Haifa, Israel – Haifa Hospital Goes Underground To Practice For Mass Casualty Attacks

Haifa, Israel – The elevator doors at the underground parking lot at Haifa’s Rambam Hospital opened in mid-June to reveal a frantic scene: Injured soldiers lying on hospital beds awaiting triage; doctors and nurses going from patient to patient, and soldiers from the IDF Home Front Command straining to assess the mass casualty situation.

The above scenario is not real. It is a drill at the Underground Emergency Hospital, at the Rambam Health Care Campus in Haifa.

The fortified underground emergency hospital was built between 2008 and 2014 at a cost of NIS 480 million ($130 million) as one of the lessons of the Second Lebanon War. During the 34-day conflict with Hezbollah, as the north of Israel came under a daily barrage of missiles, Rambam operated under constant threat.

The traumatic experience led Rambam’s Director Dr. Rafael Beyar to plan and build the world’s largest and most advanced “fortified hospital:” Three floors of Rambam’s parking lot can be transformed within 72 hours into a 2,000 bed underground hospital designed to withstand biological, chemical and conventional attacks.

The drill simulates the apocalyptic scenario of a massive missile attack on Haifa with the hospital also sustaining a hit. Medical and auxiliary staff are trained to evacuate the hospital wards in less than two hours. Upstairs, doctors check the patients and decide who can be released and who must remain hospitalized. Those who must stay are transferred in their beds and taken to safety below ground.

One floor underground, dozens of ambulances bring the injured, in this case soldiers and inflatable dolls, who receive first aid and are assessed by triage nurses.

“We are drilling an actual scenario of war,” says ophthalmologist Dr. Yinon Shapira. “The drill is a massive logistical operation. Everybody in the team needs to know what his job is according to the protocol. The underground hospital has all the facilities a regular hospital has, and it can sustain itself for a very long period. We have everything we need and it’s all state of the art.”

In the underground hospital’s command center, which is being tested for the first time after being unveiled just last month, representatives from the Home Front Command, ambulance services, police, the Health Ministry’s emergency division, nurses and Rambam’s director of emergency situations, Erez Carmon, sit around a long table monitoring the flow of data.

“The command center gives us the ability to control all the functions of the hospital and to have a complete view of all critical aspects of the number of casualties which are brought to the hospital. It is a significant contribution to our resilience,” says Carmon.

Two hours into the drill a voice sounds over a megaphone to call it to an end. Michael Halbertal, Rambam’s Deputy Director says the exercise went beyond his expectations.

“Following the Second Lebanon War, when we were unprotected and the hospital, beside treating casualties, was under missile attack, the hospital management understood that we have to provide solutions to all scenarios. The drill checks our capabilities and we see that we have at least more capabilities that we even checked in this drill,” Halbertal told Tazpit.