It's a matter of life



A calm conversation we said? Not exactly the case! The amount of incidents that this man manages in a specific time period could easily have caused many of us to have a nervous breakdown. However it seems to have no effect on Eli Bin. As the person in charge of an organization that operates 24/7 saving lives he is well trained in such an exhausting routine and he responds to each call and request addressed to him in a professional manner and with a sense of a mission. From his point of view he would have liked to be with his people in as many incidents as possible and to assist the teams and medical personnel in the field. "Naturally MDA has been placed on very high alert during the past few days due to the recent security situation", explains Bin with respect to the large number of incidents that took place at the same time. "It is important for me to be aware of all the incidents that are taking place and also to be involved in the most minor details seeing as this involves something that is of the utmost importance to all of us – saving lives".

The past few weeks have not been easy for the State of Israel. A long list of terrorist incidents hade taken place and are continuing to this day. The people who have been the busiest during this past period, alongside the police force and the IDF soldiers, are the emergency teams of MDA, medics and paramedics that are rushed out to each event occurring all around the country, in addition to their routine work of attending to thousands of calls received each day.

How do you cope with such a huge amount of calls each day?
"Our medical teams are well trained in handling various kinds of emergency situations and they practice such events during the entire year. The current situation which we are coping with today is a kind of routine emergency situation or regular emergency. This requires all the medical teams and medics to be on-call and to be available 24 hours a day, seven days a week and to be prepared for any kind of incident".

Is this a bit reminiscent of the days of the Intifada?
"The events that had occurred up until now are not identical to those that we encountered at the beginning of the year 2000 in which we experienced a long list of suicide terrorists and explosive devices; however our readiness for such events is at its best and the response of our medical teams who have worked day and night to save lives is extraordinary".
While Eli Bin had been describing the activities of MDA during the past few weeks, a call was received concerning another stabbing incident that had taken place not far from where we are. Bin immediately changes his driving route in order to reach the site and to assist the forces in place. "MDA has been bugging me in a positive sense ever since I was a teenager", he tells us.

And it is true; literally speaking Bin had grown up in MDA. "I started my way in this organization as a volunteer teenager, thereafter I become an ambulance driver and after that over the years I moved from one position to another and fulfilled a long line of functions in the organization until I become Director General". As to this day, 30 years after he first entered the MDA station in Afula, Eli Bin has not lost that teenage enthusiasm for volunteering in MDA. “Each call that is received gets my adrenaline working to go out into the field to try and assist our forces in carrying out their holy work. I know that in my position it is impossible to reach the scene of every incident and it is my duty to make sure that in all the incidents medical care is being provided quickly and efficiently, but if I am in the vicinity of such a call, in most cases I try to physically reach the scene", Bin tells us.

We reach the scene of the incident where the medical teams are already in the field and preforming resuscitation on one of the casualties. Eli Bin immediately leaps out of the car and goes over to assist the medical teams that are operating in the field. "Each time I am amazed at the tremendous dedication of our teams, the employees and the volunteers, who give their entire efforts to the organization and to saving the lives of the citizens of this country".
The MDA medical teams take care of around 600 thousand calls a year. This is an astonishing average of around 1,600 calls each day. In addition to these medical teams which comprise around 2,000 employees and 12,000 volunteers, the blood services teams of MDA raise contributions of around 300,000 blood units each year which are in turn provided to around one million patients and casualties in hospitals.

MDA is one of the emergency service branches of Israel, alongside the IDF, the Israeli Police Force and the Fire & Rescue Authority. The main difference between these parallel organizations to MDA is that MDA is required to finance the vast majority of its budget, (donations and services) without any assistance or budget from the state. "This is a unique and complicated situation. It is inconceivable that the IDF should have to finance itself or that the police should have to deal with raising funds abroad so that it can place policeman on the streets", says Bin. "Yet this is the strange and problematic situation in which we are situated and which we are hoping can be changed with the help of the Prime Minister and the Minister of Health".

In such a situation where the majority of the operating budget of MDA is raised by the organization itself and without any government support, the human asset is most critical. "The employees and the volunteers of MDA are the life line of this organization. They are the people that allow the residents of Israel to sleep quietly at night while knowing that there is someone taking care of them who will assist them with emergency lifesaving medical care at any given time and in any place – including overseas", emphasizes Bin. "I wish to thank them from the bottom of my heart for their contribution, dedication and the time that they invest in the organization and their spirit of volunteering and courage required for handling such events on a daily basis during this difficult period of time and also during routine periods".

And in fact in each of the incidents that have occurred over the past few weeks the medical teams of MDA were the first to be on site and it goes without saying that thanks to their work the lives of hundreds of casualties have been saved due to, amongst other things, the readiness of MDA and its technological advances.

