Hatzalah

Hatzolah/Hatzalah ("rescue" or "relief" in _he. הצלה), is a volunteer Emergency Medical Service (EMS) organization serving mostly Jewish communities around the world. Most local branches operate independently of each other, but use the common name. The Hebrew spelling of the name is always the same, but there are many variations in transliterationcite web |title=Affiliates|url=http://www.hatzalah.org/affiliates.php] , such as Hatzolah, Hatzoloh, Hatzalah, and Hatzola. It is also often called Chevra Hatzolah, which might be loosely translated as "Brotherhood of Rescuers."

History

The original Hatzolah EMS was founded in Williamsburg, Brooklyn, New York by Rabbi Hershel Weber in the late 1960s,cite web |url=http://www.hatzolahw.org/ourmission.html |title=Williamsburg Services] to improve rapid emergency medical response in the community, and to mitigate cultural concerns of a Yiddish-speaking, religious Hasidic community. The idea spread to other Orthodox Jewish neighborhood in the New York City area, and eventually to other regions, countries, and continents. Hatzolah, as an organization, is the largest volunteer ambulance service in the world. Chevra Hatzalah in New York has more than a thousand volunteer EMTs and Paramedics who answer more than 250,000 calls each year with private vehicles and a fleet of more than 70 ambulances.

Hatzalah members were among the first responders to the World Trade Center on September 11, 2001. Alongside other heroes, Hatzalah volunteers risked their lives to rescue, treat, and transport countless victims of the terrorist attack. In the process they earned great respect from their peers in the emergency service community.

Hatzolah organizations now function in Israel, Australia, South Africa, Mexico City, Belgium, Switzerland, several provinces of Canada, Russiacite web| title = Emergency Response Service for Jews in Russia's Capital | url=http://www.fjc.ru/news/newsArticle.asp?AID=235422 | year=2004|accessdate = 2006-12-26] the United Kingdom [cite web|url=http://news.bbc.co.uk/2/hi/health/2666123.stm|title=Jewish health service offers local care|year=2003] , and at least five states in the United States.

In Israel, the largest Hatzalah organization is called Ichud Hatzalah ( _he. איחוד הצלה), Hebrew for, "United Hatzalah." Ichud was founded in the aftermath of Israel's Second Lebanon War in 2006 when its founders decided they would like to improve unified central rescue response. A prior organization, Haztolah Israel, also exists, and is of comparable size.

Operations

Hatzolah uses a fly-car system, where members are assigned ad-hoc to respond to the emergency. The dispatcher requests any units for a particular emergency location. Members who think they will have best response times respond via handheld radios, and the dispatcher confirms the appropriate members. Two members will typically respond directly to the call in their private vehicles. A third member retrieves an ambulance from a base location.

Each directly-dispatched Hatzolah volunteer has a full medical technician "jump kit," in their car, with oxygen, trauma, and appropriate pharmaceutical supplies. Paramedic (EMT-P) members carry more extensive equipment and supplies, including EKG, IV, injection, intubation, and more pharmaceuticals. Each volunteer is called a Unit (as in, a crew of one), and is assigned a unit number that starts with a neighborhood code, followed by a serial number for that neighborhood (e.g., F-100 was Flatbush unit number 100, a"h). Ambulances also have unit numbers in the same format, with the first few numbers for each neighborhood reserved for the ambulance numbers.

In some areas there may be periods where coverage is not strong enough, for example on a summer weekend. When this happens, coordinators may assign an on-call rotation. The rotation may still respond form their houses, or they may stay at the garage through their shift. In such periods, Hatzoloh functions closer to a typical EMS crew setup, though the dispatchers may still seek non-on-call members to respond, and there will still often be a non-ambulance responder as first dispatched, even if that responder starts form the base.

Response times

Hatzolah's model provides for speedy first responder response times. Hatzolah of Borough Park, Brooklyn daytime response time averages under 2 minutes, with overall night-time averages of 5-6 minutes, regardless of the severity of the call. Each Hatzolah neighborhood's response time varies. For example, the Hatzolah organization in Los Angeles boasts a sixty to ninety second average response time. [cite web | url=http://www.jewishjournal.com/home/preview.php?id=7785 | title= Jewish Journal | year=2001] Overall, NYC branches claim 2-4 minute 90th per centile response.

