A car had flipped, and there were two injured persons from the accident.
There was insufficient time for Magen David Adom to get to the scene before one of the injured would have died.
The IDF’s West Bank medical corps sprang into action, and two very young non-doctors, one a paramedic and one with more basic IDF medical training, saved the person’s life. They stabilized him until MDA was able to send a helicopter to take him to a hospital.
IDF Central Command Chief Medical Officer Col. Avi Shina was very proud of the two young medical personnel.
In an interview with the Magazine, he said that he has under his command “hundreds of health personnel… There are doctors coming out of the Atuda program, which mixes university degrees in medicine, law, and others areas with army service.”
Only a few months ago, the IDF West Bank Medical Command was considered the hottest and most intense front for gaining complex medical battle experience and making the biggest difference as part of the ongoing Israeli-Palestinian conflict.
The West Bank: Israel’s forgotten front grows only more intense
Since October 7, the Gaza front now overshadows all other fronts in terms of casualties.
But the West Bank has not quieted down at all and, in fact, has gotten more intense for the last three months – with regular raids against terrorists, including 2,400 security arrests.
Regarding IDF medical staff experience, Shina said that at the Hebrew University, his future IDF doctors “learn medicine like everyone but also get special skills from the military. We also specially train nurses.
“You are often an extension of a battle unit, to be close by to be able to quickly attend to wounded persons.”
Shina noted that even before the current war, earlier in 2023, due to the waves of West Bank terrorism, “there was an increase in IDF dentists, therapists, and paramedics. An increase in these positions is relatively new in the IDF Medical Command, and many of them are younger, but they are good men and women who get trained to carry out specific skills for emergencies.
“We work with forces in the field, special forces, also ambulances for emergency care. We have seven ambulances spread through Central Command. We attend to IDF soldiers but also to Israeli civilians and Palestinians,” he explained.
His area of authority includes the Jordan Valley, and each brigade in the West Bank has medical personnel. His IDF teams also work with the Red Cross, which has dozens of staff in the area.
Referring to the flipped car incident, which occurred some time ago in the Jordan Valley, Shina recounted that one important aspect of what helped the emergency medical first responders to handle the situation, until MDA was able to send a helicopter to transport the patient to the hospital, was a new “whole blood” pilot program.
Whole blood consists of a single donor’s red blood cells, plasma, and platelets; it is frequently used for emergency transfusions and massive transfusions.
“We were one of the first that included them (whole blood supplies) in standard ground transportation units. They used to have them only for helicopters,” Shina said, noting that back in the spring, whole blood was only available to the Central Command (since then, its use has been expanded to other fronts).
At the time, Central Command was getting preference on certain issues over other fronts because the main ongoing threat to Israel then was the waves of terrorism emanating from the West Bank.
As to the new blood transfusions, “We have two blood transfusion products – one is plasma, and one is whole blood. Our ambulances have been very involved with the Operation Break the Wave nightly raids in the West Bank. We have been a leader in plasma.”
Valuable tool
Whole blood can be transfused into patients of any blood type, making it a valuable tool for militaries, which often need to transfuse blood in difficult environments where strategic blood typing and matching up is not always possible.
US studies had already shown that such whole blood was safe and effective in military settings, especially during combat operations. Support for using whole blood included a study of soldiers who received it during combat operations in Iraq and Afghanistan, with a finding that the risk of transfusion reactions was significantly lower than those in soldiers who had been given blood from the more traditional blood banks.
In the first few months that this new whole blood was rolled out, Shina said, “more than 1,000 people have been treated, and as many as a few thousand. It is a front with high volume.” There are many health accidents, where IDF personnel or residents get injured.
Addressing the diverse set of patients his IDF teams treat, he explained that even during times of intense conflict, “we have multiple health services which treat Israeli civilians and Palestinians together. The police and the fire department are also often both involved.”
Asked whether the IDF medical officers have been taught Arabic to work better with the Palestinian patients they deal with, he responded, “We need to do more in this area and regarding their culture. In the Jordan Valley, there are significant medical issues. The doctor in charge happens to speak Arabic. This helps a lot and we try to be aware, but we should be doing more. Language can be a significant barrier” to providing full medical care for wounded Palestinians.
In answer to whether his medical group was given more staff over the course of Break the Wave since March 2022, Shina said, “Yes, we got more staff. We do a situational assessment. Where do we need more resources and what is the best way to increase our activities? We know how to increase our staff. And the volume of blood (for treatment has been) improved.
“The West Bank ambulances got the first whole blood because we had so many wounded and more regular violent friction” with an adversary.
Regarding the evolution of his medical staff’s role since the outbreak of the current Gaza war: “With the outbreak of Operation Swords of Iron, the Central Command’s medical branch broadened its deployment to provide the best medical responses and to provide security to the citizenry who live and work in the area.
“We took on reservist doctors, medics, paramedics, and mental health officers who are equipped and trained to provide lifesaving treatment.
“We also deepened cooperation with MDA and have been taking advantage of the benefits of relations with all organizations for the benefit of citizens and those serving in this command.”
In another specific incident he described, “We had cooperation with settlers and MDA. MDA was not available fast enough. A Jewish civilian had a heart attack. The paramedic was young but skilled. She saved his life. She had a solid understanding. She did a quick diagnosis, she used an EKG. She quickly gave him the appropriate short-term emergency care needed to tide him over to get him to the hospital.”
