Hatzalah
Hatzalah, also spelled Hatzolah, is the title used by many Jewish volunteer emergency medical service organizations serving mostly areas with Jewish communities around the world, giving medical service to patients regardless of their religion. Most local branches operate independently of each other, but use the common name. The Hebrew spelling of the name is always the same, but there are many variations in transliteration, such as Hatzolah, Hatzoloh, and Hatzola. It is also often called Chevra Hatzalah, which loosely translates as "Company of Rescuers", "Group of Rescuers", or "Rescue Squad". It is the largest volunteer medical group in the United States.
History
The original Hatzalah emergency medical services was founded in Williamsburg, a neighborhood of Brooklyn, New York, by Hershel Weber in the late 1960s. His aim was to improve rapid emergency medical response in the community, and to mitigate cultural concerns of a Yiddish-speaking, Hasidic community. The idea spread to other Orthodox Jewish neighborhoods in the New York City area, and eventually to other regions, countries, and continents. Hatzalah is believed to be the largest volunteer ambulance service in the world. Chevra Hatzalah in New York has more than a thousand volunteer emergency medical technicians and paramedics who answer more than 70,000 calls each year with private vehicles and a fleet of more than 90 ambulances.Hatzalah organizations now function in Argentina, Australia, Austria, Belgium, Brazil, Canada, Israel, Mexico, Panama, Russia, South Africa, Switzerland, United Kingdom, Ukraine, and in 11 U.S. states: California, Connecticut, Florida, Illinois, Maryland, Michigan, New Jersey, New York, Pennsylvania, Texas, and Ohio. Hatzalah branches are currently being organized in other states as well.
In Israel, there are two Hatzalah organizations operating on the national level: United Hatzalah, and Tzevet Hatzalah. While United Hatzalah is inarguably the larger of the two organizations, in the past their volunteers were limited to direct response on-scene care, versus Tzevet Hatzalah volunteers, who are additionally licensed and authorized to provide emergency transport utilizing Magen David Adom ambulances. Currently United Hatzalah has a wide deployment of active ambulances and several Mobiles Intensive Care Units distributed in the greatest cities of Israel, which allows them to transport sick and injured to the nearest suitable medical center, for free.
Operations
Hatzalah uses a fly-car system, where members are assigned ad-hoc to respond to the emergency. The dispatcher requests any units for a particular emergency location. Members who think they will have best response times respond via handheld radios, and the dispatcher confirms the appropriate members. Two members will typically respond directly to the call in their private vehicles. A third member retrieves an ambulance from a base location.Each directly dispatched Hatzolah volunteer has a full medical technician "jump kit" in their car, with oxygen, trauma, and appropriate pharmaceutical supplies. Paramedic members carry more extensive equipment and supplies, including EKG, IV, injection, intubation, and other pharmaceuticals. Each volunteer is called a unit and is assigned a unit number that starts with a neighborhood code, followed by a serial number for that neighborhood. Ambulances used to have unit numbers in the same format, with the first few numbers for each neighborhood reserved for the ambulance numbers. By now all neighborhoods have begun to assign 3-digit unit numbers to their ambulances, using numbers out of the range assigned to human member units. The new system is prone to confusion since every neighborhood has a 901, 902 etc. Often times dispatch and units on calls may get confused which bus is being called, i.e, B901 or F901 especially when Flatbush busses passing through Boro Park to and from Maimonidies Medical Center can, and often do, respond to Boro Park calls.
In some areas there may be periods where coverage is not strong enough, for example on a summer weekend. When this happens, coordinators may assign an on-call rotation. The rotation may still respond from their houses, or they may stay at the garage through their shift. In such periods, Hatzalah functions closer to a typical EMS crew setup, though the dispatchers may still seek non-on-call members to respond, and there will still often be a non-ambulance responder as first dispatched, even if that responder starts from the base.
In Israel, United Hatzalah relies upon mobile phone technologies which include an SOS app and a special emergency phone number, 1221, with messages to news organizations distributed by WhatsApp.
