A heavy burden of responsibility

Giving up his specialty as a pediatrician, Col. Ram Sagi looks back at the first 15 months of his service as senior physician in the IDF’s Southern Command.

Col. Dr. Ram Sagi 370 (photo credit: Judy Siegel-Itzkovich)
Col. Dr. Ram Sagi 370
(photo credit: Judy Siegel-Itzkovich)
Israel Defense Forces Col. Ram (“Rami”) Sagi formally has responsibility for the health of soldiers throughout the Southern Command. But in fact, his purview often includes civilians in the south, the whole country and even around the world.
The Southern Command covers 60 percent of the State of Israel from Kiryat Gat down to Eilat, but only 10% of its population.
The 45-year-old pediatrician and Kfar Saba resident – who is married and the father of four – has been in the important and influential post for the past 17 months and takes the job very seriously. During a 90-minute interview with The Jerusalem Post at the IDF’s suggestion, Sagi spoke often about his mission, and the heavy responsibility that weighs his thoughts during his waking hours.
He studied medicine at the Rappaport Faculty of Medicine at the Technion-Israel Institute of Technology as part of the academic program (Atuda) of the IDF after graduating from high school. Following completion of his MD, he went on to intern at Tel Aviv Sourasky Medical Center, then did a master’s degree in medical administration, pursued his medical specialty at Ben-Gurion University’s Faculty of Health Sciences and an additional master’s degree in political science at the University of Haifa.
He then returned to serve in the IDF as a brigade physician in the field as part of the infantry. He served in south Lebanon, at the Beaufort Castle in 1995, and was wounded in Operation Grapes of Wrath, the 16-day IDF campaign in 1996 to end shelling by Hezbollah terrorists of northern Israel.
He was a divisional physician in the Second Lebanon War, studied in the National Defense College and then was promoted to his current position. “I really enjoy it a lot,” he said with evident pleasure. “I feel that I am doing a lot that makes a difference.”
One of his unforgettable experiences was going as an IDF physician to Haiti to rescue wounded in the horrendous 2010 earthquake there, which measured a catastrophic 7.0 on the Richter scale, with the epicenter 25 kilometers west of the capital, Port-au-Prince. An estimated three million people were affected by the quake, and hundreds of thousands died in the disaster.
A quarter-of-a-million homes were devastated, and 30,000 commercial buildings collapsed or were severely damaged.
“Four days after the quake, we had already arrived, set up the field hospital on a football field and seen our first patient. I was in charge of pediatric medicine on the Israel medical team. We pulled people – live or dead – out of the rubble. Because we had arrived faster than nearly all other national rescue teams, our presence was critical to save lives. We treated over 1,100 victims – about a third of them children,” Sagi recalled. “Some of them were orphans and completely alone.”
First, the team treated many victims who had suffered trauma, including severe head and chest wounds.
“There were many open and closed fractures and amputation injuries and wounds that had become infected. It was so hard when I had to select the children for treatment. I went outside, in front of the hospital, to see who urgently needs to be helped first. We had to set the priorities.”
When Sky News reported on the predicament of one child named Clifford, Sagi rushed with his team to Port-au-Prince and took him to the Israeli field hospital they set up within a very short time. “He was only 18 months old, and we performed several operations on him. When he was better, we handed him over to the American team, and he was in good condition. I remember how proud we were and what prestige Israel got from our work. I still give lectures on our work in Haiti to Israelis and foreigners.”
Sagi he wanted to render assistance in the typhoonstruck the Philippines, but was not sent with the national team because he was needed as the top Southern Command physician. But even without him, the Israeli medical delegation earned high praise for their rescue and medical work among the unfortunate Filipino victims.
AS THE top medical officer in the Southern Command, Sagi keeps his own commanders informed on medical issues, deals with ordinary routines and emergencies, ensures that the necessary medical equipment and staff are available and even deals with the mental health of his soldiers. Dozens of people – not only physicians – serve directly under him.
“There are always people in the field. It’s very dynamic.
When there were swarms of locusts in the south not too long ago, some arrived at military bases and we suddenly had to cooperate with other ministries to help get rid of them,” recalls Sagi. “More routine are dogs and cats wondering through the bases.”
The Negev and Arava, with its sometimes-extreme weather – both hot and cold within hours – complicates Sagi’s work. “We have to deal with sudden flooding as well. I and my team have to make sure that soldiers are not active during severe heat and that they always have enough water so they don’t dehydrate.”
