Thanks to pressure from the American Red Cross and friends across the United States, Israel’s Magen David Adom may soon find international acceptance.

In Balapitiya, Sri Lanka, the flags of Israel and the International Red Cross and Red Crescent Movement fly side by side in front of a small medical tent outside a center created to aid injured children.

It is, on the surface, an acknowledgment of the role Israel is playing with its humanitarian brethren in aiding relief efforts after the devastating tsunami hit Southeast Asia last December. But more important, it may be seen as the sign of changing times.

Magen David Adom, Israel’s equivalent of the American Red Cross, has been denied full membership in the movement since 1949 because it uses the Star of David as its emblem, instead of the accepted Red Cross or Red Crescent emblems. The movement is comprised of the International Federation of Red Cross and Red Crescent Societies (IFRC or the federation), the 181 national societies represented by the IFRC, and the International Committee of the Red Cross (ICRC).

But a Washington-led effort to change that status may bear fruit this fall, as the movement is forced to choose between giving Israel a seat at the table and watching the United States leave its chair—in effect, becoming a nonvoting observer.

The ARC has withheld $25 million in administrative dues from the IFRC since 2000 as a protest against MDA’s exclusion. And now, after five years, the IFRC may be forced to hold it in default—downgrading them to the same “observer status” as MDA.

“The American Red Cross is committed to full inclusion for Magen David Adom and continues to withhold funds because we’re serious about that,” said Devorah Goldburg, a spokesperson for the American organization.

The IFRC’s sanction against its founder and biggest donor could be a black eye for the international body, and officials in Geneva, where the movement’s headquarters are located, are leading an effort to quickly rectify the situation. They have appointed a career diplomat, Didier Pfirter, to gauge sentiment about allowing MDA in before November, when the American status could be downgraded. One plan would create a third acceptable emblem, a diamond or a crystal, that MDA could use in international work while maintaining the Star of David at home.

“Come hell or high water, they are going to find a way to hold their noses and accept Israel because they cannot throw out the American Red Cross,” said Marla Gilson, Hadassah’s Washington Action Office director.

The Red Cross, a Swiss flag with the red and white colors reversed, was created as an international symbol for medical personnel, material and facilities in 1864 at the Geneva Convention. It is used to protect humanitarian workers during wartime.

The symbol does not have a religious context itself, but many believe it has a Christian connotation. That is why some countries chose to use a Red Crescent, a traditional Muslim symbol, even though it was not listed as an acceptable emblem. The Red Crescent was formally accepted in 1949, along with two other symbols that are no longer used. At that time, Israel lost a narrow vote for acceptance of the Star of David.

Many believe MDA’s rejection is a form of anti-Semitism, especially since the crescent has been accepted. The issue has garnered the attention of many Jews in the United States, and lawmakers—with their Jewish constituency in mind—have sought ways to pressure the international body to welcome Israel.

“People are very passionate about this,” said Gary Kenzer, executive director of Magen David Adom, U.S.A. “They feel it is discrimination, that it is a slight.”

When Dr. Bernadine Healy became president and C.E.O. of the ARC in 1999, she inherited 500 letters from Americans blaming her organization for MDA’s exclusion. “I was astounded to learn there was one international humanitarian organization that was not part of the federation,” she said in a recent interview.

Dr. Healy is credited with championing the MDA cause. She came to the ARC as the Israeli-Palestinian conflict was reigniting in the fall of 2000 and progress toward MDA’s recognition ground to a halt.

She was criticized by many in the ICRC for a speech she gave in Geneva in 2000, in which she said MDA’s exclusion was a “betrayal of the sacred principles of this movement.”

“To my amazement, the remarks weren’t received well,” she said. Some delegates were in an “uncontrolled fury” and said allowing the Star of David would be akin to allowing the swastika as a humanitarian emblem.

Nevertheless, she continued to seek equal footing for MDA, proposing the American organization withhold $5 million in administrative dues each year—a sanction that would not affect the ARC’s aid to worldwide humanitarian projects. The move was overwhelmingly passed by the ARC’s delegates, who then brought former United States Secretary of State Lawrence Eagleburger on board to negotiate a settlement.

Dr. Healy did not last. She claims she was ousted shortly after 9/11 because she complained loudly when the ARC’s board of directors went around her to try to reverse its policy on the dues. Eagleburger has backed her story, while ARC officials have said there were a number of circumstances that led to her departure, including her handling of donations that poured in after the attacks.

But the dues still have not been paid. Dr. Healy believes the ARC was told it would be bad public relations if it changed its position, since it would look like she was fired for her support of Israel. But ARC officials say they have always stood by the sanction as a matter of principle.

Whatever the reason, the Americans’ actions could be a windfall for Israel. Still, there is much to be done before the November deadline.

With Pfirter’s help, the Swiss government is consulting with 191 governments—10 of which signed the Geneva protocols but are either nonvoting observers or have no volunteer aid organization—to determine whether the time is right to bring them together to reform the Geneva Convention’s protocols to allow for a third emblem. The entire movement must then add statutes recognizing that emblem before MDA can be judged on its merits. The ICRC, which gets its money from federal governments, must vote to recognize MDA. Then the IfRC must vote to accept MDA at its November meeting in Seoul, South Korea.

“We remain hopeful that the international community will finally accept MDA as a full member, as it did during the tsunami relief,” said Daniel R. Allen, executive vice president of ARMDI, American Friends of Magen David Adom, “but before they change the protocols, they have to agree to be brought together.”

If all of this does not happen, ARC officials say they are prepared to stand next to MDA as observers. “We think it’s a very positive sign that the Swiss government has appointed this diplomat, because it means they are seriously looking at this,” Goldburg asserted.

MDA itself has been relatively quiet, allowing Washington to do most of the talking. Kenzer said the organization believes its full acceptance will happen when the time is right. “Let it happen when it happens, but let the organization continue to do what it’s done since 1939,” he said.

The tsunami disaster relief marked the first time that MDA was actively united with the IFRC in a humanitarian relief effort, and the first time that the Star of David flew next to the Red Cross.

In a grim sense, Israel’s familiarity with violence has helped make it a valuable resource. Its tracing specialists were called on to help reunite families in countries devastated by the tsunami by using the same enhanced computer technology that has been used to reunite Holocaust survivors.

The ICRC and MDA signed an agreement in 2003, with the international body contributing $1 million a year to MDA for relief efforts. The Israelis have also signed partnerships with the American and French organizations, and have bilateral relationships with numerous others.

“Before you learn to run, you have to crawl,” Kenzer said. “These are very important steps in the crawling.”

He adds that MDA has been called on increasingly to play a role in different endeavors, which could ease the transition when it becomes a full member. In addition to the tsunami work, MDA crews have been on the scene of volcanic eruptions in the Congo and earthquakes in India.

Indeed, the international red Cross and Red Crescent Movement has dispatched staffer Anna Segall to Tel Aviv to serve as a liaison and help coordinate efforts for MDA’s eventual inclusion.

“Both the ICRC and IFRC fully support Magen David Adom’s full membership in the movement,” Segall said. “But to become a member, we have conditions of recognition.”

Segall said the movement is working to solve the “complicated legal hurdle,” but for now it is treating MDA as a full member.

The final step is full admittance, something that seems almost a dream to those who have been fighting for it, such as Dr. Healy.

“This is music to my ears,” she said when told of the November deadline. “It’s almost worth losing my job.”