What do you do in order to be prepared for such events beforehand?
"During the past few years we have acted and prepared MDA for a wide range of emergency scenarios. We had learned from our past experiences, we have drawn conclusions and made many improvements in order to be better prepared for the future events. Already during previous emergency periods that had occurred, such as the Second Lebanon War, Operation Protective Edge (The 2014 Israel - Gaza conflict), Operation Cast Lead (Gaza War 2008 - 2009), we had established a special team for drawing conclusions and for preparing for the future. Part of the conclusions that were drawn had been implemented in real time and part of the conclusions required some more time for procurement, purchasing equipment and training. We are always trying to advance and develop in order to be better prepared for any kind of possible event that may occur. Only during the past year the medical teams of MDA had operated in complex and difficult events, such as the great fire scene in the Carmel Forest, the site of fallen Grad missiles and Qassam rockets in the south, terrorist attack sites near Eilat, in Itamar and in Jerusalem and in many other event scenes, from which dozens of casualties were evacuated and treated by the qualified and trained medical teams for such purpose and each time we continue to improve ourselves".

And how have you improved your deployment in actual fact?
"We have performed vast improvements over the past few years in all aspects relating to the activities of the organization: we have increased the number of emergency vehicles, we have opened new stations across the country, we have trained hundreds of additional volunteers, we have located time slots in which the response period of MDA were not optimal and we had significantly improved such response times, we have increased the emergency care unit structure, we have enhanced the knowledge of our medical teams by having the entire medical teams attend continuing education programs and perform periodic training in order to be up to date with the most recent professional knowledge and we have taken a great deal of action in order to improve the technological means of the organization. Not in vain do the activities of MDA receive much appreciation in the country and overseas, and as evidence to such effect in various surveys that were conducted during periods of emergency MDA had received the high degree of confidence from the public, even higher than those given to the other emergency and defense entities".


And do such improvements also contribute to the quality control in the organization?
"Without any doubt yes. The quality control in the organization is performed during real time via the national call center which is combined with the management supervision call center which is maned by senior executives in the organization and the medical call center which is maned by medical specialist personal. Any nonconformity immediately appears on the computer screens and enables the manager to reach a decision and rectify any such nonconformity in real time or to conduct an immediate enquiry. All of the results of such immediate enquiries are entered by the manager into the computer and are transferred to the quality control system of the organization. Another course of action is the on-site quality control which is performed on a daily basis by the reginal supervising paramedic. Amongst his various array of duties he must conduct a quality control over the medical teams while conducting their activities on site".

Could you please go into further detail regarding the new technological improvements?
"For instance we had purchased a wide range of new improvements for our emergency vehicles, new command and control vehicles, advanced technological aids for better command over the event scene and the highlight is the new command and control system that had been introduced into the call centers of the organization during the past year all of which had been developed in house by MDA".

What is so special in such system?
"This new system allows full control over all of the events, in each scene and in any scenario by identifying the closest emergency vehicle, tracking the medical teams that are in field and more. In addition this new system drastically improves the response period of calls received by the MDA call centers such that when there is a high volume of calls in a certain call center the calls are quickly and automatically diverted to another call center which can give an immediate response to such caller. Thanks to this new system we have managed to reduce the waiting time for response in the various call centers from three to five seconds and to reach the situation were the average time in which an ambulance or intensive care unit arrives across the country stands at 8.3 seconds. An excellent response time compared with the western world. It needs to be understood that the daily amount of calls which is received by the various call centers is huge and stands at around 12,000 calls per day, while during the first 60 seconds of the call which are done by a medic or paramedic which is present in the call center, the appropriate emergency vehicle and emergency medical team is dispatched to the event scene".

Can you please further detail as to the call procedure response?
"The action of receiving the call and the dispatch of the medical team are done thousands of times each day, both in simple and in complex events during routine periods. For example, in a car accident with a large number of casualties it is first required to identify the exact place of the accident, the freely available access routes, to dispatch the appropriate required amount of medical teams to the event scene taking into account the time of arrival and the distance of the backup and evacuation places, to receive full information as much as possible as to the number of casualties, the kind of wounds and severance of the wounds. And thereafter to guide as to the conduct of any lifesaving actions that need to be taken before the arrival of the MDA medical teams, to dispatch additional emergency services such as the police and fire department, to assure the correct distribution of the casualties in accordance with the type of emergency vehicles that have been dispatched to the event scene, to perform a correct and optimal distribution of the casualties to the appropriate hospitals in accordance with the type and severance of the wounds and in accordance with the absorption capacity of such hospitals along with providing prior notice to the relevant entities and finally as I had previously stated to perform a quality control and conclude as to any conclusions arising from such incident".

You had stated that all of the developments were done in house? Didn't you receive any funding from the state for such lifesaving projects?
"You have touched a delicate spot. As I had explained, as of today a large part of the funding received by MDA is based on donations received from overseas and I personally am involved in encouraging such overseas donations. In contrast to the police, army and firefighting units, MDA does not receive any funding from the state. You have to remember that 60% of our budget is attributed to the payment of wages to our employees which is the minimum wages which is very hard to live off and it makes it hard to keep up the morality of our employees. The state is not obligated to transfer to us funds and our only chance is to request and that is what we have done just recently".

Do you estimate that this will change?
"Up until now we have always been automatically denied however lately there have been felt some changes along with the coming into office of new Minister of Public Defense, Gilad Erdan and the Health Minister, Yaakov Litzman which support our demand for funding, and I hope that this time our request shall be replied favorably".