Transferring patients from the main hospital to the underground hospital. (Pioter Fliter/RHCC) (Pioter Fliter/RHCC)
Transferring patients from the main hospital to the underground hospital

Faced with the threat of missile attacks, northern Israel’s largest hospital moved underground in a drill preparing for war.

By: United with Israel Staff

The Rambam Health Care Campus in Haifa last week prepared for a massive missile attack on Israel when it took the hospital’s operations underground to the newly-opened Sammy Ofer Fortified Underground Emergency Hospital.

This unique facility, the largest of its kind in the world, normally operates as the hospital’s parking lot, but in wartime transforms into a 2,000-bed medical facility within 72 hours. In a wartime scenario, this facility becomes the regional hospital for all wounded in the north.

As part of the drill, the hospital practiced several scenarios, some based on lessons from the Second Lebanon War, when Rambam operated under continuous missile fire. That experience led to the construction of the underground facility, ensuring the ability to care for patients in a safe and secure environment.

During the first segment of the drill, the hospital operates as if it was issued an early warning placing the Haifa region on high alert, following which the hospital departments arr instructed to evacuate to the underground facility. For this drill, logistical preparations included activating air purifiers/compressors, power generators, and air conditioning systems embedded in the walls of the underground hospital/parking lot, and the deployment of toilets, temporary showers, and other patient-ready infrastructure.

Medical teams then practiced transferring patients in their hospital beds and accompanying medical equipment to designated stations underground, including the transfer of advanced life-saving equipment such as dialysis units and surgical equipment.

The innovative facility is equipped to contend with a long-term emergency situation, as the underground hospital is expected to absorb hundreds of oncology patients, pregnant women, dialysis patients and more—all of whom require ongoing medical care while the region is at war.

Normal Functioning Under Fire

The second phase of the drill involved a scenario in which missiles hit the hospital with no warning, damaging hospital departments. This exercise involved evacuating the wounded to Rambam’s Department of Emergency Medicine, which is also fortified and is able to function during wartime in its regular location. After initial triage, the wounded were then transferred to the underground hospital for ongoing care.

The third and final drill addressed the absorption of patients arriving from outside of Rambam. In this exercise, patients were transferred by ambulance to the underground hospital. Ambulances drove in via the parking lot entrance and discharged the wounded there to minimize exposure to the outside danger. The patients were received by medical teams who then transferred them to the protected emergency department via an underground elevator.

The drill also served as the test of the functionality of Rambam’s new underground Command Center from which all emergency activities were managed. The Command Center was inaugurated a month ago.

The center enables essential hospital management and expert personnel who are responsible for directing the flow of patients based on injury severity, logistical needs, and the function of vital systems. All critical information is gathered from the hospital’s monitoring systems and analyzed by a proprietary emergency software system developed at Rambam. The emergency administration team can observe above-ground activity with the help of hundreds of cameras installed throughout the hospital campus.

Observers of the drill included Magen David Adom officials, the IDF’s Home Front Command, and the Emergency Division at the Ministry of Health, in addition to 22 international participants in Rambam’s 19th Developing and Organizing a Trauma System and Mass Casualty Management Course.

“After two months of dealing with an impossible scenario of treating the sick and wounded under fire [during the Second Lebanon War], we decided that this reality could not be repeated,” said Professor Rafi Beyar, Director of Rambam.

“About five years ago, the underground hospital at Rambam was inaugurated. This facility is of strategic importance for the entire northern region. I hope we will never have to use it, but if the day comes, we will be ready for any scenario,” he added.

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