Behind Israel’s fast response to medical emergencies

ENGLEWOOD, New Jersey — There are action heroes, superheroes, and everyday heroes. Then there are those, like Eli Beer, founder and head of United Hatzalah of Israel, who seem to embody a little of all three.

Beer, 40, traveled from Israel at the end of March to visit Bergen County as part of an ongoing crusade to promote the rapid-response EMS model that has allowed United Hatzalah to save thousands of lives throughout the Jewish state. It is the same model he has helped implement in Panama, Brazil and, soon, India, as well.

United Hatzalah is an independent, non-profit, fully volunteer-based team of emergency medical technicians who deliver fast, free first-response throughout the Jewish state. The volunteers work in what might be called a “pre-ambulance” capacity.

In Israel, emergency calls are placed to a central 911-like number and then a United Hatzalah volunteer is located via a GPS-enabled phone. The volunteer might be anywhere, from a yeshiva library to a restaurant or even in his office, when the call comes in, but when it does, he drops everything to attend to the emergency. Once the ambulance arrives, the volunteer’s job is over and he can return to his regular job or the library or the café.

According to Beer, sometimes the volunteer plays an equally important role by calling off the ambulance if it has been summoned and no longer needed.

“This frees the limited number of ambulances in Israel to respond more rapidly to true emergencies,” said  Beer.

Some of the close to 2,300 United Hatzalah volunteers are paramedics, physicians, or nurses. All are trained EMTs, certified by the Israeli Ministry of Health after undergoing 200 hours of rigorous course work, practical training, and ongoing active duty.

As a group, they are on-call 24/7 to respond to more than 200,000 emergencies each year, and the number is climbing. It is estimated that 25 percent of the calls are for critical lifesaving situations.

While United Hatzalah serves the entire country of Israel, including all areas of Judea and Samaria, it is not always the only such emergency service called into action. Hatzalah Yehuda v’Shomron, for example, is a small local unit which serves only that area and is not connected to the larger organization. Nevertheless, according to Juli Kristof, a United Hatzalah spokeswoman, when the situation arises, volunteers from both organizations meet in the field and work effectively together.

“Both organizations provide critical lifesaving services to residents of the area,” said Kristof.

That cooperation frequently makes the difference between life and death, especially after a terrorist attack, according to Yehudit Tayar, a volunteer with Hatzalah Yehuda v’Shomron. In the disputed areas, volunteers frequently work alongside the IDF, Israel Air Force’s Airborne Rescue, and security officers and personnel.

In New Jersey,  Beer met with Bergen County Executive Kathleen Donovan at the County’s Administration Building in Hackensack. He then toured the county’s EMS Training Center in Paramus and addressed the future EMTs.

“You can and will save lives,” Beer told the students. “You’re young. Your whole lives are ahead of you. If your dream is like mine – and that dream is to help people– then chase it. Go out there, save lives, and do good.”

It is no wonder the students were impressed. Beer had motored to Bergen County from his Manhattan hotel on a United Hatzalah “ambucycle,” a souped-up motor scooter used by United Hatzalah volunteers when they need to traverse Israel’s traffic-choked streets while rushing to victims. The organization’s nearly 250 “ambucycles” are outfitted with trauma kits, defibrillators, and other emergency supplies.

In Israel, the “ambucycles” notch an average response time of less than three minutes. Most ambulances take more than three times as long.

“Receiving initial treatment within five minutes of an incident assures a higher chance of survival in critical situations and speedier recovery in many other injuries and sicknesses,” said Beer.

In fact, brain and heart death start to occur in four to six minutes after the onset of cardiac arrest, and a victim’s chances of survival are reduced by seven to ten percent with every minute that passes without defibrillation and advanced life support intervention, he said.

Mike Taratino, director of the Bergen County EMS Training Center, called  Beer’s visit “an eye-opener and an honor.”

“ I hope it is the start of a relationship between us and him, a working relationship that I sincerely hope to build upon in the months ahead. Who knows where all of this will eventually lead?” he said.

As part of Beer’s visit, Donovan, Taratino, and the students learned about the founding of United Hatzalah.

On June 2, 1978, Beer was a five-year-old returning from school to his Jerusalem home on a Friday afternoon when the #12 bus exploded, its passengers victims of a terrorist suicide bomber. He has never forgotten the chaos of the incident, the wounded lying prone on the street, bloodied and begging for help, and the relative paucity of emergency rescue resources.

“I ran away that day out of fear, but I decided that, someday, I would make it my business—my dream—to help the people I wasn’t prepared to help on that day. I knew I would become an EMT,” he said.

True to his dream, at 14, still in school and working part-time in his family’s book and real estate businesses, he joined Jerusalem’s EMT squad.

He still remembers the emergency call he received concerning a young Jerusalem boy who was choking on a hotdog. Caught in a Jerusalem traffic jam, Beer arrived 20 minutes after the call came in—too late to save the boy. A doctor working in the house adjacent to the boy’s knew nothing about the emergency next door until he saw the lights on Beer’s ambulance.

“If the doctor had known what was happening in the next-door home, he could have saved the boy, and he would be alive today,” said Beer.

Determined to establish a more flexible system to improve emergency response times, Beer, at the age of 17, began to organize a Hatzalah organization in Jerusalem based on the models he had seen in the US.

Beer’s new unit purchased its own communication gear, medical equipment, and supplies, and managed to get funding from the community.

Eventually, he forged a connection with NowForce, a Maryland-based high-tech company that was created to keep emergency response and security organizations connected, thereby minimizing response times and maximizing situational awareness.

NowForce created a GPS app which is loaded onto all United Hatzalah volunteers’ Smartphones. When an emergency call is fielded in Israel, this app locates the nearest five United Hatzalah volunteers, all of whom receive a “ping” followed by instructions. The volunteers then hop onto their “ambucycles” to respond to the victim’s location.

“Every town in the world should have this app,” Beer told Donovan. “Imagine if every nurse, doctor, EMT in the county had this app and knew when an emergency was occurring and where. If they were close, they could respond. They could arrive before the regular EMTs. They could save more lives.”

On several occasions, Beer stressed that the United Hatzalah model is not intended to replace traditional ambulance squads. Its function is to assist and act in tandem with them.

“It took a while in Israel because the EMT squads thought we encroaching on their turf,” he told Ms. Donovan. “But now we work like a hand in a glove with them.”

Beer is well aware that there is more to be done if he is to meet his goal of reducing United Hatzalah’s response time to under 90 seconds. First, it will require doubling his current “ambucycle” fleet, and each unit costs $26,000.

Because the organization charges no fees and receives no compensation, it must rely wholly on grants and donations. While the Israeli government provides limited funding and local municipalities provide some project-related support, the majority of United Hatzalah’s budget is funded by individuals and foundations in Israel and abroad.

The organization’s budget last year was $3.5 million, of which approximately 92.4 percent went directly to services, including training, vehicles, equipment, and volunteer activities. Approximately 7.6 percent was applied to management of the organization.

A detailed account of projects and ways to help can be found on the organization’s website, www.IsraelRescue.org. In the US, Friends of United Hatzalah, a tax-exempt organization, can be reached at 646-833-7108.

“We need help. Nothing worthwhile or important or even essential gets done by one person alone, or even 2,300 volunteers. There are lives at stake and people lost every day that we can save,” said Beer.

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