Hospitals in northern Israel preparing for tough war
May 2, 2024 18:56:17 GMT -5
Post by shalom on May 2, 2024 18:56:17 GMT -5
‘Ready at any moment’: Hospitals in northern Israel preparing for tough war against Hezbollah
When war broke out on October 7, Israel's hospitals faced shock and astonishment, with medical centers learning lessons and adapting to a possible confrontation with Hezbollah.
By YOAV ITIEL
MAY 3, 2024 00:54
In the six months since October 7, the hospitals in Nahariya, Haifa, and Safed, alongside routine treatments, are preparing for extreme scenarios, which could break out at any moment, as a result of an escalation of tensions along Israel's northern border.
“We are ready,” these three hospitals say.
“We are preparing in case we don’t have any advance warning. It will be a surprise to everyone because confidentiality and secrecy are a priority,” Prof. Masad Barhoum, director of the Galilee Medical Center in Nahariya, a mere 10 kilometers from the border, told Walla on Thursday.
"IDF soldiers and northern residents need to know that they have someone to trust. We have 775 beds. We have prepared our underground complex for almost seven months. Although we have never had anything like this before, this is the reality, and we don't have the privilege to ignore it, and we have to face it. My colleagues and I work day by day and hour by hour for this moment. We always knew it would happen, we just didn't know when. It's closer now than ever."
"As soon as there is a war with Hezbollah, all hospitals in the State of Israel work as one," explains Prof. Barhoum. "There is a unified war room that refers every wounded person, and we can take in every wounded person who is referred to us. Of course, operating rooms are limited, and intensive care is also limited, but there are regulations for all of this. The war room will deal with moving the sick and wounded to where they need to be as we absorb and act accordingly. We will know how to treat any injured person who arrives. We are prepared for events with many casualties at a very large rate so that we will be able to optimize and prioritize our work and whatever changes need to be made. This is war.”
Dr. Masad Barhoum, director of the Galilee Medical Center speaks at the International Multidisciplinary Conference in Regba, near the northern Israeli city of Nahariya October 3, 2018. (credit: MEIR VAKNIN/FLASH90)Enlrage image
Dr. Masad Barhoum, director of the Galilee Medical Center speaks at the International Multidisciplinary Conference in Regba, near the northern Israeli city of Nahariya October 3, 2018. (credit: MEIR VAKNIN/FLASH90)
"Most of the wounded in the northern district in the last seven months came to us," says Barhoum. "The price paid by the hospital is only an economic price. The price paid by the community is just as significant and it is clear that the community here is affected. We are forced to cut back on elective surgeries. We must have a huge number of vacant beds for trauma and can only use 30-35% of them. Sometimes it goes a little beyond that, because I have no choice and I have nowhere to transfer, and all the time we do secondary regulation and transfer to other hospitals that can take some of them."
"Our economic damage is massive, among other things, because during this period many women giving birth, premature babies, newborns do not come here, but go to a hospital in Haifa or even in central Israel, without hearing booms, interceptions, falls, planes, and sirens all the time. We live through this every day. Last year, with the intervention of Health Minister Uriel Busso, we were given up to the last shekel and our debt was closed. This year, I estimate that the deficit will be NIS 150-200 million, and we will have to use the Finance Ministry and the Health Ministry, and I believe that they will close our debt.”
"We are not defined as a 'super' hospital, although we conduct ourselves as such. In recent years, we have strengthened ourselves greatly in departments such as surgery, oral and maxillofacial surgery, and trauma. We went through the civil war in Syria when 70% of the wounded came to us from it, so we already have a lot of experience and knowledge in the treatment of war trauma. Unfortunately, but also happily, we know how to do it and implement it."
The hospital has been in constant development in recent years, including the opening of new departments and the recruitment of a workforce that already numbers 3,300 men and women, among them Jews, Christians, Muslims, Druze and Bedouins, who treat the residents of the Galilee from all sectors and religions, a diverse multicultural mosaic.
The war that broke out on October 7 created a wave of shock and astonishment among these workers. The very next day, Barhoum called them together for a moment of silence at the helipad. "Our fate is tied to each other," he began, "this is the front that will win together with everyone."
