Louisville Doctors Participate in ERG Program in Nahariya

[by Shiela Steinman Wallace]

If disaster struck Louisville leaving many people injured, would you know what to do?

For Drs. Nathan Berger, Karen Bloom, Michelle Elisberg and Richard Goldwin, the answer is a resounding yes, because from October 29-November 5, they participated in specialized mass casualty training at Western Galilee Hospital (WGH) in Nahariya, Israel. This 10th Emergency Response Group (ERG) program drew dozens of physicians and administrators from across North America and immersed them in the techniques and procedures their Israeli counterparts have developed and honed under fire during Israel’s many wars.

“The program began with two days of visiting Jerusalem and a visit to the Israel Center for Medical Simulation in Tel Hashomer on the trip north,” Goldwin said.  Once the group reached Nahariya, they toured WGH “and the new, secure Emergency Department, currently under construction. Like the main hospital, the Emergency Department has underground facilities in addition to those in the reinforced first-floor facility.”

“Seeing the underground hospital being completed is fascinating, Berger said. With the weapons of mass destruction threat, their perspective is being able to care for someone while the top of the hospital is being blown to bits.”

One day was spent touring military bases in the area. Bloom reported that the ERG group was permitted into areas tourists cannot normally enter. “At Rosh Hanikra,” she said, “we walked right in, past the ‘do not enter’ sign.”

An Army major addressed the group. “He told us what really happened over the summer between the flotilla and the commander who was killed,” Bloom said. “He told us the facts and went into great detail. It was obvious that Israel was in the right.”

The Rosh Hanikra base is right on the Lebanese border, so the soldiers there are responsibility for the safety and wellbeing of the entire population in the region. Bloom reported that they also heard from a 22-year-old EMT (emergency medical technician) who is responsible for the health of all the soldiers in the north. This sergeant explained how he communicates with a nurse at WHG and how “they coordinate everything if someone gets hurt.”

The Israelis learn from every incident that occurs and every emergency response drill they conduct. They evaluate what they did and work on ways to do things better. Not only do they share it with doctors through the ERG program, but they put it to use in crisis situations around the world.

Bloom reported Col. Guy Lin, head of the Israel’s emergency hospital in Haiti “spoke to us for two hours about his experience, and it was spellbinding.

“You read about doctors going down to Haiti and there was no organization whatsoever,” Bloom said. The Americans, for example, set up their operation and let anyone who needed any kind of help in. Before long, their facility was crowded with people who needed food or a place to stay, and no room was left for those who needed medical attention.

In contrast, the Israelis sent someone into Haiti in advance of their main team to secure an area. When their team arrived, they set up their entire hospital in just a couple of days and secured the area with fences and guards. By controlling access, they were able to provide medical services.

The Israelis were also aware of the mental stress their team members would be facing as they dealt with the pervasive death, injury and illness left in the wake of the earthquake, so in addition to their operating room and recovery/post op area, they set up a maternity ward. “Whenever they got depressed,” Bloom explained, “they went to the maternity ward” to witness an oasis of new life and hope.

Elisberg was also impressed with Israel’s Haiti mission, calling their work “innovative and creative.”

The Tel Hashomer simulation center draws people from around the world. Their drills are extensive and realistic, involving many actors from local high schools. “We observed as they drilled,” Bloom said. When the participants debriefed, they discussed the entire exercise candidly – what worked and what didn’t and any ideas they had for improving the process.

“They obviously knew what they were supposed to do,” Goldwin said, “and when it was over, they weren’t afraid to say what went wrong.”

Both Elisberg and Goldwin observed that one key difference in the way the Israelis handle mass casualty incidents and the way Americans do is how the Israelis deal with psychological injuries and stress reactions.

“The thing that surprised me,” Goldwin said, “was when we had sessions with those who had taken care of victims of the Second Lebanon War, they reported that the ratio was about three to one for those suffering psychological trauma versus those who suffered physical trauma.”

“They really covered how they separate people who are very upset from people who are physically injured.”

“From an emergency medicine perspective,” Berger added, “they do mass casualty incidents using a lot less technology than the U.S. does. They have small, compartmentalized treatment teams, which is different than the U.S. casualty protocol, and the teams stay with the individual patient through the entire course of treatment, decreasing medical mistakes.”

The doctors also had the opportunity to enjoy home hospitality from their Israeli counterparts one evening. For Goldwin, it was a chance to reconnect with Dr. Moshe Goldfeld, a radiologist who spent time studying in Louisville earlier this year. Goldfeld stayed with Goldwin here. During the ERG program, Goldfeld was able to return the favor.

All four Louisvillians returned saying they learned a lot, and they other encourage doctors, medical personnel, administrators and anyone involved with disaster plans to take the program.

ERG 11 is planned for May 27-June 2, 2011. For more information, contact JCL Vice President Sara Klein Wagner, 618-5307.

ERG is a Partnership with Israel program. Louisville’s Dr. Philip Rosenbloom, the Central Area Consortium’s Medical Task Force chair, helps recruit participants for the ERG programs.

Partnership with Israel, a program of the Jewish Agency for Israel (JAFI), is designed to foster individual relationships between Israelis and American Jews. The Louisville Jewish Community has been an active participant in the program since its inception in 1997.

Louisville is part of the Central Area Consortium of Midwestern Federations that is partnered with the Western Galilee region of Israel. The Western Galilee is located along the coast of the Mediterranean Sea and extends to Israel’s northern border with Lebanon.

The Midwestern Consortium includes Akron, Canton, Dayton, Toledo and Youngstown, OH; Indianapolis, Northwest Indiana, and South Bend, IN; Louisville; Des Moines, IA; Omaha, NE; and Austin, Dallas, Ft. Worth and Tarrant County, San Antonio and Waco, TX. The Western Galilee includes Akko, Western Galilee Hospital and the Matte Asher region.

Through Partnership programs, Louisville has benefited from numerous exchanges in medicine, art, music, education and business. In July, several Israelis joined our camp staff as counselors, enhancing our camp program.

Partnership with Israel receives support from the Jewish Community of Louisville’s Annual Campaign.

If you are interested in learning more, please contact Louisville’s Partnership Chair Kathy Karr, or Sara Wagner at the Jewish Community of Louisville, 618-5307 or swagner@jewishlouisville.org.


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