Amid northern jitters, Haifa’s fortified underground hospital readies for war

Prepared in just 36 hours, 2,000-bed medical facility in Rambam parking garage can house 8,000 people, operate self-sufficiently for three days in case of nonconventional warfare

Renee Ghert-Zand is the health reporter and a feature writer for The Times of Israel.

  • Medical staff prepare the the Sammy Ofer Fortified Underground Emergency Hospital at Rambam Medical Center in Haifa following the outbreak of war, October 11, 2023. (Courtesy of Rambam)
    Medical staff prepare the the Sammy Ofer Fortified Underground Emergency Hospital at Rambam Medical Center in Haifa following the outbreak of war, October 11, 2023. (Courtesy of Rambam)
  • Soldiers help prepare the Sammy Ofer Fortified Underground Emergency Hospital at Rambam Medical Center in Haifa following the outbreak of war, October 11, 2023. (Courtesy of Rambam)
    Soldiers help prepare the Sammy Ofer Fortified Underground Emergency Hospital at Rambam Medical Center in Haifa following the outbreak of war, October 11, 2023. (Courtesy of Rambam)
  • The Sammy Ofer Fortified Underground Emergency Hospital at Rambam Medical Center in Haifa was prepared for receiving patients following the outbreak of war, October 11, 2023. (Courtesy of Rambam)
    The Sammy Ofer Fortified Underground Emergency Hospital at Rambam Medical Center in Haifa was prepared for receiving patients following the outbreak of war, October 11, 2023. (Courtesy of Rambam)
  • Soldiers help prepare the Sammy Ofer Fortified Underground Emergency Hospital at Rambam Medical Center in Haifa following the outbreak of war, October 11, 2023. (Courtesy of Rambam)
    Soldiers help prepare the Sammy Ofer Fortified Underground Emergency Hospital at Rambam Medical Center in Haifa following the outbreak of war, October 11, 2023. (Courtesy of Rambam)
  • A soldier helps prepare the Sammy Ofer Fortified Underground Emergency Hospital at Rambam Medical Center in Haifa following the outbreak of war, October 11, 2023. (Courtesy of Rambam)
    A soldier helps prepare the Sammy Ofer Fortified Underground Emergency Hospital at Rambam Medical Center in Haifa following the outbreak of war, October 11, 2023. (Courtesy of Rambam)

It may look like a garage, but it’s much more than that. Where patients, visitors, and staff at the Rambam Health Care Campus in Haifa usually park their car is also a 2,000-bed fortified underground hospital in times of war, such as the one in which Israel now finds itself.

For the first time since its opening in 2014, the Sammy Ofer Fortified Underground Emergency Hospital was fully converted this week in case of an outbreak of hostilities with Hezbollah and other terrorist groups on Israel’s northern borders.

As the north’s only tertiary care hospital (providing care from certain specialists) and level-one trauma center, Rambam must be ready.

Shortly after the murderous assault and missile barrages on Israel by Hamas terrorists from Gaza, which began on Saturday and have resulted so far in more than 1,300 dead Israelis and over 3,000 injured, the Health Ministry instructed Rambam’s leadership to put staff and IDF personnel into action to convert the 1,500-vehicle parking garage into a hospital.

The job took just 36 hours, and with the work complete, patients can be transferred from the aboveground wards as soon as the word is given by authorities.

In 2006 during the Second Lebanon War, Rambam operated completely aboveground and was not sufficiently protected when 60 rockets fell within a half-mile radius of it.

“The hospital’s management decided that this could not happen again,” said Rambam’s general director and CEO, Prof. Michael (Miki) Halberthal.

Rambam Health Care Campus general director and CEO Prof. Michael Halberthal, October 2023. (Courtesy of Rambam)

“As part of our commitment to treating patients in every scenario, it was necessary to build an area where we could do that during a military confrontation, be it conventional or nonconventional,” he said.

It took eight years to raise funds, and design and build the most innovative and largest such facility in Israel. It has 24 operating rooms and all other services and equipment to care for patients.

Thousands of tourists and medical professionals from around the world have come to see it.

Since its opening in 2014, regular drills have been staged to keep staff prepped for a real event, as is happening now.

In the meantime, at least some of the staff have had experience working in the fortified area.

“During COVID we used the underground hospital to treat COVID patients and isolate them from the rest of the patients in the aboveground hospital. But that was a limited use of the facility,” Halberthal noted.

This week, all three levels — 20,000 square meters each — have been set up to house patients already being treated at Rambam, as well as others who would be brought in by ambulance or helicopter.

Halberthal said he expects most of them would be civilian and military war casualties in need of Rambam’s trauma expertise.

Patients with medical issues could be taken to community hospitals in other cities in the north, such as Nahariya, Safed, and Tiberias. Those hospitals have already announced that they have moved their operations either underground or into fortified aboveground areas.

He noted that Rambam has already received 50 patients from the heinous Hamas attacks in the south, 11 of whom are still hospitalized. They mainly suffered bullet and shrapnel wounds.

Should Halberthal receive instructions to evacuate the aboveground buildings, the patients and staff would have to all move underground in eight to ten hours.

“It has to be very fast. Those are our orders,” he said.

The northern border has seen several successive days of skirmishes, and the hospital transfer process was kicked off Wednesday evening, when alerts went off over what was thought to be a drone invasion from Lebanon. However, when it turned out to be a false alarm, Rambam halted the transfer of patients and announced that all regular services and activities would take place as usual on Thursday.

Should the fortified underground hospital have to shift into full operation during intense warfare conditions, it would be able to house up to 8,000 individuals — patients and staff. There would even be a daycare center for employees’ children.

“We can be there for a really long time… In case of biological or chemical warfare, we can close the doors and be totally self-sufficient for three days without any help from the outside. We have all the electricity, water, food, gases, and oxygen for three days necessary for that,” Halberthal said.

He said that Rambam would prefer that intelligence information provide enough lead time to transfer all patients underground, rather than to have to do it under a surprise missile attack.

“We’d rather not have to use it. Let’s hope we don’t,” Halberthal said.

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