July 11, 2012
Israel’s fast, free and innovative way to save lives
Minutes after the words “fainting in Mamilla Mall” appeared on his pager, paramedic Arie Jaffe was defibrillating the heart of a man lying on the floor of a Jerusalem pedestrian mall.
The patient, a man in his early 60s who had been walking through the popular Jerusalem site with his grandson, was in cardiac arrest. A nurse passing by had begun life-saving procedures, but handed off to Jaffe and his partner as soon as the pair of first responders from United Hatzalah of Israel arrived at the scene. They were lucky this time — by the time an ambulance came, the patient had a steady heartbeat and was ready to be transported to a local hospital.
Jaffe is one of a vast corps of Hatzalah’s volunteer first responders throughout Israel —Jews and Arabs, religious and secular, students and professionals. Both men and women, they live and work among the population, so whoever is nearest to the scene of a call can respond. The average response time for the organization for which Jaffe volunteers is about three minutes; Hatzalah is striving for just 90 seconds.
Shortening the time between a call for assistance, the broadcast by a dispatcher and the medics’ arrival can make the difference between life and death, and Israelis’ history of suffering terrorist attacks has brought that home as much as anywhere in the world. So while Israel’s military prowess and contributions to the high-tech world are already well known, Hatzalah’s humanitarian melding of volunteerism and health-care expertise may well be its next greatest badge of courage. Applying the classic Israeli combination of technical expertise, ingenuity and doggedness, United Hatzalah of Israel is now providing an emergency response system that regularly saves lives — and is already attracting attention around the world.
The 23-year-old organization is the creation of Eli Beer, 39, a native of Jerusalem, born on the eve of the 1973 Yom Kippur War to American-born parents who immigrated to Israel in 1969. Beer said he believes spending his first month in a bomb shelter shaped the course of his life. At just 5, “I saw the first bus ever to blow up in Jerusalem — on a Friday. … It had a tremendous impact on me, as six people were killed before my own eyes, and many kids from my school were injured,” he said.
Even as a child, all Beer wanted to do was save lives, and he remembers being frustrated that there was not a better system than waiting precious minutes for an ambulance to arrive. As a teenager, he signed up to become one of Israel’s thousands of emergency medical volunteers. Soon after receiving Magen David Adom (MDA) training, he said, he was the first to arrive in response to a call for help one day, finding a 7-year-old boy choking on a hot dog. He describes a macabre scene of bystanders trying to help by picking the boy up by his feet and splashing him with water. “It wasn’t that those present didn’t want to help,” Beer said. “No one knew what to do.”
By the time a doctor arrived, there was nothing to do but to pronounce the boy dead. That was mid-1989. By the end of the year, inspired by the New York-based Hatzalah, which Beer knew of through his parents, who were then living in America, he founded United Hatzalah of Israel, wholly independent of the American version, despite the similar name. Israeli volunteers, Beer pointed out, are accustomed to dealing with the aftermath of missile strikes and terror attacks, while the Americans (there is also a very active Hatzolah organization in Los Angeles) tend to respond to calls about physical ailments, mostly within the Jewish community, traveling by ambulance rather than the ambucycle Hatzalah volunteers often use in Israel. Hatzalah’s job in Israel is to prepare patients to be transported, and the ambulances belong primarily to MDA, Israel’s national emergency medical, disaster, ambulance and blood bank service.
What Beer launched in Jerusalem in 1989 with 20 volunteers running to calls on foot now boasts 1,800 first responders nationwide, ranging in age from 21 to a 78-year old woman who lives on a small kibbutz and responds to emergencies 24/7. Hatzalah’s first-response system has become so successful that Beer is now helping to replicate the organization in other countries, including training volunteers in Panama, Argentina, Venezuela and Brazil.
In Brazil, Beer’s group assisted with the opening of United Hatzalah, creating protocols of training, guidance and equipment. Hatzalah gave the Brazilians its Life Compass technology, which guides medics to people all over the country.
For all this, Beer received a Young Global Leader award last year for his work with United Hatzalah, presented by Jordanian Queen Rania at the Davos World Economic Forum (WEF). He also received the Presidential Award for Volunteerism from Israeli President Shimon Peres. He has spoken about social entrepreneurialism at conferences in Morocco in 2010, and Davos in 2012, presenting United Hatzalah as a model for other countries to emulate. Recently, his vision and leadership skills were recognized by the WEF, which led to a scholarship to attend a WEF-sponsored management program at Harvard University’s John F. Kennedy School of Government.
