On a recent morning, a resident of Moshav Tzlafon, a few kilometers from Beit Shemesh, clutched his chest as he fell to the floor, immediately losing consciousness. Responding to the noise, his family quickly dialed for an ambulance, but feared that it would take the Magen David Adom rescue services too long to make it to their relatively isolated home. Just minutes later they were surprised when a crew of firemen came to their door. The firemen stabilized the patient so that when the ambulance arrived he was ready to be transported to the hospital. If not for the fire crew's quick response time, the man - who has since fully recovered - would have died at the scene. Israel's fire fighters are well-positioned and mandated by law to be on the scene of an accident within the shortest time possible. Yet the fire fighters do not receive any intensive first-aid training that would enable them to help in medical emergencies. As a result of a program introduced by Keren Yosef, a private organization based in Beit Shemesh that was founded six years ago, this situation is about to change. And in the many areas where the fire crew response time is far shorter than Magen David Adom ambulances, this new program can literally mean the difference between life and death. Keren Yosef was founded and run by Doris Mainzer (see sidebar) until she passed away in February 2005. Mainzer's daughter, Gina Kirsch, also a resident of Beit Shemesh, has chaired the organization since. The organization began as a small grassroots effort when Mainzer's husband Joe passed away in 1998. While his death was unrelated to treatments by ambulance services, Mainzer's other experiences with ambulance response times, staffing, and equipment motivated her to try to prevent other families from facing similar problems. Keren Yosef began with an initial donation of a defibrillator, a machine that provides electric shocks in prescribed doses to patients whose hearts have stopped functioning. Credited with saving thousands of lives around the world each year, defibrillators are considered a critical tool for ambulance crews and rescue units. Within months of that initial donation, Mainzer recognized that local ambulance crews were lacking other critical equipment and training and so were often ineffective in a variety of emergency situations. Today, thanks in no small part to Keren Yosef, Beit Shemesh's rescue services usually arrive quickly at incident sites and provide aid to the widest variety of possible medical needs. Keren Yosef has distributed more than 130 critical care kits to rescue crews throughout Israel. These kits, which include medicines and first aid materials and cost approximately US $1000 each, have been provided to ambulance units as well as individual medics and doctors all across Israel so that medical personal can ensure that wherever and whenever an emergency might occur, somebody with the proper training and equipment will be only minutes away. Sarah Sterzer, a founding member and spokesperson for the organization, says that Keren Yosef kits have saved lives in terror attacks and accidents where extra minutes can make all the difference. Recently Keren Yosef also dedicated a fully equipped multi-casualty unit that allows Magen David Adom crews to respond with one vehicle to incidents involving large numbers of victims. Complimenting their mandate to offer first respondents with necessary equipment, Keren Yosef has made public safety and first-aid education for the general public, and particularly children, a primary focus of its activities. As a result of these initiatives, more than 6,000 students from Beit Shemesh and the surrounding areas have participated in basic first-aid seminars at the local fire station. The organization also sponsors the production of informational leaflets and posters to educate the public about responses in cases of medical emergency, and has commissioned an educational CD as a refresher course in advanced life-saving techniques for medics. They also regularly sponsor CPR training courses and other public-safety campaigns. By developing historic partnerships between ambulance and fire services, these initiatives could improve the level of Israel's rescue services. In Beit Shemesh, for example, two Magen David Adom ambulances are available on every shift. But often, the available ambulance is in service at a considerable distance from another emergency. The fire services operate five satellite stations in Beit Shemesh and the surrounding areas and their response time is often between three and four minutes. According to Elie Peretz, fire chief for the Beit Shemesh area, "As a result of this new program, a life in our area should never be lost because of a shortage of medically trained respondents who can get to a scene in an appropriate amount of time." But why haven't the rescue services themselves instituted these programs? Firefighter Natan Sultan acknowledges that funding is an issue, but not the only one. With the fire departments largely funded by the cash- strapped local councils they serve, Sultan says, "We can't really expect that the local councils will be able to pay for new training and equipment." At the same time he admits, "There is an issue of the outlook of each individual branch of the rescue services. We each recognize our specific tasks - ours is to fight fires and theirs is to respond to medical emergencies." Then he adds, "It has taken the work of organizations like Keren Yosef to help change that outlook." Noting that the level of cooperation between the ambulance and fire crews in Beit Shemesh is unparalleled anywhere else in the country, Sultan, himself a volunteer medic with Magen David Adom, says the two agencies are "good friends and are involved in combined training exercises." According to Hagai Shmu'eli, spokesperson for Magen David Adom in Jerusalem, "Through the initiative of Keren Yosef, the Beit Shemesh program is achieving very positive results and we hope that similar efforts can be seen in other parts of the country. It is very clear that when agencies are able to combine their efforts it makes for a far more professional and productive operation that is to the benefit of all." To find out more about Keren Yosef visit www.keren-yosef.org


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