Israel’s Ziv Medical Center in Safed is only 11 kilometers (seven miles) away from the Lebanon border. 

“Unlike other parts of the country, our hospital is isolated, while being responsible for an area that stretches from Carmiel all the way to the border with Lebanon and Syria,” Prof. Salman Zarka, director of the hospital, tells ISRAEL21c.  

As fears of a war with the Lebanon-based terror group Hezbollah grow, hospitals in the north have been preparing for worst-case scenarios. In addition to Ziv, these include, among others, Galilee Medical Center in Nahariya and Rambam Health Care Campus in Haifa. 

Reality since October 7

The Iran-backed terror group began its current campaign against Israel just days after the October 7 attacks by Hamas, launching dozens of rockets and suicide drones at Israeli territory on a daily basis. 

Recently, the attacks have intensified, becoming more precise and deadly. Since October 7, at least 397 people have been killed by the Hezbollah attacks. Many more have been wounded. 

“The army describes the reality of the past 10 months as ‘battle days,’ where it’s not officially war,” says Zarka.

“It’s characterized by constant instability,” the veteran physician explains, adding that on “heavy” battle days they get a large influx of patients.

“Unfortunately, recently we’ve been getting more and more of those kinds of days.”

The Majdal Shams attack

Over the past 10 months, the hospital has treated 420 soldiers and civilians hurt in Hezbollah attacks, including 38 children from the Druze village of Majdal Shams. 

On July 27, a Hezbollah missile struck a soccer field in the village, killing 12 children aged 10 to 16, and injuring dozens of others. One of the kids succumbed to his wounds at Ziv. 

Zarka, a 25-year veteran of the IDF Medical Corps, is part of the Druze community. In fact, he became the first Druze to head an Israeli public hospital when he was tapped to run Safed’s medical center in 2014.

“It’s terrible, and I wouldn’t feel differently if the children were Jewish; this tragedy is much bigger than the identity of the victims,” says Zarka.

He and many other hospital staff members visited the bereaved families in Majdal Shams. 

“Some people were also sending me condolences because I’m Druze. I would just console them right back because we are all Israelis.” 

Coexistence in times of war 

In the early 2010s, when he headed the Medical Corps of the Northern Command, Zarka helped establish a military field hospital to treat Syrians wounded in their civil war across the border from Israel.

Zarka epitomizes the ideal of a doctor who doesn’t see anything other than a human being in front of him needing help. 

He applies the same principle to his job as the director of a hospital that employs and treats a very diverse population in the area. 

“The Israeli health system is characterized by multiculturalism, and Ziv is no different; every single one of our departments is multicultural. We have 1,200 staff members, who all come from different ethnic and cultural backgrounds,” Zarka says.  

“We have Jews, Muslims, Christians, Druze, Circassians and Bedouins; we’re family because we spend more time with each other than at home.”

Zarka notes that during his staff briefings, he urges everyone to keep political discourse out of the hospital. “At the end of the day, one will not convince the other, and it will only create a bad working atmosphere,” he explains. 

“Anyone who comes through the doors of our emergency room, regardless of their religion, skin color or political side, we treat them; it’s rooted here.”

Level I Trauma Center

In preparation for a potential all-out war with Lebanon, the Israeli Health Ministry reclassified Ziv Medical Center as a Level I Trauma Center last December. 

Level I trauma centers must be capable of caring for every aspect of every type of injury, and must have nearly every surgical and medical instrument available 24/7. 

Until now, only Haifa’s Rambam had that designation out of all northern hospitals. “During the Majdal Shams event, three of the children with head injuries were transported to Rambam because at the moment we don’t have the ability to perform brain surgeries,” he says. 

The transformation entails opening two new surgery departments at Ziv, expected to be completed in October. 

Zarka says the new departments will play an important role beyond the war. 

“The most lethal type of cancer among men in Israel is lung cancer, and today we [at Ziv] can’t treat it because we don’t have the capability to perform surgery on the lungs. The new departments will change that.” 

Hope for peace, prepare for war 

The medical center has been conducting drills and training sessions for the staff on how to operate in times of emergency.  

It also established a “resilience team” of social workers and psychologists to help staff members who may be struggling emotionally and psychologically.

The hospital has also been procuring supplies, equipment and medicine in case Safed becomes inaccessible. “If the war breaks out tomorrow, there are contingency plans to bring in doctors from other hospitals around the country,” Zarka notes, and more supplies and resources will be needed as well. 

“If, for instance, on an average day we use two operating room kits, in wartime we would use around 10; we would also need more fuel, more oxygen, more water,” he explains.

Philanthropies, such as US-based Partners of ZIV, have been helping the hospital replenish its inventory. “We rely on this support and really appreciate it,” Zarka says. 

Given his experiences over the last 10 months, Ziv would like Israel to rethink and overhaul its approach to war preparedness. 

“October 7 made us realize that our enemies did not disappear because we signed peace agreements,” he says, referring to deals such as the Abraham Accords.

“Building protected spaces, procuring equipment, cultivating new medical professionals — it takes years! It’s not going to happen at the push of a button. So we need to start preparing right now for what’s to come.”