News and Events

Safe Healthcare in Haifa: Rambam's Role in Wartime

Publication Date: 11/8/2023 8:00 AM

During wartime situations, Rambam Health Care Campus (Rambam) in Haifa, Israel, becomes the designated hospital for the Haifa region. In recent weeks, teams from Haifa’s Carmel Medical Center and Fliman Geriatric Hospital trained with Rambam teams to ensure a smooth transfer of patients and staff to Rambam.

Rambam staff with Fliman (top) and Carmel (bottom) medical teams. Photography: Rambam HCC.Rambam staff with Fliman (top) and Carmel (bottom) medical teams. Photography: Rambam HCC.

Rambam Health Care Campus (Rambam) is home to the Fortified Underground Emergency Hospital – the world’s largest facility of its kind – capable of caring for more than 2,000 patients. Constructed based on lessons learned following the Second Lebanon War, Rambam’s underground hospital was conceived as a regional solution for the safety of patients and hospital staff. Hence, since its completion in 2014, Rambam is the designated hospital in wartime situations.

In times of war, regional healthcare institutions without fortification will transfer patients and staff to the underground hospital. However, the actual procedures and training of teams from local hospitals, to enable transfer and care of their patients at Rambam have never been implemented – until now. Administrative and medical teams from two important healthcare facilities in Haifa recently completed a full spectrum of onsite training. The first training was provided to Fliman Geriatric Hospital (Fliman), a governmental facility. The second was given to Carmel Medical Center (Carmel), managed by the Clalit Health Maintenance Organization (HMO). Should hostilities escalate, Fliman and Carmel are now prepared and equipped for the transfer of 100 and 150 patients, respectively, and their caregivers, to Rambam’s underground hospital – ensuring continuity of care and safety.

A 1,100-bed medical center, Rambam is Northern Israel’s tertiary care center, only Level 1 Trauma facility, and the medical provider for the IDF Northern Command. In peacetime, Rambam’s fortified facility is a three-level underground parking garage. However, during extreme emergencies, such as missile, biological, or chemical threat, natural disaster, or contagion such as the coronavirus pandemic, it converts into a fully functioning fortified underground emergency hospital within 48–72 hours.

Since other medical facilities in the Haifa area have limited protected wards, transferring extremely ill patients – with their caregivers – to a safe location is critical. Professor Michael Halberthal, director general of Rambam, explains, “A lot of planning went into construction of the underground hospital. After what we experienced during the Second Lebanon War, we understood that a safe environment for patients and staff was essential. We had a vision to serve the entire northern region – even in wartime.”

The Rambam administration faced delays in having their plan approved. However, once the underground hospital was completed, the Israeli Ministry of Health appointed Rambam as the official provider of medical care to wartime casualties and critically ill patients who cannot be discharged home. The underground hospital can receive more than 2,000 patients. Of these, 1,400 are designated for Rambam patients and war casualties; the other beds will receive patients and staff from other healthcare institutions in the region. The underground facility is equipped with four operating rooms, and has areas assigned to every hospital department; it is also designed to allow continuity of healthcare to outpatients.

The training of Fliman’s and Carmel’s administrative and medical teams began a few weeks ago. The Fliman medical team was led by their hospital director, Dr. Ina Shugiyev; Carmel’s team was led by Dr. Avi Goldberg, their director general. Both teams were greeted by Professor Halberthal, who took them on a full tour of the underground emergency hospital, the Carmel delegation saw all the facilities set aside for receiving patients, triage, surgery, labor and delivery, standard patient care, and specialized care such as dialysis. They also visited the Command Center (War Room), from which all patient care and hospital activities are coordinated.

Afterward, both groups underwent training specifically aimed at the needs of their specific institutions. The medical teams developed and practiced procedures for the smooth transfer of patients and staff to designated areas in the underground hospital for Fliman (100-beds) and Carmel (150-bed). During that time, new connections were made between the employees of the different hospitals. These unique bonds will surely benefit the patients and their medical outcomes today and in the future.

Professor Halberthal, Dr. Shugiyev, and Dr. Goldberg agree: preparation and training are essential for practical and manageable solutions to the problems and obstacles encountered during emergencies. The three leaders hope that the training will not be put to the test. But if it is – they are ready to go.