One of the vital units serving at the southern border is the Caracal battalion, a mixed battalion with male and female soldiers. Because there are substantial numbers of women, Sagi is considering the possibility that a gynecologist would visit on a regular basis to treat “women’s problems.”
As there are many Beduin living in the area – and Beduin soldiers – Sagi must be alert to their special medical needs as well. The physician is in contact with Magen David Adom and other rescue agencies. “Obviously, there are always limits on our financial resources, so we have to learn how to manage to meet the needs. We have three borders – with Gaza, Egypt and Jordan, which, thankfully, is quiet. At Ein Yahav in the northern Arava south of Hatzeva, we have set up a military intensive care unit with advanced equipment that MDA medics and paramedics use in emergency for treating both soldiers and civilians.
“We must treat soldiers, of course, but since we’re there, we are also committed to rescuing civilians as well who are in need of care. A mobile intensive care ambulance is on duty, as are military helicopters,” Sagi said, recalled an event in which some teenage girls were bitten by a yellow scorpion and were rescued under his command. “There are relatively large distances [involved], so when our help is needed, I don’t think about costs. We give medical help to anyone in the area who needs it. Later we can argue over who pays and how much. If someone is injured or wounded, it doesn’t matter if they are Israeli soldiers or civilians or Palestinians.
We give the same treatment whoever they are.”
SAGI STARTED his service in the south just three months before Operation Pillar of Defense against the Hamas-governed Gaza Strip, officially launched in November 2012 with the killing of Ahmed Jabari, chief of the Gaza military wing of Hamas. The Israeli operation began in response to Palestinian groups launching over 100 rockets at Israel during a 24-hour period and was aimed at halting rocket attacks by Gaza terrorists against the Israeli population in the south.
“The communities needed protection.
Doctors, paramedics and others rushed to the area, because that was where the action was. There was no problem getting reservists. We learn from every event,” Sagi said. “We introduced new medical technologies, from dried plasma to oxygen saturation monitors and eyeand ear-protection equipment.” Two IDF soldiers died in the operation despite valiant efforts by Sagi’s team to save them. “We helped civilians too. We always try to gain from the rescue and treatment experience in person and online. We don’t film a genuine event for privacy and security [reasons], though.”
Since the military operation a year ago, there have been other incidents such as the exposure to terrorists’ tunnels, fires and routine events. “We can’t afford to permanently post an orthopedist at every base, but I am willing to pay to get key medical personnel on time to those who need them. We recently started to bring once a month a physiotherapist to the Bahad 1 (training) base at Mitzpeh Ramon and will dispatch an orthopedist and gynecologist there too, along with an ultrasound machine and other equipment.
“In Eilat, we have a dental clinic, a dermatologist and a professional to deal with mental problems. Any soldier around the country who wants a flu shot can get it without problems.”
Because of the distances involved, said Sagi, photographs of soldiers’ skin conditions, for example, are sent to specialists who can prescribe treatment that is given by a doctor on the spot.
But the medical commander is busy dealing not only with treatment but also with disease and accident prevention and health promotion. “We want soldiers and officers to think different,” he said. Nutrition, prevention and cessation of smoking and physical fitness are prime goals for Sagi. “As a pediatrician who previously treated sick children, nutrition was quite a new field for me. We are considering clinical dietitians to advise us on a better diet for more fitness and weight loss.”
As for smoking, he agrees that there is not much sense in allowing the sale of cigarettes at military kiosks at the same time as struggling to persuade soldiers to kick the smoking habit. Sagi said he will think about putting forward a proposal to bar the sale of cigarettes at these outlets, just as water pipes (nargilas) and all forms of alcohol are prohibited there.
The “Bahad City” of training facilities that is due to begin to be populated next year will be a major step for the IDF, and specifically for Sagi. It will mean the influx of many more soldiers to the area. If a railway line eventually reaches this site and beyond to Eilat, it will be a big boost for the development of the area and medical services, Sagi added.
As the IDF launched the Hebrew University Medical Faculty’s Tzameret “military track” to produce doctors specially trained to serve in the IDF, Sagi received an academic appointment at the Jerusalem medical school to lecture there regularly.
As another way to attract more physicians into the IDF, Sagi appointed a medical adminstration of 20 people that offers jobs to new immigrant doctors. “I see this as a national project. We especially focus on newcomers from the US and the former Soviet Union, as well as returning Israelis who left for European medical schools in Romania, Hungary, Italy and Lithuania because their grades were not high enough to get into an Israeli medical school. Maybe they’ll be willing to join Tzameret and become military physicians.”