Missiles above, newborns below: Israeli hospitals move intensive care underground

TEL AVIV, Israel: The Israeli Health Ministry reported Monday that 777 people have been evacuated to hospitals since the start of the joint Israeli-American war against Iran.

At least 10 people were killed directly by Iranian missile attacks on Israel, and two died on the way to shelters.

Since fighting began on Saturday morning, hospitals across the country have restructured their operations and relocated patients underground to maintain functionality.

“Look, this kid,” Professor Efrat Bron-Harlev, CEO of Schneider Children’s Medical Center, told News Digital, pointing to a young patient. “This car is his artificial heart. He has been living here while waiting for a heart transplant. He moved into the underground area along with 119 other children. This is not just a hospital, it is his home.”

So far, Schneider Children’s Medical Center has treated three children injured as a result of the war. The biggest challenge, Bron-Harlev said, is continuing to care for all existing patients while missile sirens sound across the country.

All patients have been relocated to level but one. Standing in a hallway, Bron-Harlev explained that if a missile hit at that moment, those present would have to hide behind heavy doors in reinforced areas for protection.

Once sealed, he said, the fortified section is designed to withstand even a direct missile hit and continue to operate as a unit for a limited time. “We have electricity supplied by large batteries located in another protected area, as well as oxygen and air,” he said. “How long we could stay there would depend on the extent of the damage done to the overall building. A catastrophic hit to the oxygen tanks, for example, would affect how long we could stay there.”

Lessons learned from the June 2025 12-day war include establishing a separate unit for bone marrow transplant patients with an independent ventilation system. Fresh air enters and leaves the space without circulating from the regular room, protecting children not only from missile threats but also from possible infections from other patients.

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In the event of a mass casualty incident involving seriously ill children, the hospital has prepared an intensive care unit with the capacity to accommodate up to 20 patients at a time.

The underground staff dining room has been converted into a dormitory for parents. Although there was not enough time to build fully fortified operating rooms, Bron-Harlev said part of the neonatal intensive care unit was transformed into a restricted-access surgical area.

“We are performing only emergency surgeries,” he said. “We have created two temporary but fortified operating rooms that will function until the permanent ones currently under construction are ready. Two are enough for now for emergency procedures. I hope we do not face a situation where 10 children arrive from a serious incident and need surgery, but even then we could operate on them one after another.”

In the nearby adult hospital, which is part of the same complex, the Rabin Medical Center, 17 people were treated as a result of the war. The hospital has moved 500 beds 60 meters underground.

Schneider Children’s Medical Center and Rabin Medical Center are two of 14 hospitals operated by Clalit Health Services, Israel’s largest healthcare organization, providing daily primary, specialty and hospital care to more than 5 million Israelis.

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During the 12-day war, Professor Ran Balicer, deputy CEO and head of innovation at Clalit Health Services, told News Digital that a missile targeted Soroka Hospital in Beersheba and hit a building that had fortunately been evacuated the day before.

“We have learned a lesson about the importance of preparing for Iranian attacks on civilians in general and hospitals in particular,” he said.

Within 24 hours of the start of the war, all patients not in safe areas were moved underground, where staff can focus on their care despite threats. The parking lot, Balicer explained, is more condensed than a normal room.

“There are challenges from congestion to infection control to privacy, there are no windows, all the noise and pressure is inside, it’s a physical and mental strain on the staff, but they are here to do what they promised to do,” he said.

The area includes reserves of food, oxygen and medical supplies. The hospital is also focusing on virtual care and digital health to provide effective care without requiring patients to come.

Injuries associated with war, Balicer said, include extremity injuries and other severe trauma. “Our frontline mortality rate is the lowest compared to anywhere else in the world. That’s why we have to be really effective in rehabilitation work,” he said.

The line between the front and the home front in terms of injuries is no longer clear.

“They target civilians as if they were on the front lines, they deliberately aim to attack and injure civilians with weapons that aim to cause mass casualty events,” he said.

Israeli hospitals are also being protected by IDF soldiers deployed to help transport patients during missile alerts, if necessary, and to coordinate the arrival of victims.

Major S., chief of operations for the IDF search and rescue unit, told News Digital that the forces are preparing for a prolonged campaign.

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“The last operation lasted only 12 days and was very important for our unit, but this time it is different,” he said.

“Our mindset is that this won’t be over until it’s over for good. As the war continues, we face attacks from additional fronts, including Hezbollah in Lebanon and potentially the Houthis in Yemen. We are prepared for any scenario,” he added.