Northern hospitals model coexistence as they prepare for a third Lebanon War

NAHARIYA — With Hezbollah firing rockets and drones into Israel almost every day since October 8, medical personnel at the two hospitals closest to Israel’s northern border already sense what it’s like to be under siege.

For the past nine months, the staff at Galilee Medical Center in Nahariya and Ziv Medical Center in Safed have treated soldiers and civilians wounded by attacks from the Iranian proxy terror group, taken care of babies and children, and performed emergency surgeries in fortified rooms or underground bunkers.

Galilee Medical Center director Prof. Masad Barhoum said the hospitals are “preparing for the Third Lebanon War.”

Both Barhoum and Prof. Salman Zarka, director of Ziv Medical Center, say their hospitals are on “heightened alert.” The staff is stockpiling food and supplies in case the hospitals become “separate islands” during a potential war due to infrastructure and communication shutdowns, mass casualties and destruction.

Hezbollah has fired thousands of rockets, missiles and drones into northern Israel, saying it is doing so in support of Gaza amid the war there. That war began on October 7, when some 3,000 Hamas-led terrorists burst across the border from Gaza into southern Israel, killing some 1,200 people and seizing 251 hostages amid acts of brutality and sexual assault.

So far, skirmishes in the north have resulted in 12 civilian deaths on the Israeli side, as well as the deaths of 17 IDF soldiers and reservists.

Galilee Medical Center moves underground

Within days of October 7, even before the Health Ministry and the IDF Homefront Command issued directives for the hospitals, the staff at Galilee Medical Center six miles from the northern border moved babies in the neonatal intensive care unit down to the hospital’s fortified underground facility.

“We came down here even before the first rockets were fired from Lebanon,” said Dr. Vered Fleisher Sheffer, head of the neonatal department. “We couldn’t take chances with little babies.”

Barhoum then instructed staff to move other critical departments such as the dialysis and oncology departments. Later in October, other departments were transferred, including the surgical, internal medicine, pediatrics, and women’s departments.

All the center’s departments are now in protected rooms, including the general intensive care unit, the emergency room, and the delivery rooms, which are aboveground.

The hospital has close to 800 beds “in normal times,” said a hospital spokesperson, but most of them are now empty.

In the subterranean complex, there are 450 beds. The Health Ministry has instructed the hospital to remain at 30 percent occupancy, “to be prepared for any scenario on the northern front,” the spokesperson said.

So far, the hospital has treated about 1,500 wounded, most of them soldiers.

The working conditions underground are “very difficult,” neonatologist Sheffer told The Times of Israel as medics moved through the neonatal unit crowded with incubators, ventilators, monitors, parents, and social workers.

The war, however, “is no excuse to lower our standards of care,” she said, as medics in the neonatal unit practiced a drill to resuscitate a baby.

The hospital’s surgically clean underground complex juts out in a maze of corridors with the compact feel of a submarine. The lights are dim, the machinery hums and the air smells different.

“There’s a special air-filtration system to protect us against biological and chemical weapons,” said Dr. Uriel Trahtemberg, director of the General and Respiratory Intensive Care Department of the General ICU, walking through the ward and pointing out a shower that could be used in case of such attacks.

A few minutes later, Trahtemberg stopped before another ward and raised his arms to show the double-blast doors in case of rocket attacks.

During the 2006 Lebanon War, Hezbollah fired close to 4,000 rockets into Israel, resulting in the deaths of 49 Israeli civilians and 121 IDF soldiers.

The underground facility, smaller than it is now, was used throughout that war. It was orginally built in the late 1990s under the leadership of Dr. Shaul Shasha, then the hospital’s director, who anticipated the threats in the region.

Back then, “people called him crazy,” according to a hospital spokesperson. But during the war in 2006, Hezbollah rockets damaged the hospital’s fourth-floor ophthalmology ward.

“In clear sight from our hospital windows sits a still looming threat,” Barhoum wrote in The Times of Israel in 2016. Today, he said, “Hezbollah might fire hundreds and maybe thousands of missiles at the Galilee.”

“We have been preparing for this since 2006,” he said. “We must be ready for all scenarios.”

Ready for a large-scale war in Safed

In Safed, Ziv Medical Center’s Zarka said the hospital is ready for a large-scale war.

The hospital is about seven miles from the Lebanese border and a little more than 50 miles away from the border with Syria. In 2013, as head of the IDF Northern Command’s Medical Corps, Zarka sent wounded Syrians to Ziv Hospital for care; in 2014, he took over as its director.

Since October 7, the hospital has taken in more than 290 wounded civilians and soldiers from inside Israel’s borders.

In the next few weeks, Zarka said, the hospital will be ready as a Level 1 trauma center, which means that it will have the capabilities to perform neurosurgery and thoracic surgery to treat all war casualties without transferring them to another hospital.

Set on one a hill overlooking the Galilee, the hospital appears almost pastoral, its entrance lined with large evergreen trees and people mingling at a café near its front door. Yet in the valley below, the landscape is already scarred by Hezbollah attacks, with charred grass and trees with burnt, brown leaves.

As the war moves closer, Zarka said that the facility has been combining care for residents of the north with readying for a larger war.

“In case we become a ‘separate island,'” Zarka said, “we have food, we have medication, we have oxygen to last for several days.”

MDA key after ‘man-made earthquake’ of Oct. 7

Both hospital directors coordinate with Magen David Adom (MDA) staff on “worst-case scenarios,” said MDA chief of staff Uri Shacham.

If the Galilee region is attacked and hospitals become “separate islands,” Shacham said, MDA will utilize its fleet of about 600 medicycles — medically equipped motorcycles and motor scooters — to deliver blood from MDA’s blood vault, which is protected against chemical, missile, and cyber attacks, to deliver it to northern hospitals.

Shacham said that MDA understood that “every 100 or 150 years, there’s an earthquake,” and the organization had been preparing for that possibility.

Instead, he said, there was a “man-made earthquake” on October 7. He believes a war with Hezbollah would bring “similar challenges.”

Shacham said that if communication networks are damaged, the motorcyclists will serve as couriers to deliver information.

“We’re going to go back to basics,” he said, making sure that “information is gathered, even if communities don’t have cellular reception or landlines.”

If roads are destroyed, Shacham said MDA has all-terrain vehicles, known as Unimogs, that can travel off-road to reach their destinations.

Zarka said that he has directed his staff to have “their bags packed,” and to be prepared to stay at the hospital, working 12-hour shifts. Hospitals in the center of the country will also provide more staff if needed, Zarka said.

If they are unable to reach the warzone, Shacham said, then MDA will provide one of its 23 bulletproof ambulances to transport personnel.

Meanwhile, as a possible war looms, for the staff at both hospitals work continues.

At Ziv, Zarka said that the staff is composed of “Jews, Christians, Muslims, Circassians, Druze, and Bedouins working as a family to save the lives of everyone here.”

That sense of solidarity is echoed by the staff at Galilee Medical Center.

“The closeness to the border and very tense conditions could have made a tinderbox among staff and patients,” said Trahtemberg. “We’re stronger and more cohesive. We’re working together shoulder to shoulder to do good. That’s a very powerful message.”