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from www.emerginet.com - February 2001
In His Own Words: A Primer on Israeli EMS by Alon Smolarski
The Israeli equivalent to the American Red Cross is "Magen David Adom" (MDA), which was founded in the mid-1930s. MDA is not only our local "Red Cross Society" but is also responsible for the provision of EMS to the entire country. In order to achieve this mission, MDA is funded partly by the Ministry of Health and partly by the local government. In addition, funds are collected from patients (who are refunded by our local Medicare system).
Magen David Adom also serves as Israel's National Blood Bank, and an important part of its income is a result of the sale of various blood products to the hospitals and the pharmaceutical industry.
MDA operates around 550 ambulances, both BLS and ALS. Some of them are leased to small communities that are also responsible for their operation (including the volunteers). There are three different types of units in MDA:
Physician-staffed ALS units
Paramedic units (the largest fleet of ALS units)
BLS units (manned by both paid personnel and volunteers)
The training curricula in MDA are quite similar to American standards. The first paramedics were trained in 1979 under the supervision of Dr. Nancy Caroline, who worked for Magen David Adom. Paramedic training takes about one year to complete. ACLS, PHTLS, and PALS courses are mandatory for all paramedics.
The Rescue Squadron of the Israeli Air Force conducts all medevac operations. Medevac is not routinely performed in Israel. It is only activated in the presence of major MVIs [?motor vehicle incidents], or in the occasional situation where a patient cannot be reached by other means. Many MDA paramedics also serve in the rescue squadron as reserve soldiers. The Israeli Army recently started to train its own paramedics, and three Israeli universities are now offering bachelor degree programs for paramedics.
There are still no specific laws governing the professional aspects of the paramedic profession in the Israel. The Ministry of Health issues special directives that allow the paramedics to engage in activities that are normally permitted to physicians only.
Two large private telemedicine companies also operate in Israel. They generally provide EMS to selected private customers upon a subscription scheme and are quite successful, each claiming more than 20,000 subscribers.
More information related to Israeli EMS can be obtained at the following links:
http://www.magendavidadom.org/ (a bit of a pop and mom site according to my taste)
http://www.mda.org.il/index.html (this one is MDA's volunteer site)
http://www.redcross.org/intl/mda/ (this is a position paper of the American Red Cross on MDA)
http://www.ajc.org/pre/MagenDavidAdom.htm (more of the same)
http://www.ukmda.org/
http://www.shahal.co.il/ (telemedicine company)
http://www.natali.co.il/ (also a telemedicine company)
Do not hesitate to contact me should you be interested in additional information.
About the Author: Alon Smolarski has been a paramedic since 1989. After working for seven years for MDA and three years as an operations manager for TEMS in Nigeria (dealing mainly with medevac operations), he began working as QA manager for NTLI EMS. NTLI is an abbreviation for the Hebrew name of the company: "Mobile Cardiac Units of Israel." The company has expanded its activities to cover the entire scope of pre-hospital emergencies. A recent graduate of a Bachelor of Health Sciences program, he looks forward to getting a degree in EMS management. He lives in a suburb of Haifa and works primarily in the Tel Aviv area.
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