The hid­den side of Ram­bam Med­i­cal Cen­ter

The Jerusalem Post - The Jerusalem Post Magazine - - OBSERVATIO­NS - • ALAN ROSENBAUM

‘Dur­ing the Sec­ond Le­banon War in 2006, I was triage chief at the hos­pi­tal, eval­u­at­ing in­com­ing wounded. We were re­ceiv­ing ca­su­al­ties, and the build­ing was shak­ing from the mis­siles fall­ing around us.” The speaker is Dr. Michael “Miki” Hal­berthal, CEO of Haifa’s Ram­bam Med­i­cal Cen­ter, re­call­ing the tu­mul­tuous events of the 34-day con­flict, when 60 rock­ets fell within a half-mile ra­dius of Ram­bam. At that time, nei­ther the hos­pi­tal, nor its pa­tients and staff were pro­tected from en­emy at­tack.

Af­ter the war’s con­clu­sion, Hal­berthal ex­plains, hos­pi­tal man­age­ment de­cided that those cir­cum­stances could not be al­lowed to re­oc­cur. Ram­bam Med­i­cal Cen­ter, the pri­mary hos­pi­tal for north­ern Is­rael, is com­mit­ted to treat pa­tients un­der all sce­nar­ios. Dr. Hal­berthal, who has held nu­mer­ous pro­fes­sional lead­er­ship po­si­tions at Ram­bam since 2001, and who be­came gen­eral di­rec­tor in 2019, says, “Ram­bam is com­mit­ted to treat­ing pa­tients un­der all cir­cum­stances. We don’t have the right to say that we are not ready,” At that time, the hos­pi­tal was deal­ing with two ma­jor is­sues – en­abling ad­e­quate pro­tec­tion from at­tack and ad­dress­ing the need to add ad­di­tional park­ing for hos­pi­tal visi­tors. Ram­bam Med­i­cal Cen­ter in­ge­niously solved both prob­lems si­mul­ta­ne­ously by build­ing an im­mense, three-floor un­der­ground park­ing area – each floor is 20,000 sq.m. (5 acres) – that can ac­com­mo­date 1,400 cars, and, in emer­gency, can be trans­formed into a 2,000-bed un­der­ground hos­pi­tal, fully pro­tected and se­cured from both con­ven­tional and non-con­ven­tional at­tack.

Con­struc­tion of the un­der­ground fa­cil­ity, known as the Sammy Ofer For­ti­fied Un­der­ground Emer­gency Hos­pi­tal, was funded pri­mar­ily by the Ofer fam­ily. Dr. Hal­berthal also ex­pressed his grat­i­tude to the In­ter­na­tional Fel­low­ship of Chris­tians and Jews and its founder, the late Rabbi Yechiel Eck­stein, who raised the funds for the un­der­ground hos­pi­tal’s for­ti­fied com­mand cen­ter.

Ini­tially, the work was done by the hos­pi­tal. Later, the govern­ment de­cided to part­ner with the hos­pi­tal, and Hal­berthal says that now, “It is a strate­gic fa­cil­ity of Is­rael, much more than just Ram­bam.” Work be­gan in 2009 and the sub­ter­ranean struc­ture was com­pleted in 2014. “It can be made op­er­a­tional very quickly once the de­ci­sion is made to ac­ti­vate,” he says. “Within six to eight hours we can be­gin evac­u­at­ing pa­tients to the un­der­ground hos­pi­tal, and we can reach full ca­pac­ity in 48-72 hours.” A de­ci­sion to move un­der­ground would be made by the high com­mis­sion of hos­pi­tal­iza­tion of Is­rael, the emer­gency ser­vices of the Health Min­istry and the IDF, says Hal­berthal.

The un­der­ground hos­pi­tal can ac­com­mo­date 2,000 pa­tients, in­cludes four op­er­at­ing rooms, full elec­tronic and com­mu­ni­ca­tions gear, oxy­gen, and all nec­es­sary in­for­ma­tion tech­nol­ogy re­sources re­quired for ac­cess­ing med­i­cal records. Ev­ery­thing – the lay­out of the hos­pi­tal, all the check­lists and ev­ery sce­nario – is com­put­er­ized. The un­der­ground hos­pi­tal can be used not only in the event of a mil­i­tary con­fronta­tion, but for any bio-haz­ard sit­u­a­tion and ma­jor iso­la­tion sce­nario, and in an in­stance of chem­i­cal war­fare, de­con­tam­i­na­tion would be done un­der­ground.

“This fa­cil­ity is huge,” mar­vels Hal­berthal. “In the case of a mil­i­tary con­fronta­tion or other sce­nario that re­quires it to be used, we’ll have close to 8,000 peo­ple un­der­ground, in­clud­ing two thou­sand pa­tients, three thou­sand med­i­cal staff, and fam­i­lies. If some­thing were to de­velop, we have a so­lu­tion to treat pa­tients, ca­su­al­ties and de­liv­er­ies in a pro­tected area with­out en­dan­ger­ing pa­tients and staff.”