Proximity to the border dictates additional challenges for personnel management, including about 500 workers who were evacuated from their homes and those whose spouses are in extended reserve service and on standby. Dozens of workers were summoned by Order 8 for reserve service, some immediately at the outbreak of the war and some at a later stage. "In addition, we have employees whose children were harmed in Gaza," he pointed out. "As a workplace, we accompany them, too, with hugs and love."
Already on the day the war broke out, Prof. Barhoum instructed the teams to first lower the critical departments into the protected underground complex, including the preterm, dialysis, and oncology departments. The next day, he ordered more departments to be taken down, including surgery, internal medicine, pediatrics, and maternity. Some of the departments, such as the ER, the delivery rooms, and the cardiology department, remained in their usual place because they are protected all year round. In addition, most of the operating rooms are also protected.
The underground hospital of the Galilee Medical Center is the first of its kind in the country and was established before the Second Lebanon War at the initiative of the director of the hospital at the time, Prof. Shaul Shasha. Thanks to its establishment, lives were saved then, in 2006, after a missile directly hit the ophthalmology department, which was empty following the move to the underground complex.
"We are down, but the morale of the team is very high," said Barhoum. "Even the sick and wounded understand this. It is not easy. When I go through the wards, it is quiet, and I hear from hospitalized people praising the team, even though they say that the conditions are not comfortable. But this is war."
On October 9, two days after the outbreak of the war, the first wounded arrived at the hospital from the northern border, from that fatal encounter with terrorists near Arab al-Aramshe, and since then they have not stopped flowing. While admitting the wounded throughout the last six months, the hospital wards are preparing for an escalation in the north.
Since then, hundreds of wounded people have been treated at the hospital, most of them in mild and moderate condition. Recently, 19 were wounded from a combined explosion of anti-tank missiles and UAVs in Arab al-Aramshe and were brought to the medical institution. Unfortunately, the death of one of them was determined in the general intensive care department of the hospital.
A short period of time after the start of the war, a second shock room was built in the emergency department, which allowed for the expansion of the reception of trauma victims, especially those wounded in war. Also, with the cooperation of the IDF, a second airstrip was built to accommodate helicopters carrying the wounded.
The assessments encompass the entire hospital. For example, the critical equipment of the laboratory department, led by Dr. Mona Shahada and about a hundred employees who perform about 10 million laboratory tests a year, was moved to protected premises. Dr. Shahada emphasizes that a medical diagnosis is not possible without laboratory results: "About 70 percent of medical decisions rely on the results of laboratory tests."
The functioning of the blood bank laboratory, under the leadership of Dr. Moran Zarfati, has been especially critical since the outbreak of the war. "In accordance with the requirement of the Health Ministry, we will significantly increase the existing stock of blood units in the hospital," said Dr. Shahada and Dr. Zarfati.
"In addition, the doses of blood will be increased, with the cooperation of the army, so that the wounded in the field can be treated optimally. Medical experience proves that a whole blood transfusion gives a higher chance of saving the life of a wounded person who is losing a lot of blood, much more than the transfusions given in the past." In preparation for possible war on the northern front, the emergency control system was characterized by a unique blood bank module, which is connected to the computerized systems. The module is automatically updated and gives a detailed picture in real time of the stock of blood units of its various types.
In addition, throughout the period, the hospital has been preparing for cyber attack scenarios, which may paralyze the computer systems and cause a transition to manual work.
The Rambam Health Care Campus in Haifa is the only medical center defined as a medical "super" center in the north - also in the field of trauma, and according to its management, the only one in the north with the ability to provide medical treatment for a multi-casualty event in all the medical departments needed in this type of event.
The medical center was trained two weeks ago by the Home Front Command for exactly this type of scenario - a missile strike with the arrival of 100 casualties at the same time. Rambam's emergency system is able to treat 11 seriously injured people at the same time. The emergency room was used to the immediate evacuation of "regular" patients to the wards in order to receive dozens of wounded.