Organization

Hatzolah is not a single organization. Each chapter operates autonomously, or in some cases, with varying levels of affiliation with neighboring Hatzolah chapters.

In New York City's Hatzolah, there is a very simple operational hierarchy. Usually, there are two or three members who are "coordinators,"cite web |url=http://www.hatzalah.org/central.php|title=Regional Locations - Central Coordination] managing all operations 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 Hatzoloh, 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 Hatzolah organizations pattern themselves after the Williamsburg and Central models (see operational descriptions below).

Formally, the New York City-area "Central Haztolah" is called Chevra Hatzalah of New York. It combines dispatch and some other functions for over a dozen neighborhood organizations, includingcite web |title=Regional Branches|url=http://www.hatzalah.org/localBranches.php] Williamsburg, Flatbush, Boro Park, Canarsie, Lower East Side, Upper West Side, Midtown, Washington Heights, Queens, Rockaways/Lawrence, Seagate, Catskills, Staten Island, Riverdale, and others. As each of these areas is otherwise independent, each has its own fundraising, management, garages, ambulances, and assigned members. Rockland County, NY branches have a centralized dispatch system as well, but their central organization is separate form 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 cooperation among them. Together, the combined New York State branches have grown to become the largest all-volunteer ambulance system in the United Statescite web | url=http://www.nyc.gov/portal/site/nycgov/menuitem.c0935b9a57bb4ef3daf2f1c701c789a0/index.jsp?pageID=mayor_press_release&catID=1194&doc_name=http%3A%2F%2Fwww.nyc.gov%2Fhtml%2Fom%2Fhtml%2F2005a%2Fpr138-05.html&cc=unused1978&rc=1194&ndi=1 | title=Mayor Michael R. Bloomberg Announces Two Initiatives To Redevelop Underutilized Land In The Culver El Section Of Borough Park, Brooklyn | first=M. | last=Bloomberg | year=2005] . The volunteers are trained EMTs or paramedics.

Israel's Ichud/United Haztolah's founder and director is Zeev Kashash, though the regional organization predate Ichud. Eli Beer, originally from the United States, is the volunteer Senior Coordinator for all of Ichud, which fields over 1300 volunteer medics, paramedics and doctors throughout Israel. Ichud is larger than Chebra Hatzolah of New York, though it is smaller than the combined New York City/Rockland region.

Outside of New York and Israel, there are many small Haztolah organizations, and a few sizable ones. Each of these operates as a self-contained unit, with no centralized organization or coordination. However, where there are other Hatzolahs nearby, there is often a great deal of cooperation.

Interaction with other agencies

Israel's United Hatzalah has shared its expertise with a group of Arab volunteers from East Jerusalem to form an emergency first response unit called Nuran.Fact|date=September 2008

The Chevra NYC Central affiliates boast an excellent relationship with New York City and New York State agencies.cite web |title=Fastest Response Times in the World|url=http://www.hatzalah.org/twotiered.php]

Regions

Each neighborhood or city in Hatzalah operates independently. There are some exceptions, where there is a tight affiliation with neighboring Hatzolahs, a loose affiliation of neighboring Hatzolahs, or some other basic level of cooperation.

Israel

Hatzolah Israelcite web |url=http://www.hatzolah.org.il/|title=Home page] cite web |url=http://www.hatzolahisraelusa.org/|title=Home page] is the original Hatzolah in Israel. Ichud Hatzolah is another umbrella organization, formed in 2006, mostly with chapters that had been part of Hatzolah Israelcite web |url=http://www.ynetnews.com/articles/0,7340,L-3407387,00.html|title=Haredi Rescue groups' Bitter Battle] . Other regions still recognize the older organization,cite web |title=Links|url=http://www.hatzalah.org/alinks.php] and a court injunction has barred United Hatzalah from certain activities.

Each of the two Israeli central organizations has many local chapters, close to 1,000 volunteers apiece, and provides coordinated response for larger emergencies or extra coverage across multiple localities.

Americas

The Hatzolah concept originated in the United States, in Williamsburg, Brooklyn, NY. The US has several regions, with different levels of affiliation within each region. There are also Hatzolahs elsewhere in North America.

