A typical eight-hour shift with Magen David Adom (MDA) begins by checking the ambulance. Making sure the equipment, drug kits and corpuls machine (an ECG and monitor device) is stocked and working can take around a half an hour – a very thorough check could mean the difference between life or death.

Much like the Israeli police, IDF and fire services, MDA is the only government-mandated national emergency medical, disaster, ambulance and blood bank service (providing 95% of Israel’s donated blood), established in 1930 and mandated by law in 1950. While the law mandates it’s operations, MDA, however,  is not budgeted by the state and instead relies on donations from around the world who believe in their work. As of September 2017, 70% of those who use MDA’s ambulance services never see a bill.

“This is a mission of supreme national importance and we are now beginning to build the largest and most advanced blood bank in the Middle East,” Eli Bin, MDA Director General, told Breaking Israel News.

On board the ambulances and Mobile Intensive Care Units is an ambulance driver who is at least an EMT as well as volunteer and employee paramedics, emergency medical technicians and first responders, who provide medical response and transportation to the nearest available hospital – so the doctors are ready, waiting for the patients, and not vice versa.

“MDA does not work only inside the ambulance,” maintained Bin, referring to the communication between the patient, call centers, ambulances and hospital staff.

When the MDA Control Center receives a distress call, the call is automatically forwarded to the local MDA dispatch center, alerting and dispatching ambulances closest to the incident. According to MDA, this dispatching system was the first of its kind in the world to connect the Control Center with the emergency responder, based on their location and the location of the incident.

Once the ambulance is dispatched, a crewmember reports back to the Control Center, noting departure and arrival to the incident, a well as any incident information they may find.

With 166 stations and dispatch centers around the country in addition to the National Dispatch Center in Kiryat Ono (approximately 10 kilometers east of Tel Aviv), MDA ensures a rapid and devoted response to the thousands of calls they receive daily. MDA averages a call every 15 seconds, an answer time of less than four seconds and an eight-minute response time for the ambulances.

Within Jerusalem, it is common for an average call to take an hour, with the majority of calls from elderly people with chest pain, difficulty breathing, as well as post-collision care on Israel’s roads and highways. An average morning shift on an ambulance may have six or seven calls, but on busy days, up to nine calls. Yearly, MDA receives approximately 500,000 calls.

This summer, MDA has treated Israelis for numerous conditions, including snakebites, scorpion stings drowning, and heat-related incidents.

Terrorist incidents are also a fact of emergency response in Jerusalem, with ambulances most often dispatched for terrorist attacks near the Old City, including Damascus Gate, Jaffa Gate and the Temple Mount.

Uriel Goldberg, EMT and member of the international relations department at MDA, has noticed that Israeli behavior changes on days with terrorist incidents – fewer people call for other incidents, more stay at home, drivers are better behaved on the roads and 30 minutes after attacks, there is often a surge of calls with people experiencing stress symptoms surrounding the attacks.

“Working with MDA, you get to see a side of Israel nobody else gets to see,” Goldberg told Breaking Israel News. “We have volunteers and paramedics who are Muslims from East Jerusalem, Jewish settlers, Haredim… you make friends where you wouldn’t make anywhere else. It is really a microcosm of Israel,” he said.   

Similarly, Bin expressed his pride in leading the largest volunteer organization in the Middle East with 2,000 employees and more than 22,000 volunteers representing Israel’s social and cultural mosaic. “MDA is proud not only of the wonderful co-existence, but also of multi existence, where Hebrew, Arabic, Russian, Amharic and Yiddish are intermingling with each other in the past and in the present,” he said.

In light of this diversity, Bin added, MDA educates its employees and volunteers with the “supreme value of saving lives and respect,” as the Jewish saying, “He who saves one life saves the world,” is an expression that accompanies MDA in daily work.

He maintained, “MDA is not a separate organization in Israel but is an organization whose entire activity is interwoven with the story of the state of Israel and its values as the state of the Jewish people – there is almost no event since the foundation of the state with which MDA was not involved.”

Mirroring the modern state of Israel, MDA is leading in its technology.

The MDA command and control center is a sophisticated system in which one can see all MDA vehicles around the country, including ambulances, mobile intensive care units, motorcycles, helicopters, jeeps, off-road vehicles and mobile mass casualty units. Because of the technology and vehicles, MDA can even reach Bedouin tents, to which they’ve assigned numbers to reach any victim in times of need.

Such infrastructure also improves the level of care and decreases waiting time, thus improving the chances of survival for injured and sick throughout the country. With hundreds of vehicles and thousands attended to every month, the National Alert Crew – composed of more than 5,000 volunteers and employees deployed by motorcycle – shorten response time even further.

The recently released Ministry of Health mobile application, designed and developed by MDA as per the request of the Ministry of Health Director General, is yet another example of the use of technology to save lives and improve public health.

“Our technological methods and tools are amongst the most advanced in the world,” noted Goldberg. Indeed, MDA’s technology has brought emergency organizations from all over the world to Israel in order to learn from MDA’s knowledge and experience.

As international teams come to Israel to learn, MDA also takes part in various aid and rescue missions around the world where their rich experience as an emergency medical organization is required.

Sharing the knowledge and experience accumulated over the years and assisting others throughout the world, Bin says, is his pride.

“To lead a rescue organization so large and complex that saves the lives of thousands of people is a mission and a great privilege.”