Elaine Z. Belmaker, MD'71, HS70-'72

by Marty Fisher

With every step she takes in her hometown of Beersheva, Israel, Elaine Z. Belmaker, MD’71,
HS’70-’72, MPH, is mindful of thousands
of years of history dating back to Abraham
and Isaac of the Old Testament.

But Belmaker is keenly focused on the present in
her job as medical director of public health
for Israel’s Southern District. She is responsible
for keeping the more than 500,000 people in her charge safe from bird flu, toxic waste, terrorism, and a host of other public health threats.

This past year her department successfully
contained five simultaneous outbreaks of
bird flu—the first ever to hit Israel—identifying
and monitoring more than 300 people
who had worked at or visited the affected
poultry farms.

“We interviewed the head poultry farmer at each farm, got a list of permanent
and temporary workers, the veterinarian, the electrician—all the possible contacts,
and then my nurses followed up to make sure they all took Tamiflu for seven days following contact. Thankfully, we had no human cases,” says Belmaker.

Like public health directors everywhere, Belmaker is deeply concerned with improving the health of underserved populations. In her case many of the underserved are semi-nomadic Bedouin Arabs.

In March The Lancet published the results of a 15-year study she conducted that resulted in 90 percent of a Bedouin population receiving immunizations compared to just 50 percent when the study began. The study has global implications for improving disease prevention among semi-nomadic populations.

She also published an ecological study in the journal Environmental Health: A Global
Access Science Source that showed a higher incidence of birth defects among Bedouin infants whose families live near the Southern District’s national toxic waste site. Another study—showing higher rates of hospitalization from respiratory diseases in the same population—has been accepted for publication in Archives of Environmental and Occupational Health.

Dr. Farahan Al-Sana, left, the irst Israeli Bedouin physician specialist in public health, received his training in a program run by Belmaker's department. Here he makes a home visit in the tent of a Bedouin sheik.

“All over the world, it’s always the poor people who live near chemical industries,”
says Belmaker. Because the research is based on overall populations and doesn’t account for individual risk factors, such as smoking, she says her study is not
proof, but a “strong indication of a problem.” But, it has been sufficient to convince the Israeli government to begin measures to control emissions and clean up the site.

Belmaker has also worked aggressively to prevent communicable diseases through national immunization campaigns— including a study about eliminating hepatitis A outbreaks in schools and daycares that has been accepted for publication in Pediatric Infectious Disease Journal.

Belmaker and her husband, Robert H. Belmaker, MD’71, HS’71-‘72, have lived in
Israel for more than 30 years. They met as undergraduates at Harvard University, married the day after graduation, and received their acceptance letters to Duke medical school on the same day. She says they felt very privileged to be in the first Duke Medicine class to experience the “new” curriculum in 1967. Both stayed for residency training, he in psychiatry and she in pediatrics, where she had the “amazing and inspiring” experience of working in the laboratory of Rebecca Buckley, WC’55, MD, HS’58-’64, and being mentored by Samuel Katz, MD.

The Belmaker’s daughter Miriam was born during Elaine Belmaker’s last year of residency at Duke, and a less-than-accommodating residency training director refused to excuse her from night call during her ninth month of pregnancy.

“He said, ‘no night call, no credit, no pay’” she remembers. She volunteered for
an elective in pediatric cardiology, (also with no night call, no credit, and no pay).

After fellowship training—she in adolescent medicine at Children’s National Medical
Center in Washington, D.C., and he as a public health officer at the National Institute of Mental Health in Bethesda, Md.—the Belmakers moved to Israel, where he is the Hoffer-Vickar Professor of Psychiatry at Ben Gurion University of the Negev.

In addition to her current position, Belmaker is a senior lecturer in Ben Gurion’s
Division of Health in the Community at the Faculty of Health Sciences and holds numerous professional appointments dealing with a wide range of public health concerns.

The Belmakers have five sons, all born in Israel, and their first grandchild was born
this past summer. Their daughter Miriam is currently a post-doctoral fellow at Harvard University.