A hospital that goes beyond

‘We are prepared,” said Yoel Har-Even, vice president of global affairs at Sheba Medical Center, “and we always live with a sense that something will happen.”

Since the outbreak of the Israel-Hamas war more than a year ago, Sheba’s sense of preparedness has enabled it to treat more than 2,000 casualties of the war, which includes soldiers and civilians.

Recently, Har-Even – who served in the IDF for 26 years, reaching the position of assistant to the surgeon general – spoke with this writer over Zoom and recounted some of the lessons learned by Sheba staff over the past 14 months and outlined some of Sheba’s other activities.

Of the 2,000 war casualties that were brought to the hospital, said Har-Even, four died – a survival rate of close to 100%.

“This number is amazing,” he noted, “but it’s due to the efforts of many, many people. It’s not only the hospitalization system – it’s the IDF first response teams that stop the bleeding and give blood in the field. No one else in the world is giving fresh blood at the point of injury.

“It’s the rapid evacuation by the IDF’s Unit 669, that is willing to land in every corner of Gaza or Lebanon, risking their lives and saving people by landing very close to the point of injury, and then transporting them to Sheba, where they receive trauma-level care in less than one hour. Add to that the treatment efforts of our surgeons and nurses. It’s a team effort.”

The initial civilian casualties that were brought to Sheba on October 7 and 8, explained Har-Even, were primarily suffering from hand and finger injuries sustained when attempting to lock safe room doors against Hamas terrorists, who shot through the doors. These injuries were complicated and compounded by the fact that many of the injured were unable to be evacuated for hours to the hospital due to the chaos.

Many of the military casualties from the war in Gaza, Har-Even said, were unlike those from conventional military conflicts where artillery and tank forces are pitted against each other. Instead, he explained, most of the casualties occurred in dense, narrow streets in an urban environment. As a result, there were a great deal of blast injuries and casualties from sniper fire.

Lessons learned

Revisiting the theme of preparedness, Har-Even said that the Sheba medical team learned from the Second Lebanon War (2006) and the 2014 Gaza conflict that the mental component of battle is significant.

“We understood that we need to address and treat the mental health of wounded soldiers as soon as possible. As soon as the helicopters land bearing a wounded soldier, we send a psychiatrist for intake and start the process of recovery. We begin the mental healing process at that time, rather than waiting a few months.”

A second lesson learned from previous conflicts, he added, is to have soldiers personally notify their parents, if possible, when they have been wounded in battle.

“The parents need to hear the voice of their son or daughter informing them what has happened, to tell them, ‘I was wounded, I’m now at Sheba, and they are going to operate on me, but I’m okay.’ It’s much easier for the parents to hear directly from their son or daughter than to find out from someone knocking at their door.”

Har-Even said that he has heard hundreds of inspirational stories about those wounded in the war who were brought to Sheba Medical Center.

One story that he found particularly moving was of a soldier fighting in the North who was the victim of a drone attack and was declared brain dead. Another soldier in Sheba had suffered severe damage to his lungs when his tank was hit. The family of the soldier who was rendered brain dead by the drone attack donated their son’s lungs to save the life of the soldier from the tank.

“It is one of the first occasions when one soldier donated life to another soldier, both of whom had suffered wounds in combat, while the war was still going on.”

Beyond the immediate task of saving the lives of the wounded in the war, the Sheba team assisted IDF medical corps teams, even before the invasion of Gaza, by providing training on lifesaving procedures at Sheba and in staging areas near Gaza with MSR on Wheels – mobile units that offer accessible, simulation-based training to medical teams.

Sheba also acted as a distribution center for lifesaving equipment that arrived from overseas. Workers unpacked equipment and distributed it to IDF medical units that picked it up at the hospital. In addition, the hospital sent medical teams to treat evacuees from Israel’s southern and northern regions who had been evacuated to hotels at the Dead Sea and Eilat.

One of the most challenging tasks, said Har-Even, was preparing and assessing the health condition of those who had been taken captive by Hamas and were released. “We didn’t know what shape they would be in when they arrived – both physically and mentally – and we had to be prepared for the worst.”

World outreach

Even in the midst of the war, Sheba has continued its outreach efforts to the rest of the world through its Sheba Global program, which shares knowledge and experience with healthcare professionals and institutions worldwide, sending response teams to disaster zones and facilitating the arrival of international patients under complex medical circumstances.

In the past year, Sheba sent medical personnel to Ukraine, Ethiopia, and Albania. In addition, Sheba is Israel’s largest hospital dealing with medical tourism, treating thousands of patients each year from Europe, South America, North America, and Africa.

While Sheba has supported other countries and overseas patients in its medical outreach, it has also benefited, particularly in the past year, from members of the Jewish community throughout the world who have come to Israel to visit wounded soldiers. Har-Even is particularly moved by their visits.

“Coming to Israel when everything is quiet is one thing, but coming here when missiles are flying is real brotherhood. Leaving family in North America, Canada, Australia, and South Africa and coming to Israel during a war just because we belong to the same nation is something that we don’t take for granted.

“When I talk to delegations who come to visit the soldiers, they ask me what to bring them. I always tell them, ‘They need your love and your support, not by bringing gifts. They have plenty of those, but they need your hearts.’ I tell them that if they really want to make a connection, they should bring letters from children in Jewish schools,” he said.

“Do you know what the soldiers do with the letters?” he marveled. “Every one of them covers their hospital room walls with those letters.”

HAR-EVEN EMPHASIZED Sheba’s ability to provide a rapid assessment and treatment of the wounded from the war and added that one word not used at Sheba is “no.” Any family or soldier who wants to be taken to Sheba in a secondary evacuation from another hospital will be quickly admitted to the hospital and will not be turned down.

“The second rule that my CFO said at the beginning of the war,” said Har-Even, “is that we won’t push anyone out, and for that reason we need to dramatically increase the number of rehabilitation beds in the hospital.”

Seventy percent of all IDF casualties were treated at Sheba, rehabilitated at Sheba, or are still rehabilitating there. The hospital is increasing the number of beds available for rehabilitation from 40 to 120, including staffing needs.

Har-Even noted that the hospital has hundreds of emergency beds available in its underground hospital unit in the event of an attack and is fully equipped and prepared for the worst. “We are ready, the equipment is there, and the electricity is operating.”

There are many excellent hospitals in Israel, Har-Even said, but what makes Sheba unique is that it was initially established as a rehabilitation hospital by David Ben-Gurion in June 1948. “Through all of Israel’s wars, we have gained a great deal of experience in the rehabilitation of soldiers,” he stated.

Over the years, Sheba has added many departments, ranging from mental health to pediatrics, but its roots are in rehabilitation. “Our uniqueness lies in the comprehensive services that we can offer soldiers, from acute treatment to rehabilitation, in one hospital with a single electronic medical record for all treatments, which is very important for continuity of care.”

Concluding our interview, Har-Even paid tribute to the medical team at Sheba and the Israeli medical system at large.

“One of the strengths of the Israeli healthcare system is its amazing people who are willing to leave their families and come to work 12-hour shifts. Sometimes this is with the knowledge that their cities and their families are under attack, but they keep coming to do the job for which they were trained – because this is the role we play in the war.”

This article was written in cooperation with Sheba Medical Center.