Global conflicts have undergone significant changes over time. Once-protected spaces, like hospitals, schools, and civilian infrastructure, are now often deliberate targets. Soroka Hospital in Israel, Okhmatdyt Children's Hospital in Ukraine, and Al-Mujlad Hospital in Sudan have all found themselves at the center of military campaigns. The message for hospitals and health care systems worldwide is clear: we must prepare for threats that previous medical leaders could not have imagined.
Sheba Medical Center is the largest medical center in Israel and the Middle East. During the last few decades, we have been the target of countless rocket barrages from regional conflicts. Over time, we have developed an advanced emergency response protocol that allows us to move our people, patients, and operations underground to keep everyone safe and continue delivering lifesaving care to so many in the region who depend on it.
During the national emergency precipitated by Iran's attack on Israel, Sheba Medical Center transitioned our entire critical care infrastructure – from routine operations to emergency procedures – underground in under 48 hours. This complicated choreography involved relocating 30 departments across critical specialties and securing 700 beds in underground facilities with specialized surgical capabilities. Thanks to the hard work of our staff, we maintained uninterrupted patient care with zero delays across the entire center, despite constant air raid sirens and bombs dropping blocks away.
How did we do this? By focusing on people mobilization, operational flexibility, infrastructure resilience, and sensitive clinical data protection.
Your people are your strongest asset in any crisis. While it is difficult to plan for the real thing, you can follow current events with a keen eye and create a strategy. For 20 years, we have coordinated with the Israel Center for Medical Simulation, building realistic exercises that mirrored actual emergency conditions and prepared staff for rapid deployment and resource allocation under incredibly difficult conditions. During the national emergency, Sheba Medical Center achieved an impressive 95% staff presence.
In 2025, not all health care needs to happen in a doctor's office. Sheba Medical Center did extensive pre-planning to determine which operations could be shifted to virtual and those that required an in-person presence. We transitioned 50% of our ambulatory services to remote delivery while at the same time setting up protected delivery rooms within 24 hours to maintain complete obstetric capabilities.
Resilience will look different for every health care facility. For a hospital like Sheba Medical Center that has faced years of near-constant threat, we have adapted battlefield health care tactics to make our hospital infrastructure more resilient and ensure that when we transition operations during an emergency, we aren’t starting from square one.
Our 100-bed underground field hospital, developed through Sheba's Humanitarian & Disaster Response Center (HDRC), operates alongside relocated critical departments within a comprehensive underground medical complex. This mobile field hospital technology has been proven effective in Ukraine, where it has treated over 6,000 patients. It provides rapid deployment capabilities in missile-protected areas that lack pre-existing medical infrastructure, enhancing protected bed capacity at minimal cost while ensuring quality identical to that of above-ground departments.
Clinical data and genetic material are the lifeblood of any medical center, supporting current treatment capabilities and future medical potential. Our underground relocation builds in critical functions for clinical continuity and research legacy protection. Sheba Medical Center’s laboratories secure genetic material essential for patient care—such as biopsies, pathologies, and DNA samples—ensuring treatment continuity throughout patients' lifetimes, regardless of external threats. Alongside this, decades of research data, clinical studies, and patient materials are now housed underground, preserving irreplaceable medical knowledge for future generations.
The preparedness framework that we have instituted at Sheba Medical Center in Israel is a culmination of decades of crisis management. Luckily, most hospitals will not find themselves at the center of a military conflict, but many will find themselves under threat from cyber attacks, power loss, and mass casualty events due to ever-increasing natural disasters. Traditional emergency protocols, designed for temporary disruptions, are inadequate in the face of this broad threat landscape. We must prepare for more.
Dr. Yoel Har-Even serves as the Vice President of Global Affairs at Sheba Medical Center, where he manages emergency preparedness and humanitarian projects in Israel and across the globe.