An alarm sounds and the clock begins ticking down at the Rambam Health Care Campus in Haifa.
In just 72 hours, the largest hospital in the north of Israel moves all of its patients and staff into a secure underground facility and readies itself to take in the wounded.
This is the challenge that Rambam, through the opening of its underground hospital a little more than a year ago, hopes to never encounter, but is prepared to meet nonetheless.
During the Second Lebanon War in 2006, approximately 60 rockets landed within a kilometer of the hospital. Over the course of 34 days, 792 wounded were treated in the Rambam emergency room.
“It was very stressful conditions because a hospital under fire has to continue to treat patients and soldiers and civilians and all kinds of people,” said Dr. Rafael Beyar, director of Rambam. He convened his board and together they decided that the hospital needed a secure location to treat patients during times of conflict.
In consultation with the Israeli government, Beyar and his team settled on an underground facility that in 72 hours can be converted from a three-level 1,500-vehicle parking garage into a 2,000 bed hospital set 16.5 meters into the earth. It is by far the largest facility of its kind in the world.
“It’s a unique facility. There’s a need for that,” Beyar said, adding after a pause, “I hope that the need will not be used ever, but we’re prepared to treat patients under fire.”
The engineers who designed the Sammy Ofer Fortified Underground Emergency Hospital —named for the late Israeli shipping magnate who gifted nearly $20 million for the project — journeyed to Singapore to study that Asian country’s convertible hospital.
Though the Singapore hospital offered a starting point, said Beyar, to meet Israel’s needs many adaptations and innovations were necessary.
“We had to build a surgical suite into the underground hospital; we had to build close 100 intensive care beds,” said Beyar. “We have also to include close to 100 dialysis units.”
These challenges were in addition to figuring out how to provide electricity, water, food supply, showers and toilets that can operate sealed off from the rest of the world for three full days at a time.
But innovation has long been part of the hospital’s DNA. The hospital has a partnership with the Technion, considered to be the MIT of the Middle East, and is a global leader in cardiovascular and neuro-surgery breakthroughs. (Just prior to his conversation with Washington Jewish Week, Beyar met with the president of Johns Hopkins University to discuss one such breakthrough.)
Some of that medical technology has been used to treat Syrian patients. Dr. Yoav Leiser, a maxillofacial surgeon, led efforts to create a titanium lower jaw, created on a 3D printer, for a Syrian man who lost the lower half of his face to a projectile during his home country’s ongoing civil war.
Beyar estimated that in the last year, Rambam has treated more than 100 injured Syrians who cross Israel’s border through the Golan Heights.
“Rambam is an island,” said Beyar. “Everyone works together, everyone is friends. That’s how our neighbors from around us continue to be treated. We get patients from Syria, from the West Bank and Gaza. It’s really an island of coexistence in peace and it’s a model for how people should act in the future.”
Flexibility is also key. Beyar explained that the bunker can be sectioned off depending on the need. Hospital staff and the Israel Defense Forces coordinate on drills to simulate how the hospital should react in the event of an attack or national emergency.
Though more work continues on the facility, Beyar said “we are really safe and ready for anything that can happen. Rambam has always been a place of security for people in the North in times of peace and in times of war.”