Saving Terrorism Victims Before the Ambulance Arrives

In the field of medical volunteer work, Israel leads the world in innovative services. United Hatzalah of Israel is the largest independent, non-profit, fully volunteer Emergency Medical Services organization that provides the fastest and free emergency medical first response throughout Israel. Using specially equipped motorcycle ambulances and a network of more than 3,000 volunteer medics, Hatzalah helps save thousands of lives each year across Israel.

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The group provides medical treatment in three minutes or less, a critical window of time between the onset of an emergency and the arrival of traditional ambulance assistance. As a designated national security asset by the Israel Defense Forces (IDF) Home Front Command, United Hatzalah’s LifeCompass Command Center’s humanitarian services are free, universal and available 24 hours a day, seven days a week, regardless of race, religion or national origin.

Eli Beer is the CEO of United Hatzalah. While working as a young EMT in Jerusalem, he recognized that heavy urban traffic and narrow streets often prevented ambulances from arriving in time to save a victim. He organized a volunteer unit of EMTs within his Jerusalem neighborhood. In 2006, after the Second Lebanon War, Beer brought together more than 50 separate Hatzalah chapters to form United Hatzalah of Israel. United Hatzalah pioneered the world’s first ambucycles– motorcycles equipped with a rear life-saving box that contains a complete trauma kit, an oxygen canister, a blood sugar monitor, and an automated external defibrillator. Each of the 440 ambucycles combines a driver and a vehicle agile enough to negotiate the busy traffic, obstructions, and narrow alleys of Israel.

(Photo credit: Meir Lavi)

(Photo credit: Meir Lavi)

 

United Hatzalah was started by a Hasidic Jew in Williamsburg, Brooklyn. The group currently responds to approximately 800 calls per day. During large-scale emergencies such as the 2014 Israel–Gaza Conflict, the number jumps up to as many as 1,200 calls per day. In 2016, the organization answered more than 260,000 calls.

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Eli Beer presented a TedMed talk, in April 2013, titled, “The fastest ambulance? A motorcycle,” in which he describes how he re-imagines first-response medicine by training volunteer EMTs to respond to local emergencies and stabilize victims until official help arrives. (https://www.ted.com/talks/eli_beer_the_fastest_ambulance_a_motorcycle?). The video has been viewed more than one million times to date. During his TedMed talk, Beer said “After we started our services in East Jerusalem, Jews were saving Arabs and Arabs were saving Jews. My own father had a heart attack and was saved by a Moslem Hatzalah driver.” Of the volunteer medics, 38% are Haredi, 33.7% Modern Orthodox, 23.6% Secular, 3.1% Muslim, 1.1% Druze and .2% Christian, and .3% other.

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Although United Hatzalah’s lifesaving model has reduced average response time to three minutes, the average response time across Israel remains between 10 to 12 minutes. On sudden cardiac arrest calls—the best measure of emergency medical performance—United Hatzalah’s success in reducing response times and increasing quality of care have changed in lock step with national survival rates According to the Israel Heart Society, in the 10 years since United Hatzalah’s began, the rate of cardiac-arrest deaths has decreased by 50%. With 46.4 deaths per 100,000 people in terms of coronary-related mortality, the World Health Organization reports that Israel ranks 12th best out of 192 countries.

United Hatzalah partnered with NowForce to create a proprietary mobile dispatch application to receive calls, assess the unique capabilities, mobility, and equipment of the closest volunteers, and then route the most appropriate medics to a given emergency. Today, the five closest volunteers receive alerts on their mobile phone through the NowForce command-and-control application and are guided on the fastest route.

During the high-profile abduction and murder of three Israeli youths in June 2014, United Hatzalah responded with SOS, a one-swipe emergency mobile alert application developed in conjunction with NowForce. SOS sends a distress signal to United Hatzalah’s 24/7 dispatch center and also transmits the user’s GPS coordinates to law enforcement officials. The system replaces a process that may otherwise require days of legal maneuvering and functions as an emergency safety and security alert system, complementing direct verbal communication with police, fire, or medical emergency dispatchers.

United Hatzalah volunteers assist fire and rescue services in Haifa

United Hatzalah volunteers assist fire and rescue services in Haifa

Daniel Katzenstein, the Director of Donor Communications with United Hatzalah, offered his comments on the technology and medicine scene in Israel. “If necessity is the mother of invention then self-reliance is the father and the culture of innovation is its incubator. Israel has been forced to rely on the intellectual capital of its human resources to compensate for its relative lack of natural resources as it struggles to survive in the region,” Katzenstein said. “The outcome has been the technological advances that functions as force multipliers and resource optimizers in key survival fields such as military/security, water/agricultural and bio/med tech.”

United Hatzalah - IDF Collaborative exercise (Credit: Ephraim  Greenwald - Media Division United Hatzalah)

United Hatzalah – IDF Collaborative exercise (Credit: Ephraim Greenwald – Media Division United Hatzalah)

Pertaining to United Hatzalah, he added the company has “a very flat sense of hierarchy with that Israeli sense of openness that allows all elements of the organization to float their ideas towards management. If a field medic from Ashdod comes up with a better solution for a medical problem, the solution is rapidly evaluated internally tried and tested in the field and then either modified to final implementation or rejected. If a computer programmer comes up with an app or integration solution that can reduce response time and thereby save lives it will be fast-tracked in a real-world environment as quickly as possible.”