The Sammy Ofer For­ti­fied Un­der­ground Emer­gency Hos­pi­tal is in­tended to be a re­gional so­lu­tion, and Dr. Hal­berthal notes that in the event of a con­flict, it would be dif­fi­cult to pro­vide ser­vices within in­di­vid­ual north­ern com­mu­ni­ties for pa­tients, es­pe­cially those re­quir­ing dial­y­sis. The un­der­ground fa­cil­ity can house 94 dial­y­sis units for pa­tients from north­ern Is­rael who would be un­able to re­ceive ser­vices in their lo­cal com­mu­ni­ties dur­ing wartime, as well as birth and de­liv­ery units, and space for 120 in­ten­sive care pa­tients.

Though the un­der­ground hos­pi­tal has never been ac­tu­ally used, the hos­pi­tal con­ducts drills and tests reg­u­larly to make sure that it is ready to be ac­ti­vated at a mo­ment’s no­tice. Part of the tests also in­volve sol­diers from the IDF Home Front Com­mand, which would be in­volved in mov­ing the hos­pi­tal un­der­ground. There are other hos­pi­tals in Is­rael that have pro­tected ar­eas and shel­ters, but none have the ca­pa­bil­ity of tak­ing an en­tire 1,000-bed fa­cil­ity, mov­ing it un­der­ground, and pro­vid­ing al­most dou­ble the amount of beds. “We had to write the op­er­a­tional man­ual for it, in­clud­ing pro­to­cols and check­lists, be­cause there is noth­ing like this any­where in the world. Ev­ery unit of the hos­pi­tal in­clud­ing both clin­i­cal, and non-clin­i­cal units, has a spe­cial red book, ex­plain­ing what to do in case we have to move un­der­ground.”

Hal­berthal says that the un­der­ground hos­pi­tal can re­main op­er­a­tional for 35 days, pro­vided that it re­ceives sup­plies from the out­side. In ex­treme cir­cum­stances, with­out de­liv­ery of sup­plies, the hos­pi­tal could op­er­ate for three days.

“We are ready, un­der cer­tain sce­nar­ios, to close the doors, and be self-suf­fi­cient, with­out any help from the out­side,” he adds.

The Sammy Ofer For­ti­fied Un­der­ground Emer­gency Hos­pi­tal can be used not only in the event of a mil­i­tary con­fronta­tion, but for any bio-haz­ard sit­u­a­tion and ma­jor iso­la­tion sce­nario

Ram­bam Health Care Cam­pus, the pri­mary hos­pi­tal for north­ern Is­rael, is com­mit­ted to treat­ing pa­tients un­der all sce­nar­ios

IN AD­DI­TION to the Sammy Ofer For­ti­fied Un­der­ground Emer­gency Hos­pi­tal, ad­di­tional ar­eas of the above-ground sec­tions of the hos­pi­tal have been for­ti­fied. In­fants in the neo-na­tal in­ten­sive care unit of the col­or­ful and spa­cious Ruth Ra­pa­port Chil­dren’s Hos­pi­tal are pro­tected from both con­ven­tional and non-con­ven­tional at­tack, as will pa­tients on the lower floors of the Eyal Ofer Car­di­ol­ogy Cen­ter, which is un­der con­struc­tion, in­clud­ing those in the in­ten­sive care units, the cather­iza­tion lab and its op­er­at­ing rooms. The hos­pi­tal’s emer­gency room is com­pletely pro­tected as well.

Ram­bam Med­i­cal Cen­ter, as the largest aca­demic ter­tiary re­fer­ral cen­ter in the re­gion and its only Level 1 Trauma Cen­ter, has used its knowl­edge of cop­ing with trauma and emer­gency pre­pared­ness to as­sist other hos­pi­tals around the world.

“Through­out the years,” says Dr. Hal­berthal, “we have ac­cu­mu­lated a great deal of knowl­edge on how to cope with th­ese types of cir­cum­stances, and as a re­sult, we de­vel­oped the In­ter­na­tional Cen­ter for Trauma, Emer­gency and Mass Ca­su­alty Sit­u­a­tions, which I chair. The cen­ter of­fers an educationa­l pro­gram aimed at all pro­fes­sion­als who are in­volved in the or­ga­ni­za­tion and treat­ment of mass ca­su­alty in­ci­dents; pre-hos­pi­tal forces, hos­pi­tal staff, physi­cians, nurses and ad­min­is­tra­tors.

“While not ev­ery­one is fac­ing a war sit­u­a­tion, we need to pre­pare for all types of emergencie­s – whether they are man-made or caused by na­ture. We travel around the world, teach, and ex­change knowl­edge, help­ing oth­ers pre­pare. This is part of our mis­sion.”

Re­fer­ring to the un­der­ground hos­pi­tal, Dr. Hal­berthal says, “We hope we will not need to use it.” Nev­er­the­less, it’s com­fort­ing to know that Ram­bam Med­i­cal Cen­ter is well-pre­pared, both above ground and below, to treat and pro­tect its pa­tients in the North.

(Pho­tos: Pioter Fliter, Ram­bam Med­i­cal Cen­ter)

JOINT READI­NESS drill at Sammy Ofer For­ti­fied Un­der­ground Emer­gency Hos­pi­tal with IDF Home Front and Ram­bam staff.

DR. MICHAEL (MIKI) HAL­BERTHAL, CEO of Haifa’s Ram­bam Health Care Cam­pus.

Newspapers in English

Newspapers from Israel

© PressReader. All rights reserved.