By Andrew Adler
Community Editor
Galilee Medical Center in Nahariya, Israel
From the balcony of her home near Israel’s coastal city of Nahariya, Ayala Shaul-Erez has a clear view of the Lebanese border a mere five miles or so to the north. As CEO of Friends of Galilee Medical Center, she coordinates external support of the region’s only full-service hospital. And as a wife and mother of a 16-year-old daughter, she is tasked with maintaining some semblance of domestic normalcy – where “normal” is her husband standing guard atop their home, weapon at the ready.
Shaul-Erez knows this drill all too well. “I was born here,” she said during a recent Zoom interview – “I remember the First Lebanon War in 1982 and the Second Lebanon War in 2006, so this is the third time. We never left, and we will never leave.”
A peculiar routine defines contemporary life in the Western Galilee – a physically striking region of Israel that’s also Louisville’s Partnership2Gether region. On any given day, Hezbollah may lob a few rockets or send drones across the border into northern Israel, where most are intercepted by the Iron Dome missile-defense system.
The few residents who weren’t evacuated after October 7 have become accustomed to the sound of sirens, prompting a dash to the relative safety of nearby bomb shelters. And if one or two missiles manage to get through, those same residents survey the damage and begin rebuilding what was destroyed, grateful at least to be alive.
Shaul-Erez says that the current conflict, in which Hezbollah fighters may at any moment pour into Israel, bears its own hallmarks of anticipation and anxiety.
“Yes, it’s a bit different,” she acknowledges. “The last two times, we didn’t have a situation where I was in a shelter with my daughter and my husband was on the roof with a rifle.”
Not surprisingly, October 7 was a tipping point. “When we heard what had happened in the south, we had alarms that said terrorists were on the way, so we had to be prepared. And during the Second Lebanon War there was no Iron [Dome], so every missile they sent fell. And in ’82 we slept in the shelter.
Two years from now her daughter will turn 18 and begin service in the IDF, a rite of passage for almost all young Israelis. Currently “her father is in the army (reserves),” Shaul-Erez says, “but so are many men right now.
The situation is difficult, but we’re okay. The alarms and bombings sometimes are really close, and we can hear them day and night. But again, I think as Israelis, we’re tougher than other people – so I can laugh about it.”
Still, the threat is real and constant.
“One day I came home and there were several alarms. My daughter and I went to the shelter, and there were around 30 missiles that fell in our place of living,” Shaul-Erez recalls. “It was like an earthquake.”
Travelling to and from her office is anything but a mundane 15-minute commute – not when a rocket and drone attacks are a constant threat. “Sometimes cars get hit,” she says, “and once or twice the road got hit. But we have food, we have water, and we have electricity. I mean, it could be worse.”
The Nahariyya-based medical center also has food, water, and electricity – though since the outbreak of hostilities its functioned almost entirely from a fortified underground facility. That means most of the existing above-ground structures are not being used, “so it’s a good chance to renovate and upgrade” areas that would ordinarily be difficult to access, Shaul-Erez says.
One prime example is a new, 60-bed gynecological facility, which will be situated in what she describes as something “between a shelter and a building” that “will serve women during this war, not just the next one – if there will be a next one.”
The hospital has long specialized in caring for wounded personnel, soldiers and civilians alike, whether they be Jews, Arabs, Christians, Druze, whomever. This past October 13, 17 people injured from fighting in southern Lebanon were brought to the medical center for treatment. All 17 survived.
Three days earlier, a very different event took place: a premature infant getting his brit milah – ritual circumcision – 100 days after his birth in the hospital’s neonatal intensive care unit.
““I don’t know of any precedent in the world of a NICU like ours, where we have been operating continuously in an underground protected hospital complex, amidst a war zone, with missiles and explosions overhead,” Masad Barhoum, the medical center’s director (himself a Christian Arab), said at the time. Appropriately, the below-ground complex has its own synagogue, where a rabbi had traveled from Jerusalem to perform the ceremony.
“This event underscores not just our medical professionalism but also the importance of tolerance and respect for all religious traditions,” Barhoum remarked.
“The staff and the management and I think the workers understand the fact that fact that everyone is underground saves lives,” Shaul Erez says. “And the patients the most.”
Overall capacity has been reduced from 777 beds above ground to 430 beds underground. Still, because so many people living in vulnerable areas have been evacuated to safer regions of Israel, fewer residents need extended in-patient care. Additionally, she points out, “the medical sector tries to release patients to their homes as fast as possible.”
Friends of the Galilee Medical Center – and its U.S. affiliate, American Friends of GMC – have continued to raise funds on behalf of the hospital. “We are trying our best to help the medical center in any way we can,” Shaul-Erez says.
No matter the circumstances, it can be a tense way to live. Faced with the continuing pressure from Hezbollah, customary, pleasurable diversion is often the first casualty.
“I lived in the States for a year and a half in the Bay Area (of California),” she recalled, where “life was so peaceful. Israelis are stubborn – there’s no way we give up.”
Yet even when pressures are greatest, Israelis tend to persevere. “Israelis are stubborn,” Shaul Erez emphasizes. “There’s no way we give up.”
“Living under a life threat is something I can understand, something I can relate to,” she says. “But it’s not something I think about every day (except) in summertime, when you can’t go to the beach to swim” because beachgoers would be vulnerable to air attacks. It’s those kinds of small things that make you understand the situation.
Asked if recent months have been especially stressful, Shaul-Erez answered in the affirmative, citing the psychological aftermath of Iran’s massive Oct. 26, 2024 ballistic missile attack on Israel.
Perhaps the only means of coping is to embrace a bit of absurdity.
“I got some WhatsApp (messages) from a few friends,” she remembered, “that said, ‘The next step is alien invasion.’”