Regarding the many injured people his team handles from car accidents, he noted an accident at the Ziv Junction. “There were a bunch of injured Palestinians, some whose lives were in danger. The paramedics understood the danger but are not authorized to perform blood transfers on their own authority; they need approval from a doctor.
“In this case, they consulted with a doctor by cellphone, who approved the blood transfer,” he recounted.
He said the doctor’s immediate availability to collect the critical details needed to make a decision by cellphone was also key in this case in saving that life.
“Medicine is a kind of bridge between people, and we are happy to serve as that bridge.”
N. HAS served on one of Shina’s many medical teams in the West Bank. She discussed how there are different medical teams at the brigade and battalion levels, covering different areas and with different responsibilities.
She said she received a large number of calls for assistance, ranging from injured civilians to wounded soldiers.
“We deal with car accidents, emergencies, terrorist attacks – more now than during earlier time periods.”
Regarding saving the life of the man with the heart attack mentioned by Shina, N said, “We got a very substantial thank you from the patient and his family.”
N said she had dealt with patients and chaotic scenes from terrorist attacks.
In terms of handling high-stress situations, she noted that in her first month, there was an incident where a civilian approached their base gate with a medical situation, but N stayed calm, “managed the incident and knew what to do.”
“Only afterward did I understand the significance of the event, and then I understood the broader significance of my role for the brigade,” she commented.
As far as the whole blood program, N said it was “a pilot program which is special to the IDF. They do not have this in MDA or other civilian bodies. It is only in Judea and Samaria.”
Immediately after receiving the new whole blood capabilities, “the next day it was already being used. The healing power was incredible and exponentially increased” the IDF’s lifesaving capabilities.
N originally was placed in the Intelligence Corps for one year. “Then I was offered to be an officer in the Medical Corps. I was at the officers’ course for three months, and then had additional supplementary courses relating to health issues.”
She added, “Sometimes there are even Palestinian attacks against other Palestinians. For these, we used the whole blood two more times.”
Regarding small Palestinian villages, N stated, “They have no medical infrastructure, no health center, no ambulances. A few times every week we go to provide care to Palestinians or if they approach the gate of one of our bases asking for medical help.
“Our outlook is based on health. This is a profession, and we do our job, giving the best possible care. We don’t know the race of people in a car accident when we go to help.”
In one incident, N recounted, “a baby had swallowed something bad. Or it could be very complex, like two kids were run over by a car near a village. We got them substantial care, and then got them on a helicopter to a hospital.
“You get to see the fruits of your labor of helping in real time. You often get a profound thank you. There is no ongoing relationship afterward, but it is a special moment of connecting.”
A. IS 19, from Rishon Lezion, and is a medic – not a paramedic. “Even before the IDF, I was ready to push hard for this. I had already volunteered for MDA and wanted to continue with a path in medicine.
“I knew I wanted Judea and Samaria. I have friends who are medics. It ranges from everything from Tylenol to more serious and complex issues,” she said.
According to A, officer I trained her once she joined his ambulance team, including teaching some things beyond the standard curriculum.
“I had not seen so many things like the full variety of real-world medical crises,” A recalled.
“What I saw when volunteering with MDA was not as bad. This was complete chaos. I was concerned I might even lose control, but I stayed focused and provided the necessary medical treatment.”
Later, A was asked about other assignments by the IDF which would not involve as much going out into the field with an ambulance team. But “I want to be out in the field and not stuck behind a desk. Everything we do here really matters. Anyone who needs it gets emergency care.”
I. IS 21, from Tel Aviv. He said, “I took the IDF course to be a paramedic. I served in a few different units, then got to the Hebron-Judea area.
“I tried other IDF medical sector areas but connected most with the people and work in this one. I also want to try out medicine after the IDF. I have no problem with blood.
“We work cooperatively on car accidents, sometimes even with a flipped car,” he said.
In that incident, “Two people were hurt; one only moderately, with no urgency, but one more seriously, with high urgency. The two of us dealt with it. The medical care for the situation was well known. The key was whole blood. It is a new trend in the IDF, as well as in Israel more broadly. It’s super and crazy effective and fantastic to get such cutting-edge methods that can save someone’s life,” who might have been lost before the new method.
“I was always very interested in medical care and the profession,” he stated. “When the incident happened, I was already deeper into my service. I had seen many situations before and knew what to do.
“The West Bank medical sector is very real,” he continued. “We have the urgent care center, teaching, and care for commandos for all the fronts in the area. We are here for anyone. If someone wants serious medical work, the West Bank sector is the place.”
I served there for close to two years.
“We give care. It doesn’t matter whether it’s Palestinians or Israelis, tourists, women, children, car accidents” or fighting.
“I definitely learned more health-related Arabic health words; I know how to ask about a person’s health in Arabic. This is part of our concept. We also need to give access to populations that are different from us. This becomes super interesting,” he said.
Shina concluded, “We are in the business of saving lives. There are universal values. Everyone gets treated. We have places where Jordan Valley Palestinian residents appeal straight to us. When we can, we try to do it, and with sensitivity” to the broader political and cultural complexities. ■
