Israeli Hospitals Fortify Underground Infrastructure After Wartime Medical Operations

Israeli hospitals are undertaking major infrastructure upgrades to their underground facilities following lessons learned during wartime operations, when missile threats forced the relocation of thousands of patients to basement levels and parking structures. During Operation Rising Lion in mid-2025, the Health Ministry directed hospitals to halve inpatient populations and transfer remaining patients to fortified compounds — an unprecedented undertaking for any national healthcare system. Sheba Medical Center, the largest hospital in the Middle East with 11,000 employees and over 1,700 doctors, operated extensively from underground facilities, with ambulances unloading patients into field-hospital tents erected in subterranean areas. The experience exposed critical gaps in underground medical infrastructure. Studies of the operations cited severe shortages of sanitary facilities, insufficient patient privacy provisions, and environmental challenges including constant fluorescent lighting and equipment noise. At Be'er Sheva's Soroka University Medical Center, an Iranian ballistic missile struck the surgical ward, destroying eight operating rooms and six research laboratories and injuring more than 80 people. Hospital administrators have since developed detailed protocols for underground operations. Prof. Osnat Levtzion-Korach, director of Shamir Medical Center, reported her staff has prepared comprehensive protocol booklets covering patient transfer procedures and equipment relocation for parking levels three to four stories underground. The current security situation in March 2026 has seen smoother transitions to underground operations, with advance warnings giving medical teams more preparation time. Magen David Adom has maintained maximum alert status, with all 39,000 employees and volunteers mobilized alongside every ambulance and rapid response vehicle. Looking forward, the Health Ministry is evaluating investments in purpose-built underground hospital wings with improved ventilation, privacy partitions, dedicated sanitary facilities, and noise-dampened environments. Assuta Medical Center, which opened in 2017 as Israel's first fully fortified public hospital, is being studied as a model for future construction standards across the healthcare system.