ON CALL WITH MAGEN DAVID ADOM
The personnel of Israeli emergency medical service Ma gen David A dom were once again in the news this week following a fatal shooting at a Tel Aviv bar. Rosa Doherty joined an MD A team for a shift in the city
IT IS less than 10 minutes since Yehudit called for an ambulance after her 87-year-old husband, Avi, complained of “chest pain” and “irregular pulsing”. Now Yehudit paces anxiously around the living room of their Tel Aviv home as three Magen David Adom paramedics adjust more than a dozen wires affixed to the chest of Avi, who is slumped in his armchair.
This is one of the many emergencies personnel of the national ambulance and blood bank service attend every day — the annual total is 650,000 — from people taken ill at home to terror attack victims. Unlike in the UK, or pretty much anywhere else in the developed world, the medical team is likely to be comprised of volunteers.
Just 10 per cent of those MDA calls upon are paid, explains Ido Golan-Gutin from the charity’s fundraising and international relations department. The majority of the 12,000 are “everyday Joes and Janes”.
One of those “Janes” is Roni Shisgal, 20. Preparing an intravenous line to enter Avi’s arm, she reassures him: “It is to give you a shot of adrenaline.”
Ms Shisgal was just 15 when she went out on her first shift. “It is what we do,” she says matter-of-factly. “Going into the ambulance service is like a club. It is part of how we socialise and how our society works.”
Having spent two years in the army, she is working as a vet’s assistant while “deciding what I want to do with my life. I used to do three or four shifts a week. But now I have a full-time job, I only do one or two.”
She adds, laughing: “Can you think of anywhere else in the world where this would work?” Whereas young people elsewhere were thinking about university or clothes, “in Israel we have other things to think about”.
Attending to Avi is the first call of Ms Shisgal’s 12-hour shift. Once his condition is stabilised, she and her two colleagues put him on to a stretcher and into the back of an ambulance donated by UK Friends of MDA.
Contributions from the UK — where £3 million is raised annually — and other international communities are crucial as MDA does not receive state support. Mr Golan-Gutin explains that “while treatment and ambulance call outs are covered by Israel’s health insurance companies and tax people pay out of their wages, we rely on funding from the diaspora. We get roughly 100 million shekels [£17 million] a year through charity. “They buy our ambulances, our uniform, the blood centres. We are very lucky because without that we wouldn’t be able to function.”
Ms Shisgal says that MDA’s equipment “is still the best. Every ambulance has a GPS fitted. The dispatcher knows which ambulance is under his responsibility. If we are on our way back from somewhere and we happen to be near an emergency that isn’t in our jurisdiction, the dispatcher can see it and send us there.
“We can send real time updates of the patient to the hospital, so what you see the hospital can also see. They know what to expect. And every dispatch centre also has an in-house doc-
We couldn’t function without aid from over seas
tor who can see the real time status of the patient. It means they are on hand to the team to give advice about the patients if needed.”
The driver on Ms Shisgal’s shift is Harel Sasson, 27, one of MDA’s paid staff. Turning on the flashing lights, he zigzags at speed through the Tel Aviv traffic as trainee paramedic Yoav Leibovitz, 25, monitors Avi’s condition.
“Sometimes the most effective treatment we can give someone is to get them to the hospital in the quickest time,” Mr Sasson says as the vehicle mounts a pavement to break through the gridlock. “There is no official training for driving an ambulance and you can see people here don’t move out of the way. I don’t know what it is with Israelis.”
For Mr Leibovitz, the shift is part of a training process he hopes will lead him to becoming a military paramedic. He says his MDA duties are preparing him for a job in combat zones.
“It is a fact we have terror attacks every day. Our friends have been attacked attending calls. And with the stabbings happening now, it is good for us to see first-hand, so when we are in the battlefield we know how to deal with things.”
Two weeks previously, he had treated a young woman in Jaffa who had been shot in the chest during a family dispute. He managed to keep her alive but she later died in surgery. “When she passed away, the doctors came out and talked to us. You obviously think: ‘Is there anything you did wrong?’ We talked about it and we agreed we did everything we could and I’m okay with it.”
It was hard not to be emotional in such cases “but we can deal with it. We have each other to speak about what happens.”
Asked if he is ever scared, Mr Leibo- vitz replies: “Of course we have to consider our own safety. When we go to a house, we have to see what it is like. In the case of Avi, we can see it is a regular house with no threat. But sometimes we call the police before we go inside.”