Response times
Hatzalah's model provides for rapid first responder response times. Each Hatzalah neighborhood's response time varies. For example, in Borough Park, Brooklyn, daytime response in life-threatening emergency are between 1–2 minutes, and nighttime response times are 5–6 minutes. However, in the last few years with the implementation of Truck-1 the nighttime response in Boro Park has been shortened significantly. In the Beverly-La Brea neighborhood of Los Angeles, response times average at 60–90 seconds.In Israel, the response time is under 3 minutes.
Organization
Hatzalah is not a single organization. Each chapter operates autonomously, or, in some cases, with varying levels of affiliation with neighboring Hatzalah chapters and under a central association.In New York City's Hatzalah, there is a very simple operational hierarchy. Usually, there are two or three members who are "coordinators", managing all operational aspects of the chapter.
As Orthodox Jews, many volunteers see each other daily during prayers, and especially on Shabbat. This allows them to remain organized, despite the lack of an extensive formal hierarchy.
The coordinators are responsible for recruitment, interaction with municipal agency operations, first-line discipline, and day-to-day operations. The coordinators often are responsible, directly or via delegation, for arranging maintenance crews, who are often called service members or service units, and for purchasing supplies, ambulances, and other equipment. There is also an administrative function, often separate from the coordinator function. The chief administrator is often called a director or executive director, and this is sometimes a paid position. All other positions in Hatzalah, including coordinators, are held by unpaid volunteers.
Most of the New York State branches have some centralized administration and dispatch functions, known as "Central Hatzalah", or, simply, "Central". The neighborhood organizations under Central are nevertheless independent. Most Hatzalah organizations pattern themselves after the Williamsburg and Central models.
Formally, the New York City-area "Central Hatzalah" is called Chevra Hatzalah of New York. It combines dispatch and some other functions for over a dozen neighborhood organizations, including Williamsburg, Flatbush, Borough Park, Canarsie, Crown Heights, Lower East Side, Upper West Side, Midtown, Washington Heights, Queens, Rockaways & Nassau County, Seagate, Catskills, Staten Island, Riverdale, Bergen County, and others. As each of these areas is otherwise independent, each has its own fund-raising, management, garages, ambulances, and assigned members. Rockland County, New York, and Kiryas Joel branches have a centralized dispatch system as well, but their central organization is separate from the other New York State centralized functions, and they have a looser relationship with their New York State brethren, though there is a great deal of co-operation among them. Together, the combined New York State branches have grown to become the largest all-volunteer ambulance system in the United States.
Outside of New York and Israel, there are many smaller Hatzalah organizations. Each of these operates as a self-contained unit as members of a single association, but with no centralized coordination. However, where there are other Hatzalahs nearby, there is often a great deal of co-operation.
In Baltimore, Hatzalah's response area straddles two jurisdictions; Baltimore City Fire Department and Baltimore County Fire Department. Members in Baltimore often work side by side with crews from both services.
Legal status
In the United Kingdom, Hatzalah cannot use blue lights and sirens on their private vehicles.In New York, Hatzalah usually use red and white lights and sirens, like normal unmarked emergency vehicles. In New Jersey, Hatzalah usually use blue lights. Since 2021, Florida law has permitted faith-based volunteer ambulance services to operate, allowing Hatzalah response vehicles to use emergency lights and sirens.
In Toronto, Hatzalah use green lights, having the same legal status as volunteer firefighters who also use green lights in their vehicles.
In Australia, Hatzalah are trained as Community First Responders. They are tasked by the professional services to respond to emergencies, but they cannot use flashing lights or sirens, and they must obey all traffic rules.
Community involvement
Hatzalah organizations are often involved in other community activities, on top of their primary mission of emergency medical work. Many neighborhood chapters sponsor and participate in community events, both within the local Jewish community and in the broader community.Many Hatzalahs worldwide run public relations campaigns related to safe drinking on Purim, fire safety on Chanukah, and during Passover preparations. Chevra Hatzolah in New York works closely with the New York City Fire Department on this matter.