The most dangerous time of any conflict is when the victims become numbers. The deadly toll is expressed in a running tally, while untold numbers suffer silently. Comparing the number of victims on one side with the number on the other makes conflict abstract and defames the memory of those lost. The Jewish people are traumatized by numbers – we erect monuments and museums to record and remember every name. But the story of this conflict is not complete without including the silent victims: the anonymous, the unnoticed, the uncounted, who suffer but are not included in any of the official statistics.

The alphabet soup of international news organizations has descended on Israel, presenting infographics and “money shots” as the suffering continues. The human suffering of the innocent civilians in Gaza is heart-wrenching. Israel’s suffering has been mitigated by its near fanatical commitment to protecting its civilian population.

Secure rooms capable of withstanding everything short of a direct hit from a missile have become natural features of most Israeli homes.

Color Red warning systems and smartphone apps give civilians warnings in real-time. The vaunted Iron Dome missile defense system has created a sense of security that deemphasizes the murderous intent of each Hamas missile fired.

In Israel, when the sirens pierce the air and people seek shelter, Iron Dome springs into action, but millions of people are still suffering as they hunker down waiting for the threat to pass. The stress causes blood pressure to rise, breath rates to increase and a myriad of other physiological and psychological reactions. The immediate impact on the health and wellbeing of the Israeli people is gauged by medics in the field from United Hatzalah, who are recording a sharp uptick in cases of chest pains and shortness of breath, which are often precursors to heart attacks and respiratory emergencies in parts of the population with preexisting susceptibilities.

In Ashdod, United Hatzalah ambucycle medics responded to a six-year-old child having an asthma attack in one of the crowded, stuffy shelters. One of the medics risked his life to retrieve the boy’s nebulizer from his unprotected apartment and raced back to the boy in time.

Some calming words and additional oxygen helped save the boy’s life.

There are hundreds, if not thousands, of similar cases of people suffering silently from the reality of living under the constant threat of a missile barrage. Their names are not known and their silence is deafening.

In Jerusalem, United Hatzalah medics responded to a 75-year-old American woman who was a frequent visitor to Israel. This time the sirens and the fear were too much for her. She suffered a massive heart attack and died despite the best efforts of medics on scene. How is this victim counted? Did a Hamas rocket kill her? Who is to blame? She is another silent victim mourned silently by her loved ones, to whom she was never a number.

The most heartrending report came from a United Hatzalah ambucycle medic who responded to an 81-year-old Holocaust Survivor from Belgium who was shuddering in fear. The medic gently tried to calm her down, but despite the hot Israeli summer, she was shivering as she recalled running to the cold, dark and dank coal cellar during the Second World War. The sound of every missile roar reminded her of the German bombers that seemed to be seeking out one frightened little Jewish girl.

It took some time until he was able to guide her back to the present, but her symptoms of a stroke – presumably brought on by the rise in blood pressure – were undeniable.

Her number doesn’t appear on anyone’s list, except that of United Hatzalah’s Ten Kavod Holocaust Survivor proactive care program.

Eight million Israelis have been interrupting their lives for over 10 years every time terrorists in Gaza press the launch button on a missile, mortar or rocket. On a nearly daily basis people are running for shelter from the incoming projectiles.

Without Israel’s robust civil defense program, tens of thousands more would have been killed or wounded. Some are still wounded or killed by the blasts, others are traumatized by the sound of the explosion or the wail of the siren, and hundreds of thousands more are the silent victims.

The author is president and founder of United Hatzalah.

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