Because of army and MDA commitments, he has not had the opportunity to go to university but has no regrets. “Other people do not need to fight for their independence in their country. Some people need to be the ones who take care of the people in their country. That is us and we are proud to do it.”
In five years, Ms Shisgal has seen “everything from suicide to car accidents. But for me, the worst thing is the social cases.
“Medically you might treat someone and they are okay but they live in a one bedroom house and it is dirty and in a terrible condition. They have no money and they are alone.
“My mum says I’m a robot. I come back and tell her about the things I’ve seen, people getting stabbed, and she is like: ‘How are you okay with it?’
“But she doesn’t worry about me doing this job. She worries about a lot of things, but not that one.”
It is MDA policy to prioritise those in the greatest medical need and there was outrage when Israeli media reported that MDA staff gave lifesaving treatment to a terrorist before the Jewish victim.
“Sometimes it is the terrorist who has to get the treatment first,” Mr Leibovitz acknowledges. “Do I want to treat him? No, but I have to and I do. And I do my best to save the life of whoever I get to.
“I had to go to a stabbing the other day. The victim had been hurt in his arm — it was not life threatening — but the terrorist had been shot. So we went to help him first. You just get on with it.”
Mr Golan-Gutin notes the “backlash from some people who don’t understand how you can treat a terrorist before the victim. But they have to understand we are not the judge and jury.
“This is a democracy. We don’t come to the patient and say: ‘You are the Arab terrorist, you die.’ It is not for us to decide who gets treatment or not and that is the right way to look at it, even if it hurts.
“We have Arabs, Israelis, Druze, Bedouins, Christians all working together. It is unique to us as an organisation. It works because everybody works towards one cause. It is a beautiful thing.”
Mr Leibovitz says that MDA also helps the Palestine Red Crescent, its equivalent in the Palestinian territories.
“We can’t operate there, but if a patient needs to go to an Israeli hospital, they come to the army on the border and we take the patient for treatment. There is a lot of working together but people don’t want to see that.”
And Avi? He was fine.
Do I want to treat a terrorist? No, but I have to and I do
ON SUNNY FRIDAYS, Dizengoff Street, the heart of Tel Aviv’s proudly scruffy strip of cafés and saloons, hosts long afternoons of coffee and light drinks that gently carry its patrons towards a night of partying.
Last Friday, the languor was interrupted by the rat-a-tat of a semiautomatic weapon that left two people dead and the city on edge.
Rain poured down on Israel over the weekend, so it was difficult to tell if Dizengoff was empty due to the weather or due to the terror, but all signs pointed to the latter. Shuttered locales had hung notices of mourning. Both Arab and Jews, it appeared, were too frightened to return to work as the gunman remained on the loose.
Along the street, skittish women were buying groceries with their children, kept away from school. The Tel Aviv municipality reported that fully half of the school-age children from north Tel Aviv were absent on Sunday and Monday.
Ari Samuel, 29, an American immigrant working in advertising, said: “I think the personal attacks are definitely different to missiles. I’ve been here four years, and I’ve been through two wars with missiles, but not really gunmen shooting up bars. Tel Aviv is a paradise, an urban paradise, so when you live in a place like this you tend to forget where you are in the world.”
That luxurious calm seems to have been shattered, despite the fact that Friday’s attack was not the first in Tel Aviv since the surge of Palestinian violence began in early October.
At a vintage shop, Edna Banet, a Jerusalemite, argued edgily with Elisha Regev, a collector of Israeli artifacts from Herzliya, about the reaction of Tel Avivis to the shooting. “There was an attack in Tel Aviv, and now suddenly you all take off,” she said. “We’ve been having attacks in Jerusalem daily. Yesterday there were two stabbings, and no one is saying a word!”
“In some way it has had an impact on residents and on every individual,” Mr Samuel said. “Obviously, it could happen anywhere in the world. It could happen in New York, in London, in Paris, obviously. But I think that people in Tel Aviv will probably continue as scheduled. The city doesn’t really stop for that kind of thing.”
An MDA medic rushes to assist victims of the bar attack in Tel Aviv
MDA paramedics deal with a patient outside a Jerusalem court
Yoav Leibovitz and Roni Shisgal at the end of their shift in Tel Aviv
Avi , who has suffered chest pains, is wheeled into an ambulance
Netanyahu lights a candle at the scene of