If you or somebody near you is hurt or ill and calls 101 for Magen David Adom, the first person to arrive may come on foot, in his private car, a motorcycle, a motorbike, a four-wheel-drive Tomcar, an "ambuboat" on Lake Kinneret or even a bicycle - but not an ambulance.
These rescuers volunteer for MDA - and in many cases, they are also unpaid medics or paramedics for United Hatzalah on call 24 hours a day who stop whatever they're doing to reach the person in need. They are usually only a few minutes away.
You can distinguish them from MDA's paid personnel by their bright orange-and-black vests, which bear the symbol of MDA on one pocket and that of United Hatzalah (UH) on the other. UH volunteers (aside from only four paid staffers) are not paid even for their gasoline, and include Jews and Arabs, men and women, religious and secular. Some of the haredim and Arabs perform recognized national service as UH volunteers.
Despite the diversity, the average UH volunteer is a religious man sporting a black kippa, a beard and ritual fringes. And the average recipient of their lifesaving assistance doesn't know the difference between MDA and UH, or why both organizations are essential.
I WASN'T sure myself until I went to interview Eli Beer, the founder and chief coordinator of UH and others in the totally voluntary organization as well as in MDA and elsewhere. Beer, who came on aliya from New York with his parents in 1969, earns a living from his family's real estate company, but spends even more time in the cramped and dusty rented headquarters of UH, along with Daniel Katzenstein, a haredi medic who came here from Dallas 11 years ago and is its executive administrator.
During the long interview, Katzenstein is always listening for his beeper, which constantly receives alerts from MDA's communications system (to which all MDA and UH medics and paramedics are linked). While I was there he jumped up, donned his vest, grabbed his equipment and raced across the street to the Center 1 shopping center where a laborer had fallen into a pit. Returning half an hour later, he says an MDA ambulance team - based at its Jerusalem headquarters 100 meters away from UH - showed up a bit later to finish the job. Beer and Katzenstein say UH's volunteers often arrive before MDA ambulances because they are spread out in the communities and not in formal ambulance-dispatching stations. "Every volunteer is a 'branch' ; we have no buildings," notes Beer. Since getting treatment during the first 10 minutes after a heart attack or injury is vital, the voluntary organization stresses speed in arrival to increase their patients' chances of survival.
Beer recalls that in 1979, he launched the organization with a few friends and neighbors in the capital's Bayit Vegan quarter after an Egged bus was attacked by a suicide bomber. "It seemed to take a long time for ambulances to come; it was Israel's first such bus bomb. Taxi drivers were rushing wounded to Shaare Zedek Medical Center. I had always wanted to be a doctor and didn't manage to do it, so I volunteered with MDA and had a large radio scanner that alerted us to people in need," recalls Beer, who is married to a special education teacher and is a father of five. He proudly notes that for her bat mitzva, one of his daughters donated her monetary gifts totalling $9,000 to buy a motorcycle for UH.
HATZALAH JERUSALEM was established that year with donations and a small band of volunteers, according to the Hatzalah model in Flatbush, Brooklyn. Still living solely on donations, UH has expanded to 1,500 volunteers in 70 locations from the Golan Heights in the north to Eilat in the south, responding to over 300 emergencies a day and 100,000 a year - on Shabbat, festivals and Yom Kippur as well.
UH is now the largest volunteer organization to be integrated into the emergency services led by MDA. It has a NIS 10 million budget, separate from that of MDA, from which it purchases services including training of all medics and some of its equipment. Some volunteers also attend specialized lectures from Prof. Avi Rivkind, chief of surgery and the trauma unit at Hadassah University Medical Center in Jerusalem's Ein Kerem, who serves as UH's unpaid medical adviser.
Unlike MDA (the national first aid, rescue, ambulance and blood service), UH does not run a large fleet of donated ambulances, but has only eight (three in Beit Shemesh) wich it uses only for emergencies. Beer also says MDA has many times more volunteers, but when they provide services such as taking someone to a hospital outpatient clinic, MDA can be more costly than private companies.
(MDA's response appears below.)
UH "doesn't compete with MDA. We provide services to MDA while volunteering for United Hatzalah. We also help the two private ambulance companies, Natali and Shahal, and voluntary organizations like Yad Sarah, Ezer Mizion, ZAKA and Hahovesh," says Beer. "We don't want to replace MDA; we just want to save lives."
There have been numerous newspaper reports in the past year about MDA - which has competed unsuccessfully against private companies in some public tenders to provide first-aid services in schools and elsewhere - refusing to allow its paid staffers to volunteer with UH or those in private companies to volunteer for MDA.
(Again, MDA's response appears below.)
As about 65% of volunteers are Orthodox men concerned that what they do not violate Jewish law, UH consults with Rabbi Azriel Auerbach. Beer recalls that on one Yom Kippur, he rushed to Jerusalem's Pisgat Ze'ev neighborhood to save a secular man who had choked on food he'd eaten during the Jewish fast. Wearing a black kippa made of leather - not part of the usual haredi "uniform" - Beer identifies himself just as "a Jew who loves every type of Jew. We believe in tolerance. We would help someone hurt while marching in the gay parade." UH volunteers have treated both policeman and Toldot Aharon hassidim injured during the violent Jerusalem demonstrations sparked by the opening of the Carta parking lot on Shabbat. UH volunteers have never been attacked by haredim when driving through neighborhoods to save lives on Shabbat and holidays, Beer says.
As UH volunteers handle injuries from many preventible accidents, in recent years it has offered lifesaving courses for parents around the country. It is much better to prevent injuries than to treat them, adds Katzenstein. Overburdened haredi parents with a large brood of children sometimes pay too little attention to safety, concedes Beer.
