First responders stay calm amidst the chaos

While Israelis take cover in bomb shelters with Iranian ballistic missiles overhead, many courageous people leave the comfort of their shelters to rescue people from the rubble.

“We have to leave even when the sirens are on,” said Terry Goodman, a South African-born paramedic with Magen David Adom (MDA), Israel’s national emergency medical, disaster, ambulance, and blood bank service, “We wait inside the shelter for two minutes instead of the ordered 10 after we hear the bangs of the explosions, and we then get suited up with our shrapnel vests and helmets and go out.”

Goodman said that if she is driving in the ambulance on the way to get someone who is in distress and a siren goes off, they immediately stop the ambulance and leave it, and depending on where they are, they will either lie on the ground with their hands on their heads or try to find shelter. After she hears the bangs, she will get back in the ambulance and continue. But when there’s a patient in the ambulance, things get a bit trickier.

“If we have someone in the ambulance who can get out of the ambulance with us, we will suit them up and they will also leave the ambulance with us. And if it’s somebody who cannot leave the ambulance, then we stay with the patient in the ambulance, and the other two people will leave the ambulance. If it’s an urgent call, if we are doing CPR [cardiopulmonary resuscitation] or something urgent, we continue driving, we don’t stop. That’s what’s endangering us.”

Goodman has been working as a medic with MDA for 23 years, starting during the Second Intifada in 2001. However, the damage she has witnessed during the war with Iran beginning on 13 June is unlike anything she has ever seen before.

“Before, with rockets coming in from Gaza, there’s been a lot less damage,” she said. “These rockets have [caused] much more damage from the shock waves. The radius of the shock wave and the damage is much greater.”

South African-born Laurence Seeff, who has been working with MDA for nine years, said that the Iranian attack caught everyone by surprise, so MDA mobilised, and 30 000 volunteers and 3 000 workers across its emergency services and blood services sprang into action.

“There have been some hits close by, and obviously, we see what you see on TV, lots of destruction,” he said, “but because the general public has been obedient as far as the orders and guidelines from the civilian command are concerned, there have been fewer casualties than was initially expected.”

MDA teams were called to provide medical treatment at many scenes, arriving in large forces of ambulances, intensive-care units, and drivers on MDA motorcycles. So far, there are 1 258 casualties including 24 deaths, 16 seriously injured, 27 moderately injured, and 712 lightly injured. There have been 213 panic victims, and 266 people were treated on the spot and didn’t require evacuation to a hospital.

Seeff said what he had seen on site wasn’t too different from what the ambulance drivers have seen, but there’s the addition of absolute chaos when boots hit the ground.

“When there’s a hit in an area, you have all the emergency services arriving on scene, which means police, fire brigade, and emergency medical services along with the civilian command,” he said, “You have to wade your way through absolute chaos, and we practice co-ordinating everything as well as possible, but there’s always an element of chaos. People are in shock, people are hysterical, looking for family members, looking for pets. You have some that are wounded, and you have to be very careful because the protocol is safety first.

“People are falling while running to the bomb shelters before the rockets come in, a lot of people faint, and some have heart attacks, all because of the pressure and shock of what is going on,” Goodman said.

South African olah Dr Gila Nussbaum, who works in the emergency department at a hospital in the south, said that because of the war, the protocols within the hospitals have had to change to be in accordance with the Home Front Command.

“The biggest challenge is that in active wartime, the rest of the hospital guidelines and parameters and capabilities change. For example, they’ve stopped doing all elective procedures and surgeries. And they closed down all of their outpatient clinic departments,” she said, “But the emergency department keeps running. And even though it’s war, a lot of people don’t stop having heart attacks and strokes and car accidents and falling off roofs, and things like that.”

As a result of Soroka Medical Center in Be’er Sheva being hit by an Iranian missile on 19 June, many of its internal medicine patients have been transferred to Nussbaum’s hospital. “Some of the internal medicine wards in Soroka sent patients directly to us to continue their treatment,” she said.

Goodman said that while it’s scary being out in the field dealing with emergencies, it’s almost as terrifying to leave her children alone while ballistic missiles are flying overhead.

“There is a sense of helplessness that I’m not actually with my kids when these missiles are flying, the buildings are shaking, and I’m out helping other people, and can’t help my family, that’s been difficult for me,” she said, “I’ve been through so many wars, the sights I see don’t affect me, but you know, when my family is sitting in bomb shelters, I’m out there thinking that if something, if shrapnel lands and kills me, they will be alone.”

Seeff said that though these sites are devastating, he goes in thinking that there’s a job to do. “What you are designated to do is difficult, it’s stressful, and it can be scary sometimes. Ambulance services and emergency medical services aren’t for everyone. I’ve been in the game for quite a while, so I’m a lot calmer than most people because, as a first responder, you never know what you’re going to come up against, what you’re going to see. You kind of get used to that at some stage, and just take things slowly and work according to protocol.”