Ramban built a unique hybrid facility through lessons learned from the Second Lebanon War, including a huge underground parking lot that can be transformed into a protected underground hospital in just a few hours with the capacity to receive up to 1,700 patients and casualties. The last exercise saw one floor used to treat the lightly wounded.
Prof. Mickey Halbertal, director of the Rambam, told Walla: "We hope to soon return to the routine of medical treatment and research - what we are meant to do for the benefit of the community, but we are also ready at any time for extreme events and practice our preparedness regularly. Rambam is a very experienced and very active trauma center, 365 days a year and if we need to. I can assure the population of the north that we will meet any task to save lives."
The Ziv Medical Center in Safed has also stated its preparedness. The strategic importance of the hospital, which has 330 hospitalization beds, together with its advanced level of medicine, led the Health Minister to declare Ziv a "super center." The meaning of the decision is that, starting last December, the medical institution is in the midst of a vigorous process of becoming a trauma center, with new neurosurgery and thoracic surgery units, which join the existing services, and allow the reception and treatment of head and chest trauma injuries and, of course, complex injuries.
As part of learning the lessons from the Second Lebanon War, it was decided, among other things, to strengthen the hospital's trauma system, the hospital underwent a comprehensive renovation in recent years, as part of which all the departments were upgraded, including the emergency medicine department. It still does not have an underground hospital, but in the meantime, according to estimates, 250-300 beds are already placed in protected spaces.
Ziv is of special strategic importance due to the short distance from the scene of the battles in Lebanon or the Golan Heights, and the medical center is constantly being attended by wounded by airlift to the designated airstrip. Since the beginning of the war, about 220 soldiers and civilians have been treated at the Ziv Medical Center, which makes it one of the leading medical centers in the reception and treatment of battle casualties in the north.
"Since October, we have been in emergency preparedness and have not neglected routine treatments for a moment. Ziv is prepared for scenarios in the north with great support from the Health Ministry and mainly based on the excellent, professional and trained staff," Prof. Salman Zarka, director of the medical center, told Walla.
"We will continue to balance war preparedness along with professional medical response to all the residents of the north and the security forces. We witnessed how the south of the country and the surrounding area, as well as the Galilee and the Golan, are Israel's protective layer - and therefore it is important to continue to strengthen these areas."
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When war broke out on October 7, Israel's hospitals faced shock and astonishment, with medical centers learning lessons and adapting to a possible confrontation with Hezbollah.
By YOAV ITIEL
MAY 3, 2024 00:54
In the six months since October 7, the hospitals in Nahariya, Haifa, and Safed, alongside routine treatments, are preparing for extreme scenarios, which could break out at any moment, as a result of an escalation of tensions along Israel's northern border.
“We are ready,” these three hospitals say.
“We are preparing in case we don’t have any advance warning. It will be a surprise to everyone because confidentiality and secrecy are a priority,” Prof. Masad Barhoum, director of the Galilee Medical Center in Nahariya, a mere 10 kilometers from the border, told Walla on Thursday.
"IDF soldiers and northern residents need to know that they have someone to trust. We have 775 beds. We have prepared our underground complex for almost seven months. Although we have never had anything like this before, this is the reality, and we don't have the privilege to ignore it, and we have to face it. My colleagues and I work day by day and hour by hour for this moment. We always knew it would happen, we just didn't know when. It's closer now than ever."
"As soon as there is a war with Hezbollah, all hospitals in the State of Israel work as one," explains Prof. Barhoum. "There is a unified war room that refers every wounded person, and we can take in every wounded person who is referred to us. Of course, operating rooms are limited, and intensive care is also limited, but there are regulations for all of this. The war room will deal with moving the sick and wounded to where they need to be as we absorb and act accordingly. We will know how to treat any injured person who arrives. We are prepared for events with many casualties at a very large rate so that we will be able to optimize and prioritize our work and whatever changes need to be made. This is war.”
