WATCH: A look inside the world’s largest fortified hospital in Haifa
Rambam Hospital in northern Israel has spent decades preparing for how to operate during times of war. Now, it has become second nature, as the latest war with Iran sends their operations underground
At first glance, the facility looks like any large underground parking garage. Painted parking spaces, road markings, and concrete pillars show the distinct interior. But there’s more to it than meets the eye. The space is equipped with oxygen and vacuum lines, advanced air-conditioning systems, and reinforced infrastructure. Everything needed for surgery, intensive care, and emergency treatment.
Within just 12 hours on February 28, Rambam converted the three-level parking structure into a 2,000-bed fortified hospital. Deputy Director Dr. Avi Weissman recalls how the transformation began with a single siren.
“Nobody told us when it was going to happen,” says Weissman.
“As soon as the alert went off, everyone just knew. Nearly 3,000 employees showed up and began moving patients under fire. Every few minutes we had to stop and take cover. But twelve hours later, we were fully operational.”
The underground facility was built after the Second Lebanon War, with the goal of ensuring medical care could continue even during heavy attacks. Since then, it has been activated four times: during the COVID-19 pandemic in 2020, in the aftermath of October 7, throughout the 12-day conflict last year, and now amid the ongoing Iran war.
Each floor of the underground complex has a distinct medical focus. According to Dr. Adi Katz Biton, an oral and maxillofacial surgeon at Rambam, “The second floor is for internal medicine, and the third floor is for surgery.”
Working underground comes with unique challenges. Equipment and support services, like imaging or consultations, are located in different parts of the campus, making logistics complicated under stressful wartime conditions.
“Everything is different from what we’re used to,” says Dr. Katz Biton.
“But we do our best to make things as normal as possible. Our nurses’ station, our supplies, even a fridge for staff — everything is arranged so we can function without disruption.”
The underground hospital doesn’t just serve Rambam’s patients. During large-scale conflicts, it also shelters staff and patients from nearby hospitals, including Hillel Yaffe and Carmel, that lack safe spaces big enough to serve their patients.
With the IDF increasing its operations in southern Lebanon, the facility remains on high alert, ready to treat both civilian and military casualties.
“We’ve handled multiple mass-casualty events,” says Katz Biton.
“Everyone knows their role. The triage is quick, the teams are calm, and protocols are very clear.”
Watch the full video report:
For medical staff, wartime work often comes with personal sacrifices. Schools across the region are closed, leaving many doctors and nurses struggling to care for their children while working extended hours. To support them, half of the facility’s second floor has been transformed into a makeshift daycare center run by local childcare workers and hospital volunteers.
“They’re rambunctious, but it helps us focus,” laughs Katz Biton, holding her two restless children as she picks them up from the children’s play area.
According to Aviva Feldman, who coordinates training for the hospital’s pediatric epilepsy program, the childcare team includes familiar faces from Haifa’s local community. “Many of them already know the kids,” she explains, “which helps create a sense of normalcy in these abnormal times.”
As Dr. Weissman puts it, the hospital’s strength comes from its people.
“You have to take care of your family while taking care of your employees. The secret here is our staff. That’s what makes it work.”