To train and supply each of Hatzalah’s medics can cost upward of $5,000, and as much as $7,500 for those who are provided with defibrillators. An ambucycle costs $26,000, including the helmet, siren, medical gear, license and insurance. Despite the pressure of fundraising for an organization with an annual budget in excess of $5 million — 90 percent of which comes from charitable donations and 10 percent from the government and municipalities to support the cost of local training — Beer said he believes Hatzalah remains the only emergency medical service in Israel that does not charge for any of its services. The majority of donations come from Batya — Friends of United Hatzalah in the United States (including a recently opened Los Angeles branch) – as well as from Canada, the U.K. and France. Israelis donate 30 percent.
Many believe that Hatzalah is simply a Charedi enterprise. Indeed, Beer, himself an Orthodox Jew, sees Hatzalah as a model for training Charedi men, whose employment lags far behind their non-religious counterparts. In Israel, ending the Charedi exemption from army service and integrating of Charedim into the workplace has taken center stage — in mass rallies on the streets of Tel Aviv, in a notable Supreme Court ruling and in government debates. Beer also sees United Hatzalah as a prototype for addressing Charedi national service: “We initiated a program four years ago through which Charedim could satisfy the requirement of army duty or national service as a citizen volunteer with United Hatzalah,” he said.
I called Nissim Hassett to talk about his national service with United Hatzalah, which he did at the same time he was studying law. Now 32 and married, Hasset spoke only two hours after the birth of a son. For him, Hatzalah was the answer, he said. “The main reason I joined is because I wanted to save lives, but as a yeshiva student, I couldn’t go on to work unless I joined the army first. But the army itself isn’t suitable for the ultra-Orthodox for many reasons, including [being given time for] prayers,” Hassett said.
While living in the area of Jerusalem known as “the seam” — where east and west meet, an area that between 1948 and 1967 was a no-man’s land separating Israel and Jordan — he would regularly go on calls for Hatzalah into East Jerusalem’s Arab neighborhoods of Sheikh Jarrah and Wadi Joz, his unambiguous appearance as a Charedi Jew notwithstanding. Today, Hassett works as an intern in a Tel-Aviv law firm. By year’s end, he will take the bar exam.
Beer said more than 60 Charedi volunteers have completed their national service obligation with United Hatzalah and have then gone on to find jobs. But Beer stresses that Hatzalah, in fact, also offers a remarkable picture of cooperation among the nation’s disparate communities. In Jerusalem, for example, most Hatzalah volunteers come from the Charedi community, but secular Jews and Israeli Arabs participate as well. In Eilat, Ra’anana and elsewhere in the country, most of the volunteers are Orthodox.
For example, Murad Alian, 39, an Israeli Arab, first met Beer 22 years ago, when they trained together in the MDA medic course. Today, Alian considers himself a close friend of Beer, saying he is proud of the volunteers who work for United Hatzalah.
“Some of our volunteers work in the Old City [of Jerusalem],” he told The Media Line. “If we have a CPR [cardiopulmonary resuscitation call] we — Arabs, Charedi and secular Jews — meet each other in the house of a patient. We work in harmony, in a wonderful way, to do all the treatments together.”
Hatzalah’s ambucyles offer some advantages, too. For an Israeli ambulance to enter certain neighborhoods in East Jerusalem, it must wait to be accompanied by a military escort before it can travel to the site of the call for help. This often means it takes extra time to arrive. Meanwhile, United Hatzalah volunteers are able to respond more quickly traveling by private car or ambucycle.
Alian said that more than 80 Israeli Arabs currently volunteer for United Hatzalah, and another 30 are training to be first responders. By day, he works at Hadassah University Hospital — Ein Kerem, doing medical translations between Hebrew and Arabic.
“All our blood is red,” he remarked. “We paramedics have trained in courses together; have been at numerous scenes with multiple bus explosions. We meet up for coffee after work, and our families have visited each other.”
Beer said it’s not uncommon for one volunteer responding to a call — rushing from his synagogue to the scene of a car accident on a highway — to meet up with a second medic who ran from his mosque — with the two arriving simultaneously.
“Within minutes,” Beer said, “the two first responders, both wearing the same Hatzalah uniform, are working side by side on patients. It’s a scene more Israelis need to see.” Asked whether having men and women first responders work together has ever caused awkwardness at the scene of a call, Beer emphatically replied, “Never happens.” Currently, however, only about 50 women work in United Hatzalah, he said, because so many calls come “at 3 or 4 o’clock in the morning, and a woman can often find herself on a call where someone has died, and she would find herself all alone.”