Dr. Masad Barhoum, director of the Galilee Medical Center speaks at the International Multidisciplinary Conference in Regba, near the northern Israeli city of Nahariya October 3, 2018. (credit: MEIR VAKNIN/FLASH90)Enlrage image
Dr. Masad Barhoum, director of the Galilee Medical Center speaks at the International Multidisciplinary Conference in Regba, near the northern Israeli city of Nahariya October 3, 2018. (credit: MEIR VAKNIN/FLASH90)
"Most of the wounded in the northern district in the last seven months came to us," says Barhoum. "The price paid by the hospital is only an economic price. The price paid by the community is just as significant and it is clear that the community here is affected. We are forced to cut back on elective surgeries. We must have a huge number of vacant beds for trauma and can only use 30-35% of them. Sometimes it goes a little beyond that, because I have no choice and I have nowhere to transfer, and all the time we do secondary regulation and transfer to other hospitals that can take some of them."
"Our economic damage is massive, among other things, because during this period many women giving birth, premature babies, newborns do not come here, but go to a hospital in Haifa or even in central Israel, without hearing booms, interceptions, falls, planes, and sirens all the time. We live through this every day. Last year, with the intervention of Health Minister Uriel Busso, we were given up to the last shekel and our debt was closed. This year, I estimate that the deficit will be NIS 150-200 million, and we will have to use the Finance Ministry and the Health Ministry, and I believe that they will close our debt.”
"We are not defined as a 'super' hospital, although we conduct ourselves as such. In recent years, we have strengthened ourselves greatly in departments such as surgery, oral and maxillofacial surgery, and trauma. We went through the civil war in Syria when 70% of the wounded came to us from it, so we already have a lot of experience and knowledge in the treatment of war trauma. Unfortunately, but also happily, we know how to do it and implement it."
The hospital has been in constant development in recent years, including the opening of new departments and the recruitment of a workforce that already numbers 3,300 men and women, among them Jews, Christians, Muslims, Druze and Bedouins, who treat the residents of the Galilee from all sectors and religions, a diverse multicultural mosaic.
The war that broke out on October 7 created a wave of shock and astonishment among these workers. The very next day, Barhoum called them together for a moment of silence at the helipad. "Our fate is tied to each other," he began, "this is the front that will win together with everyone."
Proximity to the border dictates additional challenges for personnel management, including about 500 workers who were evacuated from their homes and those whose spouses are in extended reserve service and on standby. Dozens of workers were summoned by Order 8 for reserve service, some immediately at the outbreak of the war and some at a later stage. "In addition, we have employees whose children were harmed in Gaza," he pointed out. "As a workplace, we accompany them, too, with hugs and love."
Already on the day the war broke out, Prof. Barhoum instructed the teams to first lower the critical departments into the protected underground complex, including the preterm, dialysis, and oncology departments. The next day, he ordered more departments to be taken down, including surgery, internal medicine, pediatrics, and maternity. Some of the departments, such as the ER, the delivery rooms, and the cardiology department, remained in their usual place because they are protected all year round. In addition, most of the operating rooms are also protected.
The underground hospital of the Galilee Medical Center is the first of its kind in the country and was established before the Second Lebanon War at the initiative of the director of the hospital at the time, Prof. Shaul Shasha. Thanks to its establishment, lives were saved then, in 2006, after a missile directly hit the ophthalmology department, which was empty following the move to the underground complex.
"We are down, but the morale of the team is very high," said Barhoum. "Even the sick and wounded understand this. It is not easy. When I go through the wards, it is quiet, and I hear from hospitalized people praising the team, even though they say that the conditions are not comfortable. But this is war."
On October 9, two days after the outbreak of the war, the first wounded arrived at the hospital from the northern border, from that fatal encounter with terrorists near Arab al-Aramshe, and since then they have not stopped flowing. While admitting the wounded throughout the last six months, the hospital wards are preparing for an escalation in the north.
Since then, hundreds of wounded people have been treated at the hospital, most of them in mild and moderate condition. Recently, 19 were wounded from a combined explosion of anti-tank missiles and UAVs in Arab al-Aramshe and were brought to the medical institution. Unfortunately, the death of one of them was determined in the general intensive care department of the hospital.
A short period of time after the start of the war, a second shock room was built in the emergency department, which allowed for the expansion of the reception of trauma victims, especially those wounded in war. Also, with the cooperation of the IDF, a second airstrip was built to accommodate helicopters carrying the wounded.