New York City

By far the largest Hatzolah group is in New York Citycite web |url=http://www.hatzalah.org |title=Official Web Site|publisher=Chevra Hatzalah of NYC - Central] . The sixteen local divisions share rabbinic counselcite book |title=Madrich L'Chevra Hatzalah |last=Handler |first=Mechel |coathors=Rabbi Dovid Weinberger |publisher=Feldheim] , radio frequencies, central dispatch and lobbying, but have separate fundraising and management.

New York City chapters include Boro Parkcite web |url=http://www.bphatzolah.org/ |title=Official Web Site|publisher=Hatzolah of Borough Park] , Canarsie/Mill Basin, Crown Heights, Flatbush, Lower East Side, Midtown, Queens, Richmond, Riverdale, Rockaways/Lawrence, Seagate, Staten Island, Upper East Side, Upper West Side, Washington Heights, and Williamsburg.

The Catskills division is the seventeenth "neighborhood" of Central Hatzalah of New York City. While the Catskills have a year-round operation, the vast majority of their activity is in July and August, when summer residents arrive. A plurality (possibly majority) of these residents live in areas covered by NYC Hatzalah ten months of the year. A similar proportion of the Hatzalah EMTs are New York City members, carrying New York City radios, so it is logical for dispatch to use this frequency. However, there are dedicated Catskills dispatchers, who are familiar with the camp, bungalow colony, and hotel locations in the Catskills. The Catskills dispatchers use C-BASE as a radio call sign, while other NYC dispatchers use H-BASE as a radio call sign.

The Flatbush chapter corresponds roughly to "Jewish Flatbush," which is not the same as the Flatbush, Brooklyn neighborhood that runs along Flatbush Avenue. As Orthodox Jews began populating Midwood and nearby areas in the 1960s and 1970s, the name Flatbush came into common usage to describe the area, possibly in contrast to East Flatbush, a long-time large Orthodox neighborhood that was declining at the same time.

The Flatbush chapter's primary service area comprises the Brooklyn neighborhoods of Midwood, East Midwood, Madison, and Gravesend. The extended area includes Brighton Beach, Manhattan Beach, Ditmas Park, and Kensington, and occasionally Bensonhurst.

The Boro Park chapter's extended service area also includes Kensington and Bensonhurst, as well as Sunset Park. Boro Park also sometimes covers Ditmas Park.

The Riverdale chapter covers parts of Yonkers, in Westchester County.

The Canarsie/Mill Basin chapter was originally just the Canarsie division. As the Canarsie Orthodox neighborhood declined, and the Mill Basin one grew, Canarsie started taking more calls and members from nearby Mill Basin, and is now primarily a Mill Basin operation. Canarsie/Mill Basin also covers nearby Georgetown. There are parts of the Brooklyn neighborhood of Mill Basin that border Madison/Midwood/East Midwood, so there is some overlap in coverage with Flatbush. Unusually, Canarsie/Mill Basin's radio call sign prefix is "K." At the time the chapter formed, "C" was already in use for Catskills, so the phonetically identical K was selected.

Other radio call prefixes that are not direct initials include:
* Y for Washington Heights (short for yekkes, a reference to the German-Jewish community of K'hal Adath Jeshurun in Washington Heights. [Rabbi Kaganoff] ) Alternatively some say Y is for Yeshiva University which is where the ambulances are operated from. It was not able to be W because that is Williamsburg, Brooklyn.
* ES for Lower East Side; originally, East Side and Lower East Side were synonymous, until the later formation of the Upper East Side chapter.
* M for Upper East Side; M is for Manhattan. The reason for this is because the original dispatch system could only do 1 or 2 letter codes so M was the only thing that anyone could think of. The M area is from 34th Street to roughly 125th Street from Central Park to the East River.
* WS for Upper West Side; originally the West Side covered the Upper East side above 34th street as well. The ES covered below 34th.
* Midtown does not have a letter prefix, and is primarily a virtual chapter, relying on Upper West Side and Upper East Side response. It is an ambulance from Brooklyn that sits on 47th Street and is staffed by members that work in the diamond district area. It is used for daytime calls in Mid-town Manhattan. The ambulance is referred to as Mid-Town 1 when it is in NYC.
* Boro Park uses just B, not BP.
* Five Towns and Rockaways are a combined chapter. It started in Far Rockaway, and would have been used radio call prefix R. However, Rockland County Hatzolah was forming at the same time, and even though Rockland is not affiliated with NYC, R was considered confusing. Lawrence adjoins Far Rockaway, so the chapter is called Rockaway/Lawrence, with radio call prefix "RL." Lawrence is one of the "Five Towns" of Nassau County, and all five towns are part of the primary service area.
* SI for Staten Island covers primarily the Willowbrook area, although the response area is the entire Island. There is a separate division within Staten Island, the "R" for "Richmond". This area covers the south end of Staten Island, known in the Jewish community as where "the Yeshiva" is (referring to R' Reuven Feinstein's yeshiva). Although the R is a separate, autonomous division, they have no ambulances, and rely on the SI to "load up" ambulances for response. They also have no Paramedics for response in that area.