I asked Katzenstein about Israeli military training as a springboard for science, technology, and medical innovation. “I would focus more on the mindset than the training. The Israeli military encourages innovative thinking in the problem-solving process from idea generation all the way through to implementation. With so much to risk if you are behind on the technology curve, calculated risk taking is encouraged. United Hatzalah’s passion to find the fastest, highest quality and most efficient method to provide lifesaving emergency medical intervention is driven by a similar level of intensity. We have actively recruited and advanced key operational personnel from the ranks of relevant fields in the IDF.”

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Israeli citizens utilize many of the new innovations created within its own healthcare environment such as United Hatzalah of Israel and provide financial and emotional support. “United Hatzalah is very close to the emergency healthcare end user particularly when they are in their most vulnerable stage, the moments after a terror attack, car accident or other medical emergency,” Katzenstein said. “Once the citizens of Israel experienced near immediate emergency medical response due to the innovation of ambucycles, a revolutionary GPS colocation dispatch app and an intelligent distribution of committed volunteers responding from within the community, all stakeholders in the Israeli medical environment took notice and applauded its implementation. The grass-roots approach to overcome logistical, administrative and pessimistic obstacles was far more effective and faster than a formalized top-down approach.”

What’s in the future for United Hatzalah? “Right now we are working on exporting our lifesaving model and technology to foreign countries. United Hatzalah of Panama was our first direct international adaptation in a Jewish community. Our activities and consultations in Brazil, Lithuania, India and others also bore significant impact. The current adaptation of United Hatzalah as United Rescue for the general community in Jersey City NJ has been an encouraging development and is a springboard to many other American and foreign cities interested in the model. If the light unto the nations we carry is a flashing red strobe so be it.”

Israeli medics from United Hatzalah train Panama United Hatzalah how to deal with a mass casualty incident (MCI).

Israeli medics from United Hatzalah train Panama United Hatzalah how to deal with a mass casualty incident (MCI).

During the March 2015 American-Israel Public Affairs Committee (AIPAC) Policy Conference—the largest yearly gathering of the pro-Israel movement in the United States—United Hatzalah was honored as a featured innovator. AIPAC’s Innovation Showcase was presented before 16,000 attendees and serves to highlight emerging technology developed in Israel but with worldwide impact. Eli Beer, on behalf of United Hatzalah, has received numerous international accolades, including the Israeli Presidential Award for Volunteerism in 2011 and the Institute of International Education’s Victor J. Goldberg Prize in 2013.

“I guess you could call this a lifesaving flash mob and it works. We all want to be heroes,” Beer said. “We just need a good idea, motivation, and lots of chutzpah, and we can save millions of people that otherwise would not be saved.”

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I asked Beer what has set the scene for technology and medicine in Israel. “Israel, unfortunately, is disposed with endless challenges since its establishment until today,” Beer said. “Unfortunately, in the past two decades, terrorism has challenged Israel and medical services in many different ways, forcing us to think out of the box and find and create solutions to these challenges resulting in innovative technology, operational solutions and efficient implementation and execution.”

During our discussion, I asked Beer about the distinctive characteristics of Israel in Medicine and Biotech that differentiates it from the rest of the world? Beer replied, “I think it goes back to the Start-Up Nation, in High-tech and Biotech. I think that the Israelis, in general, are thinking out of the box and after high school, they go to do their army service that puts the reality burden on them forcing them to think and operate more creatively, in an environment of creativity and innovation and not just standing by and waiting to see what happens. By nature, Israelis seek new solutions throughout all areas of life and Biotech is no exception.”

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Beer offered his take on unique ways of coming up with creative solutions in his company. “Our organization is unique in that we provide emergency medical treatments on a community level,” he said. “We always are looking for ways to minimize response times and maximize the treatment and care provided. We have both medical and IT people working together to develop both better medical solutions and technological logistical solutions.”

“With the Israeli need to innovate since 1948, as the country was mostly desert, Israel has had a springboard to ‘try’, everything could be possible in a growing society and creativity has flourished,” Beer said. “In the past 3 years over 80 companies were funded by one VC alone. There are many multiples of this figure with many buoyant buy-outs.”

I asked Beer about the necessity of underground operating rooms at Hadassah hospital and other medical centers. Beer replied, “Reality, very simple. Every 2-3 years, there is a war in which mortars and missiles are shot all over Israeli, from up north in Lebanon or in the south from Gaza, making the Israeli home front a place regularly under attack. Underground shelters and operating rooms have been built to protect the people in Israel and continue with operations as normal during such attacks.”

When asked about the most important things he is working on right now, Beer replied, “Saving lives,” he said. “And bringing response rates from three minutes to 90 seconds.”

 

(The above was written by Robert A. Norman, and was previously published on http://www.thecuttingedgenews.com/. This version has been updated from the original to reflect accurate numbers and titles of personnel within the organization.)

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