Dr. Yuval Bloch, until recently the head of Hadassah Hospital’s outpatient clinics, ambulatory services, and Emergency Preparedness Team in Israel, was the keynote speaker at a Cincinnati Children’s Hospital Medical Center conference entitled “Mass Casualty Preparedness: At Home and Abroad” on Friday, September 27. This was the third annual all-day conference for professionals throughout the region, who are seeking the most up-to-date and effective disaster planning information as well as the best manner in which to assess and treat emergencies.
The idea for this type of conference came after a delegation of emergency room physicians, nurses, and a trauma surgeon attended the International Conference on Healthcare System Preparedness & Response to Emergencies & Disasters (IPRED) in Israel in 2012. The team went under the auspices of Cincinnati Children’s Israel Exchange Program (IEP), which fosters collaboration between the Cincinnati hospital and hospitals in Israel, regarding patient treatment, research, and technology. During the trip the delegation spent time learning about emergency preparedness work, and also met Dr. Yuval Bloch. They were so impressed with his expertise that they invited him to be the keynote speaker at the next similar type meeting in Cincinnati.
The conference also came on the heels of the many recent, grievous mass shootings which have occurred in our country over the past decade, as well as the Boston Marathon bombing tragedy last April. At that time, it was often reported in newspapers that doctors and nurses and other staff at Massachusetts General Hospital said they felt prepared for the massive number of casualties they received in a short span of time, because they had received training a few years before from Dr. Avi Rifkin, head of surgery at Hadassah Medical Center in Jerusalem.
So as with Massachusetts General, when searching for the most well-trained and knowledgeable medical professional on mass casualty preparedness, we turned to Israel.
Dr. Bloch began his presentation with a video of the collapse of the third floor of the Versailles Wedding Hall in Jerusalem in 2001, which resulted in the death of 23 of the over 500 guests and the injury of 380. Many of the injured were taken to the Ein Kerem location, as it was closest to the Hall and the only Level 1 trauma center in Jerusalem. This was the biggest civil disaster in Israel at the time, as it was later determined that it was the result of structural defects in the building.
The response to the disaster also included coordination with the Army’s Search and Rescue Team, who came to the site to look for victims of the collapse. More than 200 of the injured guests came to Ein Kerem that night, and Dr. Avi Rifkin determined that the Emergency Room was not big enough, which led to the creation of a secondary ER for such calamities as this.
Dr. Bloch said it is the norm “to learn from our mistakes and create something to solve the problem.” He said another way they learn is by helping others. He stated that they have responded to natural disasters in a myriad number of countries, including an earthquake in Mexico in 1985, an earthquake in Turkey in 1999, an earthquake in Haiti in 2010, and an earthquake and tsunami in Japan in 2011. In Haiti, the Hadassah field hospital was the first and largest to be set up and last to be dismantled in the country, and it only took 89 hours from the time the team learned of the disaster until they had set up the facility. He said medical professionals from other countries marveled at their speed and acuity at serving so many patients in distress at one time.
Bloch said he thinks the Israeli emergency response is so good because of Israel’s unique socio-cultural fabric, the existential threats to the country, a military approach to solving problems, inter-agency cooperation, national coordination, and thinking outside the box. “If something happens once in Israel, all hospitals then prepare for it. We all feel the need to prepare; we don’t need to be told, ” he remarked.
Dr. Bloch ended his presentation with a summary of the “Israel Emergency System” which includes inter-agency cooperation, experience through repeated drills, implementing lessons learned, and thinking outside the box.