Catskills, the Five Towns, and Yonkers are the only areas outside of New York City covered by NYC chapters.

Rockland County, NY

The "RH" (Rockland Hatzolah) is the only other affiliate umbrella in the United States outside of NYC Central. In some ways, it is the opposite of NYC's affiliation model. Whereas NYC has a central rabbinical board and separate community fundraising, Rockland has common fundraising, but several distinct sets of rabbinical oversight.

The stratification of rabbinic oversight is primarily due to several large Hasidic communities affiliated with Rockland Hatzolah. Generally, Hasidim always follow the rulings of their sect, with authority vested in the Rebbe (Grand Rabbi of the sect) and Bais Din (Rabbinical Court of the sect).

Recently, the Village of New Square, which was previously under the auspices of the Rockland Hatzoloh administration opted to part ways and create their own organization, which is expected to eventually result in a completely separate organization, operating under it's own DOH license. The dispatch would probably remain centralized, where all Monsey and New Square units would transmit and receive on the same channel in the event that mutual aide is necessary.

New Square has recently implemented an unprecedented move, in which a group of female CFR's (Certified First Responders) responds to calls which involve OB related emergencies. This provides for a more comfortable environment for the patient, considering the nature of modesty that is present in New Square.

New Jersey

There are six independent Hatzolah organizations in New Jersey. They are (in order of date established) Lakewood, Jersey Shore, Union City, North Jersey, Union County (Elizabeth/Hillside), and Passaic/Clifton.

Elsewhere In the United States

The Orthodox community in Waterbury, CT, centered around the yeshiva there, has its own Hatzolah.

The Hasidic community is Kiryas Joel (Monroe), NY has a Hatzolah, known as the KY area, that operates completely separately from all other New York State Hatzolah organizations.

Los Angeles has a Hatzolah chapter which only does direct response. They do not use an ambulance, relying on the city for transport. There is an affiliate in the San Fernando Valley.

Baltimore [http://hatzalahbaltimore.com/] recently started a Hatzolah.

Hatzalah of Miami Dade is the only Hatzalah in Florida affiliated with Chevra Hatzalah TM and is operating under the auspicous of the South Florida Orthodox Rabbinical Counsel. Like its sister chapter in Los Angeles only does direct response, does not use an ambulance, and relies on the county Fire Department for transport.

Other Americas

Mexico City has a Hatzolah. In Canada, there are Hatzolah chapter in Toronto, Montreal, and the Hasidic community of Kiryas Tosh.

Throughout the world

Though North America and Israel have the vast majority of Hatzolah activity, there are scattered Hatzolah chapters throughout the world.

Europe

Hatzolah chapters are located in England (North London, Manchester); Antwerp, BE; and in Zurich.

Moscow has recently formed Hatzolah.

Australia

There is Hatzolah in Melbourne and Sydney.cite web |url=http://www.ajn.com.au/news/news.asp?pgID=344|title=Jewish First-Aid Response Team Launches]

Africa

Johannesburg, ZA has a Hatzolah.cite web |url=http://www.hatzolah.co.za/ |title=Home page |accessdate=2008-09-14 |publisher=Hatzolah Medical Rescue - Johannesburg |location=Johannesburg |archiveurl=http://www.geocities.com/chevrahatzalah/johannesburg.html |archivedate=2004]

ee also

*List of Hatzolah chapters
*Shomrim ( "custodian" or "guardian" ) citizen patrol organizations
*Chaverim (literally, "friends") roadside assistance squads

References

*Other Hatzolah neighborhood procedural guides (limited circulation books)