As Israel faces renewed rocket and missile attacks, the country’s civilian first responders are once again being pushed to the front lines.
When missiles hit homes, apartment blocks, or public gathering places, the people rushing toward the destruction are often paramedics and volunteers from Magen David Adom, Israel’s national emergency medical service.
“While Israelis stay in shelters, the men and women of Magen David Adom run out of the shelters toward the buildings that were hit.”
— Uri Shacham
Video: 8:21–8:48
At the National Religious Broadcasters Convention in Nashville in February, I spoke with Uri Shacham, Chief of Staff of Magen David Adom, about what MDA actually does, how it prepares for wartime mass-casualty events, and why its role has become even more critical as Israel confronts escalating regional threats.
More Than Ambulances
Magen David Adom is often described abroad as Israel’s version of the Red Cross. But that shorthand barely captures its real function. In practice, MDA serves as Israel’s nationwide ambulance service, a central pillar of its blood services system, a humanitarian network, and a mass-casualty response force all at once.
“Magen David Adom is Israel’s emergency services system. In practical words, it is the ambulance service for the entire State of Israel — but it is also the national blood service supplying hospitals and the IDF.”
— Uri Shacham
Video: 0:18–0:44
Shacham explained that MDA collects more than 250,000 units of blood annually, processes those units, and distributes them to hospitals throughout Israel. The Israel Defense Forces also rely on blood supplied through MDA’s system. In wartime, that function becomes indispensable, because rapid access to blood can directly reduce mortality for critically wounded soldiers and civilians alike.
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| Israel's Red Cross, Magen David Adom's Chief Uri Shacham, shows stats of their operation |
MDA also operates across the full social fabric of Israeli life. Shacham stressed that there is no discrimination in its lifesaving mission, whether in blood services, volunteering, or emergency treatment. In the field, the patient comes first.
“It’s not uncommon to see an ambulance with a Muslim, a Christian, and a Jew as one team… because the only thing that matters is the person who needs help.”
— Uri Shacham
Video: 1:55–2:34
A Nationwide Network of Lifesavers
According to Shacham, MDA operates roughly 2,000 ambulances, about 200 ambulance stations, and more than 3,000 emergency vehicles in all. It is supported by nearly 40,000 people, the overwhelming majority of them volunteers.
One of the most important innovations in MDA’s model is the motorcycle fleet. These medics can cut through traffic and reach patients before an ambulance does, allowing treatment to begin in the earliest minutes of a crisis.
“The motorcycles rush through traffic and arrive first to the scene, allowing the paramedic to begin treatment before the ambulance even arrives.”
— Uri Shacham
Video: 3:27–4:21
The Protected Blood Center That Came Online After October 7
Among the most consequential projects MDA undertook was the creation of a secure blood services center capable of operating during wartime. With the help of American donors, that vision became the Marcus National Blood Services Center, much of it built underground for security.
“When Israel needed a secure blood compound after the atrocities of October 7th, the new blood center became operational two days later and provided what the soldiers and the injured needed most.”
— Uri Shacham
Video: 5:22–6:06
According to Shacham, the facility became fully operational on October 9, 2023, just two days after the October 7 atrocities. That meant that when Israel suddenly needed a secure, high-capacity blood operation under wartime conditions, MDA was ready.
“Magen David Adom is much more than an ambulance service… it is the backbone of Israel’s resilience.”
— Uri Shacham
Video: 6:24–6:46
Missiles, Mass Casualty, and the Scale of Threat
Shacham drew a sharp distinction between the kind of rockets long fired from Gaza or by Hezbollah and the much larger destructive potential of Iranian ballistic missiles. The scale of the threat changes the emergency burden dramatically for first responders.
“An Iranian missile carries at least a thousand pounds of explosives — like a bus full of explosives falling from the sky.”
— Uri Shacham
Video: 7:53–8:18
“While all the Israelis stay in the shelter, Magen David Adom people run out of the shelter… toward that whole block that collapsed when the missile hit.”
— Uri Shacham
Video: 8:21–8:48
Preparing Now, Not Later
Shacham said MDA has been expanding ambulance readiness, stocking vehicles, increasing training, conducting surprise drills, and improving coordination with the IDF. That preparation is based on the understanding that if a major escalation comes, it may come suddenly.
“We don’t know when it will happen, but we understand that it will. So it’s not a matter of if — it’s a matter of when.”
— Uri Shacham
Video: 9:44–10:17
How Supporters Abroad Can Help
Magen David Adom relies heavily on donations to expand its fleet, acquire medical equipment, strengthen blood services, train paramedics, and prepare for large-scale emergencies.
“When you support Magen David Adom, you support Israel.”
— Uri Shacham
Video: 12:29–12:38
What Shacham describes is a model of national resilience built not only on military defense but also on civilian response. In Israel, where threats can emerge with little warning, Magen David Adom remains one of the institutions that makes ordinary life possible.
That is why MDA’s importance rises every time the war reaches deeper into civilian life. It is not merely there after tragedy. It is one of the reasons more people survive it.
For readers who want to learn more or contribute, the site that Mr. Shacham gave is https://savinglivesinisrael.org.
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