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February 22, 2018 3:28 pm

First Aid Under Fire: Israeli Officer Details Medical Challenges at Gaza Border

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An Israeli soldier stands near a military jeep next to the border fence with the southern Gaza Strip, in Nir Oz, Israel. Photo: Reuters / Amir Cohen. In emergency care during combat, every minute can make the difference between life and death.

Lt.-Col. Dr. Gilad Twig, the outgoing chief medical officer of the Gaza division, told JNS about the latest techniques that the IDF Medical Corps is employing to get its personnel ready for some of the toughest situations imaginable.

Twig has served as a combat battalion doctor for many years. He was once the doctor of the secretive, elite Shayetet 13 naval commando unit. For the past 18 months, he has been deployed on the Gaza border, where he has been helping to get the Gaza division better prepared for providing medical care under fire.

“The past 18 months have been the most significant time that I have served,” Twig told JNS. “The division is located very near to the Gaza Strip, with all of the implications of being in close proximity to Hamas [entails],” he said. “But [the division also gets to know the] civilian communities in the Gaza border area. This was a great opportunity to see the creativity of these communities, and to view just how significant the military’s role is here.”

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Twig described some of the training programs that he oversaw to ensure readiness for combat situations, which can break out at a moment’s notice — as recent incidents have shown. Four IDF soldiers sustained injuries — two of them serious — when a bomb hidden in a flag mast planted on the Gaza border blew up on February 10.

The division must also be able to deal with a big incident leading to multiple injuries. At the Re’im base in Israel’s south, the medical corps created a learning and simulation center, where army medics and doctors study past incidents to better apply military medicine.

From stopping blood loss to giving first aid under enemy fire, the training focuses on a number of key acts, Twig said. “We first move the injured to a place that is more secure [from enemy fire]. Then we try to stop the bleeding in all sorts of ways. We do this quickly, based on the understanding that an incident can [lead us to get stuck] in a hostile environment.”

While training through various scenarios, Twig’s department films the medical personnel with four different video cameras. Afterwards, they go to an inquiry room to see how they performed. When they watch videos of themselves, Twig said, the medics become their own “best critics” and their own most effective trainers. Even highly trained and experienced military doctors often see themselves from the side for the first time this way, he said.

“This makes the learning process very clear and very simple. Someone can see that during the simulated incident, they don’t strive to engage [the patient] as much. They will see this much more clearly than if someone tells them,” he explained. Twig added that this type of learning experience is both intense and formative.

Some 300 medical personnel have passed through the training and personnel center over the past four months. “Some came especially to train here,” noted Twig. “Some are members of special forces. We trained medical crews belonging to the [IDF’s] commando brigade twice.”

Twig’s unit also trains medics that are part of armed civilian-response teams located in Gaza border communities, known in Israel as “Readiness Squads.”

“They represent the first response to every incident,” said Twig.

In addition, new breakthrough treatments have begun entering service. Some were used for the first time during the summer 2014 conflict with Hamas. Others arrived afterwards. These include new, powerful painkillers, more advanced arterial tourniquet (devices for restricting heavy bleeding from arteries) and new military ambulances for evacuating the wounded out of combat zones.

The ambulances come with advanced vital-sign monitors. “It is very important for us to get the wounded into hospital as soon as possible,” said Twig. “The new ambulances are much faster and roomy inside. They are of the highest standard.” He said that “without doubt, there has been a big step forward. We expect that the evacuation process will take less time. The main prerogative is getting the seriously wounded to hospitals as soon as possible.”

Aside from military trauma care in the field, the IDF Medical Corps has also launched a transport system for soldiers who need to receive routine medical care, but who are located in far-flung bases. And once a soldier comes in for physiotherapy, which is a common need, “we see what else we can provide for them since they are already at the clinic,” he said. Examples include using the opportunity to provide dental care.

Asked to look back at his time as the doctor of the famous Shayetet 13 naval commandos, Twig noted that “this is a unit that faces very significant challenges, and which operates in the air, sea and ground. The challenge for doctors is knowing how to adapt and building medical responses that suit these things. These are very different needs. Injuries from the battlefield or from training can be very complex. I can say that it was a big privilege to serve there — and a big challenge.”

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