Although millions of Israelis who are busy with the routine of daily life don’t
feel it, there are 200,000 rockets and missiles pointed at the country’s
population, and any future war could involve an initial onslaught of enemy
Additionally, while the probability of a missile or
terrorist attack on Israel involving unconventional weapons is very low, the
threat cannot be dismissed out of hand.
Under the shadow of these extreme
and plentiful security threats – faced by no other population in the world –
Israeli military and health officials have quietly been developing an
inter agency network designed to ensure that hospitals in Israel will be able to
cope with the worst-case scenarios, without any costly delays or
In fact, the safety system they have put into place is ready
to be activated at any moment, and forms an invisible protective layer that, one
must hope, will never be needed.
The agency at the heart of preparations
for the unthinkable is called the Hospital Preparedness Branch (HPB), and is a
part of the medical department of the IDF’s Home Front Command.
a unique body,” a senior source from the HPB told The Jerusalem Post
“Here, we write our own doctrine.”
Funded by the Home Front Command and
the Health Ministry, the HPB represents a maze of inter organizational
connections that, like the roots of several neighboring trees, have ended up
twisted around one another in a way that looks confusing to the outside viewer,
but works with remarkable efficiency.
All year-round, the HPB checks to
see if Israel’s 27 hospitals are ready for chemical, biological, or radiological
attacks, as well as pandemics and earthquakes.
It stores the chemical
protective suits paramedics would need to reach victims, and practices showering
the injured at hospital entrances before passing them on to doctors, who are
trained to identify the attack and inject the patient with the lifesaving
The HPB has its own army units that can be instantly dispatched
to hospitals to set up showers for victims of chemical attacks. In drills, a
“yellow line” forms a key feature – this is the line that patients cross after
they have been cleansed outside of poisonous chemicals and passed on to civilian
nurses and doctors.
The HPB has its own medics, who can treat
unconventional attack victims in the field as well. Should an unconventional
weapon be deployed in Israel, the HPB will be the agency that will broadcast
information over mass media to civilians on how to identify symptoms and when to
come to hospitals.
And it is the agency that stocks up on protective
suits against chemical, biological, and radiological incidents (each incident
requires its own special suit).
But the HPB’s role isn’t limited to these
nightmarish emergencies. It also jumps into action in case of a conventional
missile attack, acting as an oil to smooth a hospital’s transition from
peacetime to a time of war.
“During a war, we will hold around the- clock
evaluations to take many decisions. We will decide whether a senior hospital
doctor, who is also a reserve soldier in the IDF Medical Corps, will treat
civilians in the home front, or soldiers [in a field hospital],” the source
An “inner cabinet” – already formed – is the decision-making body
for such dilemmas. It is made up of the Health Ministry’s director-general, the
head of the IDF’s Medical Corps and the head of the HPB.
meets every Sunday at the Health Ministry’s Emergency Branch in Tel Aviv to pore
over the results of drills and monitor the progress of hospitals in preparing
for the worst.
Construction of hospital wards that are immune to rocket
strikes, or the number of showers for chemical attacks in each district, are
normal topics of discussion in this cabinet. The outcomes of drills are also
analyzed and discussed.
“We have to be ready at all times,” the source
said. “The aim is to minimize injury in the best way possible.”
real emergencies, hospitals will become very different places from the centers
of treatment they now are.
All non-critical surgeries will be
Many beds will be set up in corridors.
can be released to their homes will be sent on their way.
will take, in accordance with the conditions on the ground, life-and-death
The HPD is, in the most Israeli of ways, a work in progress.
It first saw life during the Second Lebanon War, when it assigned Home Front
Command units to the entrances and parking lots of every hospital in northern
Israel to assist with patient reception.
After the war, the HPD decided
that its units would be partially called up in all future conflicts, not just
extreme scenarios involving unconventional weapons.
“Everything is very
fresh, but we’re advancing forward in leaps and bounds,” the source
The agency has full access to the Health Ministry’s computer
systems, and knows how full each hospital is at any given time.
Operation Cast Lead in Gaza in 2008-2009, when southern Israel was under rocket
bombardment, the HPD evacuated hospital wings that were not protected against
It was the first time that the organization’s units arrived
at hospitals within an hour of receiving an official IDF call-up
“For the first time, military units solely designed to assist
hospitals were called up. That is an upgrade,” the source said. Today, the HPD
has evolved to deal with any mass-casualty incident.
It houses a national
medical control room, which is staffed by Health Ministry personnel who provide
an initial alert of a developing incident. Then, if necessary, the relevant
hospitals go into emergency mode, and units are deployed.
“We’re not in
the era of wars on the frontlines,” the source pointed out. “Today, the home
front is the target.”
Hospitals, much like air force bases and the
government, will have to ensure “operational continuity” – a key term in the IDF
today, used to describe the ability of a complex body to function under heavy
Between 25 and 30 drills involving every imaginable
scenario occur a year, a major increase from the past. Until 2007, there were
17- 20 such annual exercises.
During chemical drills, a mock missile is
planted in the ground, releasing a yellow gas that represents a deadly chemical
Within minutes, masked paramedics and medics are on the scene,
loading “injured” people onto stretchers, hosing them down with water and
ferrying them to the first reception areas set up in parking lots outside
“At first, a hospital might not know it has patients from a
chemical attack,” the source said. “The symptoms will only be recognized
On Thursday, the Nahariya’s Western Galilee Hospital became the
latest medical center to practice for a chemical attack.
Members of the
public would prefer not to think about such awful developments. But the staff of
the HPB makes it their business to ensure that Israel can’t be caught off guard.