A multi-vehicle collision involving a garbage truck, a bus and three cars, on Route 443 on Thursday, triggered a rescue effort that ultimately enlisted all of the civilian emergency medical response teams for both the Jerusalem and Ayalon districts. Two people were killed and 29 were injured in the collision, which occurred between the Ofer army base and the Maccabim Checkpoint in the westbound lanes of the major Jerusalem-Tel Aviv artery. Traffic was stopped completely as rescue workers struggled to free three victims of the crash who were trapped in the wreckage. The Tel Aviv-bound side of the road was not reopened until the late evening hours. Itzik Ben Aharon, regional manager of MDA's Ayalon Region, was in charge of the medical response teams at the site and said that the collision was the worst that he had seen in the area in the past year. "It was a very difficult collision to respond to," Ben Aharon said. "It involved a very large number of victims, and tied up all of our available ambulances." 15 ambulances - including five advanced trauma support vehicles - and one mass casualty mobile unit - a specially-outfitted vehicle funded by donations to provide logistic support for such incidents - responded to the call. The driver of the garbage truck was killed immediately, and the second victim, a Modi'in Illit resident, was critically injured and succumbed to his injuries after an hour-long rescue attempt. Three others were moderately injured, including one of the victims who was trapped in the wreckage and rescued by emergency crews. The rest of the injured, mainly passengers on the bus, were evacuated with light injuries to Assaf Harofeh Hospital, near Ramle, and Shaare Zedek, Hadassah Ein Kerem and Hadassah Mount Scopus Hospitals in Jerusalem.. The initial investigation indicated that the collision occurred when the garbage truck's driver lost control of his vehicle and swiped the side of a private vehicle, crushing it into the safety rail on the side of the road. Two other cars and a bus operated by the Superbus company that services the Modi'in area then collided into both vehicles. Emergency personnel at the scene said that speed appeared to be a major factor in the collision, which left mangled vehicles strewn across the highway. Police later revealed that it was the garbage truck driving on the shoulder at an excessive speed that caused the accident. Hours later, 11 people were lightly injured in a collision between a bus and a car in Rehovot.