In Northern Israel, Clashes With Hezbollah Drives a Hospital Underground

The entrance hall to the Galilee Medical Center in northern Israel is mostly empty and quiet. Roaring warplanes and the intermittent thunder of artillery have replaced the sounds of doctors, orderlies and patients at this major hospital closest to the border with Lebanon.

Nearly all of the hospital’s staff members and patients have gone underground.

Getting to the hospital’s nerve center these days involves navigating past 15-foot concrete barricades and multiple blast doors, then descending several floors into a labyrinthine subterranean complex.

That is where thousands of patients and hospital workers have been for the past six months as strikes have intensified between Israeli forces and Hezbollah, the powerful Iranian-backed militia in Lebanon, just six miles to the north.

The underground operation at Galilee Medical Center in Nahariya is one of the most striking examples of how life in northern Israel has been upended since Hezbollah began launching near-daily attacks against the Israeli military in October in solidarity with Hamas, the Iranian-backed group that led the attack on southern Israel that month.

The cross-border fire has prompted tens of thousands of Israelis to evacuate towns, villages and schools and forced factories and businesses to close. On the Lebanon side of the border, tens of thousands more have fled their homes.

The hospital had been preparing for such a scenario for years, given its proximity to one of the region’s most volatile borders.

“We knew this moment would arrive, we just didn’t know when,” Dr. Masad Barhoum, the hospital’s director general, said in an interview last week.

Hours after the Hamas-led attack on Oct. 7, Galilee Medical Center staff members feared that Hezbollah might mount a similar assault. Even before the government issued evacuation orders, hospital executives decided to relocate most of the vast complex to an underground backup annex. They reduced the 775-bed hospital to 30 percent capacity in case it needed to suddenly accommodate waves of new trauma patients.

“It’s our duty to protect the people here,” Dr. Barhoum said. “This is what I’ve been preparing for my whole life.”

The hospital’s towering internal medicine ward now stands empty, its wide, neon-lit hallways wrapped in silence. In the ward’s current location below ground, the whirs of hospital machinery mingle with the beeps of golf carts carrying supplies through narrow tunnels that open into the hospital’s parking lot, offering the only hint of sunlight.

Patients lie in beds separated by mobile curtain racks in a maze of halls. Visitors sit on plastic chairs in a makeshift waiting room, since the space is too crowded to allow everyone to pay a bedside visit. Tubes and wires running across the ceiling give the space the feeling of an engine room.

In the neonatal intensive care unit, new parents in protective gowns huddle to bottle-feed their baby in a dimly lit room. Doctors perform a procedure on another tiny patient a few feet away.

The neonatal unit was the first to move below ground on Oct. 7, said Dr. Vered Fleisher Sheffer, the unit’s director.

“While everyone feels safer here,” she said, “it’s challenging because we are humans, and now we must stay underground.”

Her unit also went underground in 2006, during Israel’s last all-out war with Hezbollah: Dr. Fleisher Sheffer recalls commuting to the hospital along barren roads as air-raid sirens blared. A rocket hit the ophthalmology ward one day, but the patients had already been moved, hospital officials said.

That war lasted just over a month, and the threat from Hezbollah was felt less in the years that followed. Oct. 7 changed that.

The day before New York Times journalists visited the hospital, a Hezbollah strike hit a nearby Bedouin village, injuring 17 soldiers and two civilians. The injured were brought to the hospital’s I.C.U., where one of the soldiers died on Sunday.

“These are our neighbors,” Dr. Fleisher Sheffer said, referring to the Hezbollah militants. “It’s not like they are going anywhere, and neither are we.”