Many burns result from hot-water samovars left close to the edge of kitchen countertops, electric hotplates and ritual candles.
UH is always ready to hear about new ways to prevent accidents. When I told him of my suggestion to reduce the number of young children left in sizzling vehicles, Beer wanted to hear more. The idea - which I had raised in discussions with the past six health ministers but which they did not implement - involves the printing of stickers reminding drivers not to leave children in vehicles for any reason. The stickers would be supplied by the License Bureau in every language, and affixed to the inside of the driver's door. Without it, no vehicle could be relicensed.
Beer jumped at the idea and immediately asked his colleagues to design stickers that UH would hand out free. And indeed, in a few weeks, they were available in Hebrew, English and Arabic, with Russian and other languages to follow.
Having them inside the door will not be mandatory, but the message will get out, and maybe the Health Ministry will copy the idea.
Katzenstein said he is thinking of additional stickers to remind parents not to leave children unsupervised when around candles, when in the bathtub or near swimming pools.
Asked for comment, Rivkind recommends that Deputy Health Minister Ya'acov Litzman convene representatives of all the public rescue organizations "and not let them out until they agree to work together under an umbrella organization." Such coordination should be put into effect by law, if necessary. "Disagreements among the organizations are like children's fights, and duplication is a waste of funds. It's a small country; these organizations and their managements can remain separate, but must work together efficiently."
In his experience, says the internationally respected surgeon, "United Hatzalah medics have often arrived first, on a motorbike or motorcycle, to resuscitate people, and an MDA ambulance comes later to continue it and take them to hospital. Hatzalah - and MDA - have wonderful, devoted volunteers. I give lectures on trauma that are attended by UH volunteers, but when I invite MDA paramedics, for some reason they have not come. I work with MDA too, and officials know what I think about the dispute."
Ministry associate director-general Dr. Boaz Lev, who has formal responsibility for supervising rescue organizations, says "MDA is the official lifesaving organization. UH volunteers, who do a wonderful job, work under the aegis of MDA and officially volunteer for MDA. If any complaint is filed against either organization, we try to investigate. There is one system for notifying medics of calls for help, and it should be available to all public services so medics who are the closest can reach the victim the fastest."
Asked about claims that MDA charges for all its services, Lev notes that it is required to do so by law. MDA has "never been in such good condition as it is now under its director-general Eli Bin," he adds, despite criticism by the State Comptroller in a 2006 report of the procedures involved in MDA appointments, including Bin's. "MDA actually supervises itself very well and meets international standards."
Asked to comment on tensions with UH and other issues raised in the reporting of this article, including certain unsubstantiated allegations that are not included in the piece, MDA spokesman Yerucham Mandola issued this formal response to a series of questions put in writing to him by this reporter:
"The matters forwarded for our response are a collection of slanderous accusations with no link to reality by clearly interested parties with only one purpose - to find fault in the national lifesaving organization of Israel, Magen David Adom. [It] is held in high esteem both in Israel and the Jewish communities abroad.
"Regrettably, this is not the first time that these interested parties - who are not under the control and supervision of the state authorities - make these false accusations, this time in your newspaper - the herald of Israel among the Jews in the Diaspora - for the purpose of obtaining contributions, not through real deeds and support in the community, but through maligning the reputation of MDA staff and volunteers, who work around the clock in order to save lives....
"MDA has scores of activity points, and there has never been nor will there ever be any differentiation regarding the faith of its staff and volunteers - active side by side - religious staff and volunteers, Orthodox and secular, some of whom also volunteer in other organizations such as Ezer Mizion, Yad Sarah, [United] Hatzalah and Zaka. MDA demands that its volunteers act with integrity and loyalty towards the organization and gladly accepts any person meeting the professional requirements and interested in volunteering, provided he does not work in a parallel or similar organization; that would place him in a position of a clear conflict of interests.
"MDA trains its 14,000 staff and volunteers to act according to the highest international professional standards and is supervised according to international standards.
"MDA has indeed undergone a change in the past 20 years from a small organization to an operational organization with 112 [first aid] stations throughout the country and about 700 ambulances and mobile intensive care units... MDA is available in every corner of the country around the clock. The MDA teams and the 'first-responders volunteer brigade' arrive at every incident in a span of time that has no parallel in Israel and worldwide. MDA has developed a variety of services and has adopted advanced technologies in the field of emergency medicine, logistics, computer array, and has been equipped with 100 motorcycles for swift response and buggies with high mobility in difficult terrains that are as good as the Tomcar...
"MDA's preparedness for emergencies is on a level with no par and it proved its capabilities during the bloody incidents of the intifada, the Second Lebanon War and Operation Cast Lead.
"Within the framework of improving activities and adopting modern technologies MDA has replaced the old beepers with MIRS equipment featuring advanced GPS technology, the result of a unique development by MDA. The new technology makes it possible to locate volunteers in an efficient and swift manner in any place in the country, thereby shortening the response times significantly, which is crucial to saving lives.
"According to the decision of the State of Israel and differently than with the other security and emergency forces, financed by the State, MDA has to maintain its essential services for those who need them, by means of remuneration. Thus the organization can provide the various services it offers - dispatching centers, increasing the number of ambulances and MICUs, improving the professionalism of its teams and the quality of its services. In addition, the funds collected serve for the organization's deployment and preparedness for national challenges, training the public and enriching it with the knowledge required for coping with different emergency situations...
"As for the proposal of Prof. Rivkind....,there is a no more appropriate response than that Deputy Health Minister Litzman, who during his visit at MDA [headquarters] said he had no doubt that [it] was the decisive professional factor in everything related to emergency medicine in Israel and all the others should work according to its professional guidelines and criteria."