How to continue running a vital health system under Katyusha fire? How to guarantee that tens of medical students will proceed with their essential studies? How much does a war cost a hospital?
An article published in the prestigious US scientific journal, ACADEMIC MEDICINE, answered these questions, and stimulated great interest among hospital administrators and medical personnel who deal with trauma and health system management during crises. The article’s writers were the leadership and trauma team of Rambam Health Care Campus (RHCC). Three years after the outbreak of the Second Lebanon War, they summarized the management issues facing a large hospital under fire.
A reminder: Rambam, the largest hospital in northern Israel, supplies vital medical care services to all residents of this region. This includes oncological care, neurosurgery, delivery room facilities, emergency rooms for children and adults, and dozens of other services. During the two consecutive months of war in July-August 2006, the RHCC continued providing all those services. At the same time, it absorbed hundreds of patients from the north and the Haifa area, who had been wounded in missile attacks. As missiles landed near the RHCC itself, its medical teams treated patients in bomb shelters and protected areas within the hospital.
In summarizing the hospital’s activities, the Rambam leadership – under the supervision of hospital director Prof Rafael Beyar – found that in the 20th century, there was only one example of health centers that acted similarly to Rambam: English hospitals during WWII. These facilities continued to operate under threat of bombs, to treat soldiers wounded in battle, and to provide necessary medical services to the population.
The RHCC administrators concluded, and wrote in their article, that hospitals like Rambam must be prepared adequately if they are to stand up during attacks. These facilities must be outfitted with secure spaces that can be used for hospitalizing patients and providing treatment under fire. This conclusion is being implemented through the accelerated construction , during the last two years, of thousands of meters of underground areas that can withstand conventional or unconventional attacks.
Another issue is the loss of income during war. Rambam, for example, lost more than 40 million shekels – 10% of its annual budget – during one month of the war up. This shortfall resulted from war-related expenses and reduced income due to a sharp drop in the number of hospitalized patients.
Link to the article:
http://160.109.108.127/author-site/review?i=09013e3181b596cf&d=jwfbaltimore