MAGEN DAVID ADOM - Saving Worlds

by M. Drucker

Out in the volatile Middle East, Israel's EMT system has endured over 2 years of incessant and ferocious terrorist attacks. Their courage and humanitarian work leaves our heroic American EMT workers open-mouthed in admiration, yet they remain excluded from the International Federation of Red Cross and Red Crescent.

 

Magen David Adom (MDA) was organized in 1930 in Tel Aviv as a volunteer "shoestring" operation by seven Israeli doctors as a one-room emergency medical service. A second MDA group formed in Haifa in 1931 and a third in Jerusalem in 1934. In 1935, a national organization was formed to provide medical services to the public and the Hagana.

Its founding members were physicians, members of the Hagana and private citizens. During the 1936-39 Arab Riots, MDA gave first-aid training to the Hagana and the auxiliary police and medical aid to the wounded. During World War II, MDA worked within the framework of Israel's Civil Defense Organization, an arm of the Jewish Legion of the British Forces.

Officially ratified by the Knesset in 1950, MDA has provided vital lifesaving services during all of Israel's wars , as well as in times of peace.

Two American EMT journalists, Jeff Forster and Mike Taigman, spent 2 weeks in April 2002 riding with MDA crews. Their report, published in Emergency Medical Services, is full of adventure, tragedy, and praise of their Israeli counterparts. They ponder the differences between American EMTs and the MDA in terms of approach and fortitude.

"If this trauma happened in America, EMTs see a young boy blow up in the arms of their partner, you'd expect the EMTs would be off work for a few months and undergo extensive counseling/CISD. Some may never return to work at all. This is one area that separates the remarkable Israeli EMS professionals from any EMS folks we've ever worked with.

We asked them, "How much time did you take off after this incident?" They gave us a funny look and said, "Sure, it was terrible; we talked about it a lot. But we went home, got some sleep and were back at work for our shift the next morning. They offered us psychologists; we've talked with them in the past. It doesn't help as much as talking to your MDA friends. You can't let stuff get you down; there may be another bombing this afternoon, and we must be ready for it.'

As we finished interviewing, Dr. Glick, an Orthodox Jew on staff, was paged to respond to a Palestinian clinic to help a febrile child suspected with meningitis.

 

In America, our crews wait for the police to secure a scene before entering. With the threats faced by the MDA crews, they know that the police cannot secure their scenes. One EMT we spoke to was driving in his car off duty and came across a terrorist sniping. This EMT drew his 9mm semi-auto and shot the terrorist, until he collapsed. He then re-holstered his weapon and grabbed his medical first response that all MDA folks carry in their personal cars. He worked diligently to save the life of the man he just shot, including performing one-man CPR until the ambulance arrived.

Another EMT responded in his private car to the scene of a shooting. As he arrived, he heard shots. Grabbing his short-stocked M-16, he used one hand to empty two clips of ammunition into the house where the terrorist was shooting from as he dragged five injured people behind the safety of cover with his left hand. A policeman killed the terrorist. The EMT slung his M-16 over his shoulder and coordinated the scene as the medical incident commander.

After hearing these stories, Prime Minister Ariel Sharon commented, "Rather than just lifesavers, you are like the IDF's Elite Fighters." They see every life saved after an attack as one person the terrorist wasn't able to kill. Saving lives is their contribution to the war on terrorism.

 

In most American EMS systems, a few crews are sent to the scene to do a size-up and then call for additional help. MDA's 1,300 full-time EMTs, paramedics, dispatchers, physicians, blood bank workers and 7,000 are on call and paged when an incident occurs.

Whoever is closest responds to the scene in ambulances, personal cars, on motorcycles, on foot, or in ambulances they take home at the end of their shifts. MDA gets people and resources to the scene very quickly.

Responding can be life-threatening, because terrorists often plant secondary and tertiary devices designed to injure or kill rescuers there to help the victims of the initial blast.

MDA ambulances carry level III body armor, and the units that work in the most dangerous areas carry ceramic body armor designed to protect against high-powered sniper fire and shrapnel from explosions.

The MDA responders that arrive first quickly extricate patients to the safe area. "It's just not safe for us or the victims to stay in the danger zone," says Guy Caspi, MDA's chief instructor for multi casualty incidents (MCIs).

MDA also serves as the nation's blood bank. During an attack, they move blood products to the hospitals closest to the incident, and also set up mobile donor stations nearby so blood can be collected for the victims.

For large MCIs, the National MDA Communications Center in Tel Aviv tracks patients and their destination hospitals on a new projected computer database. The communications center is also a safe room, with a pure air system and the ability to live there completely sealed off for quite a few days. Here, they coordinate with the Israeli military, the Palestinian Red Crescent, hospitals, police, environmental experts and their own blood bank.

 

Before the Intifada, MDA and Palestinian Red Crescent (PRC) Society ambulance service enjoyed a good working relationship. PRC's first two ambulances were donated by MDA. MDA instructors taught PRC's initial three EMT classes.

Tamar, an EMT in Jerusalem, shared this perspective: "I don't hate Palestinians. It's very hard for me to fight another people, but I must save my life, my family's life. We treat them also. We get to a car accident and you don't think 'Is this a Jew or not a Jew?' You treat. You treat everyone, everywhere, every nation. I'm sorry to say that it is not the same condition from the other side."

With all the terror, death and destruction they've seen and touched, Israeli EMTs, dispatchers and paramedics are remarkably free of anger toward the Palestinians. Their kindness, respect and compassion for each other and their patients is personified by Jerusalem paramedic Eyal, an immense man with a shaved head, an easy smile and a 9mm Glock on his hip.

"When we take care of an Arab, we treat him as his children would treat him. In Arab tradition, it's important to respect the family elder. We watch what their children do, and we do the same."

After a Jerusalem bombing killed the parents of two Arab children, one an infant, a Hassidic MDA volunteer's wife left her infant child at home and went to breastfeed the infant.

Israel is not permitted to join the International Red Cross and access its funds and resources because it does not use the Red Cross symbol. Other emblems are allowed, however, including the Red Lion used by Iran before the revolution and the Red Crescent used by Moslem countries.

The American Red Cross is working to change this status, and is witholding dues from the International Red Cross until this is righted. They also work together with the MDA on many projects of benefit to both organizations and countries.