The assessments encompass the entire hospital. For example, the critical equipment of the laboratory department, led by Dr. Mona Shahada and about a hundred employees who perform about 10 million laboratory tests a year, was moved to protected premises. Dr. Shahada emphasizes that a medical diagnosis is not possible without laboratory results: "About 70 percent of medical decisions rely on the results of laboratory tests."
The functioning of the blood bank laboratory, under the leadership of Dr. Moran Zarfati, has been especially critical since the outbreak of the war. "In accordance with the requirement of the Health Ministry, we will significantly increase the existing stock of blood units in the hospital," said Dr. Shahada and Dr. Zarfati.
"In addition, the doses of blood will be increased, with the cooperation of the army, so that the wounded in the field can be treated optimally. Medical experience proves that a whole blood transfusion gives a higher chance of saving the life of a wounded person who is losing a lot of blood, much more than the transfusions given in the past." In preparation for possible war on the northern front, the emergency control system was characterized by a unique blood bank module, which is connected to the computerized systems. The module is automatically updated and gives a detailed picture in real time of the stock of blood units of its various types.
In addition, throughout the period, the hospital has been preparing for cyber attack scenarios, which may paralyze the computer systems and cause a transition to manual work.
The Rambam Health Care Campus in Haifa is the only medical center defined as a medical "super" center in the north - also in the field of trauma, and according to its management, the only one in the north with the ability to provide medical treatment for a multi-casualty event in all the medical departments needed in this type of event.
The medical center was trained two weeks ago by the Home Front Command for exactly this type of scenario - a missile strike with the arrival of 100 casualties at the same time. Rambam's emergency system is able to treat 11 seriously injured people at the same time. The emergency room was used to the immediate evacuation of "regular" patients to the wards in order to receive dozens of wounded.
Ramban built a unique hybrid facility through lessons learned from the Second Lebanon War, including a huge underground parking lot that can be transformed into a protected underground hospital in just a few hours with the capacity to receive up to 1,700 patients and casualties. The last exercise saw one floor used to treat the lightly wounded.
Prof. Mickey Halbertal, director of the Rambam, told Walla: "We hope to soon return to the routine of medical treatment and research - what we are meant to do for the benefit of the community, but we are also ready at any time for extreme events and practice our preparedness regularly. Rambam is a very experienced and very active trauma center, 365 days a year and if we need to. I can assure the population of the north that we will meet any task to save lives."
The Ziv Medical Center in Safed has also stated its preparedness. The strategic importance of the hospital, which has 330 hospitalization beds, together with its advanced level of medicine, led the Health Minister to declare Ziv a "super center." The meaning of the decision is that, starting last December, the medical institution is in the midst of a vigorous process of becoming a trauma center, with new neurosurgery and thoracic surgery units, which join the existing services, and allow the reception and treatment of head and chest trauma injuries and, of course, complex injuries.
As part of learning the lessons from the Second Lebanon War, it was decided, among other things, to strengthen the hospital's trauma system, the hospital underwent a comprehensive renovation in recent years, as part of which all the departments were upgraded, including the emergency medicine department. It still does not have an underground hospital, but in the meantime, according to estimates, 250-300 beds are already placed in protected spaces.
Ziv is of special strategic importance due to the short distance from the scene of the battles in Lebanon or the Golan Heights, and the medical center is constantly being attended by wounded by airlift to the designated airstrip. Since the beginning of the war, about 220 soldiers and civilians have been treated at the Ziv Medical Center, which makes it one of the leading medical centers in the reception and treatment of battle casualties in the north.
"Since October, we have been in emergency preparedness and have not neglected routine treatments for a moment. Ziv is prepared for scenarios in the north with great support from the Health Ministry and mainly based on the excellent, professional and trained staff," Prof. Salman Zarka, director of the medical center, told Walla.
"We will continue to balance war preparedness along with professional medical response to all the residents of the north and the security forces. We witnessed how the south of the country and the surrounding area, as well as the Galilee and the Golan, are Israel's protective layer - and therefore it is important to continue to strengthen these areas."
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