A peer-reviewed study by researchers from Israel has garnered attention amid ongoing global concerns regarding the targeting of healthcare facilities in Gaza. The paper provides actionable insights designed to assist hospitals around the world in preparing for extended armed conflicts and large-scale emergencies. The research emphasizes the importance of strategic planning and resource allocation in maintaining healthcare services under duress, addressing a critical need for improved resilience in medical infrastructure during crises.
Why It Matters
The paper, published by the Cambridge Univerrsity Press, draws lessons from the MCI (mass casualty incident) protocol in the 300-bed Assuta Ashdod Hospital in Israel during the October 7, 2023, Hamas-led attack. Therefore, on the day of the attack, the hospital’s MCI plan was quickly activated and 87 casualties were treated for gunshot wounds, blast injuries, and burns. Despite the upheaval, the hospital was able to function, thanks to a rigorous protocol set in place.
Much before the attack, the hospital had installed “a strong culture of emergency preparedness,” that included MCI drills conducted every three months, the researchers found. The hospital was specifically designed with “protected infrastructure,” in sensitive areas with reinforced concrete. After imaging, patients were moved to a “holding area” looked after by an emergency physician while scans were reviewed. “On October 7, patient care was provided while the hospital remained under ongoing rocket attacks,” say the authors.
How It Works
Curiously, the word Palestine, whose healthcare system is all but dismantled by Israeli strikes, does not figure once in the paper. This coincided with the destruction of infrastructure, energy, water, sanitation, agriculture, housing, and healthcare. In the two years following October 7, 2023, over 10% of the population of Gaza has been directly killed or injured by Israel attacks, according to a paper published by The Watson School of International and Public Affairs, at the U.S.-based Brown university. In the two years after the October 7 attacks, Israel has retaliated with a prolonged war against Gaza, where 67,075 people have been killed and 1,69,430 people have been injured, totalling 236,505 casualties, according to the Gaza Ministry of Health.
Key Questions
Dr. Nerlander hoped that “the tragedy of that day can be converted into knowledge that can save lives and avert suffering in the future, wherever it occurs. For the Israeli study, semi-structured interviews were conducted with 19 emergency department staff members who worked on the day of the attack, who narrated their professional experiences.
The study, said the researchers, hoped to “generate actionable insights for hospitals seeking to develop resilient MCI plans that remain functional during wartime. “Hospital mass casualty incident (MCI) plans must be able to remain operational during wartime, affirms the says the paper.

