been hospitalized with allergic reactions to a chemical compound which had recently been developed.We identified the source of the allergy and designed preventative measures,” he recalls.“It’s incredible to be working directly to improve the health of a whole community of people,” he adds. “We go in, meet with the safety managers, medically assess the workers, figure out what hazards they are exposed to and then, if necessary, carry out larger-scale studies.”He has also been researching emissions from the country’s largest power plant, and more locally, air pollution in Haifa itself.At the end of April, researchers and physicians in the occupational and environmental health field gathered at Rambam for the Joint American-Israeli Medical Toxicology Conference. At the gathering, Amster presented his findings on the detrimental effects of living near a power plant, and also organized sessions on toxicants in the workplace.“This was the first conference in Israel bringing together toxicologists and physicians from the field of occupational medicine to learn about toxic exposures in the workplace,” he explains.In the morning, participants presented new research on toxicants ranging from radiation to pollution, and then in the afternoon, Israeli physicians learned, practically, how to manage such exposure.“This conference was important, not least because physicians were exposed to interdisciplinary research from non-medical fields,” says Amster.HIS LATEST appointment is as a faculty member at TeAMS.“I teach public health, toxicology and clinical skills, which involves teaching American medical students all the necessary ‘doctor’ skills to complement their scientific knowledge,” he explains. “I teach a variety of topics, from bedside manner and cultural sensitivity to how to conduct a physical exam.”Both practicing medicine in Rambam and teaching students at the Technion have led him to appreciate Haifa’s multicultural nature.“Every day, I am fascinated by the diversity of Haifa’s population and the range of people I see in my clinic,” he says. “For the American medical school students, this diversity is an invaluable opportunity to learn and develop skills such as cultural sensitivity, working with a translator and identification of culture-specific diseases.”In addition, the medical school’s small classes enable him not only to be a lecturer, but also to mentor the next generation of American doctors studying in Israel.As Amster reflects on his two years in Haifa, he looks forward to the future.“Not only do I love the North of Israel, but as far as environmental health goes, there is a world of opportunity here,” he says.As an active member of the country’s public health community, he dreams of his next research project: studying the regional transport of pollutants.“It has been extremely satisfying being able to contribute to Israel,” he says. “I don’t know what the future holds, but participating, in some way, in the future of both American and Israeli healthcare is an honor.” ■
