Israel to launch world’s first underground blood bank

By Simona Shemer

Thirteen miles (20 km) outside Tel Aviv and 49 feet (15 meters) below ground, Israel’s Magen David Adom (MDA) medical service is quietly building a $100 million facility set to become part of the country’s national defense strategy against war, natural disasters, missile threats, and state emergencies, with the capability to operate normally even under direct threats.

This cutting-edge national blood bank, which broke ground in the central Israel town of Ramle November 2016, will be the world’s first blood lab to go underground and will include “the introduction of new technologies” related to blood work, says renowned hematologist Dr. Eilat Shinar, the current director of the Magen David Adom Blood Services Division in Israel.

The center will also be the “vanguard” of blood centers around the world, adhering to strict standards but innovative in its approach in dealing with blood supply-related emergencies.

Magen David Adom

Israel’s Magen David Adom (MDA) is responsible for the collection, processing, testing, and distribution of blood for the entire country.

“The new blood services center will enable MDA to better respond to the increasing needs of both the civilian and military systems regarding blood and blood components, as the population in Israel is growing and aging. The increased laboratory space will facilitate the introduction of new technologies, which will improve blood quality and safety,” says Shinar. “The protected building will allow us to work, uninterrupted at all times, during natural and man-made disasters.”

The facility, a six-story building featuring three floors above ground and three below, will have a main core laboratory of 5,0000 square meters where blood will be processed and stored. The underground space will serve as a bomb shelter, allowing workers to continue operations even with the threat of missile attack, Shinar explains, adding that the structure is expected to open by 2020. She also says one of the reasons the mixed Jewish-Arab city of Ramle was chosen as the location was due to its proximity to all major highways.

In addition to conducting all types of blood-related work, including separation by centrifugation, freezing filtration and labeling, blood type testing and testing for infectious diseases, the facility will feature a Quality Control laboratory, which will oversee all laboratory activities.

Shinar says the additional space in the new facility will enable her team to undertake more R&D projects, but wouldn’t disclose any specific details about these initiatives except to say that some of the research will focus on the different blood subtypes among the diverse Israeli population.

The facility is set to be called the Marcus National Blood Services Center, following a $25 million donation to the project by Home Depot co-founder Bernie Marcus’s Marcus Foundation.

A better facility

Currently, MDA – Israel’s national emergency medical, disaster, ambulance and blood bank service – is responsible for the collection, processing, testing, and distribution of blood for the entire country, providing the 280,000 blood units, of which 250,000 are sent to hospitals around the country and to the Israeli Defense Forces as needed, as there is no designated military blood bank. The Israeli National Blood Services, a division of MDA, was introduced in 1987. This blood center is located at Tel Hashomer Hospital in Ramat Gan, outside Tel Aviv, and currently employs more than 200 workers as lab technicians and phlebotomists.

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“What we have right now is not safe enough,” says Shinar. Should the center in existence, concentrated in a single location, become damaged, she explains, it could destroy, slow down, or cut off the entire nation’s blood supply. And for a country under ongoing threat of missile attacks from neighboring countries and territories, that situation is untenable, and part of the reason MDA decided to secure a new location.

“After the Second Lebanon War in 2006, Operation Cast Lead in 2008, and the other conflicts with Gaza in 2012 and 2014, it became very clear to us at MDA that the current National Blood Services Center simply doesn’t cut it,” Shinar said back in 2016 as MDA began construction. “We realized that if we wanted to prevent a major health crisis in Israel, we [had to] build an improved and highly secured blood bank.”

Prof. Eilat Shinar. Courtesy

Prof. Eilat Shinar

When asked about specific national emergencies that would have benefited from an expanded, secure blood supply storage facility, Shinar refers to the  2014 Israel-Gaza conflict known as Operation Protective Edge. According to a report in Israel’s Haaretz newspaper, on the night of July 8, 2014, MDA director-general General Eli Bin ordered Israel’s blood supply to be moved to an underground shelter as some Israeli cities came under heavy rocket fire. Shinar also cites July 20, 2014, the day when the Israeli military entered Shuja’iyya, a populated neighborhood of Gaza City, which resulted in heavy fighting. The IDF suffered 13 fatalities over an 8-hour period with numerous soldiers wounded and sent to Soroka Hospital in Beersheba, many in serious condition. Shinar said that “hundreds” of blood units were necessary to help the wounded soldiers in that emergency situation.

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The need for a new facility is also a question of numbers.

When Israel’s current national blood center was inaugurated more than 30 years ago, the population’s country was just 4.4 million. Today, it’s nearing nine million, according to the Central Bureau of Statistics. This doesn’t even take into account the more than three million tourists that annually visit the country and are sometimes in need of blood in emergencies, Shinar explains. “We are fully aware that we need a bigger place,” she says, noting that the current facility is too small to accommodate the increasing demands of the country’s growing population.

The new blood bank, according to Shinar, will be able to hold 500,000 units, double the number of its current location, with availability for more as Israel’s population continues to rise, with numbers expected to hit the 20 million mark in the next 20 to 30 years.

MDA still plans to keep the current facility as a backup to the underground one.