Underground and surrounded by tech, Israeli paramedics watch and wait for Iranian strikes


TEL AVIV — The main nerve center for Israel’s primary emergency service could resemble any dispatch hub in any American city — a hive of uniformed first-responders surrounded by ceiling-height monitors and an expanse of computers.

But Magen David Adom’s dispatch unit in Ramla, about 12 miles southeast of Tel Aviv, is more than 100 feet underground, safeguarded by thick walls and a sophisticated respirator system capable of providing clean air in case of conventional and nonconventional attacks.

“You wouldn’t imagine any other emergency services, civilian emergency services, in the world working in a shelter. But for us, this is a need, a basic need,” said Uri Shacham, MDA’s deputy director and chief of staff. The MDA’s role, he said, was “to make sure that no matter what happens outside, no matter how challenging the situation, this brain actually continues to function.”

Uri Shacham.Dave Copeland / NBC News

When NBC News visited the facility Tuesday, the mood seemed busy but relaxed as about a dozen uniformed dispatchers handled phone calls and plotted routes for emergency vehicles on an array of screens.

Soon enough, phones blared with news of incoming projectiles from Iran. The alert seemed to arrive on civilian phones just as quickly as it came to the attention of the dispatchers.

Within minutes, a dispatcher’s screen showed green ovals indicating the likely destination of the missiles.

At first, two or three covered most of the greater Tel Aviv area, Israel’s largest metropolitan region covering around 586 square miles and home to more than 3.9 million residents.

Dispatchers at Magen David Adom unit in Ramla.
Dispatchers at Magen David Adom unit in Ramla.Dave Copeland / NBC News

As the missiles approached, the ovals turned orange then red and fragmented into more than a dozen smaller ovals as software narrowed down their likely paths.

A separate screen showed a city map and the location of what the system had identified as potential fallen debris or a missile impact.

The map showed ambulances already on their way to the site, though the dispatcher never picked up the phone because the information traveled automatically from the military through the dispatcher and on to nearby ambulances and motorcycle medics.

An ambulance bus at the Magen David Adom unit in Ramla.
An ambulance bus at the Magen David Adom unit in Ramla.Dave Copeland / NBC News

“In the past, if I would receive the call of a burning house due to a missile fall, they would have to call me and say, listen, there is a fire, send your ambulance,” Shachem said. “Now we work on the same computerized system. And once they put in their system — a fire in Tel Aviv in this location because of a suspected missile hit — it will automatically be sent to Magen David Adom, sparing time, sparing any info detail that is lost during translation.”

The highly sophisticated system seems to stretch the limits of just how far human error can be reduced.

Itai Orion driving an ambulance.
Itai Orion driving an ambulance.Paul Goldman / NBC News

Yet, on the sharp end of all that inhuman infallibility, there are still paramedics like Itai Orion, who counts himself lucky for not yet having been called out to the scene of a missile strike.

But his wife’s family lives in Beit Shemesh, where a direct hit Sunday killed nine people huddled in a bomb shelter — the largest single death toll of any strike since Iran’s counterattack began.

When the missiles struck, Orion said, he felt just as vulnerable about his family’s safety as if he were a regular civilian.

“Having to go through that, you know, that moment where you’re not sure if everyone’s OK and you have to check in and they’re not picking up because there’s no cell reception in the protected space,” he said. “That’s just, you know, run of the mill, par for the course, Israeli experience right there.”



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