The dysfunction displayed by government ministries in the weeks after October 7 have placed a heavy burden on local authorities serving communities along Israel’s international borders. The list of problems that they have been dealing with – and continue to deal with – is long and painful: evacuating residents, relocating schools and kindergartens to where the evacuees are, welfare issues, rebuilding damaged infrastructure and much more. Mayors and council heads have complained  vehemently that – even under these extraordinary circumstances, when they are being called upon to fill entirely new roles that are completely different to their routine operations – it took the government many weeks, and in several cases months, to find the necessary funding.

Some local authorities organized quickly and efficiently; others less so. Especially problematic have been the Arab local authorities, where old, familiar problems resurfaced – chief among them managerial irregularities and budgetary issues, which were only exacerbated by Finance Minister Bezalel Smotrich’s threat to freeze funding. There is also, however, a mirror image of this situation, which demonstrates the potential inherent in local authorities that show determination. Take, for example, Majdal Shams Regional Council on the Golan Heights, adjacent to the border with Syria. Officials there were sick of waiting for the government ministries and, using local resources alone, they pushed in the first weeks of the war for the establishment of a field hospital. In addition, they set up a civilian rescue unit and an armed rapid-response team.

The field hospital is designed to give immediate medical attention to wounded residents and, in urgent cases, to perform live-saving operations. Abu Saleh says that the local authority has purchased all the medical equipment needed for 15 beds and that there is an option to expand it.

Challenges and Initiatives: Community Doctors Volunteered

The Druze village of Majdal Shams, which has a population of 11,000, is no stranger to emergency situations. Over the past few decades, however, the crises experienced by residents has mainly been limited to extreme wintery weather. After the outbreak of the current war and a number of missiles landing on the Golan Heights, the local council, headed by Dulan Abu Saleh, decided to press for a solution to one of the problems that residents frequently experience as a result of stormy weather: the difficulty in obtaining emergency medical care. The closest hospital is in the Ziv Medical Center in Safed – more than an hour’s drive away when there’s no traffic. An emergency security situation could make the hospital in Safed inaccessible for several hours and could cost many lives. In Israel, however, setting up a field hospital is a process that can take up to a decade – as residents of Sderot, Kiryat Shmona and Dimona can testify.

The closest hospital is in the Ziv Medical Center in Safed – more than an hour’s drive away when there’s no traffic. An emergency security situation could make the hospital in Safed inaccessible for several hours and could cost many lives.

In a conversation with Shomrim, Abu Saleh explains that the council decided that it was done waiting for the various government ministries and, instead, to push for the immediate establishment of a field hospital. He says that the council decided to repurpose the parking garage of a building that is suitably protected against missiles – as other hospitals have done in the past when they needed additional space immediately. The building, he says, was built as part of a process of mapping out the village’s security needs which began in 2015, in conjunction with the IDF. As part of this process, it was decided to build a number of structures to provide emergency housing for residents. Among the various ministries which contributed to the cost of construction were the Defense Ministry, the Education Ministry, the Economy Ministry and even the Housing Ministry.

The field hospital is designed to give immediate medical attention to wounded residents and, in urgent cases, to perform live-saving operations. Abu Saleh says that the local authority has purchased all the medical equipment needed for 15 beds and that there is an option to expand it.

A much more pressing problem when it comes to medical institutions – especially those located in the periphery – is recruiting staff. In the case of Majdal Shams, the answer came from the community: among the village’s residents are physicians, paramedics and nurses who work in hospitals across northern Israel and who have agreed to volunteer their time to the initiative. Their commitment to the hospitals in which they work, Abu Saleh explains, created a serious problem and the answer was to set up an emergency route, ensuring that there are also five medical professionals on call during times of national emergency. “For security reasons, I cannot go into details of what the medical team in Majdal Shams looks like,” he says, “but all the doctors and nurses who live in the village are completely on board and are fully familiar with the workings of our new field hospital. In an emergency, we will work with full coordination and we will give our dedicated service to anyone – civilian or soldier.”

Another issue, inevitable, is budgets. Abu Saleh says that “we have prioritized emergency situations above all else and we would have set up this field hospital with or without external funding. At the moment, we are also asking for financial help from the government and it’s important to add that Mifal Hapayis (the national lottery) has helped us hugely with some of the funding.”

According to Abu Saneh, the field hospital will be operational during wartime and, once the war is over, the plan is to put the medical equipment into emergency storage so that it can be up and running again within three hours.

Majdal Shams Takes Multi-Faceted Approach with Civilian Rescue Unit

The emergency preparedness planning in Majdal Shams did not stop with the field hospital. Village officials also decided to set up a civilian rescue unit, to be made up, among others, of local paramedics and medics with relevant experience. Members of the rescue team are very familiar with the village and their role is to extricate and provide first aid to anybody in need, until forces from the Home Front Command or Magen David Adon arrive on the scene.

“We divided the village into quarters and each quarter has a rescue team that knows every inch of the land,” Abu Saleh explains. “In dangerous and frontline quarters, our best and most experienced people are deployed. The most challenging quarter, for example, is the agricultural land since residents spend a lot of time there and it’s a very large area, which needs a lot of resources and different kinds of personnel.”

As is the case in all Israeli communities on the border, Majdal Shams also has a rapid-response unit. According to Abu Saleh, the unit was brought into operation during the coronavirus pandemic, when it assisted the Home Front Command that oversaw medical treatment for residents. Over the past few weeks, the rapid-response unit has undergone intensive training in the use of firearms and its members are present, alongside the IDF, ready for any eventuality.

Preparedness and Complicated Ties with Israel

Majdal Shams’ decision to get organized is interesting not just because it is a specific local initiative – something relatively rare in Israel – but also because of the complex relationship that Druze residents of the Golan Heights have with the State of Israel and its institutions. In 2022, Shomrim reported that 20 percent of the Druze residents of the Golan asked for and were granted Israeli citizenship and that the number of such requests is increasing from year to year. The internal debate raging within the Druze community about Israel has not disappeared and may even have become more acute against the backdrop of the atrocities committed by Hamas in southern Israeli communities. Organizing emergency response teams is seen as protecting residents of the village but it also entails close communication with Israeli authorities – something that raises the fraught issue of the connection to Israel.

“Our primary goal is to protest residents and I have seen almost complete cooperation from everyone. Of course, there is a very small minority that opposes this. They are always against any cooperation with the military,” Abu Saleh says, adding that “we cannot sit by and watch Israel send soldiers to serve and protect our village, and we do nothing to defend ourselves.”