Hatzalah

Hatzalah's model provides for speedy 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.[14] In the Beverly-La Brea neighborhood of Los Angeles, response times average at sixty-to-ninety seconds.[15] In Israel, the response time is under 3 minutes.[16]

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.[2][17]

In New York City's Hatzalah, there is a very simple operational hierarchy. Usually, there are two or three members who are "coordinators",[18] 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 (police, fire, and EMS), 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 (see operational descriptions below).

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[17] Williamsburg,[3] Flatbush, Borough Park, Canarsie, Crown Heights, Lower East Side, Upper West Side, Midtown, Washington Heights, Queens, Rockaways & Nassau County, Seagate, Catskills, Staten Island, Riverdale, and others. As each of these areas is otherwise independent, each has its own fund-raising, management, garages, ambulances, and assigned members. Rockland County, NY and Kiryas Joel (Town of Palm Tree) 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.[14]

Within Israel, the largest local organization is Magen David Adom.

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.

A marked and an unmarked unit respond to an incident in Toronto

Most EMS rely on crews with scheduled shifts operating from a known location. Due to its members and the communities they serve usually living in proximity, Hatzolah relies little on scheduled crews and stations, and, rather, has all service members on call 24/7 and members responding from wherever they are.[26]

Language, religion, and culture barriers create challenges for an emergency medical service. Hatzalah is built to consider these challenges, especially with regard to Halacha (Jewish law) and communities that only speak Yiddish or Hebrew.[27]

A Jew reluctant to violate Shabbat rules when receiving medical attention may be more at ease and easily convinced of the medical urgency when the EMT or paramedic is a fellow Orthodox Jew. A woman or girl worried about physical modesty and contact may be helped by knowing that a Jewish provider will be aware of the details of her concerns, and will act to reduce the problem as much as possible.

Every Hatzalah response crew will include at least one mental health professional (either a psychologist or psychiatrist), even if the emergency is not psychological in nature. The mental health professional functions to deal with potential psychological elements of the medial emergency including: calming the patient before and during transport to hospital, calming surrounding individuals on the scene, and dealing with actual psychological/psychiatric emergencies. Some Hatzalah chapters globally have their own mobile crisis units.

In areas where the EMS charges a fee, lower income clientele lacking health insurance may have a reluctance to call for an ambulance, unless the evidence of urgency is overwhelming. A volunteer service, with less overhead costs, tends to reduce that reluctance. Hatzolah will often handle "check-out" cases without charge. In this way, the true emergencies among those check-outs may be recognized and treated quickly, where the caller might have otherwise not sought treatment.[28]

In contrast with most other EMS agencies, many Hatzalah volunteers will remain at the hospital with the patient long after bringing them to the emergency department. This is especially true during serious cases, where volunteers will remain in order to help the patient and/or their families navigate the sometimes confusing series of events that occur during an emergency. Members will stay to explain, advocate, and sometimes help make arrangements to bring in other specialists or arrange transfer to higher care facilities.

United Hatzalah's relationship with Magen David Adom, however, is strained, and MDA has banned its members and volunteers from also volunteering in other rescue organizations, including Hatzalah.[35][36]

The Chevra NYC Central affiliates boast an excellent relationship with New York City and New York State agencies.[11]

Hatzalah was the subject of controversy as articles in the New York Post[37][38] and JEMS Magazine[39] criticize the organization for its discriminatory practice of not allowing women to join. A group of Orthodox women founded an organization called Ezras Nashim, an all-female Orthodox Jewish volunteer EMT ambulance service.[40] They cited the need for modesty and sensitivity to the needs of fellow Orthodox women, with the goal of preserving women's modesty in emergency medical situations, especially childbirth: "This is a woman's job. Historically, women have always delivered babies in traditional Jewish values, pointing to the Hebrew Bible Book of Exodus, where the first midwives were women, Shiphrah and Puah.[41][42] "In our community, women also have a very strong motivation to seek female doctors", said their lawyer, Rachel Freier, a Brooklyn Civil Court Judge and Haredi Orthodox Jewish mother of six.[43]

Hatzalah members were among the first responders at the World Trade Center following the September 11 attacks on September 11, 2001.[44][45][46] Alongside other rescue workers, Hatzalah volunteers rescued, treated, and transported victims.[46]

Hatzalah was not dispatched by the city's 911 system, and a print-out of the 911 job from FDNY EMS does not list them as responding units.[47] However, audio recordings exist of Hatzalah's own dispatch, including members calling for help during the collapse of the first tower.[48] There are also well-known photos of destroyed Hatzalah ambulances[49][50] and the destroyed cars of Hatzalah members, in the aftermath of the attack.[51]

Hatzalah chapters across the United States continued to service Jewish communities during the COVID-19 pandemic. The organization saw a 250% increase in emergency calls during the pandemic.[52] In addition to medical response, Hatzalah worked with rabbis and community leaders to communicate to Jewish communities the need for self-isolation and the implementation of safety precautions.[53][54] Multiple Hatzalah chapters donated ventilators and masks, as well as other vital personal protective equipment, to local hospitals in need of the equipment.[55][56]

On June 24, 2021, (10 days after Governor Ron DeSantis signed the law that would allow Hatzalah in Florida to operate) at approximately 1:22 a.m. EDT, Champlain Towers South, a 12-story beachfront condominium in the Miami suburb of Surfside, Florida, United States, partially collapsed, causing the death of 98 people. Four people were rescued from the rubble, but one died of injuries shortly after arriving at the hospital. Eleven others were injured. Approximately thirty-five were rescued the same day from the un-collapsed portion of the building, which was demolished ten days later. Hatzalah of South Florida (HSF) was one of the first agencies on the scene providing triage care to survivors and families. HSF was on site for the duration of the rescue and recovery operation providing medical and rehab support to the IDF search and rescue team from the home front command as well as the out-of-town FEMA USAR teams.[57][58]